Thursday, 6 November 2014

Patient Series - Patient 8 Introduction

Initial Background Questions:

Please state your age, gender, country of origin and where you live (if different to origin) and how long you have had the condition?

Age: 62

Born in UK. Live in Blyth, Northumberland.

Do you have it in both feet or any hands?

My lumps appeared suddenly in July 2013. Both feet are affected. Left foot had one lump in centre of arch; right foot the lump is close to ball of foot. The lumps appeared after walking holiday in France. Suspicion that a 7km walk down a steep road after watching the finish of a stage of the Tour de France may have contributed to their appearance!

I had previously suffered from rather stiff toe joints, arch aching and cramps whilst walking and during the night.

I have Dupuytrens in both hands. Very slight pull towards of cord between first and second fingers on both hands.

Please detail any family history or common risk factors which apply to you:

I have thyroid cancer. Have no thyroid gland left and take levothyroxine daily. High dose to inhibit the thyroid stimulating hormone. Ledderhose and Dupuytrens developed since treatment started.

Please list any treatments you have had, the time since you had them, the progress (or lack of) after treatment and any side effects:

Ledderhose diagnosed in November 2013 after ultrasound.

Referred to consultant surgeon. Surgery was dismissed as successful removal was unlikely. Remains an option only as last resort. Cortisone injections were suggested and I have had one injection directly into the lump on my left foot. Found the injecting of the anaesthetic particularly painful. Lump was swollen at first then settled down. No real benefit identified.

Now working with podiatrist. Have had memory foam inserts to inform the making of insoles to support my arch and to correct a slight turn of my foot when walking. Now on third insole. The lump on left foot has grown and new insole will have a gap so that no pressure is put on it. Insoles expected this week. I now have open appointment with the podiatry service. I  can make my own appointment if there is any change.

Please detail any other information from your past which you think may be relevant and not covered in the monthly questions:


Monthly Questions:

1. In the last month have you noticed any changes in the pain or size of the nodules? Or have any new nodules have developed?

A recent change overnight one nodule changed to two. These two have merged to form a long lump.

2. Please list a) The maximum pain b) the average pain c) the minimum pain you experienced this month and anything that improved or worsened the pain. 

A. The worst pain is the acute pain I feel when I stretch my foot and a stinging tearing sensation is felt, e.g. when attempting to run up stairs or walking in the morning or getting out of bed in the night.

B. Generally I have a medium pain after long walks, shopping etc. lumps feels bruised. Pain is tolerable.

C. General pain is usually an ache or at times a burning sensation during the night.

3. In the last month what medication or treatments have you had, please describe in as much detail as possible including whether prescribed or home treatment, if applicable where the treatment was administered, by whom, cost (if happy to share) and how this has impacted the condition.

I find a foot spa with oils relaxes my feet when I have pain.
Try to start the day with simple stretching exercises by pulling up my toes. Toe joints are quite stiff.

4. Please describe how the condition has impacted you on a daily basis in the last month and any new steps (not treatments) that you have taken to try and alleviate this impact. 

Ledderhose has impacted on everyday life. Try not to stand for long periods and do not walk as far either whilst shopping or in the outdoors. Always walk with a stick if walking in the hills and this does help relieve some pressure and helps stabilise to the feet.

I can walk for several miles and I do walk the dog daily. I always wear supportive boots or trainers with insoles when I go out. Feet often sore afterwards.

5.Please describe the level of exercise that you have been able to achieve this month and any specific diets you have used if you think they have impacted the condition.

I follow a low fat diet and this month have had no alcohol.

6. Please list any other information that you think would be useful.

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