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More on managing the condition
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05/17/2011 05:48
Cyclist 
05/17/2011 05:48
Cyclist 

More on managing the condition

Hi there
An update: My nodules haven't shrunk since the first round of radiation treatment, but they have stopped progressing. I visited the sports physician to gain more understanding about how to continue to stay fit despite my foot challenges.

Skip this paragraph if you know my story: I'm currently in the middle of 2 cycles of radiation treatment (RT) in Germany for aggressive LD in both feet that have grown quite large in less than 6 months since getting symptomatic. Since this time, I've experienced nerve pain around the ball of my foot and general all over aching of the feet. Since the RT additional sensitivity when walking especially on hard surfaces (the whole foot feels bruised - note nodules less of a problem) and problems with re-occurring inflammation around the balls of the foot. At this stage I'm living in hope that my condition will improve as my feet recover from the RT.

Sports physicians are GPs that have specialised to keep athletes (and others such as myself) active through injury and rehabilitation, so I thought this would be a good pathway for getting some specialised support. The aim of my 1 hour consultation was to get some medical explanations for my observations of my condition.

My overall experience with the sports physician was positive so I thought I'd share the advice I received. I'd like to think my feet will continue to improve and I can adjust how I view this advice in the future:
- walking causes the foot to pronate and this stretches the tendon which could be causing the nerve pain because mine are thickened
- treat walking as a high risk activity as different weight distribution can cause injury including stress fractures
- use a pedometer to measure how much walking is manageable
- take up swimming and cycling (!!) for fitness - I can do as much cycling as I want!!
- take up snow-skiing or rollerblading (as the boot prevents pronation) for a safe weight-bearing exercise

Please note that not everyone experiences the condition in the same way and I have thickened tendons and cords, so you may be able to continue walking more than I am able to at present.

I'd be interested in hearing other people's stories about this .

Thanks and all the best
Di

Edited 05/17/11 09:02

05/17/2011 11:16
spanishbuddha 

Administrator

05/17/2011 11:16
spanishbuddha 

Administrator

Re: More on managing the condition

Hi Di

Thanks for the interesting feedback both on your condition and the consultation. Roller blading, eh!? There are some oldies my age who do that on Eastbourne sea front. My hand since RT in February is stable and I'm getting ready to go back for round two. Now trying a PSC Pattstrap for the Plantar Fasciitus, and wearing Fitflops nearly all the time, hoping it might clear this summer.

05/17/2011 11:35
Chobe2 
05/17/2011 11:35
Chobe2 
Re: More on managing the condition

Hi Di,

I had my first round of RT on my hand and both my feet the week of March 21. The nodule in my hand has been quite active since and has definitely grown but at first my feet felt better. 3 weeks after RT I got a dog that requires quite a bit of exercise so we have been hiking daily for about an hour up and down the mountains where I live and my feet are really feeling it. The nodules seem to have grown and my feet are very sore all the time. Did you ever hear back from Prof. S about how much exercise was safe?

I'm going back to Germany on June 12 for the second round of RT but am feeling a little discouraged right now!

Diane

05/18/2011 02:46
Cyclist 
05/18/2011 02:46
Cyclist 

Re: More on managing the condition

spanishbuddha:
Hi Di

Thanks for the interesting feedback both on your condition and the consultation. Roller blading, eh!? There are some oldies my age who do that on Eastbourne sea front. My hand since RT in February is stable and I'm getting ready to go back for round two. Now trying a PSC Pattstrap for the Plantar Fasciitus, and wearing Fitflops nearly all the time, hoping it might clear this summer.

Hi Spanishbudha
Good to hear from you and that you are doing well. About the rollerblading - I'm more from the generation that feels more comfortable in rollerskates myself!

I forgot to mention another piece of advice was to give MBT shoes a go, because even though they increase the pressure on the areas where nodules occur, they don't allow pronation.

Di

05/18/2011 03:06
Cyclist 
05/18/2011 03:06
Cyclist 

Re: More on managing the condition

Chobe2:
Hi Di,

I had my first round of RT on my hand and both my feet the week of March 21. The nodule in my hand has been quite active since and has definitely grown but at first my feet felt better. 3 weeks after RT I got a dog that requires quite a bit of exercise so we have been hiking daily for about an hour up and down the mountains where I live and my feet are really feeling it. The nodules seem to have grown and my feet are very sore all the time. Did you ever hear back from Prof. S about how much exercise was safe?

I'm going back to Germany on June 12 for the second round of RT but am feeling a little discouraged right now!

Diane

Hi Diane
Have you been in touch with Prof S about your hand nodule continuing to progress? I did email Prof S with my question about foot soreness, but it bounced back due to an email issue at my end and then I never got around to resending it. I will follow up and get back to you though.

Interesting that we're having similar experiences with foot soreness... it makes sense to me that feet, with the larger nodules and tendon involvement, and the fact that we have to put all our weight on them, would create problems, particularly when undergoing RT. What do yours feel like? Does 'bruised' describe the sensation?

I can manage about an hour of walking too, but took it really seriously when the sports physician described walking as a high risk activity. The problem is that if a weakened foot experiences a stress fracture, it will mean no cycling for me as well as not much walking!

Have you tried the massage ball? I find that when my feet get really REALLY sore, it helps to settle them down.

Take care and keep in touch!

di

05/18/2011 13:06
Chobe2 
05/18/2011 13:06
Chobe2 
Re: More on managing the condition

Cyclist:
Chobe2:
Hi Di,

I had my first round of RT on my hand and both my feet the week of March 21. The nodule in my hand has been quite active since and has definitely grown but at first my feet felt better. 3 weeks after RT I got a dog that requires quite a bit of exercise so we have been hiking daily for about an hour up and down the mountains where I live and my feet are really feeling it. The nodules seem to have grown and my feet are very sore all the time. Did you ever hear back from Prof. S about how much exercise was safe?

I'm going back to Germany on June 12 for the second round of RT but am feeling a little discouraged right now!

Diane

Hi Diane
Have you been in touch with Prof S about your hand nodule continuing to progress? I did email Prof S with my question about foot soreness, but it bounced back due to an email issue at my end and then I never got around to resending it. I will follow up and get back to you though.

Interesting that we're having similar experiences with foot soreness... it makes sense to me that feet, with the larger nodules and tendon involvement, and the fact that we have to put all our weight on them, would create problems, particularly when undergoing RT. What do yours feel like? Does 'bruised' describe the sensation?

I can manage about an hour of walking too, but took it really seriously when the sports physician described walking as a high risk activity. The problem is that if a weakened foot experiences a stress fracture, it will mean no cycling for me as well as not much walking!

Have you tried the massage ball? I find that when my feet get really REALLY sore, it helps to settle them down.

Take care and keep in touch!

di
Thanks for your response Di. Yes, I did contact Prof S but mainly about timing for my second round of RT. Since my nodules have been active he suggested coming back sooner rather than later so I'm scheduled for the second round 12 weeks from the first which is the minimum amount of waiting time. When are you planning on going back? A word of caution: June 12 is a German national holiday. I didn't know this until after I had booked my trip so since the clinic will be closed on Monday Prof. S has altered my treatment schedule to work with the 4-day week. I haven't gotten the massage ball yet but am planning on buying one in Germany - I hear they're inexpensive there.

Yesterday I cut my walking back to about 40 minutes with a dog obedience class in the evening and my feet weren't nearly as sore. I think I'll try 2 shorter walks a day and see if that works better. "Bruised" would be a good way to describe the soreness but it affects my entire feet all the way up to my ankles. Is your soreness that widespread?

Hope the next treatment is a success for both of us! Take care, Diane

05/19/2011 08:45
Cyclist 
05/19/2011 08:45
Cyclist 

Re: More on managing the condition

Hi Diane
Yes, my whole feet are sore! Sometimes felt in my shins and calves, more so than ankles. In my case I would think this is more attributable to the different way of walking, but the bruised foot feeling more to the impact of RT. The sports physician suggested that the RT may have 'sensitised' the feet.
Yes, hopefully our feet will improve soon and we don't have to give up our beloved walks!
Keep in touch and feel free to private message me if you want to exchange in more detail
Di

06/11/2011 21:53
Cyclist 
06/11/2011 21:53
Cyclist 

Re: More on managing the condition

Hi All
Further update from information gained from visit to Prof S.:
- Prof S. has advised that allowing foot to move naturally is the best as this will keep it strong, so this suggests it's not necessary to go for MTBs or to stick to snow skiing and rollerblading...
- how much exercise advisable - it's different for different people, so best to experiment and then find a balance that works for you
- foot sensitisation - may or may not improve with recovery, it happens to some people and while inconvenient, is still preferable to losing all feeling in surgery

Recovery:
- wash away the metabolites (chemicals that linger in the foot while the foot is recovering from the RT) by dipping feet in and out of hot/cold foot bath for 10 mins each evening
- wear circulation stockings to encourage good circulation, especially in hot weather or when sitting for long periods
- strengthen the foot by standing on a step and allowing each heel to drop down towards a lower step in turn before pulling it up again until you are on your toes

Modification of exercise regime:
- not advisable to do sports that involve a lot of sudden stopping with change of direction
- okay to do any sport including running and cycling that allows you to get into a smooth rhythm. This is supported by the evidence of patient experience where many continue to run with this condition.

Hope this helps
Di



Cyclist:
Hi there
An update: My nodules haven't shrunk since the first round of radiation treatment, but they have stopped progressing. I visited the sports physician to gain more understanding about how to continue to stay fit despite my foot challenges.

Skip this paragraph if you know my story: I'm currently in the middle of 2 cycles of radiation treatment (RT) in Germany for aggressive LD in both feet that have grown quite large in less than 6 months since getting symptomatic. Since this time, I've experienced nerve pain around the ball of my foot and general all over aching of the feet. Since the RT additional sensitivity when walking especially on hard surfaces (the whole foot feels bruised - note nodules less of a problem) and problems with re-occurring inflammation around the balls of the foot. At this stage I'm living in hope that my condition will improve as my feet recover from the RT.

Sports physicians are GPs that have specialised to keep athletes (and others such as myself) active through injury and rehabilitation, so I thought this would be a good pathway for getting some specialised support. The aim of my 1 hour consultation was to get some medical explanations for my observations of my condition.

My overall experience with the sports physician was positive so I thought I'd share the advice I received. I'd like to think my feet will continue to improve and I can adjust how I view this advice in the future:
- walking causes the foot to pronate and this stretches the tendon which could be causing the nerve pain because mine are thickened
- treat walking as a high risk activity as different weight distribution can cause injury including stress fractures
- use a pedometer to measure how much walking is manageable
- take up swimming and cycling (!!) for fitness - I can do as much cycling as I want!!
- take up snow-skiing or rollerblading (as the boot prevents pronation) for a safe weight-bearing exercise

Please note that not everyone experiences the condition in the same way and I have thickened tendons and cords, so you may be able to continue walking more than I am able to at present.

I'd be interested in hearing other people's stories about this .

Thanks and all the best
Di

06/12/2011 02:15
flojo 
06/12/2011 02:15
flojo 
Re: More on managing the condition

Quote:
wash away the metabolites (chemicals that linger in the foot while the foot is recovering from the RT) by dipping feet in and out of hot/cold foot bath for 10 mins each evening

Never heard about this before. Wonder if this would apply to RT for hands? Does anybody know?

06/13/2011 01:53
Cyclist 
06/13/2011 01:53
Cyclist 

Re: More on managing the condition

Hi flojo
I would say this is the case as the RT process is the same, just in different parts of the body.
Hands are more in use though, so it may not be as necessary as feet that are more prone to being held still for longer periods of time when sitting at work etc
Perhaps someone could ask Prof S. at a consultation and feed this back to the forum
Di

flojo:
Quote:
wash away the metabolites (chemicals that linger in the foot while the foot is recovering from the RT) by dipping feet in and out of hot/cold foot bath for 10 mins each evening

Never heard about this before. Wonder if this would apply to RT for hands? Does anybody know?

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