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The nutshell is don't ever have foot surgery unless it's to repair a catastrophic injury/trauma and there is no choice if you want to save the foot. The risk/fa

The nutshell is don't ever have foot surgery unless it's to repair a catastrophic injury/trauma and there is no choice if you want to save the foot. The risk/failure rates are so high and not honestly explained. I was left with ruined joints, damaged tendons, nerve damage, and RSD that spread up my legs and affects my whole body to a degree. I was misinformed and flat out lied to and have never met someone to this day who had such surgery that was better for it either immediately or in the long run. It ruined my life and I lost everything.

TallGuyShort 9y ago
For what it's worth, I have 2 friends who had knee replacement surgery a couple of years ago to address chronic knee pain, and despite being wealthy and committed enough that they were able to participate in all the recommend physical therapy for recovery, they are both still in more pain than they were before, and 1 of them has actually been getting worse in recent months, and was just told by doctors that based on the images from before his surgery, the surgery they performed was unnecessary and didn't address the root cause of his original pain, and that new imagery showed a lot of damage most likely CAUSED by the surgery. I don't know enough to say, "don't have knee (or foot) surgery", but my limited anecdotal experience really makes me want to see data on such surgeries and how many people feel they are better of because surgery than they would have been with a lifestyle change that avoided a lot of stress on the knee (or foot).
- hestipod 9y ago
  I dont have references right now but I have continually heard that long term studies have proven that knee (which I have also had that made things worse) and back surgeries (those two common ones have been extensively studied) show no overall improvement in pain years on compared to those who skipped surgery. In fact it is often worse and precipitates new issues. Surgery is a huge cash cow in the US. The ones that are my only option, but am terrified to have given the past, and dont have the stability or money for would cost something like 25,000usd minimum per foot in this country and take 6 months to a year each to recover from with high complication/failure rates AND are likely to exacerbate the RSD. I am guessing based on previous experience it would be maybe 10-15% of that in Poland where I lived before and got excellent care...and that is paying full cash private prices there. I dont want more surgery at all but I can't live like this either. This is what they did to me and the lack of options they left me with. *@astura has linked some in this thread
  - TallGuyShort 9y ago
    It's almost like there's a closely related cash cow incentivized to keep people in worsening chronic pain such that they need pain killers or something.
    - hestipod 9y ago
      I have been down that road too and spent years in total heavily medicated with various things that just cost me a ton and added more problems. I was usually treated as if my side effects were attempts to get something "better" when I just wanted something that worked and didn't screw me up more. Getting off of them was a nightmare as well and I ended up in the hospital once after seizures. The benefits were always outweighed by the costs.
- astura 9y ago
  We know at least some widely used surgeries are probably no better than a placebo. "Placebo" in surgery is when they get a surgical crew together, anesthetize the patient, make an the appropriate incision, and then dick around for the time it would take to perform a surgery, maybe passing some tools back in forth. Basically, an elaborate ritual. https://fivethirtyeight.com/features/surgery-is-one-hell-of-a-placebo/ https://fivethirtyeight.com/features/surgery-is-one-hell-of-... >A 2014 review of 53 trials that compared elective surgical procedures to placebos found that sham surgeries provided some benefit in 74 percent of the trials and worked as well as the real deal in about half.1 Consider the middle-aged guy going in for surgery to treat his knee pain. Arthroscopic knee surgery has been a common orthopedic procedure in the United States, with about 692,000 of them performed in 2010,2 but the procedure has proven no better than a sham when done to address degenerative wear and tear, particularly on the meniscus.3 >Meniscus repair is only one commonly performed orthopedic surgery that has failed to produce better results than a sham surgery. A back operation called vertebroplasty (done to treat compression fractures in the spine) and something called intradiscal electrothermal therapy, a “minimally invasive” treatment for herniated disks and low back pain, have also produced study results that suggest they may be no more effective than a sham at reducing pain in the long term. There's even the question of is the pain even caused by the thing we are trying to fix? >And then there’s what Thorlund calls “car repair” logic — something looks broken, so you try to fix it. A patient comes in with knee pain, and an X-ray or MRI exam shows a tear in the meniscus. The tendency is to assume that the torn meniscus is the cause of the pain and so should be fixed. However, studies show that MRIs can find all kinds of “abnormalities,” such as cartilage damage, even among people without knee pain. One such study looked at the MRI scans of more than 300 knees and found no direct link between meniscus damage and pain. “You can have a meniscal tear without having any problems,” Thorlund said. >Back pain follows a similar pattern. Studies that examined MRIs of people’s backs show that things like slipped, bulging or herniated disks correlate very poorly with pain. Herniated disks and other supposed abnormalities are also common in people without back pain, and it’s telling that studies find that spinal fusion, another popular back surgery used to address disk problems, does not produce better results than nonsurgical interventions.
  - TallGuyShort 9y ago
    It would never have occurred to me to look for studies in which "placebo surgeries" had been performed. Thank you for the data!
maccard 9y ago
While I'm sorry that this has happened to you, it's not fair to pin it on foot surgery. The same can be said for the majority of surgeries. I'm not in the US, FWIW. I've a family member who has had 3 surgeries on their hand (the last 2 to repair the damage done by the first one). Meanwhile, I have multiple friends who have had various surgeries for small sports injuries that are fully recovered. The risks and failure rates _are_ very high, but if you read the documentation[0] that they give to you, they are honestly explained. Anyone going for surgery should strongly consider whether or not being placed under a medically induced coma, cut open poked around in, and sewn back together, along with the possible complications of all of the above, are worth the procedure happening. (That's not to say don't do it, but there's no such thing as risk free surgery). [0] The piles of forms that they stuff in front of you are filled to the brim with this information. You are normally handed them at an incredibly inconvenient time, and told not to worry about them.
- deleted 9y ago
  [deleted]
- hestipod 9y ago
  I don't recall receiving any forms explaining risks at all let alone the outcomes I experienced, just consent for "the procedure", HIPPA, and "guarantee to pay them" forms etc while I had an IV in my arm and was being wheeled down the hall. I was explicitly told beforehand it was a low risk procedure and I quote "I can't promise it will improve things much but it can't make it worse and if we dont do this you will be crippled by 50." I spent years stalling and getting second opinions and got agreement with him and suggestions for other surgeries as well. NOBODY told me what could happen. The same family and people who preached about "trusting the professionals" then turned to victim blaming (which is all too common I have learned) when things went bad and said "Why did you trust them? Take responsibility for your choices!" This was not a time when it was as easy to research doctors reputations online either and frankly it wouldn't matter because they are like Amazon reviews. People tend to look back in time and put it on the patient and say they should have been smarter, known better etc.
zzz95 9y ago
If I may add, it goes for any procedure and medication. Unless, it is an emergency, or a clear case of immediate attention, avoiding is better. Unfortunately, most surgery (including dental) is crude and rudimentary, good for saving lives, but leaves the patient with chronic problems. Unfortunately, the burden is on the patient to make informed decisions at the time of suffering. As an anecdote, my friend was given a handful of painkillers just before a procedure. I repeatedly told that he were not used to painkillers and perhaps decrease the amount. They did not even consider the smaller size of the patient. Within 20 mins he suffered seizures with just painkillers. Of course, later they apologized. Just got lucky that no permanent damage was done.
intrasight 9y ago
I had same experience with shoulder surgery. No lies nor pressure to have surgery - was my choice since I figured "it couldn't make things worse". I was wrong. I think that everyone considering orthopedic surgery should seriously evaluate the data on success rates. My plan is to wait another five or ten years and hope that the state-of-the-art is improved and then hopefully have my shoulder fixed.
klenwell 9y ago
I came to the same basic conclusion regarding back surgery (and surgery generally: avoid if at all possible) after reading this other New Yorker article years ago: https://www.newyorker.com/magazine/2002/04/08/a-knife-in-the-back https://www.newyorker.com/magazine/2002/04/08/a-knife-in-the...
hycaria 9y ago
I don't want to diminish your testimony which I have no doubt is made with honesty, but there are always two sides to a coin, and sometimes we're too enthusiastic and hopeful to assess the benefit/risk balance with pragmatism. And this can also happen to physicians as well IE wanting to try out a new protocol/technique, boost some statistics over something, having a "nice" case etc. I simply feel that the world is way less deliberately malign that we picture it to be (especially when we're its victim).

TallGuyShort 9y ago

For what it's worth, I have 2 friends who had knee replacement surgery a couple of years ago to address chronic knee pain, and despite being wealthy and committed enough that they were able to participate in all the recommend physical therapy for recovery, they are both still in more pain than they were before, and 1 of them has actually been getting worse in recent months, and was just told by doctors that based on the images from before his surgery, the surgery they performed was unnecessary and didn't address the root cause of his original pain, and that new imagery showed a lot of damage most likely CAUSED by the surgery. I don't know enough to say, "don't have knee (or foot) surgery", but my limited anecdotal experience really makes me want to see data on such surgeries and how many people feel they are better of because surgery than they would have been with a lifestyle change that avoided a lot of stress on the knee (or foot).

hestipod 9y ago
I dont have references right now but I have continually heard that long term studies have proven that knee (which I have also had that made things worse) and back surgeries (those two common ones have been extensively studied) show no overall improvement in pain years on compared to those who skipped surgery. In fact it is often worse and precipitates new issues. Surgery is a huge cash cow in the US. The ones that are my only option, but am terrified to have given the past, and dont have the stability or money for would cost something like 25,000usd minimum per foot in this country and take 6 months to a year each to recover from with high complication/failure rates AND are likely to exacerbate the RSD. I am guessing based on previous experience it would be maybe 10-15% of that in Poland where I lived before and got excellent care...and that is paying full cash private prices there. I dont want more surgery at all but I can't live like this either. This is what they did to me and the lack of options they left me with. *@astura has linked some in this thread
- TallGuyShort 9y ago
  It's almost like there's a closely related cash cow incentivized to keep people in worsening chronic pain such that they need pain killers or something.
  - hestipod 9y ago
    I have been down that road too and spent years in total heavily medicated with various things that just cost me a ton and added more problems. I was usually treated as if my side effects were attempts to get something "better" when I just wanted something that worked and didn't screw me up more. Getting off of them was a nightmare as well and I ended up in the hospital once after seizures. The benefits were always outweighed by the costs.
astura 9y ago
We know at least some widely used surgeries are probably no better than a placebo. "Placebo" in surgery is when they get a surgical crew together, anesthetize the patient, make an the appropriate incision, and then dick around for the time it would take to perform a surgery, maybe passing some tools back in forth. Basically, an elaborate ritual. https://fivethirtyeight.com/features/surgery-is-one-hell-of-a-placebo/ https://fivethirtyeight.com/features/surgery-is-one-hell-of-... >A 2014 review of 53 trials that compared elective surgical procedures to placebos found that sham surgeries provided some benefit in 74 percent of the trials and worked as well as the real deal in about half.1 Consider the middle-aged guy going in for surgery to treat his knee pain. Arthroscopic knee surgery has been a common orthopedic procedure in the United States, with about 692,000 of them performed in 2010,2 but the procedure has proven no better than a sham when done to address degenerative wear and tear, particularly on the meniscus.3 >Meniscus repair is only one commonly performed orthopedic surgery that has failed to produce better results than a sham surgery. A back operation called vertebroplasty (done to treat compression fractures in the spine) and something called intradiscal electrothermal therapy, a “minimally invasive” treatment for herniated disks and low back pain, have also produced study results that suggest they may be no more effective than a sham at reducing pain in the long term. There's even the question of is the pain even caused by the thing we are trying to fix? >And then there’s what Thorlund calls “car repair” logic — something looks broken, so you try to fix it. A patient comes in with knee pain, and an X-ray or MRI exam shows a tear in the meniscus. The tendency is to assume that the torn meniscus is the cause of the pain and so should be fixed. However, studies show that MRIs can find all kinds of “abnormalities,” such as cartilage damage, even among people without knee pain. One such study looked at the MRI scans of more than 300 knees and found no direct link between meniscus damage and pain. “You can have a meniscal tear without having any problems,” Thorlund said. >Back pain follows a similar pattern. Studies that examined MRIs of people’s backs show that things like slipped, bulging or herniated disks correlate very poorly with pain. Herniated disks and other supposed abnormalities are also common in people without back pain, and it’s telling that studies find that spinal fusion, another popular back surgery used to address disk problems, does not produce better results than nonsurgical interventions.
- TallGuyShort 9y ago
  It would never have occurred to me to look for studies in which "placebo surgeries" had been performed. Thank you for the data!

maccard 9y ago

While I'm sorry that this has happened to you, it's not fair to pin it on foot surgery. The same can be said for the majority of surgeries. I'm not in the US, FWIW. I've a family member who has had 3 surgeries on their hand (the last 2 to repair the damage done by the first one). Meanwhile, I have multiple friends who have had various surgeries for small sports injuries that are fully recovered. The risks and failure rates _are_ very high, but if you read the documentation[0] that they give to you, they are honestly explained. Anyone going for surgery should strongly consider whether or not being placed under a medically induced coma, cut open poked around in, and sewn back together, along with the possible complications of all of the above, are worth the procedure happening. (That's not to say don't do it, but there's no such thing as risk free surgery). [0] The piles of forms that they stuff in front of you are filled to the brim with this information. You are normally handed them at an incredibly inconvenient time, and told not to worry about them.

deleted 9y ago
[deleted]
hestipod 9y ago
I don't recall receiving any forms explaining risks at all let alone the outcomes I experienced, just consent for "the procedure", HIPPA, and "guarantee to pay them" forms etc while I had an IV in my arm and was being wheeled down the hall. I was explicitly told beforehand it was a low risk procedure and I quote "I can't promise it will improve things much but it can't make it worse and if we dont do this you will be crippled by 50." I spent years stalling and getting second opinions and got agreement with him and suggestions for other surgeries as well. NOBODY told me what could happen. The same family and people who preached about "trusting the professionals" then turned to victim blaming (which is all too common I have learned) when things went bad and said "Why did you trust them? Take responsibility for your choices!" This was not a time when it was as easy to research doctors reputations online either and frankly it wouldn't matter because they are like Amazon reviews. People tend to look back in time and put it on the patient and say they should have been smarter, known better etc.

zzz95 9y ago

If I may add, it goes for any procedure and medication. Unless, it is an emergency, or a clear case of immediate attention, avoiding is better. Unfortunately, most surgery (including dental) is crude and rudimentary, good for saving lives, but leaves the patient with chronic problems. Unfortunately, the burden is on the patient to make informed decisions at the time of suffering. As an anecdote, my friend was given a handful of painkillers just before a procedure. I repeatedly told that he were not used to painkillers and perhaps decrease the amount. They did not even consider the smaller size of the patient. Within 20 mins he suffered seizures with just painkillers. Of course, later they apologized. Just got lucky that no permanent damage was done.

intrasight 9y ago

I had same experience with shoulder surgery. No lies nor pressure to have surgery - was my choice since I figured "it couldn't make things worse". I was wrong. I think that everyone considering orthopedic surgery should seriously evaluate the data on success rates. My plan is to wait another five or ten years and hope that the state-of-the-art is improved and then hopefully have my shoulder fixed.

klenwell 9y ago

I came to the same basic conclusion regarding back surgery (and surgery generally: avoid if at all possible) after reading this other New Yorker article years ago: https://www.newyorker.com/magazine/2002/04/08/a-knife-in-the-back https://www.newyorker.com/magazine/2002/04/08/a-knife-in-the...

hycaria 9y ago

I don't want to diminish your testimony which I have no doubt is made with honesty, but there are always two sides to a coin, and sometimes we're too enthusiastic and hopeful to assess the benefit/risk balance with pragmatism. And this can also happen to physicians as well IE wanting to try out a new protocol/technique, boost some statistics over something, having a "nice" case etc. I simply feel that the world is way less deliberately malign that we picture it to be (especially when we're its victim).