severe pain three weeks after ganglion surgery

I had surgery March 15, 2013 to remove a ganglion cyst on the bottom of my toe. The doctor,ran into some issuse while he was performing the procedure. It was much larger than he had thought, it wrapped itself around a nerve so tight that is was extremely damaged so he had to remove a section of the nerve, it had also wrapped around a deep blood vessel and I had a DVT because of that so he also had to remove that section of the vessel. The stem had gone so deep that he was all the way into the joint of my big toe to remove the entire cyst. I am now 4 weeks post surgery and still in extreme pain. The sutures were left in for 15 days, I had to go to urgent care to have them removed, because they had embedded in my toe and they had to dig to get under them with a needle, I was also put on an antibiotic for infection. I am now expericing a horric burning, ripping sensation in that toe, and bone pain in the bottom of my foot. I try to tell the doctors all this but they just keep acting like I am being a pain in the butt and telling me to get over it already. My foot is still swollen also. Is this still normal seriously???? Would love to hear your thoughts!!! Thanks so much!

RESPONSE

Hi,

According to my math you had surgery three weeks ago on the bottom of the toe which obviously means in order to walk, you have to put pressure on the surgical site.
Three weeks post op is still well in the recovery period for this type of surgery, meaning there should still be tenderness.
Pain is a relative term and so it is difficult for me, being on the other side of the internet, to determine if your actual pain is out of proportion to what you should be experiencing at this point.
Your ganglion cyst sounds more like a synovial cyst but I am just splitting hairs here at they both appear somewhat the same when you first see them. It is just that a synovial cyst arises out of a joint, where as a ganglion cyst usually arises off a tendon.
What I do not understand here is why you had to go to urgent care to have your sutures removed; that is something the surgeon should be doing.
Not that I want to play referee here because I am just an outsider looking in, but either your doctors are just blowing you off or you are overreacting to the pain from the surgical procedure and again I am in no position to determine which is the case.
So, if you are in as much pain as you state which sounds like more than you should be at this point AND your doctors seem to have no interest in you, then the smart move would be to seek the services of another foot specialist in your area and get a independent opinion of what actually is going on.
The reason I think you need another set of qualified "eyes" looking at your foot is because even though you should still have some degree of discomfort three weeks post op, your complaints seem to be beyond "some discomfort" at this point and even with all the extra work that had to be done, you should still not be in this much pain. Having a tiny blood vessel, probably vein and a small nerve removed does not add much more trauma to the surgical procedure so I do not know why you should still be in extreme pain.
The only possible explanation I can possibly think of is that perhaps they did not remove enough nerve and ended up suturing some the nerve back into the tissue which would end up causing a neuritis (nerve inflammation) and thus perhaps add to the pain.
But again, I am only guessing here and that is why I think you should let another doctor familiar with this type of surgery, take a look at your foot.

Marc Mitnick DPM
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