Second Opinion

Toes my foot in happier days

Here’s a goofy mix of foot-related songs to enjoy whilst I relate the latest.

On Monday I went back to my orthopedist because of the previously noted issues I’ve been having with my lower left extremity. I hate going to see that guy because he’s in a big hospital downtown and I feel very lost in the shuffle. It’s like going to seek medical care in a factory. The doctor is nice enough, but I was left with the feeling that he didn’t really have a clue what was causing the discomfort in the front part of my foot. Just taking a while to heal from the break, he said, but that seemed to be a guess. He said my x-ray looked fine, so it must be the “soft tissues.” Just be patient, and if sandals feel better than shoes (they do) then wear ’em.

I posted a tweet to this effect: “Orthopedist says my foot is probly just healing slowly – give it some more time and hope for the best.” I was planning on writing an entry here under the title “Prognosis Unknown.” But before I could get around to it, some friends of Facebook commented on the tweet and next thing I know I’m talking on the phone to a retired (and wacky) podiatrist. Obviously he couldn’t examine me over the phone but he didn’t hesitate to say there’s no way it should be taking this long to heal, since I broke my damn toe four months ago. He advised that I should see a podiatrist, and predicted I’d be given a steroid injection.

So yesterday I rode my bike uptown to the offices of Dr. Edward Lang. What a difference — what an amazing difference. Not only did I receive a better quality of care, but the aesthetic experience was much more pleasant, and stuff like that matters to me. But most importantly I felt like Lang knew what he was doing. He was friendly but also explained everything to me like I’m an intelligent person capable of understanding.

In a nutshell: new doctor, new diagnosis, new treatment. If you are interested in the gory details read on.

The discomfort in the front of my foot is caused by a neuroma — or perhaps more properly a perineural fibroma. He said if I looked this up I would see the word tumor, but not to be alarmed by that because it’s not a tumor in the sense of the term with which I’m familiar. Basically it’s a swelling of the nerve, and he said I had the biggest one he’s seen in years. It took him about five seconds to find this, by squeezing my foot a certain way, and I sure felt it. He confirmed it with sonography.

But I’ve got multiple issues, so the fun didn’t stop there.

The problems in my heel? Plantar fasciitis and (related) bone spurs. Funny, anytime I mentioned my heel problems to anyone, they always asked me if I had plantar fasciitis. I had to plead ignorance because the orthopedist never used that term. When I quizzed him about it on Monday he said it was “calcaneal dennea” or something like that but I can’t find any definition for that term and it did not ring a bell with either podiatrist.

As for my ankle, he confirmed the presence of arthritis there, saying it was a “tremendous amount.”

He gave me not one but two steroid injections, one in the forefoot, one in the heel. He also gave a prescription for some Mobic, which I understand is “a nonsteroidal anti-inflammatory drug (NSAID) in prescription form. It is used to relieve the pain and stiffness of osteoarthritis and rheumatoid arthritis.” I’m not sure I’ll actually take this because frankly the pain in my ankle is not so bad, especially compared to the other stuff I’m experiencing. I don’t like taking drugs like that unless I really need them, especially considering the anti-inflammatory side-effects: ulcers, internal bleeding, clots, heart attack, stroke. Though the arthritis in my ankle was undoubtedly exacerbated by the sprain, I’m worried that I’m going to be prone to arthritic joint problems as I get older, so I really need to start doing preventative maintenance.

I’m going back in a couple weeks.

I am so glad I got a second opinion. And to think social media helped steer me in the right direction.

Lower Left Blues

keep left

As previously noted: I sprained my ankle a couple years ago. In December I broke a toe. Also, something seems to be wrong with my heel. This is all on the same foot, the left one.

On Mardi Gras, a pit bull sunk his teeth into my calf. I can still see the marks. It wasn’t a serious injury, but since it was my left calf, it seemed to add to the general drama on that side of my body.

Then, over the last week or two, my knee has been giving occasional flare-ups of severe pain, the kind of sudden pain that make you shout obscenities at the top of your lungs. This seems to happen almost exclusively on stairs. I’m not sure, but I think this is probably the same knee that gave me trouble eleven years ago, just around the time I moved from Bloomington to New Orleans. Which may be the same knee that gave me trouble in high school.

Need I mention that it’s my left knee? It’s as if my lower left limb is under a curse.

Getting back to the foot: I recently bought new shoes in size fifteen. That’s two or three sizes bigger than what I usually wear. Anything smaller just seemed to be uncomfortable. I think it has something to do with the broken toe. I’d have thought it would be healed by now. Maybe it has. Maybe it’s healed funny.

I know of course that wearing a shoe that’s too big might cause other problems, but I really didn’t know what else to do.

The bigger shoe size seemed to help, or so I thought. I took my first long walk yesterday. It became clear that I’ve still got serious issues. I wouldn’t describe it as pain. Rather, I’d say that the front portion of my foot feels swollen and uncomfortable — but only when I walk around wearing a shoe. I haven’t observed any actual swelling.

My orthopedist prescribed an orthotic to help with my heel. It’s like an insole, but it’s custom-made, and it’s supposed to give more support. It’s also expensive, and not covered by my health insurance unless I’m diabetic. I had the mold made a while back; I’m supposed to go get the thing fitted this afternoon. Maybe that will help, but I kind of doubt it. Right now my heel is bothering me less than the front of my foot. I don’t think they’re related, but I suppose it’s possible. Ironically, the orthotic requires me to wear a shoe, and I’d rather not wear shoes right now. Sandals are more comfortable, but incompatible with the orthotic. I’m not even sure what’s wrong with my heel. I’m not sure the doctor told me. I was so distracted with my toe and ankle that I didn’t ask more questions about my heel.

I’m not the world’s most athletic guy, but I do enjoy getting around on my own two feet. I ride my bike to work most days, but I like to walk sometimes as well. So these problems are really bothering me. The confusion is almost as aggravating as the discomfort — perhaps more so. I don’t understand what’s going on or how to fix it. I guess I need to get back to the doctor.

Broke My Damn Toe and Other Entries in the Annals of Idiocy

I’ve been wanting to visit a podiatrist, but I am daunted from seeking healthcare, daunted by my insurer. Humana refuses to thoroughly update their database of “approved” physicians to reflect the reality of post-Katrina New Orleans. This may come as a shock but after the floods of ’05 many doctors simply ain’t there no more.

I became so aggravated that I called Humana and asked them to find a specialist and make an appointment for me. To their credit, they did so in fairly short order.

So Tuesday morning I got in our shiny new rental car and made my way to see an orthopedic podiatrist in the medical district. As long as I was headed in that general direction, I figured I’d go on to the Quarter and catch a haircut from Pat at the Monteleone. It was pouring rain as December chugged on its way to becoming our wettest month on record. I found a place to park on the street, fed the meter, got my haircut, went around the corner to Cafe Beignet for a cup of coffee, petted the big fluffy cat perched under my table, and finally made my way back to the car, scurrying along under the ubiquitous balconies in a vain effort to stay dry.

I reached into my pocket for my key and was distressed to find it wasn’t there. I must have left it in the rental. What if I locked myself out? But no, I told myself, if hte key’s in the car, I must not have locked it, because the clicker is on the keychain.

Then I got to the car, pretty much soaked, and sure enough the door was unlocked. And there was the key, right where I left it.

In the ignition. With the engine running. It had been sitting there unlocked and ready to go for forty minutes.

Sound familiar? It should. Because Xy did the exact same thing a couple years ago. At which time I remarked:

…it’s so stupid it seems like something I would do.

And I guess I’ve proven myself correct on that point.

(Later when I recounted this tale of luck and folly to Xy, her immediate question was: “Are you pregnant?” For the record, I don’t think I am.)

The rain had been positively pounding down the whole time, which is I’m sure the only reason the car was still there. It’s also why I didn’t notice the motor was running when I left it. I could not hear the engine over the sound of that rain.

I went on to the doctor, filled out a vast ream of meaningless paperwork, waited around a while, got some X-rays and finally confirmed that my pinky toe is indeed broken. Yup, I broke my damn toe. Broke it a week and a half ago. I stubbed it on a piece of furniture while trying to change P’s diaper in the middle of the night. (And she didn’t even need a diaper change. Just wanted to get out of the crib.) The only real treatment is to tape the pinky to the fourth toe and let it heal.

I’ve also got some arthritis in my ankle, the one I sprained about a month before Xy’s stunt with the car. And I’ve got some pain in my heel for which the doctor prescribed an orthotic to wear in my shoe. My left foot is just a mess.

Ouch

As I was walking to the Post Office Saturday morning, some jackass asked me for directions. I stepped up to his car, and when we were finished talking, I realized I was standing on an ant hill.

Foot

Actually the guy wasn’t a jackass at all. He was very polite. But my foot is now covered with 16 fire ant bites (or are they stings?) and I’ve got to blame somebody.

Update: I got stung Saturday morning, but the irritation didn’t really begin until Sunday, with pustules in full effect by Monday morning. I took a couple sick days because it just wasn’t comfortable to wear a shoe. Now it’s Friday and the pustules are starting to diminish. I used some topical hydrocortisone to relieve the itching at first, but then I remembered the hot water method. Years ago I discovered this was a great way to deal with poison ivy, and it works for fire ants too. Just bathe in water hot as you can stand, and the itching goes away for hours. Ralph Robert Moore explains it this way:

The itching is caused by histamines produced by the insect bite or poison ivy rash. Exposing the affected area to hot water draws the histamines to the surface of the skin, where they are washed away.

I don’t know if that’s just his speculation or if there’s scientific research to back it up, but one things for sure: it works.