Wednesday, May 15, 2013

My Foot Has Invisible Issues

Perhaps it's because of all the time spent in third-fifth grade rocking my gym class in kickball, but for some reason my right foot has had it out for me over the last four years.

In 2009, while squatting (wearing sandals for this = bad choice) by my new used car to change the license plate, I shifted my weight and had an unpleasant experience. I remember feeling something pop in my foot, followed by intense pain and swelling. I thought I had just torn something and that it would eventually heal, so I put off going to the doctor. Nearly two months later, after I had been hobbling around on a seriously fat foot the whole time, Wife forced me to see a podiatrist. I did, and I was diagnosed with an avulsion fracture. This is basically where part of your tendon pulls a chunk (a small one, in my case) of bone away from the rest of bone. Mine had occurred right at the base of the big toe on my right foot, on the bottom side. Since the tendon hadn't completely separated, there was nothing to do for it but put it in a big air boot to immobilize it and carry on with life. The most inconvenient thing about it was driving - had to do it with my left foot, since I couldn't flex my right one. Weird.

Anyway, at the same time as the x-ray showed the avulsion fracture, it also showed evidence of gout. GOUT. I remember thinking, "What, have I suddenly skipped five decades of life, that I have gout??" My doctor couldn't explain it either - my diet was fine and everything. I was put on colchicine, and in six weeks (when the boot came off) I was pain-free. I don't know if the injury had anything to do with it or not, but there it was.

So this past December, while walking up the stairs at my wife's sister's and brother-in-law's house (where I had been staying at the time) in the pitch-dark of night, I tripped on some boots/shoes. This wasn't just a trip-and-catch-yourself kind of trip. This was a I-think-I-just-broke-my-cold-toe-off kind of trip. The only part of my foot that caught the edge of the stair was the tip of my right big toe, forcing it back almost flush with the top of my foot as I tumbled forward. It croaked like all the frogs in heaven, lighting up with a fiery pain that took my breath away. Probably the worst sprain I've ever had - located at the area marked by the red square in the above image. It swelled up something fierce the next day, and I could hardly walk. After a few weeks the pain went away until it only hurt when I tried to flex the toe.

And that's how it has stayed for the past SIX MONTHS. If I stub my toe, or try to flex or rotate it, it's a solid 9 on the 1-10 pain scale, and I'm not exaggerating. Otherwise, there's no pain. None when walking, and only a little if you press on the joint. I finally caved and (since I've also built up a weird throat issue and a separate foot issue - topics for another post, another day...) went in to the doctor yesterday, and got x-rays taken today. They gave me a disc of my scans, which for some fool reason was only designed to work with Internet Explorer on a Windows machine, so I had a heck of a time trying to view the images. After some Q-style hackery, I managed to extract these from the interactive software disc (after which I found a real gem: the OsiriX software), saving them as jpegs and uploading so you can have the glorious experience of seeing my foot bones:

Right Foot, Medial View X-Ray

Right Foot, Superior View X-Ray
Right Foot, Superior-Lateral View
Most awkward moment of the image-taking experience: My feet are so big they wouldn't fit on the x-ray plate. That's why a couple of the images above are positioned diagonally; they had to turn the plate to fit my foot and "avoid clipping." Awesome.

Now you're probably wondering, "What do these images show?" That's a great question. As far as I can tell, a fat load of nothing. Granted, we just started our Introduction to Radiology course this week, so while I know a bunch about how x-ray imaging works, I know almost nothing about how to read them. Still, I can't see anything broken, and I don't see any of the cloudy/grainy evidence of gout around the joint that I remember seeing four years ago. They also show no evidence of the other (more transient) pain that I've been having in my foot near the ankle joint.

And so, I'm going to wait for my primary care doctor to review the films, then most likely refer me to a specialist. Ho-hum. At least there's no evidence that I have gout again - though at least that would've been an answer. Probably the worst part about all of this is that the weather is finally nice outside, and I just want to go running! But hey, at least I am still able to walk, and my health in general is intact. In the end, it could be much, much worse.

1 comment:

Joshua said...

Dang that sucks, hopefully there is a definite remedy.

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