All that changed when Hurricane Ike roared through Houston in September 2008. When I saw the storm coming, I loaded up 2 of my 3 kids and hit the road, traveling to St. Louis, where I grew up and my mom and 3 of my sisters still lived. The drive was long (13 hours), but the trip was worth it! My oldest daughter was in her junior year at Washington University in St. Louis, so we got to visit her and hang out with family for 9 days--Hurrication!--until our schools could reopen. One night as I left my sister's house in the dark, I thought I had stepped down the last of her cement steps, but there was one more. I twisted my left ankle, terribly injuring tendons on both sides of the foot. Swelling, bruising, and lots of pain eventually led to an MRI, which revealed I have an extra bone in my foot, an accessory navicular bone, which can cause the types of foot structure problems I suffer from. My physical therapist suggested I get orthotics. So I visited a podiatrist and paid out-of-pocket for a pair of custom orthotics (insurance company denied this important preventive health care expense, of course!). After about a year and lots of anti-inflammatories and physical therapy, the pain in that foot simmered down to manageable.
Fast-forward to the present, September 2010. I got very excited in the past few weeks about a running program called "Couch to 5K." I finally found something that would keep me motivated to get out there and exercise, and I was excited about the goal of running the 5K in the Susan Komen Race for the Cure. But then my right foot got dramatically worse. It began hurting all day long, and I was icing it a few times a day just to get through. I finally had to face the music and say, "Julie, you've got to stop this running program! You can't be a runner if you have bad feet." But my foot had been hurting more than usual all summer, well before I started running, so there's something else going on, too. I've been trying to buy shoes all summer, but can't because my foot hurts too badly. I see a comfortable-looking shoe on the rack, put it on, and yelp in pain, slipping it off as carefully as I can. Everything presses on that big toe joint; everything hurts. Then my foot started waking me up at night, screaming in pain. I decided I'd better figure out what's going on. I saw 2 podiatrists this week. The first one I saw just pushed surgery, without even showing me my x-rays and explaining why. He was full of ego. Really turned me off. But on Wednesday of last week, the second doctor spent an hour with me, going slowly through my x-rays, and explaining everything he saw. It fascinates me to look at x-rays and see what's going on inside--I should have gone into medicine, apparently. Listening to him show me what he saw on the x-ray, it makes sense that my foot is hurting so badly!
First, there is a small bone in my right foot that is broken into 3 pieces. You can see it if you compare the left foot to the right foot. There are two small, round bones under the base of the big toe bone, called the sesamoids. You can see them through the toe bone on a normal x-ray. On an x-ray of a foot that has a bunion, the large toe bone is displaced, so one of the sesamoids seems to be on the side of the big toe bone, because the bone has drifted off-center for years. So if you look at those 2 little bones on my right foot x-ray, you can see that the one that's still under the toe bone is broken into 3 pieces. BUT, he's not even sure that's what's causing the pain. It might be an old break that never healed. More concerning is what's visible in the spaces between the metatarsals and phalanges. On my 2nd through 5th toes, the spaces are good-sized and well-defined. It's not really space, of course; that's where cartilage is. But on the large toes, the spaces are fuzzy and smaller. And the large toe bone has white areas just beyond the space. This means the cartilage is worn away and the bone is developing arthritis. Groan. I suspected as much.
The last interesting thing on the x-ray is that you can see the extra bone I have in each foot, the accessory navicular. It's rare (2-12% of the population), and it's the primary cause of all my foot mechanics and eventual bone structure problems.
Here's a frustrating little tidbit I learned at my appointments: both doctors said the orthotics I paid so much money for 2 years ago are not helping my feet. They are too flexible and don't have a high enough arch. Apparently, some docs prescribe this type because they are easy to get used to, so they don't have to listen to patients complain about their orthotics killing them during the break-in period. Ugh. Frustrating.
So, I had hoped, when all this pain started up and I sought the help of podiatrists, to find a way to get my foot back to functionality and pain-free without surgery. But now I'm not sure that's going to be possible. Apparently, with cartilage loss already beginning, it's all downhill from here. But Dr. L. wants to get an MRI first, to see what's really going on with the cartilage and with that cracked up sesamoid. It will tell him what he has to do when he gets in there, just fix the bunion, or replace the entire joint. Dr. L. suggests Thanksgiving for surgery. So this blog is my attempt to document my journey forward. I think the decision to let someone cut on my foot and mess around with the bones is a huge one. I've heard so many horror stories about bunionectomies gone wrong, including my own mother's. I'm on my feet all the time as a teacher. I don't want to make any unwise moves that will result in lifelong foot pain or deformity. On the other hand, that's basically what I've got right now, so I'm open to the possibility of surgical intervention, and I'm cautiously moving forward. MRI results on Tuesday . . . we'll see what he says.
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