November 23, 2005

Mayo Land



I am leaving the Land that is Mayo in a few hours. This entire town is centered around the clinic and caters to the hundered of strangers that descend upon their streets every day as they come from all over the world to visit their famed buildings.
Coming to Rochester this week is the first time that I've ever traveled to a location where I was completely on my own to get transportation around a city. Even in Guatemala, I had someone picking me up or a car at my disposal. It has been mostly confusing, inconvenient, and expensive. But I have survived...even though I ended up at the airport almost 3 hours before my flight.
I decided I should take advantage of this down time and free wireless internet to try and muddle through exactly what happened in the last 24 hours and figure out what I am going to do next, so that I can collect my thoughts before everyone starts asking.
First: The Diagnosis
I was seen by an orthopedic surgeon and his minions yesterday morning at the Clinic that is Mayo, after a round of x-rays. He was, quite possibly, the most blunt doctor I have ever encountered in my life. No mincing of words, no easing into the situation, no caring if what he said was going to be devastating. Just Bam! Here it is, this is what I think.
And this is what he thought: I have a screwed up joint/foot. And it's not ever going to be normal and it's not ever going to function normally. I have early-onset arthritis in that joint (that was new info for me). I have extremely limited upward flexibility in the joint. In normal feet, it's like a 75 degree angle, I have a 17, maybe 18. I should have never had the surgery I had. I have a great deal of scar tissue that is holding up the joint, but there is no good way to deal with that. Removing it by surgery will just create new scar tissue while I am trying to recover from the surgery. There is no explanation for why the pain started, or why my left foot, which is also stiff (also new info), doesn't hurt.
I have compensated for that stiff joint by have an over-extended joint above it, and I also have a spur on the top of the bone (that was a new one for me as well). He wasn't impressed with either of my earlier surgeries or recovery times (the ones dealing with my ankle). Kept asking questions about why it had taken so long and what exactly had happened. He didn't understand why I had had the bunionectomy or the screw removal. He was the first one to not be opposed to the cortisone shots, although he asked a lot of questions about them.
All of this was said in about 20 minutes or so. He poked and prodded and measured and stressed, and then said all of that rapid fire. He then launched into my options.
I have two. Kinda.
One: Get a new orthotic. Actually, it's a modified shoe. One with a rocker bottom on it, so that I am able to walk without actually having to flex my toes. I'm sure they come in many stylish colors.
Two: Another surgery. This one is for a condition called hallux rigidus (which basically translates into rigid big toe...clever, huh?). They go in and remove part of the bone so that it can move upward more. This surgery has about a 80% success rate. BUT (of course there is a but), they've never done it on someone who has already had the surgery I've had. So there goes any guarantees. And it will whittle down a bone that has already been whittled down considerably by the first surgery. And, of course, create more scar tissue.
And that's it. Those are my options. Actually, I have to try the shoe first and then if that doesn't work, then they would think about doing the 2nd surgery.
He actually said to me, "You aren't giving us much to work with here."
I was too dumbfounded to even respond. I felt guilty, like it was my fault all this had happened to me. But then I snapped out of it.
And he was gone. They gave my back all my x-rays and medical records, and that was it. My long-awaited appointment at Mayo was over.
So, it's now the next day, and this is the first time I've actually sat down and thought through all of that again. I'm still not sure of the ramifications yet. It doesn't seem like this will be over any time soon. Actually, I don't think this is ever going to be over. The orthotic isn't going to fix anything, it's just going to allow me, hopefully, to walk less painfully. But it isn't a permanent solution. And the surgery doesn't sound so sure-fire either.
I don't know what I'm going to do. I have another appt with my TN doctor next week, where I will relay all this and he will get the results from my physical therapist. I guess we'll go from there. I don't know if he's going to want to continue trying anything or if I still have to go to PT.
I just don't know.

November 17, 2005

Jump Start Anyone?


Three times a week I get hooked up to this machine to have a steroid zapped into my foot.
So far...I can't tell a difference.
But the machine it pretty cool, nonetheless.

November 11, 2005

The Big 2-4

Moments after Turning 24.



I looked a lot happier last year.

It was such a weird birthday last year. No one I actually saw that day acknowledged that it was my birthday, but I received tons of emails from home.

Today, I have been home, and have receieved phone calls from many of my friends and family, but it's been a lonelier birthday than last year's ever was. I guess it has a lot more to do with my current state of mind and situation than anything else.

I'm so not handling this all very well anymore. Physical therapy (the latest attempt to fix the pain) is kicking my butt all over the place. So far, it's PT-3, Tori-0. I have another round tomorrow, which I am totally not looking forward to. I know it's all "no pain, no gain" and everything....but sheesh.

Oh well. Here's to a new year of life. I'm thankful for the last one, even though it didn't go exactly according to plan, and I'm looking forward to whatever this new one brings (mostly, so long as it doesn't involve too much more PT). It's all just part of the big adventure, right?

November 2, 2005

The Rest of the Story

As I sat in a high tech exam room in the Orthopedic Clinic of the UW hospital in July, I can remember trying to catch my breath from the blow that felt like it had been physically dealt to me by this quiet surgeon. I'd waited almost 4 hours for him to come in and give me his verdict on my case. His PA was in the room also, a young woman who reminded me a lot of my oldest sister. She was very good with eye contact, something I'd noticed immediately, but at this point, I was looking anywhere but her eyes. The doctor was finishing up his little speech, his eyes glued to the x-rays on the light board over my left shoulder. I just stared at the travel magazine on the rack over his head, blinking and swallowing rapidly, trying to stop my eyes from filling up.

After reviewing my pre-op x-rays and looking at the series that were made that morning, he came to the conclusion that almost everything I've done to deal with this issue had been more harmful than helpful. He thought I should have never had the surgery I had...that it fixed what seemed to be an obvious problem, when in fact, it wasn't ever the cause of the pain. Not only had the surgery been wrong, but the cortisone shots (7 over a 2 year span) were widely discouraged by most doctors, especially on such a small joint. I should have never had one...let alone 7 injected. I had lost a lot of flexibility in the joint because of the surgery and had a great deal of scar tissue from the surgery and shots.

And to top it all of...as if that wasn't bad enough news...he had no clue where the pain was coming from or what to do about it.
That was the physical blow part.

He sent me for an MRI the next week, and thus began the chapter of this story that I am in now. But that day...walking out of that clinic without dissolving into tears was so incredibly hard. I made it all the way to the parking garage before they came. I had called my mom, and as I started to talk, I lost it. It was so much worse than anything I was expecting to hear from this appointment. I couldn't believe it. All of that for nothing.

Well, fast forward a month. The MRI didn't reveal too much...the screw had caused too much disturbance. It did show some inflammation around a bone on the bottom of my foot, but they weren't certain that meant anything. Their advice was to take the screw out. Sometimes they can cause post-op pain, and it's a simple procedure. So that's what we did. Only, I had to come home to do it. And that fact right there has been my undoing.

I've been home for 2 months now, I found a new doctor...again, and they took the screw out at the end of September. And tomorrow, I am going back to the doctor with the news that it didn't change anything.

I cannot begin to adequately convey my frustration with this situation. It would be one thing if I were dealing with all of this while I was working or in school. But that's not the case. I am at home, just waiting for this to be resolved. Due to the joys of health insurance, I can't work full time nor can I change companies. Basically, I am stuck pulling part time shifts, living with my parents, and I am still dealing with the same amount of pain. Every. Day.

And I'm about to go completely insane. This was not supposed to happen. I wasn't supposed to still be here. I had a job offer, at a place I love. I had a career picked out...at least temporarily. I had the yearnings to travel again and seriously contemplated moving to Italy after Christmas. I had all these possibilities in front of me...all I had to do was come home to deal with my foot for a month and then I could get back to deciding my future.

It would be easier to deal with if I knew what I was up against. But now, with the screw out and no change, this has turned into something I don't really know how to deal with. I finally got an appointment at Mayo, for the 22nd. So, if my TN doctor can't figure out a course of action tomorrow, then I have to wait 3 more weeks before I can get any other answers.

Part of me just wants someone to tell me that they can't do anything about it. That it will just be a chronic pain issue, and to buy some SAS orthopedic shoes and deal. That way, I could at least make a decision about what I'm going to do next. But this hopping from one doctor to another, hoping that someone will fix this just leaves me hanging.

I wish I could tell you that I've used these last 2 months of unexpected vacation to do great productive things. I wish that I'd made a difference in the world by donating all my free time to charities and helping people. Instead I've become a master of filling up days with nothingness. For so long, I just thought all I had to do was get past the surgery, and then I could go and join the human race again. But in the past month, as it became more and more evident that it hadn't fixed anything...I just went to a really dark place, where watching The West Wing and drinking a lot of Diet Coke seemed like the best use of my time.

It's just so disappointing. All of it. The situation and how I've reacted to it.

Maybe tomorrow will bring more answers. It's more likely to bring more frustrations and tears, but I have to hope that it will be more than that. It's all that I have to get me through this.