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.

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