I know you are itching for an update on my foot situation. Here it is.
Status: I have an incomplete fracture in my fourth metatarsal, some amount of ligament tearing at my tarsal-metatarsal joint complex, and considerable bone contusions, effusions and edema across my forefoot and mid foot to cope with. Oh, and mild osteotalar injury, too.
Translation: I have a very small bone break, DEEP bruising, soft tissue swelling and persistent fluid buildups in my right foot. And slight damage to the cartilage that cushions the ankle-heelbone joint. There is no evidence of completely torn ligaments or dislocated bones that can result from severed or severely stretched ligaments. All this according to two MRI scans done last week.
Upshot: “You almost had a much nastier injury,” my first orthopedist told me, after reviewing my MRI results. As of Wednesday, two foot and ankle surgeons agreed that, surgery probably isn’t called for, but I need to stay off my foot for another six weeks at least. That means May 15 I can try putting weight on it and reintroduce the concept of being bipedal back into my life. I’m allowed to get in a pool and flounder around starting in two weeks, which makes me a happy, albeit atrophied, little fish.
Contemporary cultural background: It seems that, besides the fracture, I have what borders on a Lisfranc injury, a rare bone/ligament clusterf*!#% at the top of the mid foot which other bloggers have jokingly referred to as a “Lizzy” or a “Lissy.” I saw one statistic suggesting that one in every 55,000 foot injuries is diagnosed as a Lisfranc case. These injuries are notoriously difficult to diagnose and complicated in their healing process.
Historical background: The injury takes its name from a field surgeon in Napoleon’s army who developed the tough love amputation approach to dealing with necrotic tissue in soldiers who fell from a horse with a foot stuck in a stirrup. The injury often seems to result from simultaneous crushing and twisting forces. When searching for something else to be thankful about, I remember that I do not have to ride into war on a horse in the 1800s.
The longer takeaway: You do not want to even come close to having one of these injuries. They are life changers. But if you come up with suspicious symptoms in your mid foot following this type of injury, here’s my advice (which I wish someone had given me.) (1) The emergency room sucks undeniably, but may kick into gear the chain of command and timeframe you want to trigger for this type of injury. Consider a trip there. In this instance, it may be worth the time and frustration. (2) Skip seeing your small town family care doc, and go directly to the specialists, especially if your insurance allows visits without referrals. (3) Don’t delay in getting an MRI to help diagnose your problem and settle on the best treatment path. (4) Pay attention to what your instincts and your foot are telling you. Give more weight to these inner voices than those external voices that will tell you that you just have a bad sprain and that you are overreacting. Hopefully the outside voices are right, and all you’ll need to rehab is your ego. But in case you’re the one in tens of thousands who needs a surgical fix, you want to find out about that in the first 10 days after your injury. That may be your window for the most effective surgical repairs. (5) Many successful Lisfranc recovery stories are out there, but you have to force yourself to flip from negative to positive thinking and actively seek them out.
The shorter takeaway: Are you catching the drift? A rural or undertrained doc can miss the signs of a Lisfranc injury and set you up for a lifetime of hurt, alignment problems and reduced mobility. You can come back from one of these, but your chances are the best if you manage your case with the worst-case scenario in full view.
Broader editorial commentary: Someone whose opinion I respect generally has pointed out that not everyone has health insurance or can afford pricey trips to the emergency room, expensive specialists and over-priced MRI scans. It’s a valid point, but misses a key nuance in the sideways healthcare debate in our country. That is, everyone should have access to free and/or affordable quality health care services regardless of income level. If you are privileged enough to have health insurance coverage, don’t be swayed by the criticism that the ER, medical specialists, diagnostic tools such as MRIs, and surgeries are bougie luxuries which should be avoided on principle in solidarity with poor people. There’s nothing to be gained from limping through poor health in the name of justice. Instead get the care you need and vow to use your improved quality of life to secure a single-payer health care system in this country which takes the profit out of an industry that claims to care for people’s health. We could save a lot of taxpayer money and grief through such reform. You can find news and citizen action resources on health care reform at the healthcare-now website,including information on the recently reintroduced HR 676 ( Expanded and Improved Medicare for All Act) in Congress.
Back to my situation and scratching your curiosity itch briefly. In terms of both my treatment and my future travel plans, all options remain on the table. The timeline remains uncertain. The patient remains optimistic and determined to be able to walk, swim, run and dance again. And yes, even travel to far-away places. The way forward remains uncertain and painfully slow. But isn’t that just like real life?
I used to think that mantras were cheesy and abstract things. Now I understand that they enable people like me to hang onto the positive edge of a difficult situation. Mine currently goes like this: ” I will be stress-free. I will be sickness free. I will be injury free. I will be pain free. I will have good blood pressure, good circulation, a good attitude and faith in my body’s ability to heal.” A little long, I know, but there’s no rule that says you have to be efficient or a realist in crafting your mantra. Mostly, you have to breathe deep while repeating it back to yourself. And I figure, negotiating with your body is just like any other bargaining: ask for what you want and maybe you’ll get what you need.
Ironically, when I could most use diversions and projects to focus on, I am finding it difficult to force myself to be social. If you can call, stop by or invent a sedentary task for me to complete that would help you or the world in some way, please do. I promise to return the favor someday when you need that kind of help from your friends and family. Thanks for the love, support and empathy, and for not allowing me to wallow.