Wednesday, December 16, 2009

Life on the Sidelines, I Don't Think So

I have been dealing with chronic pain in my ankle for several years now. It's almost pain-free some days and freakishly painful other days. I never know when it's going to act up and there doesn't ever seem to be a particular cause when it does's fine one minute, then I take one step and it hurts like a hot poker. I changed jobs in June of this year and was without insurance for the first 90 days on the new job. Maybe because of Murphy's Law and my having no insurance coverage for 90 days or maybe because the new job entailed some pretty long days on my feet ...but the ankle got bad and stayed bad all summer. It got bad enough my ankle would fold over on me from time to time. The level of pain when that happened spiked to about a 12 on a scale of 1 to 10. It would level back off to a throbbing 8 or 9 within a minute or two, but still.

I went to my regular doctor in September, as soon as my new insurance kicked in. He did xrays and decided I had re-torn the tendon on that ankle and had 'something serious going on with my tibia.' He put me in an air splint to keep the ankle stable and referred me to an orthopedic surgeon in our area. I wore the air splint for three weeks while I waited for my appointment with the orthopedic doctor. The new doctor ordered an MRI and decided the 'something serious' was either osteochondritis dessicans or vascular necrosis ...neither of which is a good thing. He put me in a knee-high moonboot and had me make a follow up appointment in a month to see if the moonboot helped my pain and stability issues. Of course it helped stabilize my ankle ...with my foot securely encased in thick layers of foam and molded plastic, there was no chance of it flexing any direction at all. After a couple of weeks in the boot, the pain was considerably less too. This doctor said that if the first 30 days in the moonboot helped, he would prescribe physical therapy to strengthen my ankle and wean me out of the moonboot. I was hopeful. But two days before my follow up appointment with that doctor, his office called to say they were referring me to an orthopedic surgeon 100 miles away in Temple. I had Scott & White insurance and their main hospital is in Temple so that's where I would have to go. I asked the nurse why he didn't want to at least keep the appointment and see if the moonboot had helped and she said that he consulted the other doctors on staff and they all agreed that the issues with my tibia needed surgical intervention that they were not equipped to handle.

Well it took a while to get the appointment at Scott & White in Temple but the big day was today. I took the day off work and Yeoldfurt went with me. We left this morning and took care of some errands here in Caldwell, then headed north on Hwy 36 to Temple. We scoped out exactly where the clinic was and then wandered around the local mall in Temple until time for the appointment. The staff at the clinic were all very nice, very accommodating, but the opinion of the two doctors I saw was disheartening, to say the least.

It is their opinion that the lesion on my tibia is vascular necrosis which means a portion of the bone is dead. In some such cases, they can remove the dead bone tissue, cast the affected limb and allow (hopefully) healthy bone to fill in the void. But my lesion is too large and too deep within the joint ... so that's not an option. The only surgical alternatives are fusing the joint or doing an ankle replacement. Both of those options would stabilize the ankle and eliminate the pain ...which is a total fix for what is vexing me. But they said that, at 53, I am still too young for either of those options. Apparently, fusing the joint would aggravate and accelerate arthritic changes that are already evident in my lower foot and ankle replacements are only good for 10-15 years patients are not typically approved for replacement surgery before the age of 65.

All they had to offer me is a brace. A big ugly leather lace up brace. They said I need to reduce stress on the joint and as much as possible, prevent the ankle folding over on me as that would cause further damage. They also suggested I use a walking cane. A cane?! They wrote me a prescription for the ankle brace plus a permanent handicap placard for my vehicle.

On the long drive up there this morning, I was psyching myself up for a surgical solution and three months of not being able to do all the things I love ...ride the horses, work in the garden, drive the tractor ...basically just live MY life. But I was only mentally prepared for hearing I would miss out on three months worth of living. I was in no way prepared to hear that this was going to have a permanent impact on my daily life.

I had my cry on the way home and Yeoldfurt was his usual supportive self, telling me all the things I still COULD do and how we would get around the other things that I still wanted to do. He's very resourceful when he sets his mind to it. I'm not resigned to this yet. I'm at least going to get a second (and maybe third) opinion. In the meantime, as of right now, I'm going back to MY life as I want it to be. I'll wear the brace for now, but I'm not going to forego the things that make me happy. It's supposed to be sunshine and clear skies this weekend. I intend to spend a good bit of both days on the back of my horse.



Blogger Kim said...

so sorry to hear that your ankle is that bad. I hope the 2nd opinion is better news.

December 16, 2009 at 3:42 PM  
Blogger Felinae said...

I'm glad you are going to go for a second opinion.
I know you will find a way to ride again. Is there a way YOF could fashion a special kind of stirrup that would keep your ankle stabilized?

Good luck to you my friend, I will keep saying prayers for you.


December 16, 2009 at 5:07 PM  
Blogger WomanWhoRunsWithHorses said...

Even if the second opinion is no better than the first, I'm not going to quit riding. I am already working on a splint that will fit INSIDE my riding boot and I think it will work. I don't need support from my ankle to ride. I can ride with no stirrups at all. But I need to have support for when I dismount ...planned or unplanned. Sunshine and temperatures in the mid-60's this weekend horse better eat her Wheaties the next couple of days, I plan to give us both a work out this weekend.

December 16, 2009 at 6:31 PM  
Blogger Humble wife said...

Oh HB~ I am sending hugs from NM. I am so glad YOF went with you, and I am praying for you here.

I have heard this conversation about a cane, although it was for Bill after he had his accident. It took him nearly a year to come to grips with it as he was 37 when he had his accident. I am so understanding of what you are feeling, and have an ear whenever you wish to vent.


December 16, 2009 at 7:06 PM  
Anonymous Anonymous said...

Hoss Boss, I'm conflicted as to what your two doctors told you. I think they are not being nearly aggressive enough in your treatment. And this whole thing about age being the main factor in surgery is lame.Do they expect You to live in pain and disability for the next ten years? Go see somebody else and when you go do not tell that doctor of the previous doctors findings. That way he or she will not be biased in their diagnosis. As always your friend. fk

December 16, 2009 at 7:51 PM  

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