Let's start from the beginning. When I was 5 or 6 I had surgery for an infection in the bones of my right foot. I was in the ICU for several weeks after as well. I don't remember too much about the ordeal, but I do remember being very afraid of the cast saw. Anyway, the doctors said that osteoarthritis would hit me in my mid to late 20s.....and boy did it!
Fast forward to the summer of 2011. I had just moved back to Illinois from Massachusetts where I had been living for the previous two years. I was in constant pain. It had been something I had been dealing with for a few years, but because I didn't have a primary doctor in Massachusetts, I just dealt with it. Braces, shoe inserts, ice, heat, icyhot, salonpas, I tried it all. Nothing seemed to work, so my stubborn self finally called the doctor. Just kidding, my mom was tired of listening to me complain all the time and SHE made the appointment for me. That's right, at 28, my mommy had to call my doctor for me.
Appointment 1 (June) was with Dr. Slonek my primary care doctor. He made me walk up and down the hallway, made me stand on just the bad foot, made me stand on my tiptoes, and made me point and flex them a million times. He pushed on, rotated, and poked every inch of my foot. The diagnosis was Tendinitis. He sent me for a series of X-rays and gave me a prescription for high dose Naproxen. I got a phone call a few days later from the office. The X-ray showed some unusual degeneration. I was told to make an appointment for an MRI and follow up with the Orthopedic department. The MRI (June 25) was very loud and very long. I had it done with and without contrast. Bless my sister's heart because she sat in the room while I had it done. These are the findings:
"Bony alignment at the ankle mortise is anatomic, and there is no evidence of acute fracture. There is marked diffuse, irregular narrowing of the ankle joint space, with focal areas of near full-thickness articular cartilage loss noted on the tibial and talar sides of the ankle joint posteriorly. There is extensive reactive subchondral cystic change and reactive marrow edema throughout the talar dome, as well as within the posterior tibial plafond. Generalized osteochondral irregularity is noted along the talar dome, but no unstable osteochondral free fragment is identified. Small to moderate degenerative osteophytes project off of the tibial plafond, talus and medial/lateral malleoli. No definite bony erosions are identified. The subtalar joint space is preserved, without evidence of arthritic changes. "Whatever that means. Here is a picture I had taken of my MRI. I can't find the CD with the rest of the images on it to show my actual ankle. This is a view of my foot from the bottom.
Appointment 2 (July) was with Dr. Gonzales in the Orthopedic/Sports Medicine department. He reviewed my X-rays and MRI. He had me do everything Dr. Slonek made me do. He was in shock over how young I was, and how degenerated my joint was. He told me that he sees this in patients that are much MUCH older than me. I was given some samples of Celebrex and a referral to the foot and ankle specialist at the office.
The Celebrex worked MIRACLES for me. I was relatively pain free. I was able to work out harder and longer without wanting to cry. I could get through a whole shift at work without wanting to rip my foot off. The downside: I was sick, and I mean SICK. I was nauseous, my stomach hurt, and I pretty much wanted to die. I tried taking it with food as prescribed, without food, and I was still extremely ill. I should mention that I was also sick when I was on the high dose Naproxen as well. NSAIDS clearly do not agree with my body.
Appointment 3 (July) was with Dr. Arndt. We went over my X-rays and MRI. I told him I stopped taking the Celebrex because it was driving me crazy. We discussed several options. Surgery was immediately put out there for me. I wasn't quite prepared for that, so we opted for an Arizona AFO boot. It would help me stand better and help take the pressure off my foot. There will be pictures of it at the end. Dr. Arndt also sent me to a rheumatologist just to make sure that I wasn't facing rheumatoid arthritis.
Appointment 4 (July 30) was with Dr. Lin. We went over my history, and although she said it was highly unlikely that I had RA, she understood Dr. Arndt's concern and we did the blood work. She also gave me a prescription for a topical NSAID cream called Voltaren since the other pills were making me sick.
The boot was very uncomfortable. I was starting to notice that my foot would hurt more by the end of the day. I was getting nervous because I knew that if this wasn't helping me, and I couldn't take the medication, that surgery would be in my immediate future.
FUCK. FUCK. FUCK.
I made another appointment with Dr. Arndt to follow up about the boot towards the end of August. I voiced my concerns, and he said that surgery was my best route at this point. He laid out three options for me. Ankle Fusion, Ankle Replacement, and Ankle Distraction. A fusion would leave me with no range of motion, and I would probably have to quit my job (I am a manager at a popular Italian restaurant chain) and find a quiet desk job. A replacement would be feasible, if I didn't lead such an active lifestyle. I would end up wearing it out too fast. I had never heard of this Ankle Distraction he was talking about. Dr. Arndt explained it as pulling the bones apart to create new joint space. Sounds intense, right? He explained that this will put off having my ankle replaced or fused for some time. It wasn't going to burn any bridges for any future surgery. So I shed a few tears, and agreed to the Ankle Distraction. He said it would put me out of work for three to four months so I had to choose wisely when I was going to schedule this. I could have done it immediately, but because I didn't want to put my boss in a stressful situation to replace me, I chose December. December 21 to be exact.
I will save the surgery itself for another post. This is already getting to be a pretty lengthy post.
So why am I writing this blog? There is very little information out there on the internet about this procedure. I actually found another blog about a man who had several different external fixators after a snowboarding accident. His really helped me answer questions I had when I was up at 3am because I couldn't sleep. Maybe my journey will help someone one day. If not, at least I will have some documentation of this time of my life.
Thanks for reading!
- Vanna
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