Friday, November 16, 2012

Model Patient

A few weeks back I wrote about the sudden foot pain and trip to the podiatrist, and even though I wasn't 100% convinced about the diagnosis of joint capsulitis, I took his advice.  Or rather, I listened to his advice and applied bits and pieces of it where I felt I could compromise. 

The doctor had given me some orthotics to wear in my shoes and metatarsal pads to relieve pressure from the ball of my foot.  His strict orders were to: stay off the foot, ice the foot, take Motrin regularly, wear rigid shoes, and keep the foot as immobile as possible.  Then come back in two weeks.

Translation: Don't run for two weeks.

During this two weeks of healing I tried to find other ways to keep active because of a marathon I have hanging over my head in January.  (Whose idea was this?!)  I started swimming with the track girls a couple times a week, and spent a lot more time on my bike.  I started to really enjoy swimming which I thought I never would, and found a nice 10 mile loop on the bike that I can ride on my lunch break.  I stayed optimistic and thought of this as a great way of cross training.  With the exception of my foot, I really had never felt better!  I even went on a challenging mountain bike ride and only tipped over a handful of times.

Two weeks later I walked gingerly back into the podiatrist's office.  He asked how things were going.  Here's how the conversation went:
Me: Well those orthotics are great, I really feel better walking with them.  But I still have just as much pain.  I would say I'm maybe 10% better.  I wanted to be about 80% better by now.  I need to get back to running very soon.
Doc: Only 10%? That's surprising.  And you've been icing it? And taking Motrin?  Keeping the foot immobile?
Me: I definitely didn't run, that I can promise you.  I iced it once and bought a bottle of Motrin but it didn't really hurt except for when I walk so I didn't bother taking any.
Doc: What about keeping the foot immobile, how's that been going?
Me: Yes, definitely.  I've been wearing my stiffest pair of sneakers.  For example, when I went mountain biking last weekend, I wore some stiff trail shoes.  I know what you're thinking, that I shouldn't be pedaling, but really it was not a problem.  I have regular pedals, not clips, so I could just put the pedal in the arch of my foot instead of the ball.  Smart, right?
Doc: You're kind of a psycho, you know that? 

The doctor then spent some time looking at my foot, the wear pattern on my shoes, analyzed the way I stand, and then started poking around the top of my foot.  We kept up a friendly banter while this was taking place, where he lightly scolded me for being a bad patient.  He asked why I work out so much, saying "obviously it's not to look good".  I really didn't know how to respond to that!  Luckily that awkward moment passed quickly when he touched a spot on the top of my foot that made me gasp. 
Doc: That looks like it hurt a lot.  I thought you said it didn't really hurt.
Me: Well it didn't until you just touched it.
Doc: Remember when I asked you how much it hurt on a scale of 1 to 10, and you said 5? You should've said 10.  Just for the record, that's a 10.
With that, he ordered an MRI on the foot to see if it was a fracture or any type of tear.  In the meantime he told me (you guessed it): Rest, ice, Motrin, keep it immobile, and for the love of dirt... no mountain biking! 

The poking around he did really made my foot sore so I took his advice and iced it, and even popped a few Motrin here and there.  I had my MRI on a Saturday night, and Monday morning the doctor's office told me that I had a fractured 3rd metatarsal bone.  I needed to immediately get over to a medical supply place to pick up this sweet walking cast. 

The boot was awkward to walk in but definitely provided a lot of relief to my foot.  That's a good thing because I was headed to a four day horse show and was going to be doing a lot of walking around.  I needed all the help I could get!  The boot didn't keep me from working out though.  I wore it on the bike, and even wore it up to the pool. 

Also during this time I had my annual awards banquet for my running club.  Last year I showed up on crutches and loaded with pain killers after having my hip surgery.  I'm officially turning into "that person" that always has something wrong.  Ugh.
I wore the boot from Monday until the following Wednesday.  Although the boot didn't bother me, it really started making my good foot hurt.  The boot is so much higher off the ground than a sneaker, and it was causing me to put too much stress on my good foot.  And since I need at least one good foot, the boot came off.  Plus, I was starting to feel better.  In fact, I may have texted a couple people that I was nearly ready to run again.

Yesterday I went back to the podiatrist.  I wore my sneakers and was practically almost not really even favoring it at all.  Naturally the doctor wanted to know where my boot was.  I explained why I wasn't wearing it, which of course made him concerned about the other foot.  I said not to worry, I'm starting to feel better and I'm pretty sure I can run soon.
Doc: You aren't ready to run yet.  Your foot is broken.  You can't run until your foot is no longer broken.  We won't know that until we do xrays in a couple weeks.
Me: So you're thinking two more weeks then? 
Doc: We'll talk about it in two weeks.  In the meantime, you need to wear the boot.
Me: I'm not wearing the boot.
Doc: Okay.  Maybe you can return the boot.  Is it still in good condition?
Me: Not really, my buddy dropped a full margarita on it.
Doc (eye roll): Okay, how about crutches.
Me: Absolutely not.
Doc: Okay. Sit tight.  I'll just wrap it up.  You'll like this.
(Doctor proceeds to wrap my foot all up nice and snug with some wrap that has some sort of pasty glue like substance).
Me: Perfect! I like this better.  So I just have to take this on and off?
Doc: Nope. This is a cast.  It doesn't come off.
Me: What?! Well is it waterproof?  I'm going swimming tonight.
Doc: No you're not.  Your foot is broken.  You're benched.  Think of it as a vacation.  You needed a break.  And you got one, bahaha!  (Doctor humor). You're not allowed to move your foot.  Have you been taking your Motrin?
Me: No. Why, do you think I should?
Doc: Do you understand that your foot is broken?

So here's what I'm up against for the next two weeks:  No running, swimming, biking, or any sort of unusual activity.  In two weeks I'll go get xrays (on both my feet), and then I'll meet back up with the doctor to hopefully get the green light to run again. 

One thing that several people mentioned is that stress fractures can happen pretty easily if there's a vitamin D deficiency.  I ran this by my friend Becca, a pharmacist, and she agreed that I should definitely be taking supplements.  She turned me onto Viactiv chocolate flavored chews, which taste way too good to be a vitamin.  So now I start my day off with 2 multi-vitamin gummies and 1 calcium and vitamin D chocolate chew religiously.  See?  Sometimes I really can be a good patient!