Wednesday, July 09, 2008

Head Over Heels

Today was my first trip to the podiatrist. I actually had a good time. I had some x-rays done, met the good doc, then answered various questions about my medical history. I was really proud when the first few questions yielded good answers:

Blood pressure problems? No, sir.

Heart problems? No, sir.
Smoker? Nope.
Drinker? Not a drop.
Retinopathy? *pause* In remission?
Surgeries? Tonsils and Appendix.
As a child? No, as an adult - '03 and '01 respectively.

Okay, well, I knew not every question could have a peppy answer. After all, I'm not at the podiatrist because I was bored. My left foot has been KILLING me. For the last two weeks, walking has been very painful. I hobble around, limping, trying to figure out the best way to stand on my left heel, knowing that they tell people with plantar fasciitis that they shouldn't walk on the balls of their feet. But DAMN. This is a lot worse than the old, familiar morning heel pain.

While the x-rays were being developed, he did the requisite neuropathy testing. I've never failed the tuning fork at my endo's office, but figured he probably had some other toys to try. He pulled out a machine that looked like something Thomas Edison would have put together (see above photo). It was a black case with a dial and had a wand with a vibrate-y nub on the end (essentially a type of tuning fork itself) and he held it to my toes. I sensed the buzz immediately. He was impressed enough that he tried it again. He said he was going to put me down as a 10. Apparently, this is a good thing. I'll take being a 10. Then he pulled out a small acrylic box of white sticks, each with a different length of filament (called monofilament wires) and asked if he could try some tests he doesn't get to do often. I closed my eyes and had to tell him which foot he was touching with the filaments. We got through the first filament and then even the next one down before my fabulous feet had the man thoroughly impressed. My feet are heads above the rest, apparently. I was so proud I actually secretly thanked my mother for obsessing about my diabetic feet as a child.

So why does my left one hurt SO BADLY? He pressed his thumb into my heel and I yelped.

And that brings us to the x-ray. There is a bone spur at the base of my heel where the plantar fasciia connects to the heel joint. It looks like a nasty little hooked beak of bone that juts up into the bottom of my foot. Even though it looks mean, that's not actually what hurts (so they say). But it does prove that my plantar fasciitis is legit and has become severe. Bone spurs are a side effect seen in 70% of people with plantar fasciitis. As the fasciia becomes more and more inflamed around the joint, your body deposits calcium in a ridiculously stupid attempt to solve the problem itself.

Prognosis: thankfully good. He sprays some very cold spray (called "cold spray" - I saw the can and we joked about it) onto my instep near the base of the heel and gives me a cortisone shot. (My blood sugars are at LEAST 100-150mg above normal ever since - oh joy.) But that will kickstart the anti-inflammatory effect my foot has been aching for, pun intended. Tomorrow I will start on anti-inflammatory pills. He says they shouldn't effect my blood sugar levels. That will be a relief.

I went home with generic orthotic insoles (insurance doesn't cover the customs and I can't help but feel like I just bought bargain bin when I could have had designer footwear). I promised him that I would do the stretching exercises he showed me four times a day and return to him in three weeks. I can go back to the gym, but no weight-bearing exercises - for cardio, I can do a bike. The exercises are essentially wall push-ups where you keep your heels squarely on the floor, about shoulder width apart, while you lean into the wall (including your butt) for five second intervals. I'm to intersperse that with 5 standard calf raises on my tip toes. Total of 5 sets of each, four times a day. I can wear the orthotics in either athletic shoes or heels (I know, I was surprised too), but I shouldn't wear any flip-flop or mule footwear, as it causes your p.f. to grip and contract when we're wanting a good long s t r e t c h.

So I'm home. I've kicked my feet up, fussed at my husband a lot (hey, my sugar was like 300. back off, folks), and just finished my last set of stretches for the night. My sugar is at a nauseating 229 now and my basals are at 150% until I come down off my steroidal high. I'll know it's time to return my basals to normal when my sugar crashes. That's like knowing when it's time to hit the brakes by the appearance of a tree limb stuck in your windshield. But that's how you play this game.

All in all, the podiatrist was a good experience and I feel pretty relieved that the problem is what I thought it was and is treatable. I feel fortunate, vindicated, and - when my sugar finally comes down and I can return my basal rates to normal, I will add - slightly less pissy about my week.

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