Embracing the Needle

The last 10 days have been a bit tumultuous in terms of dealing with my ankle. To say that I became obsessed with the whole topic is no exaggeration, and while I generally enjoy obsessions this one was no fun, leading to overindulgences of the fattening sort as well as the usual harbinger of obsession: the inability to think of anything else.

So, yes, I did everyone who reads here a major favor by not posting. I'd like to thank Brian and my mother for listening to me talk about my ankle ad nauseum. Also, thank you to the mom of my 6-year-old's little friend from school, who always greets me by saying, "How's your ankle?" Bless her heart.

My neighbor, who broke her knee Christmas week, was on track to heal before me, perhaps even before I got an accurate diagnosis. Now, though, I have hope of beating her to full-activity status. I will give you the shortest version I can muster. Which won't be all that short.

When I last posted, I had had an abnormal bone scan was scheduled for a CT scan. After an agonizing wait last Wednesday, the orthopedist finally called at 6:45pm to inform me that the scan was ... normal. No breaks, no fractures, just some "healing activity" on the bone which was too clinical for me to understand fully, he said. He suggested a cortisone shot (needle in joint! needle in joint!) or a trip to an ankle and foot specialist.

After a weepy evening, because I still lacked a diagnosis -- and who was to say that the cortisone would even work? -- I rallied in the morning and began Googling my brains out. Literally. At first I thought I had synovitis (chronic inflammation of the joint lining), but then I read my radiology reports again and figured I most likely had a bone bruise or occult fracture. I'm pretty sure I've read every Web site, message board and blog post about ankles that exists online. Yeah, it was a huge waste of my time.

By Thursday night, I'd put my brains back together and began looking for the most impressive foot and ankle orthopedist I could find. (This is where having a PPO for insurance comes in handy: no referrals required.) I began with the senior foot/ankle guy at Lahey Clinic, but he couldn't see me until March 11. Friday morning I called this guy, and he saw me Tuesday afternoon.

I drove to Newton-Wellesley Hospital with sweaty palms, anticipating having no choice but to get a cortisone shot. After giving birth to three babies with no drugs, I have no idea why I reacted the way I did to a cortisone shot. As my seven-year-old would say, I was a little wah-wah baby.

My new doctor has a state-of-the-art office and casually x-rayed my ankle and looked at the images on a monitor as we chatted. He never bothered to read the notes of my previous orthopedists. He looked at the MRI, read the report, stuck the film showing the fluid in my posterior subtalar joint (heel) up on the light board, then examined my foot. He loaded my CT scan onto his laptop, which provided a pretty cool 360 degree view of my ankle. Then he gave me the lowdown.

My bone scan was within normal limits, according to him. What I have is flexor hallicus longus tendonitis, also known as "dancer's tendonitis." This tendon passes through the heel, along the inside of the ankle, under the foot to the big toe. The clinical signs from his exam were a painful heel bone and a big toe that wouldn't bend up. He said he only sees this type of tendinitis once a year or so, and that's why the other orthopedists couldn't diagnose it.

At first I was skeptical, but then he began describing the kinds of activity I could do, such as riding a bike or an elliptical, and what I should avoid at all costs: walking or running uphill. Which made me remember my walking route from last fall, featuring two huge hills that I liked to sprint to the top of. Every day. Hmmm. Suddenly the diagnosis made total sense to me.

He said he'd "love to" aspirate the fluid, i.e., stick a big-ass needle in my ankle, to confirm the diagnosis and make sure he had the right spot to put the cortisone. I asked if the problem would resolve on its own with physical therapy and he said absolutely. So I said, "What the hell! Let's do the needle thing anyway!"

Yeah. Right.

During the flurry last week of not getting an answer from the CT and contemplating a cortisone shot, I scheduled an appointment with Mass. General Hospital's acupuncture/TCM guru. I see him a week from Saturday.

I've never had acupuncture before but I have high hopes. I'm going to ask him to address my ankle, my hip, and my obsession with using Google to diagnose/scare the crap out of myself. And perhaps my need to eat chocolate before bed, my inability to keep my house clean, my addiction to buying books ...