Friday, April 1, 2011

When your old roma's looking ratty, pick up a neu one.

Had my first physical therapy session. No huge whoop.

Earlier in the week, the wife and I had lunch with Dr. Ralph at his office and he showed me my x-rays from last week. He said they were clean and didn't show any fractures, though this wouldn't rule out a stress fracture necessarily, as they often don't show up in x-rays. He said I'd be in good hands with his friend Jacko, one of the physical therapists in the area. His name isn't really Jacko, but that's a similar name to the one he goes by, which also isn't his real name. In fact, if you took the famous 80s Australian Energizer Battery pitchman Mark "Jacko" Jackson, aged him 30 years, grew his hair out into a gray pony tail, removed his Australian accent and penchant for shouting "OY!" in your face, and put him in scrubs, you'd have something that approached what our local Jacko looks like.

On Thursday, I went to see Jacko for the first time.

Jacko's was a tiny two room office in one of the local medical arts buildings, into which he'd manged to stuff four curtained off patient areas, his own desk area, a small library and his receptionist's desk. The quarters were cramped enough that I felt like I was co-starring in Das Boot.

On my way back to my particular curtained off patient area, I met Jacko himself. I'd not yet had my patient history taken, but Jacko grinned at me, shook my hand, took a quick gander at me and said, "So's it hurt your heal?"

"No," I said. Do I look like the kind of guy who has pain in his heal? Eh, maybe.

"Front of the foot?" he then asked.


"Got a planter's wart?"

"Nope," I said.

He paused for the briefest of moments, as though weighing his odds at a fourth guesstimate diagnosis. "All right. I'll be in there in a minute." I'm still not sure what this was, but my impression is that he was trying for a Holmesian visual diagnosis and had missed his intelligence roll.

Several minutes later, after his assistant had taken my history, Jacko came back to have a look and a feel of my foot. (I'd washed that foot extra, for his benefit.)

He listened to my description of the situation and how I didn't really feel pain unless the foot was bumped or squeezed from the sides of the front of it. Then he clamped down on the front of my foot and gave it a solid squeeze.


He then examined the toes, pinching between each one and further down the foot itself until we located the tender point of the pain, about an inch back between This Little Piggy Had None and Wee Wee Wee.

I agreed that this area seemed to be where the pain was focussed, but that it actually spread out across the entire front of my foot when agitated. I reached down and tried to squeeze my foot so I could feel the sensations of the pain in order to describe it. Somehow, though, I couldn't really feel the pain as well when I squeezed it, likely because I can't bring myself to really give it a go

"Nope, you're going to have to do it, or I can't feel it," I said. Jacko was more than willing to squeeze the hell out of the sides of my foot again. Physical therapists are all about gain from pain.

"YAIYAAIE YEAH, THAT'S WHERE IT IS, ALL RIGHT! " I shouted. "Yeah, I can definitely feel that below my big toe."

Jacko seemed to think this was curious. "Have you dropped anything on your foot recently?"

"No," I said. It is very rare indeed that I drop anything significant on my foot. In fact, since age 5, I can probably count on one and a quarter hands the number of times I've dropped something on my foot. I don't know for sure, of course, but I've always thought this stemmed from the time when I was five-years-old and decided I wanted to be Charles Atlas. We were at my Mamaw's house, in back woods Wayne County, Mississippi. I'd seen one of the Charles Atlas ads in a comic book and asked my dad what I had to do to get muscles. He he told me I had to lift weights. He even found me a weight to try it with in the form of a 5 pound cast iron iron, of the sort people used to heat on the stove and then use to iron clothes, but which later became common ly used as doorstops around the time electric irons became affordable. I was only allowed to lift this weight while wearing my hard Sunday shoes, so I didn't drop it on my foot. Of course the one time I decided I didn't want to hassle with putting on my Sunday shoes, I dropped the thing on my foot, and but good. I had blue toes for a week. Since that time, though, when I cause something to fall toward my foot, be it from dropping it from my hand or accidentally knocking down a shampoo bottle in the shower, my feet automatically move out of the way of whatever is plummeting toward them, even to the point that they've done it while my eyes were shut tight from getting soap in them. My theory is that having something dropped heavy on my foot at so early an age caused me to develop hyper-vigilance of the feet and super-charged my pedal reflexes. My wife will tell you that bullshit, but it's bullshit that makes sense to me. (Hey, that would make a great title for my first book. "Some Bullshit That Makes Sense To Me.")

Jacko considered my foot some more and said he thought it was probably a neuroma, which is extra growth in nerve tissue, sometimes caused by a tumor, sometimes just agitation. Actually, Jacko told me what specific type of neuroma it was, but I wasn't listening so good at that point because he was still squeezing the shit out of my foot in his demonstration of how the tissue between two of the bones had become enflamed. He didn't rule out stress fractures and agreed that an MRI would likely show what was going on best, but neuroma was the likely candidate and he had some techniques which he thought would reduce the swelling. He was going to try electric shock therapy.

Okay, Jacko didn't call it that. He said he'd be electrically stimulating the tissue there. But I knew an electro shock machine as soon as he began adhering electrodes in strategic places along my foot.

"You're gonna feel this," he said, turning up the dial on a small black box. And presently I did, as my foot began to thrum with pulses of current.

"Yep, there it is," I said. Jacko set the black box down and said he'd be back in a few.

The shocks from the device were certainly not pleasant, but were quite tolerable. With each pulse my toes would curl on their own.

After about 25 minutes, the pulsing suddenly stopped. Was it on a timer? Was it out of battery? There was still a green light on the black box, but I was no longer feeling anything from it.

I called to Jacko's assistant, just beyond my curtain. "Hey, is this thing supposed to stop shocking me at some point? Cause it has."

Evidently it had run out of juice, while shocking Juice.

Jacko returned and had a look at the foot again.

"And you're sure you didn't drop anything on it?" he asked.

"I'm sure," I said. "Not dropping things on my feet is my mutant ability." I considered telling him about the cast iron iron, but decided the story would take too long and would risk having a licensed physical therapist scream "Bullshit!" in my face. Or, in this case, maybe "Oy!"

Jacko's question about my possibly dropping things stemmed from the fact that the symptoms seemed to manifest across my foot, rather than only in the tender point. This seemed odd to him, but not enough for him to declare it was something other than a neuroma.

My foot didn't feel noticeably different after the shock therapy, either, but this is just the first step. I go back next week.

1 comment:

crsunlimited said...

Funny you should mention your right foot. I too have had an unexplained pain three times in mine. Probably a stress fracture. It only hurt when walking, and only then at the upper front part of the foot.

I blamed the wife kicking me in her sleep. The only thing that got rid of it was staying off it and putting ice on the top of the foot where it hurt.

Still not sure why I got this pain on 3 separate occasions, or if in fact it was a stress fracture. Really didn't see a point in going into a doctor when it went away.

The odd thing about it was it wouldn't be there at all, and then suddenly while walking I would feel it hurt once. Then after that every step seemed to aggravate it.

The first two times this happened I limped along for a bit. Anti-inflammatorys seemed to help but not kill all of it. Then I would give in and iced it. I thought at some point it would just work itself out, but it didn't.

The third time this happened I was grocery shopping with the family. Halfway through our shopping it started in. By the time we got to the van I was limping and there was a considerable amount of pain. I took 2 Ibuprofen and grabbed a bag of frozen corn and put it on my foot.

By the time we got home I could walk with very little pain. I stayed off it all night, icing it most of the night, and the next day it was gone.