Three months ago, on a beautiful Sunday morning I went for a run and felt some tingling sensation under the big toe of my left foot. I was just about to start a 3-mile run around the lake with my boyfriend. Well it wasn't painful at all just ticklish and so I ignored it and proceeded with my run. But my toe kept tingling afterward. The next day the tingling sensation turned into a dull ache and soon became painful. Instantly I made an appointment with a podiatrist for the next day. I was pretty much limping by late evening. Anyway I went to see the podiatrist who took x-ray of my foot. To my surprise, I had fractured a tiny bone (tibial sesamoid) under the big toe called "tibial sesamoid". Sesamoids are two pea-sized bones that help the big toe in the joint movement. The podiatrist told me to stop all activities/exercise for next 4 weeks and give my foot complete rest. He strictly asked me not to wear high-heels and only wear comfortable shoes. I followed his instructions for next 4 weeks and even canceled a bunch of activities that we had planned for our Mexico trip. We pretty much laid on the beach the entire time and avoided long walks etc.
Anyway I went for my follow-up appointment 4 weeks later. Please note by this time my foot was much better and I felt mild pain that too occasionally. He took x-ray of my foot again and told me that the fracture had actually healed by 75%! Wow! I was so relieved yet he cautioned me that it may take a long time for the fracture to fully heal. And I had to continue being inactive for another 4 weeks or so. I asked him if I could do anything to speed-up recovery and he recommended Ultrasound bone stimulator device that cost around $1500! Well after inquiring with my insurance I found out that they would cover 90% of the cost. Being inactive for a month had made me somewhat restless and in hopes of getting a quick recovery I decided to go for it. I had to pay around $400 out of my pocket to cover the costs. I religiously started using it for 20 minutes everyday.
But after a week of using the bone stimulator I started feeling intense pain, sometimes throbbing that kept me up at night. And so I went to the podiatrist again and this time he even invited the customer rep of the company that makes the Bone Stimulator. She was nice and told me that it wasn't common for people to experience pain after using the stimulator and actually recommended using it twice a day instaed of just once. Anyway the podiatrist took x-ray yet again and found no change in the bone condition. But this time he put me in a "surgical sandal" and cut a hole in it's pad right where the ball of my foot would sit. He said that would take pressure off of the sesamoid bone and help reduce the pain. He still thought that I didn't need casting or even surgical boot! By this time I had lost all my faith in this dude and in my mind I knew I had to go for a second opinion. And so I promptly took copies of my -rays with me on my way out.
I made an appointment a week later from that day with an Orthopedist Surgeon who seemed to have good reviews. He looked at my x-rays and instantly told me that I didn't have a fracture! He said that it's not a fracture it's just how my bones are shaped and I needed to get an MRI done in order to determine what was wrong. And so I went for an MRI that same afternoon. After taking a quick glance at my MRI, he changed his opinion right away and told me that it is indeed a fracture! Oh wow! Dr. FlippityFlop! He took it rather personally, the fact that he changed his opinion and that he "reluctantly" agreed with the podiatrist's diagnosis. He totally dismissed me after that. But I insisted on getting something out of this appointment and after much questioning he told me about the options I had, surgeyr being the last one. He recommended wearing a surgical boot for next 4 weeks. And so I went from "surgical sandals" to surgical boots in a week! I wore them everyday, limping my way through the day, in hopes of finally getting healed. And as expected, I became the target of many jokes at work ranging from "You look like a Storm Trooper!" to "Hey Darth Vader!!" :) But all done in good spirit!
Anyway I wasn't satisfied one bit with the second opinion that I got from Dr. Flip Flops and so I decided to go for a third opinion. This time I took recommendation from my manager/friend and his wife. They both are seasoned runners and know a thing or two about "injuries". His wife is currently battling stress fracture from her recent marathon training. So she referred me to her Orthopedic Surgeon (Dr. T) who specializes in Sports Medicine. And so a week later I was at his office waiting to finally get an answer to my problem. He came in and warmly welcomed me to his clinic. He then proceeded to very gently look at my foot, wow finally a doctor who had what we call "bedside manners". He was very considerate and genuinely looked concerned about my pain. He told me that he wasn't very aggressive and takes more "humane" approach towards medicine. After looking at my x-rays he too made an instant conclusion like the previous doctor did, that it wasn't a fracture! But here comes the good part. He actually gave me reasons for his conclusion. He drew a picture of the sesamoid and told me that if I had a fracture, the edges of the bones would be jagged but since they are smooth (which even I could clearly see with my own eyes in the x-ray!) hence it wasn't a fracture. "Well! What is it then?", I asked. He said I had inflammation of the sesamoid bone or sesamoiditis because I have a Bipartite Sesamoid bone. In layman's terms, I was born with a sesamoid that was naturally "fractured" -- I was born with two tibial sesamoids instead of one. Only 10% of the population is born with such bone and people with bipartite bones are prone to get inflammation if they participate in vigorous activities like running, dancing etc. In other words, if there was such a thing as screening for potential runners, I would probably fail that screening simply because I have bipartite bone and I'm more likely to develop problems like sesamoiditis. Oh if only I knew, I would have chosen something else like bicycling or other low-impact activities. Thanks Ms Hindsight! But the damage is already done and Dr. T told me not to beat myself over it for it was sheer bad luck that it happened to me! He seemed confident that I will resume all my previous activities and even run again! Oh boy! Please don't give me false hope Dr. T! However I had to go crutches for next 6 weeks! "You need to calm this inflammation down", he said for my bone (or rather my bones, remember I have two!!!) couldn't bear my weight (all 102 lbs. of me) anymore. Sob Sob! He put me in a better surgical boot that comes all the way up to my knees. And so I went from a "surgical sandal" to ankle surgical bootie to a full blown knee-high surgical boot, all in matter of couple of weeks! Dr. T told me that if I had seen him on day one, he would have put me in a cast and crutches right away. But alas I went to "Dr. Inexperienced" who couldn't even read my x-rays right! But like they say, "Better Late Than Never". Well! Dr. T told me to try the knee-high boots for now and continue doing the bone stimulator treatment for I had already paid for it and so why not use it. It's kind of stupid since the bone stimulator only works for fractures and not inflammation but it wouldn't really harm me. However he told me that if the pain didn't go away in 10 days then I should come back immediately and get a cast.
And so here I am, wearing a surgical boot and walking on crutches day-in and day-out. It's been 4 days into the boot/crutches situation and the pain is still there. Well! I need to be patient. I have been greatly humbled by my experience so far. So many things we take for granted, walking on two feet being one of them. But I'm lucky for my boyfriend is there to take care of me. My bosses have been understanding as well and letting me work from home. My next appointment is on 12/20! Wow that's seems like eternity. Meanwhile I'm doing more research and already fond out about Extracorporeal shock wave treatment (ESWT) that is generally used and is FDA approved for Plantar Fasciitis and heel spurs. I am going for a fourth opinion on 11/22 to a podiatrist who specializes in ESWT and see what he thinks of my condition.
Wish me luck please!
