In the beginning....part 4

By the 22nd I had an approval for an MRI and requested referrals for second opinions.

On the morning of the 23rd I went to the Foot Center. I did not fully realize what a teaching hospital entailed until I went here. Perhaps this is the exception and not the rule, it was during the holidays, but the administrative staff was disorganized the students were...students...and the actual doctors seemed overwhelmed.

They did do a very thorough examination and history, noting the discoloration took X-rays and I waited to be seen by the actual doctor. They came back and said the X-rays didn't show anything and that they would recommend and MRI and these types of injuries could take a long time to heal. For me it was basically an extra backing to wait on the surgery proposed by my original Doctor, but to stay with him. One of the student attendants talked with me for a bit because she was writing her thesis paper on ballerinas with sesamoiditis. Interesting, but no new information to be gleaned.

I got to the HSS a half hour earlier than recommended and worked on my paperwork. The waiting room staff had noted they had received my referral. I was ushered into X-rays before seeing the doctor and then to a waiting room. By the time the doctor came to see me he had already examined the x-rays.

But the first thing he said was that the discoloration was consistent with a sesamoid injury. He checked my alignment and determined the reason for the injury was not structural (meaning I didn't have a high arch and the reason for the injury was overuse/trauma). Upon examination of the X-rays he noticed the beginnings of a bunion forming (probably because the hobbling), some odd coloring in my big toe, and two oddities in the sesamoids themselves. 1) the fibular sesamoid seemed to be slighty smaller and ever so slightly out of alignment 2) the fibular sesamoid was darker than the tibular. We discussed the consequences of a sesamoidectomy (he noted that I had done my research) and that he liked to wait up to year with conservative treatments. He encouraged me to get my MRI at the HSS, if just for the superior technologies. I was able to switch my MRI to the HSS, but first I had to talk to Dr. Werter, who thought the pain might have something to do with the TB I had when I was little...reaching far and wide.

Yes, it is true that sometimes TB can show up in bones and the stomach, but I had it as a little girl a long time ago and it was a primary infection in my lungs. If it was going to show up anywhere it would have already done so. The only time I really have to worry about it is when I get pnuemonia, which is why I get allergy shots, or if I need to be tested....but that's another story.

Got the MRI scheduled for Dec 31.
Then I met with an orthotics specialist for a new pad for my boot. The pad already in place was an improvised J pad, in an attempt to even out the pressure placed on the first MPJ (first metatarsal joint). He had also give me an arch support which I had removed because it was not relieving the ache in my arch and was also causing me some heel problems.
This orthotics specialist (I think her name was D. Sauer) became slightly irate on my behalf for the improvised pad. She removed it, checked my alignment, marked where this new off-loading pad would go (it resembles a raised bump) and explained that this pad would lift and isolate the first MPJ. Whether the bone was bruised, broken or if it was all soft-tissue. Immediately I felt a difference in the right direction. It felt like the way I had to gimp without the boot.
She also told me (when I had mentioned my previous doctor only saw one of these types of injuries a year) that they saw 15-20 a week.

With a renewed sense of hope I returned to work.