Can you be both utterly thrilled and majorly pissed off at the same time?? Wow, what a whole lot of stress and headache we could have saved if the doctors had followed basic protocol - which is get an MRI if a navicular stress fracture is suspected.
I wasted 7 weeks in a boot after two wrong diagnoses all based on physical exams. It was my PT - who is in Australia - who had high doubts about this diagnosis. He said I don't have the running mileage to warrant this kind of injury and he only sees it in high level athletes. I've asked about MRIs with each of those doctors and their answers were, "Only if things seem to not get better." My PT said he cannot build me a reloading program unless he has a confirmed Dx. So I told them my PT asked for an MRI. Magically, it was scheduled very quickly after that. The only mention on the MRI that could explain the pain could be the "mild degenerative changes in talonavicular joint" aka mild arthritis? I am thrilled to report no evidence of a stress fracture!! After reading my own MRI report online, I put on normal shoes! I see the second surgeon next weeks which would have been the follow up in the boot. I've debated cancelling it, but I have questions still. I am pissed that this is the second time this exact clinic gave me the wrong diagnosis. Same clinic where my ACL surgeon and PA are located. I think I'm done with this place after next week's appt. Next few weeks will be spent getting used to walking, monitoring pain (no stabbing pains yet, but it's not pain free still) and reloading the foot with weight lifting gradually. I chat with my PT in a couple weeks to update and get a plan laid out. My 3 year anniversary is quickly approaching. My tradition of doing something I'm physically capable will have to be tweaked. I don't think my foot will be ready to xc ski or snow shoe, we'll see. Yesterday was the 3 year anniversary of my accident. See full story here.
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Today is week 5 since I saw the first podiatrist, and 4 weeks in the walking boot, 1 week without the walking boot. Overall, 10 weeks dealing with the new foot issue.
I saw a second podiatrist yesterday. I had this appointment booked before I saw the first podiatrist. The doctor yesterday is one of the best in the valley (hence the 6 week wait), so I didn't want to cancel the appointment despite already being on a path with the first doctor. After having done extensive research on my bone stress injury I had the feeling that the first doctor was being far too lenient with my injury. He was hyper focused on plantar fasciitis, he also wasn't going to mention a boot until I asked him as he was walking out the door! I had the sense he was not aware of the seriousness of a navicular stress injury. As per his suggestion (after I brought up the boot idea), I wore it for 4 weeks (he said 6 would be ideal), but let me take it off for my trip to Hawaii. I didn't hike, but I did walk in the sand at times, and yes I had a good amount of foot pain that limited what I could do. I brought my boot with me to Hawaii, but after seeing the conditions - the rain, mud, sand, water, muggy heat - it was all very incompatible for wearing a boot. I probably should have put it back on as it does help with waling pain, but it would have been a major hassle/hindrance to everything. Not the same as when I'm at home sitting at work or going to the gym where it's totally doable. First doctor also had no follow up visits and I was considered released unless something became worse. Anyway, I kept the appointment for yesterday's doctor mainly as a second opinion. He agreed that the 4 weeks was far too short. He took x-rays, compared to 5 week ago x-rays and noted that now there is a suspicious line down the center of my navicular bone so he is calling is a stress fracture. Not all stress fractures present on x-rays, but sometimes they do after a period of time rather than early on. He doesn't agree with the talonavicular joint being the source of pain (two bones colliding as I pronate inwards). Instead he said it is the navicular proper. This is a high risk bone. Treatment needs to be aggressive. He is having me come back in every 3 weeks to test the N-spot - the classic location of pain with navicular injuries. If it still hurts upon palpation, then back in the boot for another 3 weeks. This agrees with literature I've read. It needs to be fully healed and pain free before I go boot free. We are going to watch for a trend. If it gets worse or stays the same in 3 weeks, we do an MRI, consider non weight bearing, etc. He emphasized that naviculars take very, very, very long time to heal. They cannot be rushed. The only thing that did not agree with literature is the 6 weeks of non-weight bearing (NWB). All literature points to this, and he said we don't have to consider non-weight bearing right now, but may in the future. He has seen naviculars heal without NWB. From what I've read, these injuries can take 4-9 months to return to full activity. The quicker return being with those that started with 6 weeks NWB. Ugh, do I go NWB on my own? Tat would be a true PITA if I did go with crutches! Not sure my wrist can take it. So returning to where I left off pre-injury is going to take a while. Pulling out all my mental tricks and tips once again because this could be a longer haul than first thought. I hate the thought of losing strength and functionality with this new injury, the time it will take to build it all back up, reintroduce walking, then weights, then running, etc. It's going to take time. |
AuthorA 45 year old active female who tore her ACL in January 2017 (at the age of 40). Reconstructive surgery in February 2017 with bone-patellar tendon-bone autograft. Archives
November 2022
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