“Ow! Quit it.”
Bart Simpson, each time Lisa, Maggie, and then Homer touch his bandaged arm where he had his tattoo removed.
The Simpsons, Season 1 Episode 1
Before I get to custom insoles, part deux, I wanted to say I’m tired of foot exams. They start with Does this hurt? And no matter what the answer is, What about this? Is right around the corner.
There are twists, and turns, and pressure.
Six “Ow! Quit its” and two snickers (his) later, we confirm I’m still stuck in Camp Chronic Inflammation.
In my last post, I talked about graduating from the standard diagnostic questions–What did you do this time, what were you thinking, why come to me now?–to my diagnosis and treatment plan.
Here’s how the treatment plan’s unfolding.
“Bright light. Bright light.”
Gizmo, reacting to the camera’s flash
I’ve used a number of prescription painkillers over the years: Hydrocodone, Percocet, Codeine, and likely some I don’t remember. Oxycodone, maybe? I tolerated them well.
Nabumetone was different. One of its rare side effects is changes in vision. In my case, it was light sensitivity.
I was watching television, and the screen and room were so bright, I felt like I’d just emerged from solitary confinement. Either that, or the alien mother ship had arrived to bring me aboard.
No, thank you.
I buy a Costco-sized package of Voltaren from… Costco. You use it to treat arthritis.
Now, as a middle-aged, cross-training kind of guy, I’ve got arthritis sprinkled throughout my body. I don’t feel like I do, but my x-rays and MRIs feel like I do.
So, I’d need vats of this stuff. Sticking with the tubes for now. My foot is the guinea pig in this little science experiment.
Twice daily, I’m rubbing it in. Or, maybe my foot’s rubbing it in, ‘cause rub-a-dub-dub, it ain’t workin’, bub.
Scale back on workouts
I was a bit uncooperative with this part because I feel it when I don’t work out.
Turns out I can also feel it when I do. Taekwondo kicks and power walking uphill are the worst offenders. They aggravate the area, which aggravates me.
I also feel it when I do too much. I didn’t think strength training and power walking the same day were too much. The fireworks marathon in my foot set me straight.
So, moderation and avoiding flexion are my workout workarounds. Know how your heel rises when you’re climbing stairs? That’s bad for business right now.
Not all sadists are physical therapists, but are all physical therapists sadists? I could make a case.
I kid, and my physical therapist is awesome. She holds the industry’s highest certification despite her abominable taste in Halloween candy (candy corn). It’s the only time I’ve considered walking out on a session.
My at-home physical therapy routine consists of stretching and strengthening exercises:
- Toe curling exercises (back, back and turn in, back and tilt out)
- Band exercises (front, back right, left)
- Walking on heels across the room
- Walking on balls of feet across the room
- One-legged balance drills on the foam pad (some with eyes open, some with eyes closed)
- Wobble board rotation drills (go “around the clock” trying to keep the outer edge in contact with the floor).
This routine reminds me of the action movie training montage before the main character gets their a** kicked.
Iontophoresis treatments with dexamethasone
Did you skim that headline? Me, too, and I had to write it.
The physical therapist extracts the dexamethasone solution with a syringe and applies it to a battery-powered patch’s cotton center, soaking it.
She applies the soaked patch to the area scoring highest on the “Ow! Quit it.” scale, then removes a tab to activate the battery.
This is where the magic happens…
The negative charge in the battery meets the negative charge in the solution, they repel each other like members of Congress, and the medicine goes into my foot.
If I don’t experience a burning sensation, I leave the bandage on for four hours. If I do experience a burning sensation, it’s because… wait for it… my foot is burning. The cotton pad dries out and my foot becomes kindling.
If this “treatment” sounds sketchy, random, and somewhat medieval to you, then we’re on the same page.
The first treatment helped. The last five didn’t.
I wasn’t burned, though. Other than financially.
Custom orthotic insoles
The podiatrist’s medical assistant used a tablet to scan the bottoms of my feet. Not the tech setup I had in mind for the job. Seemed like my feet could’ve just as easily ended up in a meme.
It took a couple of weeks to get them, and they’re a perfect fit. The podiatrist strongly recommended I use them an hour per day, increasing use gradually over time before I try working out with them.
Sensing the intelligence test at play, I listened.
I waited until I was wearing them eight hours a day before exercising in them. I’ve never had an issue with them.
Scored myself some new Altra Torin 8’s. That, after visiting Fleet Feet and trying on at least a dozen pairs.
Doesn’t sound like many until you consider that my wonderful sales associate replaced each pair’s insoles with my custom ones, then laced them for me.
My podiatrist recommends a new pair every six months. With back and foot issues, I’m all in. Having the right support is critical whether it’s a mattress, chair, or footwear.
Ergonomics for the win.
Next step (ha!)
Bad to the bone”
Bad to the Bone
George Thorogood & The Destroyers
Album: Bad to the Bone
The tendinitis has improved, but I’ve plateaued. The issue now seems isolated near the capsule at my fifth metatarsal.
Cortisone injections can be risky in this confined area because the needle can separate tendons from muscle and bone. Since most separations lead to divorce, I’m bearish on cortisone injections.
So, what now?
Another MRI for my image collection. Answers. And, I hope, a new and improved treatment plan that leaves me with happy feet.