Sunday, April 5, 2009

Part One: How I got there from here

Where to begin...the first real sign of a problem was after the 1997 Chicago marathon, when about two weeks post-race my right ankle ballooned as if I had sprained it. I ended up seeing an orthopedist who recommended custom orthotics.

At this point I'd like to drive home this huge lesson I've learned per my wife Jen: YOU MUST BE YOUR OWN BEST HEALTH ADVOCATE! Doctors may either not know all that is available to them or not think to tell you about things like aggressive surgery or - yes - amputation as an alternative. From what I know from this Monday morning armchair call, there was a much better chance had I had corrective surgery at this time (1997) that I might have avoided this surgery now. If you are having foot or ankle problems see someone who specializes in this area, not an orthopedist who might specialize in hip replacement. Do your own research, ask questions, talk to others, check out forums, and educate yourself as much as possible. Be aggressive, it is your life, your one body, don't assume anyone else knows what is best for you.

Over the years I tried different orthotics and got the most cushioned running shoes I could find (Nike Vomeros rock!) and was able to run with ever increasing pain. The peroneal tendon area was often very sore from my ankle to a protruding 5th metatarsal. Around 2002 I started feeling a little numbness in my right foot when running, more so when doing track interval workouts where generally you are always making left turns. I also found I could not move my lower leg very far forward when doing calf/achilles stretches.

Things continued to get worse, and in mid-2007 I decided I would try to run one more Boston qualifying marathon and if I didn't get my time that I would focus on running some 800m and 5k races. Around November of that year I found the pain was so awful that I was forced to quit training. I was referred to Dr. Ohlson who is a foot and ankle specialist.

After taking x-rays and looking at my foot, as well as presenting my case to his peers, his take was "dude, your running days are over." Any of you runners reading this think about that being said to you.

I said doc, look, Oscar Pistorius has no lower legs at all yet nearly qualified for the so-called real Olympics and me, with an intact but damaged foot, can hardly walk? Here my courage failed me, because I wanted him - the physician - to bring up the subject of amputation. Instead, over the next few weeks of x-rays and MRIs we decided to try some aggressive surgery in an attempt to fix things well enough so I could run again. Seemed reasonable, right? Besides, even now in hindsight, how many times would I be asked "so you cut off your foot without trying anything else?"

On April 8, 2008 I had foot surgery that included: Dwyer osteotomies of first metatarsal (big toe) and calcaneus (heel), talus debridement, peroneal tendon repairs, and some holes drilled into the bone to try to stimulate cartilage repair.

I was not expecting to be in much pain when I woke up from surgery, but let me tell you the first thought that ran through my brain was "this is almost as bad as having my foot run over by the bus!" Holy guacamole! It felt like my foot was being ripped apart in several directions.

The pain was very bad for the first week, a bit better the second week, then steadily got better for several more weeks. Putting the foot below the heart caused the nastiest discomfort but eventually time won the campaign and I started PT.

In the end all of the peroneal pain went away, but in the joint bone-on-bone contact and the deformity from the arthritis was not helped by the osteotomies. We have discussed a tibial hindsight I would have preferred this to the calcaneus but I am convinced with the amount of arthritis and joint deformation that this would not have been successful either.

On to Part Two....


  1. there should really be a disclaimer at the top of this post warning the readers about those pics! YOWZERS Richard!!

  2. I did think about it...probably should.