January 27, 2014
I just share this stuff. Here is one of many events about how I know why medicine is called, ‘practice”.
A Meeting of The Minds
January 23rd was my follow up appointment for my foot. I am always interested to learn something new about how the human body works, what it does when the human body acts unexpectedly, and it was about me- so of course, I was riveted.
Did she, or didn’t she?
Did I really have osteomyelitis? It was what I felt a very valid question between the doctors. Less than two weeks after my discharge, I did not look like a patient who just spent 45 days in the hospital. I came to my appointment dressed in jeans, Ugg Boots, a sweater and looking good. I did not in any way look like someone who was ill or recovering, except for my knee scooter.
I took both shoes and socks off. I believe that during examination of visible body parts that do come in pairs, doctors should see the “mate” for comparison. Before I even heard the word, “scleroderma”, I had cute, Flintstone-ian feet. That day, I presented my two Flinstonian feet for examination. Really, my feet look pretty good for someone who has had circulatory problems thanks to Raynaud’s, for 20 ears and counting. My toes are fused straight on the second knuckle of all my toes, but I can still wiggle them when I want to. A tendon on the third toe on my right foot is so weak, the toe appears to be trying to twisting toward the second toe. The orthopedist suggested I do the “buddy system” with those toes by taping them together to get that middle toe stronger and help straighten my twisty-toe. What a simple solution. I can’t believe I have never asked before. What are we talking about? Oh yeah, I almost lost my foot, but I didn’t.
We had a look at those feet-ies.
So the doctors examined both feet, but of course focused on my left two small toes, which sat there looking healthy and nourished with blood. I sat on the examining table as they congregated around the computer. I don’t think they were baffled, I think they were surprised. They looked at my hospital admitting MRI used to diagnose osteomyelitis, and there was doubt by these doctors I had osteomyelitis. But after looking at my MRI after discharge, they said it looked like I had osteomyelitis. There was discussion and debate between the doctors. Repeating it will only confuse matters more because a conversation between doctors who are educated in what they do will debate. (Remember; medicine is practiced, people.) Not strong debate, like an argument. I have every bit of confidence in you, reading this post and your intelligence. But I do not trust my ability to repeat what I heard, or thought I heard. It can become very easy for me to overanalyze statements. In conversations where critical thinking is used and then overheard by another, it’s very easy to take points out of context. For example, I could have walked away thinking I did not have osteomyelitis and I was over diagnosed. No, it’s not that simple. In the case of a remote possibly of loosing my foot, I want a doctor to err on the side of caution. A wait and see approach has more often than not, resulted in serious damage to my hands. And active or not. Yes, I lost 45 days of my life. Big deal. I’m still here and intact, or as they say in the 1980 movie, Airplane!, *”Free to pursue a life of religious fulfillment”.
Long story short…
This team of doctors had in their office a young patient, with complicated diagnoses and complications stemming from the damage done by not one, but two very not as-rare-as-you-think, unusual diseases. Having them together, that makes me an anomaly. Every doctor in that room had never seen a patient with both at the same time, and there I was ready to walk out and ease myself back into an active life. They looked at my MRI with showed there was no infection in my toes, but something was in my foot. Not on the bones, but next to them, which they thought was inflammation from one of the two diseases I had, most likely the scleroderma. Sarcoidosis effects my thoracic lymph nodes. My feet had no swelling or pain and I was not on any pain medication. This was not the usual outcome of someone who almost lost her foot to an infection. What they told me is they thought the course of antibiotics stopped the infection before it could get inside the bone. That sounded great to me and I’m sure a best possible outcome observed by those doctors, but now what?
We wait, observe, then doctors review test results and see me in 2 weeks.
I go back again in 2 weeks. Before I go, I am to get x-rays, blood work to see if I have inflammation present, in addition to the normal CBC Chem Panels and whatever else. I see the same doctors and we decide to where to go from there. If I have any symptoms of infection, I was instructed to go to the emergency room and have the Infectious Disease Team paged. ER docs are amazing and their competency is not doubted, but this anomaly must have no delays in treatment by the Infectious Disease Team. It really does make this anomaly feel special. (See what I just did there? I found a way to feel all warm and fuzzy about my medically complicated ass.)
You may be wondering, “But Karen, how does your ego trip help me?”
Well, if you take anything away from this, I want you to not hesitate to go to a doctor or emergency room if you have an infection in your own foot. If a treatment doesn’t work, don’t “wait and see” if symptoms do not improve. Waiting only gives an infection more time to get closer to your bone. Once it gets into your bone, it can get into your blood. Make no mistake, if you wait and it continues, you will loose your foot or possible have a life threatening infection in your blood.
But Karen, I cannot afford to pay for medical care.
Maybe. But can you afford to be rushed to the hospital by ambulance after collapsing from an infection in your blood? Can you afford to die? Look, we all know I get socialized healthcare from the Veteran’s Administration, but medical costs are not the only cost of a hospital stay. Remember, my car did get ticketed, towed, impounded, then repossessed by the finance company because the impound fees were about to exceed the value of my car. The second week I was in the hospital I had a choice. I could leave and go sit in a courtroom and fight this, putting my foot at risk of injury and speeding up the infection process, or sit still and use my energy to save my foot. I can always get another car and any bad reporting to my credit agency scares me as much as a fly in the room. My past is filled with drama stemming from a lack of money. Money comes and goes. When feet go, they are gone forever.
Go and get care. Your life and those who love you, depend on it.
I see statuses of people who are talking about an ongoing health problem that can quickly escalate into a life threatening health condition that could have been prevented with early intervention. The #1 reason people wait for medical treatment? Money. I’m not going to lie and make it pretty. I have been through a bankruptcy, continued horrifying credit and now repossession of my vehicle, as result of pushing aside those responsibilities for time with my son and doctor’s appointments that conflict with appointments at the DMV, or unexpected complications that put things like parking tickets or paying for my cable TV in the back of my mind. I have skipped a meal or two in the past to do be able to do something fun with my son, or pay for gas money to go see him. That no longer happens because doing so, puts my heath at risk. So I cut corners elsewhere.
Still not convinced the sore that won’t heal doesn’t need attention?
While in the hospital, and since my discharge, I have heard stories from amputees and family members of amputees with similar stories that began like mine: a swollen, infected foot. At the time of my infection I had no open sores, buy many talked about how they, or their loved ones had open sores and did not seek treatment. I have talked to so many people I cannot give you an accurate count. So, don’t take my word for it. It probably won’t take you long to find someone near you who either knows someone or has lost a limb to an infection that was not treated until it was too late. Don’t be someone who could have kept their foot with early intervention.
*Now, have a laugh.
My sense of humor comes from a steady diet of classic 80’s movies as a teenager. Please enjoy these clips from the 1980’s classic, Airplane! Scleroderma, sarcoidosis, diabetes and anything involving a terminal, chronic, or life threatening illness and be serious and soul sucking. Revive your spirit with some laughter. If you don;t like the clip I present, find your own. Laughing at what scares us, or finding something to make us laugh when scared only makes us stronger.
And something a little more recent, this classic scene from Tommy Boy. With my limited range of motion in my hands, wrists and elbows, I find this scene especially funny.
Both clips I shared are from the YouTube Channel, Movie Clips. Check them out and subscribe. If Airplane & Tommy Boy aren’t your cup of tea, you will find something else there, I’m sure of it!
To learn more about Scleroderma: