Written on June 16, 2013 by Daniel P. Malito
Here we are again, our time together has come once more. Even though I make it look otherwise, it isn’t easy to find eclectic subjects to write about every two weeks. Oh sure, I can always find something run-of-the-mill to ruminate on – how bad I feel, how my disease takes things from me, the misery of the previous two weeks, and maybe even the bad decisions I’ve paid the price for. The trick is coming up with something besides those usual gripes to talk about that you, my readers, might actually care about. Usually, something happens to me in the fourteen days between columns, so I get lucky. These past two weeks have been uneventful, though, so I have to resort to telling you about the latest fiasco with my ankle replacement. I implore you to bear with me and promise that as soon as aliens land in my back yard or my head falls off, I will share it with you posthaste.
As many of you know, I recently had my ankle replaced. I was basically walking on the side of my right foot before the operation, and I was supposed to be walking flat after the procedure. It didn’t work out that way, though, and my ankle was still twisted under. Granted, I was not as bad as I was before I went under the knife, but the deformity was still noticeable. Ever the optimist, I told myself that my physical therapist would be able to help me to push the ankle the rest of the way flat. Unfortunately, after months of PT, the ankle is still not where it should be. So, on the advice of my therapist who I trust implicitly, I went to see someone to have a brace and an orthotic made. For those laymen among you, this meant I was going to have a device made to wear at night, and one made to wear during the day inside my shoe that would help force the ankle flat.
I wasn’t thrilled that now I was going to have to use another assistive device, but anything is better than getting another surgery. So I went to see the orthotic maker and he did his thing. This included taking a mold of my foot and ankle and recording all the vital measurements of both of my feet. It takes a bit longer than you’d think, but you can’t really use an off-the-shelf device if you want to see results, you need to pay for couture. Since good old Medicare doesn’t cover orthotics unless you suffer from diabetes (apparently every other illness in the world can’t benefit from their use), I was left with a fairly steep out-of-pocket bill. But, I told myself, yet again, “this is better than surgery.” The orthotist finished up and told me to come back in three weeks for my first fitting.
Three weeks later, after some yard work and resulting hip pain (that’s another column), I returned to the wizard of brace and was handed my “orthotic.” Now, when I think of an orthotic, I think of an insert that goes in one’s shoe to help correct supination, pronation, or some other deformation of the foot and ankle. Well, the “orthotic” I got was more like one of Frankenstein’s fat boots – and not the pretty ones you see in movies. This was a big, black, leather-clad, lace-up, sheath that went halfway up my leg and could be seen from space. Once I was strapped into this ridiculous eyesore, the orthotist had to almost rip my sneaker in half to fit the damn thing inside. Right about then I was wishing I didn’t wear shorts to the appointment. I almost asked to trade pants with the assistant but I thought that my request might be misconstrued.
So there I was with my Polo Shirt, white hat, merino shorts, and Bigfoot’s sock sticking out of my right shoe. Feeling like the Australian about to boot Bart Simpson during the cartoon family’s trip down under, I shuffled around the office to confirm that the device fit and didn’t do more damage than good. Much to my chagrin, the boot fit fine, so rather than waste the fine lace-up job that the orthotist had done, I told them “I’ll wear it out, thanks!” I was informed that the night brace would be available in another few weeks so I thanked them and walked, lopsided, to my car.
When I sat down in the driver’s seat I realized that I hadn’t thought this whole “driving myself to get an orthotic” thing through. My right foot was the one covered with the leather leg clamp, and that’s the foot most Americans (and me) drive with. Pulling out and almost hitting an old woman on a bicycle, I realized it was going to take a little getting used to. When you are wearing what amounts to a ten pound weight on your gas pedal leg, the term “heavy foot” takes on a whole new meaning. On the ride home, I almost rear-ended at least ten cars, and hit the brake so hard that I almost caused a four car rear-end pile up at least twice. I learned a few new curse words that day, I can tell you.
By the time I arrived home, the gauntlet-type orthotic device hurt so much I was ready to take it off. My instructions were to only wear the device an hour or two a day until the leather was broken in, and now I knew why. Luckily, it only took about five wearings before the orthotic molded to my foot and I was able to remain strapped into Shaq’s slipper for hours on end. It was then that I noticed a huge problem with the device I had never wanted and didn’t like wearing.
When I go to therapy twice a week, my therapist uses a specific method, honed over weeks of trial and error, in order to “loosen” up my ankle and give me some more range of motion. When I leave there on Mondays and Fridays, for at least a few hours after, I can almost walk like a normal human being, and that’s of great value to me. This is also where the problem with my new boot arises. Since the black monstrosity was constructed with a mold of my lower leg and ankle, it fits very snugly and doesn’t give me any room to move. This is good because it keeps me from getting worse, but it is bad because it prevents my ankle from getting any better. So even when I improve my ankle’s range of motion at therapy twice a week, it immediately goes back into Shrek’s big black shoe, ergo my ankle goes right back into the position it started the day at. As you and my therapist can obviously see, that does me no good whatsoever. Ugh.
So now both my therapist and me have to take the time to visit with the orthotist in order to put our heads together and come up with a way that the boot can put pressure enough on my ankle to keep any gains we make from evaporating. The orthotic maker swears that no one makes a device that can do this, but I keep wondering how I can be the only person in history who needs an ankle to evert and pronate at the same time. It seem everyone else either gets their ankle fused, or they are young enough to have their foot successively casted until it sits straight. So, once again, here I am, relegated to a “less than 1%” bracket by my Rheumatoid Arthritis. This is a recurring theme, for I always fall into that category of “very rare instances,” or “in a small number of cases,” or even “this almost never happens.” I’m used to this by now, though, so I’ll stick it out as I always do. Frankly, though, I have a feeling I’m going to have to go back under the knife, but I’ll hold off on that for a while. Allison and I promised each other no surgeries for at least the next year. Easy for her, difficult for me – let’s just hope Frankenstein’s fat boot does the job.
P.S. Before I drown in a deluge of e-mails; yes, I know it’s actually called Frankenstein’s monster, but “Frankenstein’s monster’s fat black boot” is a bit klunky.