...and now for the right

It has been over three years since a post was made on this blog. This is a good thing. The surgery to remove a heel spur on my left foot worked well. Although the recovery took a long time, eventually I was no longer experiencing any pain outside of "normal" pain everyone probably feels from being on their feet for a long time. The scar is minimal on my left foot. All is (was) good. 

Back when I was first diagnosed with my left foot heel spur and Achilles tendon issue, the doctor told me I also had one on the right. It didn't bother me at the time so it wasn't a problem.

This summer, though, I started to feel a bit of an issue on the right side. It wasn't too problematic, though; just concerning. In early October, though, I was taking a simple step in the hallway, turning my right foot a bit at the same time. I immediately felt a stabbing, stinging pain in my right foot...to the point that I yelled out a bit. It also felt like something inside (tendon, ligament) slid around in there. This was followed by general pain in the heel area primarily. The pain wasn't constant, but would hit me whenever it felt like it. 

Finally I decided to go to the doctor. The same doctor I had seen previously for my left foot. He did an xray and examination but wasn't convinced that it the spur, even though he did see it on the xray. Luckily for me (very luckily), he decided to order an MRI. A follow up appointment was scheduled two weeks later. 

The sting/stab thing happened a few more times...always when I was slightly turning the foot and ankle. I wore a boot most of the time, always when I was out of the home. The pain gradually increased in frequency. 

I returned to the doctor and was relieved when he told me that according to the MRI, the Achilles was in good shape. He then told me that I had a torn peroneal tendon; more specifically a longitudinal tear. At the time, I had no idea what that was, but frankly the doctor didn't seem concerned. He examined my foot again and found a tender area on the inside of the heel. He thought this might be a nerve impingement so he injected a steroid for relief. He told me that in a couple hours the foot would likely feel great. He then said he'd send an order for physical therapy to help as well. He set an appointment for a month later. 

I went home and the foot didn't feel great in two hours. It felt horrible. Feeling that I do a terrible job of describing pain, I decided to try to an examination of my own. I squeezed right behind the ankle bone (malleolus) and it caused tremendous pain. This was an area the doctor didn't focus upon, or really test. 

I was curious about this area of pain, and was also curious about peroneal tendons. I decided to consult "Dr. Google." A bad idea in many cases, but in this instance it caused more questions for me. I found that the peroneal tendon is actually two tendons: the brevis (shorter) and longus (well, um, longer). The tendons help stabilize the ankle and and are often injured when one rolls their ankle. I found that if a tear is long enough, no amount of physical therapy is likely to work. Many publications stated that surgery was the only fix. I became concerned.

What I didn't have is a copy of my MRI. The next morning I found it was easy to obtain a copy from the provider. I read the report and noted the good news about the Achilles, and quickly found the bad news about the peroneal. It was the peroneal brevis tendon. My next question was about if it was a "large" tear. The report stated: "Apparent longitudinal split tear of the peroneus brevis tendon at the level of the ankle joint, hindfoot, midfoot and extending to its insertion on the base of the fifth metatarsal." This did not sound small. I became more concerned. 

I looked up longitudinal tears (or splits) of the brevis tendon and found that such splits are often made worse by repeated stress from the longus tendon, which resides right behind the brevis. The tendons often slip out of the channel of the leg bone, causing pain. This sounded very similar to my experience of the pain caused with a slight turn of my foot.  

Then I received a call from the physical therapy provider. They said they were calling to set up an appointment for treatment for my Achilles tendon issue. I was confused...nothing wrong with my Achilles. I became even more concerned. 

I decided to email the doctor and ask about whether I should be concerned about the peroneal tendon. I let them know that the symptoms of a peroneal brevis tendon tear sounded similar to what I was experiencing, so I was concerned with attending physical therapy. The doctor's office emailed me back and said to proceed as previously advised.

It was time to call a different doctor for a second opinion. I did so.

A few days later I was in a new ortho's office. A new xray, but luckily they had a copy of my MRI. The doc did an examination and I did a little better job of explaining my symptoms to him. His diagnosis was quick.

He told me I had a significant longitudinal tear of the peroneal brevis tendon; yes, it was long. He said I had three options: 1) physical therapy, which research indicates isn't very successful with this type of issue, 2) platelet-rich plasma therapy, which also has shown limited success in research, and 3) surgery. He stated surgery is the sure-fire way for an active person to resolve a torn peroneal tendon. 

So much different than my previous doctor. Just like that, I have a new foot doctor. 

I have decided upon surgery. It is set for a month down the road on December 11th, 2020. What a year 2020 has been.