I decided to start blogging my experience of my foot "issues" that have have been having. The name comes from "Fumi and the Bad Luck Foot" (http://www.imdb.com/title/tt0493418/) which is a short film about a girl with very bad luck with her left foot. The title seemed to be almost perfect to describe my current situation.
To provide some history, at some point in the past (within the last 7 or so years), my dear wife dropped a can of Diet Coke on our kitchen floor. It developed some sort of puncture and sprayed the entire kitchen. It came to rest standing on its end, with a thin fountain of cola spewing high enough to reach our 16 foot ceiling. There, in the shower or soda, I started the cleanup effort. I was mopping the floor bare-foot (not sure why I thought that was a good idea) and within a minute or two, I slipped and kicked the underside of our dishwasher door with my left foot. Immediately I knew that it was a decent injury when I grabbed my big toe (which had born the brunt of the impact) and noticed how the sticky coke feeling quickly became a slimy blood feeling. dear wife grabbed a tea-towel and I suspect that she knew it was bad when I mentioned going to the ER! Trip to the ER, tetanus shot and 8 stitches in my left big toe later I went home to rest up.
Fast forward to 7 weeks ago. I was outside our house and slipped on some wet moss on the sidewalk. Wearing only flip-flops on my feet, I had a split-second choice to make on how to stabilize myself. I pushed my left leg out, caught the ground with my left big toe and planted my full weight on my toe, bent under my foot. It hurt. A lot. I hobbled back to the house (no doubt I was not using any bad language or anything) and informed my wife what I had done. It would seem that I hadn't broken anything because I could sort of move it - but it still hurt. I has a few scratches and a large bruise forming just under my nail-bed. I reseted for the rest of the day and the following day it seemed quite swollen, but again it was moving... sort of. Anyone I chatted with told me that I shouldn't both going to the doctor as they "can't do anything with toes" so I left it to get better. It didn't.
A week or so after the injury, I decided I'd better go to the doctor to see what she thought might be wrong (it was still swollen, the bruising was still bad and although I could walk, I had a pronounced limp). I saw a practice partner for our family doctor (who was out on vacation) who looked at my toe, said that it wasn't broken (because of how it was able to be moved etc) and that I probably just pulled something and it will get better in a week or two. She chose not to do an x-ray because she said there wouldn't be anything they would do anyway. She gave me anti-inflammatory meds and a course of antibiotics. I didn't ask any other questions and went about the following weeks as normal.
I returned to the same doctor 12 days later after the meds had run their course because my toe was still swollen, still bruised and I was still walking with a limp. She threw up her hands and said that she had exhausted her knowledge and referred me to an Orthopedic surgeon. Luckily, the doctors practice that I go to has several on staff so I assumed that I would get an appointment within a few days.... WRONG. The next available appointment with the only orthopedic surgeon in the practice that would see patients with feet problems was over 1 month out. I said that I would find another in the area. Thanks to Facebook, I got a couple of recommendations in the local area, and as it turned out, the only board certified foot and ankle ortho agreed to see me in 2 weeks.
Just a few days later, I lost my balance and planted my left foot, with full force, down onto the edge of an upturned piece of Barbie furniture that had been left on the floor. It cut a hole through my sock and lacerated my foot and toe. Back to the ER, this time they wanted to do x-rays to confirm that the wound was free of debris so I asked them to see if there was a break/fracture. They confirmed that the bones were intact. 14 stitches and a prescription for Vicodin later I was hobbling out of the hospital.
Fast forward 10 days to returning to my family doctor (now back from vacation) to have the stitches removed. I chatted with her about my toe issue, she took a look and wondered if there might be tendon damage. She was eager to hear the result of my appointment with the ortho (to whom she had directly referred people in the past even though he is not part of her practice). Tendon damage sounded bad - as my dear wife said: "that sounds like surgery is in your future". I sure hoped not. I looked up a bunch of online references including ways to prevent, identify, diagnose, and treat tendon damage. There were some commonalities, and my injury and symptoms were in line with many of the descriptions.
The appointment with the the orthopedic surgeon played out pretty much exactly as I had come to imagine it would. He looked at, pulled, pushed and bended my toe. He took some x-rays at his office which were immediately available to view on the monitor mounted to the wall in the consulting room. No broken bones. Most likely tendon damage. His first thought was Extensor Hallucis Longus (EHL) tendon was entirely ruptured and that it had likely started to retract into my foot. This tendon starts as a muscle in the front of your leg/shin and becomes a tendon before it runs along the top of your foot and connects to the bone at the tip of your big toe.
There is another tendon (your Extensor Hallucis Brevis) that connects to the lower bone in your big toe.
These tendons allow you to extend (straighten) your big toe. While other tendons on the underside (flexor tendons) bend your toe.
He felt that the best course of treatment was to leave it for a while to let the swelling subside, monitor if the the tip bends down too far or becomes stiff. And then do an operation to fuse the joint into a straight position which (with the use of the brevis tendon) I would still have some movement. Later that day, he called back and left me a voicemail to call him in the morning to talk about an alternative option that had occurred to him after I left.
The following morning I called, and spoke with him. He felt that a better option would be to transfer the brevis tendon to the top bone, thus keeping me with a moving joint and still enabling my body to flex and extend using the remaining tendons. The only drawback was that it needed to be done as quickly as possible to minimize the impact of the injury to the joint and other tendons (in particular that the joint could become stiff in the bent position and that the flexor tendons could contract through lack of use. I told him that I wanted to see a second opinion before agreeing to surgery. He agreed that would be a prudent measure on my behalf and said that we could arrange the surgery as soon as I was ready.
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