Monday, February 14, 2011

A Carnivore's Guide to Cardiology: A Hole in Some of my Parts

There’s a major pothole in the highway of my cardiac exercise plan.  Here are the answers to the questions frequently put to me as I hobble by.

Q: What’s wrong?

A:  It’s very difficult to walk with this giant clunky boot Velcroed to my leg.

Q: Why would you wear such an uncomfortable thing?

A:  I have a high grade partial tear of the left Achilles tendon.

Q:  How did you do it?

A:  Mostly by being old and foolish. 

Q: How about an answer that doesn’t describe nearly everything you do?

A: I have a hunch this is a reinjury from when I was young and foolish.  I started running regularly about twenty years ago, and stopped about ten when my knees sat me down for a long talk (that consisted of a Cosgrove like, “Cut it out.”).  During that time I had several instances of pulled calves and tendons. The first was quite spectacular. I was tooling around the track in the RPI Armory at top speed as Dare blared on my headphones from the Transformers soundtrack (the greatest nerd running tape ever created), and catching up to a pair of attractive girls.  As I passed them my calf felt like the explosion of a poorly made retread and I collapsed and tumbled into the corner amidst a pile of cargo nets and wrestling mats. I could tell the girls were really impressed when they asked if I was still alive.   I stopped running for a stretch (literally) and continued again after healing. Minus the stellar show to impress the ladies, this pattern repeated frequently during the time I ran.

Fast forward to a few incidents in Disney World in November where I dashed through the parks go back for lost or left stuff, and I pulled them again.  The pain abated pretty quickly and I was back to my normal high speed lumber. Then at a Christmas dance, my wife’s “Latin roots” fueled dancing put my “Baloo memories” fueled dancing to shame. In order to regain some ego, I unwisely decided to demonstrate how to dance to a Ramones song that came on. I bounced up and down a grand total of two times and felt a pop in my ankle. This time, the pain didn’t go away after weeks of pathetically slow treadmilling. I went to the orthopedist I use to keep my knees working so I can exercise my heart. He clinically confirmed my “old and foolish” diagnosis and sent me for an MRI.

Q: What’s being done?

A: Initially, the doctor looked at my ankle, and told me to continue my normal exercise, but don’t incline the treadmill.  I added extra stretches and figured (foolishly, yet again) that this would be easy.

After the MRI when a tear was reported, I was still allowed to continue exercising the same way. I was also told to “listen to my body”.  I did not need this advice. I am still very surprised this happened as I am way too unathletic and uncompetitive to have such a sport related injury. There is no gene in my makeup which would make me keep striving when my body says, “Hey, this hurts now.”

Upon my next office visit, we looked at the tear together…OK he looked at the tear and I looked where he pointed at the MRI and nodded a lot.  Then he told me to not use the treadmill at all, and bike only carefully. (If I didn’t work with Doctors regularly, this may have surprised me. It also made me reflect that perhaps standing on a ladder for nearly four hours bashing ice off of the gutters with a hammer the day before was probably ill advised.)  He then said he was putting me in a boot.

Q: So is that the big thing on your foot?

A: Yes.  On my way out the door to the doctor’s office, I told my co workers I was asking for the RoboCop option.  Imaging my excitement when he said he was putting me in a boot and added, “Like RoboCop”.  (I even put the soundtrack on in my car to prepare to walk with the proper rhythm.)  Sadly, I did not leave the medical supply store with a gleaming steel leg outfitted with mechanical holster holding an automatic hand cannon.  Instead my foot was constrained in a Velcro and plastic straight jacket.  

We went straight to the mall after acquiring this torture device, as my wife insisted I buy new shoes with thicker soles so I’d be more balanced (physically, the option to be mentally more balanced was lost years ago.)  My argument that I didn’t need them faded quickly as I listed heavily to starboard, to the point that I was making a bee line for a point somewhere between the Sears service entrance and some bushes on the far side of the food court.

Q: Doesn’t this mess up your cardiac exercise?

A:  In a word.  “Ow.”  In several words, “Yes there have been some changes.”

Due to a rare stroke of luck, the guy who sold me the boot also had a hand bike he had refurbished for only ten bucks.  I’ve been doing two days of that with one day of desperately trying not to fall off the stationary bike in between. Consequently my newly stable weight lost a bit of its stableocity, and I’ve had to work on my whole, “eating healthy but constantly” to be a tad on the less constant side.  On the positive side, I think my arms are getting bigger, but that may be due to the effort required to pull on, and tighten the evil foot constraint every morning.

Q: How long will you be in that thing?

A: Immediately I figured out that it would be “too damn long”, although I don’t know the real duration.   It turns out one of the reasons that it was so uncomfortable was that the “extra pads” supplied are actually supposed to be used to protect the back of my foot.  I might have known this if the guy who sold me them actually PUT ONE IN when he locked me within its confines the first time.  Luckily, I figured it out shortly before the big clunky thing started to draw blood, and with the extra padding I’ve downgraded my assessment to “too long.”

I won’t know the true length until I go for treatment. The best way to treat this is Platelet Therapy.  However, the insurance company still classifies this procedure, which has been done successfully for twenty years, as “experimental”. This is much like classifying gravitation as “only a theory”.  At first I didn’t understand why they wouldn’t cover a procedure that is way less expensive for them than surgery. Then I realized that “not actually paying anyone” would be way less expensive for them than either option. Since I’d probably pay an equal amount of co-insurance, co pays, and co “here’s another cost we’re not covering anyway,” I’m opting for the less traumatic Platelet Therapy.  Of course I still had to wait for the insurance to reject it so I could get the offer of the procedure at a reduced cost. Shortly, I’ll get my blood sucked out and spun, after which my platelets will be infused with other helpful organics into my ankle.

The procedure sounds convoluted enough that I may still get some superpowers out of this after all.  Following the whole RoboCop bait and switch, I’m figure I’m due…

Stay out of trouble.


longbow said...

Death Panel!! that's how they turn you into a RoboCop!

Anonymous said...

Jeff, There's a great low impact aerobic exercise that is incredibly popular--they call it "swimming."

Jeff McGinley said...

I have heard of that exersize...Stay tuned to this blog for a future installment of "A Carnivore's Guide to Cardiology": "Jeff's Swim Journal"