Friday, June 22, 2012

Charcot Attack

Charcot Attack
The last ongoing or recent medical BS to update is the Charcot foot. I could deal with this better if I wasn’t so visually impaired. The original injury that triggered this rare diabetic problem would not have happened last autumn if I was not blind.
Very briefly, Charcot is a massive and typically painless swelling of the foot in response to and injury, one of the body’s usual defense mechanism gone into overdrive. There’s two main stages, both typically prolonged. The first is the healing of the triggering injury. The second is recovery from the healing. During the Stage One process, the swelling typically restricts circulation and thus limits nutrient and blood supply to the foot. These reductions cause the foot to atrophy and weaken. As my triggering incident did not include broken bones, I was able to be more active during Stage One than most people can be. I tried to stay active despite my roommate’s restrictive mothering in order to reduce any atrophy.
Maybe things would have been worse if I had completely reposed last autumn and winter, but a sinister level of atrophy did occur.
The almost cartoonish level of swelling ran from the toes to the knee with the most bloated and most stubborn point at the ankle. It stayed swelled for months, from October to February. It drastically reduced in February through April, but this was in reaction to the prednisone prescribed for the retina reattachment recovery, not true healing. I learned this when I temporarily discontinued the prednisone to reduce the steroid’s side effects.
I seemed to have two periods in which the ankle collapsed. Both of these happened at times when I was fully resting the foot and leg, the first in November when I temporarily ceased bowling, and the second while I was imprisoned in the hospital.
I note here for people reading this via an online search for Charcot foot: in the times in between the full rest periods, I could use the foot only because I had no broken or fractured bones that might shift and stab out of the foot. Most Charcot patients do have broken bones and should stay off the foot entirely.The difference before and after the hospital stay was drastic and unignorable. Before, the foot was uncomfortable to use. After four days totally off the foot, the boned in the ankle creaked and clicked if I tried to use it. The longer period of rest in the autumn made the changes less obvious at the time, but drastic changes had occurred.
The foot had swelled and remained that way for months. This did reduce circulation, which inhibited the flow of nutrients to the foot. The are that developed the worst problem was deepest, not furthest in the foot and maintained the worst swelling: the center of the ankle.
The ankle collapsed enough that my right legs was about a half inch shorter than the left leg.
I had seen a podiatrist three times, and on the third visit he prescribed a brace to be made and wished me luck.
True to my luck, I just keep hitting the jackpot with the quality of doctors I end up with. People referred to that first podiatrist as the best in the state. I quickly came to refer to him as "Doctor Dumbass."

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