Sunday, September 12, 2010

Goal Deferred

Once a week, I get an email from Pulse Magazine.  Subtitled "Voices from the heart of medicine," the magazine "tells the personal story of health care," frequently from the providers' perspective.  I have read of doctors who can pinpoint the moment where the lost the ability to empathize, medical personnel candidly recounting their worst days (and what they learned from them), and patients' efforts to cling to shreds of hope as they battled horrific diseases and a medical system that is difficult to navigate.

In its New Year's post, the magazine asked readers to chime in with their wishes.  Dr. Maurice Bernstein, of the Keck School of Medicine at the University of Southern California, wished for this:

For my first-year medical students, I wish that their interest in patients as persons continues into next year. For my second-year students, I hope that when they enter their clerkships in the summer they will remember what they learned about humanism and will still think of Mrs. Mary Jones as a patient in room 210 and not as "the gallbladder in 210."

It must be tremendously difficult to think of "patients as persons."  As I revise my timeline a heck of a lot longer out than I had hoped for running my sub 30:00 5K, I reflect on a summer of trying to figure out what was wrong with my heel, a journey that detoured through two men with medical degrees before being put back on track by a shoe salesman and a massage therapist. 

When I first started experiencing heel pain in early July, I had (in retrospect) just started doing homegrown turnover drills and completely changing my mechanics to try to stop heel striking.  I iced it, babied it, took lots of ibuprofen and, like many of us, kept on running!  Stop #1 was at a chiropractor (who does have an MD degree also).  He proclaimed this issue as plantar fasciitis, and had his staff apply an ultrasound treatment.  (He did have access to my xray, which did not show anything amiss.)  I came back 5 or 6 times for more ultrasound treatments (with a copay each time).  At my follow up visit with him, where I explained that the pain was radiating up my entire calf, he essentially told me to get better/different inserts and/or shoes.  HMMMM.

Next stop:  the podiatrist.  When I look back on the interaction, I am not sure he even touched my foot (although he did look at the xray).  His diagnosis, within 3 minutes of chatting briefly with me:  plantar fasciitis.  His remedy:  stretching, ibuprofen, inserts (that he happens to sell for $45 each).  As I left, I was handed a few poorly copied handouts with stretches on them.  HMMMM again. 

When I posted a whiny Daily Mile workout report mentioning my alleged PF on Facebook, I heard almost immediately from Shannon Sullivan and the light at the end of the tunnel began to break through.  He has dealt with many runners over the years and has probably seen more runners' feet than you can shake a Thorlo sock at.  I visited him on a Sunday afternoon and he spent a good hour with me, trying to help me sort it all out.  We talked extensively about the onset of the issue, how it had progressed, and what I had tried to do about it.  We looked at my shoes (important tip when dealing with any foot/heel/ankle issue and runners - have your shoes with you when seeking answers).  After feeling my foot, he said, "I don't think you have plantar fasciitis."  I think I heard little New Balance clad angels singing.  Why?  Because he had listened to me; when I explained that I knew PF pain and this was not it, I wasn't told to cough up a copay and stretch. 

The second part of my rescue team is Kim Ortloff.  She and I were slightly acquainted through Gulf Winds Track Club, and I sent her an email briefly describing my situation and my theory that this was not PF.  When I met with her and she spent an hour reviewing the situation and kneading deep into my foot/ankle/calf muscles, I walked away feeling understood and having an answer.  The answer is that the changes I made in early July led to some type of insult to my subtalar joint, and that resulted in the constellation of other issues I had.  Besides some answers about my specific injury, I gained a great deal of insight into how I can better guide my body through the healing process and return to running (five minutes at a time?  really?  is this like an auction -- ten minutes anyone?  please?). 

When I look back on the summer and my attempts to get answers and stay on target toward my goal, I just wish I had been more assertive with medical degree holders #1 and #2.  I wanted to shake them by their Hawaiian shirt (#1) and lab coat (#2) and say:  don't you realize how much running has come to mean to me???? 

I am already seeing silver linings to this situation, like my intensified cross training, the money saved from not paying race entry fees, and a few more hours sleep on Saturday mornings.  When I return to running, I plan to be fitter than I am now, and more prepared to aggressively stalk that sub 30:00 goal (less the turnover drills, perhaps). 

This seven foot rope (for stretching) is going to be my new best friend:



I just wish doctors #1 and #2 had done a little stretching themselves to try to run a mile in my shoes -- I think the answers would not have been quite as cursory if they had done so. 

2 comments:

Tricia said...

SO happy you got an answer.

I am struggling with heel pain,have been since december. I've seen 4 doctors and tried all kinds of pills,creams,orthotics,injections,shoes,rest,etc. It is SO frustrating.

Hope I can get an answer soon too.

Karen Thurston Chavez said...

Your post reminds me of this one from our Broken Hearts' blog. If only more doctors were better listeners. It's all in the patient interview.

http://brokenheartsbigbend.blogspot.com/2010/07/where-have-patient-interview-and.html

Thanks, Paula, for a great post.

KTC