Still hobbling along…

by Yule Heibel on October 11, 2011

And now it’s three weeks, give or take a day, that this mystery ailment has limited my mobility: I’m referring to my possibly-stress-fractured right foot, which still hasn’t significantly improved. As I wrote on Sept.28, an x-ray failed to reveal a fracture – and I was actually quite happy about that …probably because I thought I’d be tripping the light fantastic within a week since, surely, there was no fracture. Right? Well, my glee was premature.

Turns out I needed a bone scan after all.

Earlier today, I went to the hospital to get an injection of radioactive phosphorous, and several hours later my foot bones were scanned for about 30 minutes in three 10-minute increments: both feet together, once in pigeon-toe position; then side-by-side from the side; and finally flat on the plate, filmed from top and bottom.
While it will be another week before I can return to the walk-in clinic for the doctor’s assessment, I did get a peek at what the technician was producing for the radiologist who will read my scans. Did not like what I saw.

First, the good-interesting part, the science (as understood by unscientific me): The method for getting the images is ingenious – from what I gathered, the radioactive material (quite a minimal amount) emits …well, radioactivity, which the camera can then pick up, over 10 minute increments (times 3, for a total of 30 minutes). This in turn creates a composite of what’s going on in the foot: where in the foot is the osteo-related cellular activity going gang-busters, for example, and where is it just chugging along in business-as-usual mode. Think of it as a webcam on a live event. In an x-ray, tissues and bones are bombarded by a single “large” dose of radiation all at once, which the camera snaps quickly. But in the scan process I underwent today, it’s sort of the reverse: the camera works slowly, capturing the tiny amount of radioactivity that’s actually in my system, and which is making visible what’s happening with the bones (maybe that’s the phosphorous part?, I don’t know). It captures this over time, and all that data is put together to create an image. Neat! 🙂

But now for the part that’s bad-mysterious: from the scans, even I could tell that there were two major problem areas in the right foot. The heel (which, interestingly, had been giving me problems for months – like plantar fasciatis, yet not), and the tarsal (cuboid) area right across the foot were clearly in trouble. Both areas lit up like xmas trees.

I plan to walk for decades to come. Sure hope we can figure out not just that there’s something broken, but also how to make sure there’s no repeat performance once it has healed.

On the comic relief front: after injecting me with the radioactive phosphorous (which is done in the hospital’s nuclear facility – I kid not, scientists don’t mince words), the technician cautioned me to stay away from pregnant women and told me not to coddle babies (no problem). She also said that if I were to travel through airport security in the next week or so, I might alarm the security personnel. For some reason, this made me want to book a flight right away.

When I went back in the afternoon, a man was lying on a gurney – he didn’t seem conscious. While I sat in the waiting area for my scan, he woke up, calling for a nurse. He needed to urinate, so the nurse provided him with a plastic bottle …which her colleague then took from her, saying (no joke) that she needed to dispose of it since the contents were radioactive.

This of course made me wonder how I’m contributing to toxic waste in the CRD when I go to flush my toilet at home…

I also asked how much I was costing the system with my scan and was pleasantly surprised to learn that my procedure was only at the ~$400 mark. Well done, BC Medical. But if I had my druthers, I’d prefer not to cost you a dime…

{ 3 comments… read them below or add one }

maria October 11, 2011 at 9:31 pm

I sure hope you get a diagnosis with treatment to follow soon. Weird to think about the radioactive issue once you leave the hospital and well, leave other things in the pipes… $400 seems such a bargain. We just paid almost that much for one shot of medicine for someone in our family — and this has to be done twice a month … and we have insurance. Don’t get me going!

Yule October 11, 2011 at 10:04 pm

Ouch, you have to pay that much for the shots, even with insurance? Good lord, how much are they without insurance?
There was an interesting article about the cost differences between identical medical imaging procedures in the US and in Japan. In the US, the costs were in the …oh, 5 figures or something completely extraordinary like that. Meanwhile, in Japan they were in the 4-figures. The reason had to do with how much “fluff” was offered on the side. In Japan, it’s no-frills. The machines are up-to-date and modern, the technicians are on the ball, but everything else is bare-bones and spartan. Very spartan. In the US, in contrast, there was (according to this article, anyway) a lot of patient-coddling. I think the US experience was described as being akin to a spa procedure – largely because the American consumer demands such treatment. Since I haven’t had any kind of procedure in the US in what’s closing in on decades (my CT scan or whatever it was for sinus problems in the early 90s was probably the last thing I underwent), I can’t speak to how accurate this article was – or whether it’s true across the country or not. At any rate, the biggest surprise for me was even wrapping my head around “extras” as being the driving factor in upping medical expenses.
I’m sure you’re not getting extras when you go for a shot, though. I guess the question is, why do the drugs cost so damn much?
As for my foot: aye, it’ll be interesting whether the follow-up in a week is as illuminating as that radioactive tracer in my blood today. I have a feeling I’ll just be told to “take it easy!” I’d like instead to figure out how this started, why, and how I can prevent it from continuing/ coming back! 😉

maria October 12, 2011 at 9:30 am

The insurance won’t cover the injection because the drug is available in pill form. However, the nature of the problem is such that a symptom is non-compliance. So the injection is the right medication for now. There is no convincing the insurance company of that – and overall, it’s a good insurance company too. Of course, it’s the pharmaceutical company that stands to win the most with all this.

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