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Of Doctors, Feet, and Protocol

Jan Chait

October 12, 2010

Maybe I have an(other) infection in my calcaneus (heel bone). If so, it will be number three. I’ll know more after I have a nuclear bone scan on Thursday. (I’ve gotten quite good in the past few months at deciphering bone scans.)

Hopefully, the latest news isn’t bad, but I’ll admit to hearing my car’s tires repeating “I could lose my foot. I could lose my foot,” all the way home from the doctor’s yesterday.

I’ve already had a good portion of my calcaneus removed in two surgeries. How much more if needed? I don’t know. Will the infection, if indeed there is one (and lab tests point to one) be cleared up with one more surgery? Will I have to have all of what’s left of my calcaneus removed? What do you do without a heel bone? When it comes to walking, that is.

On the other hand, I’m not exactly walking now unless I’m leaning pretty heavily on a walker.

Is the infection a run-of-the-mill one, albeit stubborn as heck? Or is it connected to that case of MRSA I had back whenever it was? Invasive MRSA can lead to bone infection.

Usually, I’m pretty much a Pollyanna kind of person. Oh, I sometimes think about the worst case, albeit fleetingly, but assume that it won’t happen. It probably began as a defense mechanism against my grandmother, who I spent a lot of time with. She always expected the worst. “What if you do such and such and so and so happens?” she would say.

“What if it doesn’t?” I would answer back. And it usually didn’t. (My husband takes after my grandmother a bit. I suppose at least one of us has to worry.)

Or maybe after telling everybody I probably have a bone infection, I’ll have to embarrass myself by confessing next week that I don’t. Or didn’t. Which would be a good thing. For that, I could take some embarrassment. Even a lot of embarrassment.

The other thing that happened in the past week is that I went to see my regular podiatrist, Dr. A. He’s the one who referred me to Dr. B, whom I’ve been seeing for the past year and a half (plus one week and three days, but who’s counting?).

Dr. A said he hadn’t heard anything from Dr. B, so he’d assumed all was well.

I wish. Over the past year and a half, I told him, I’ve had six surgeries. I’ve had MRSA. I’ve had C. diff. I’ve rarely slept in my own bed because the bathroom is too far away to walk there comfortably. Instead, I usually sleep in a recliner that’s only five feet away from a half bath. I’ve taken maybe two “naked” showers: That is, a shower without a plastic cover over dressings on my foot and leg. I haven’t ridden my bike. I haven’t been in a swimming pool — not to play; not to exercise. I’ve been on antibiotics almost constantly. Therefore, I’ve had diarrhea pretty much constantly. I’ve had four PICC lines. My blood glucose has been on a roller coaster depending on whether I’m on antibiotics or not. I’ve cut back considerably on work because I haven’t felt that well.

So Dr. A said he’d call Dr. B. After a meeting he had in 10 minutes. “It’s going to take longer than ten minutes,” he said. (Dr. A did not sound happy.) Yesterday, when I saw Dr. B, there was no mention of Dr. A. There was also no eye contact. He did order a bone scan right away, which is good. I’m trying to decide if I want him cutting on me again.

I’d been wanting to see my regular doc for a long time, but was hesitant. Frankly, I believed protocol was being followed. And I didn’t want Dr. B to feel bad.

Protocol dictates that, every time a referred doc sees you, he sends a note to the referring doc, a physician friend tells me. “I performed surgery on patient on date, during which I blah, blah, blah. I will see patient in my office in one week to etc.” “Patient presented with a slight infection, for which I etc.” “Infection has gotten worse; patient has been referred to Dr. C, who is an infectious disease specialist.”

Etc.

Wasn’t done. At least not after the first little bit.

As far as protocol on my part, I believe I’m to wait until I’m released by Dr. B before I go back to Dr. A. If I’m wrong, I’m sure somebody will let me know.

Finally deciding that the doctors work for me and that I’m the one who cares about my well-being more than anybody else, I called Dr. A and asked if I could please come and see him. “Of course,” he said.

So here I am. I’m not sure if I want to continue seeing Dr. B, or if I want to ask Dr. A if he’ll take over my care. Dr. B is a good doctor. I just don’t feel that he is listening to me. Dr. A is also a good doctor and has several more years of experience than Dr. B. He’s also taken care of my feet since the 1990’s, knows me and knows my quirks — including the fact that I don’t often freak out, unless I’m in fear of losing a foot or something.

One thing I’m sure of, however: With the foot thing and with the recent discovery of some background retinopathy in my eye, I’m going to stop joking about ending up as a blind, bilateral amputee being carted off to dialysis three times a week. It’s getting too close for comfort.



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