Sunday, August 15, 2010

Life under the knife

More cutting is on the way--I have yet another surgery scheduled for Wednesday morning, September 1. I don't what the deal is with me having surgeries scheduled for the first day of the month. I have a complete hip replacement on October 1, 2009, and a hernia repair surgery on April 1. I guess God just wants me to get it out of the way up front. This will the third one in less than 12 months. So, what is it THIS time? I have posterior tibial tendon dysfunction,otherwise known as PTTD. What is that? The website "Your Orthopaedic Connection"explains it much better than I can:
Tendons connect muscles to bones and stretch across joints, enabling you to bend that joint. One of the most important tendons in the lower leg is the posterior tibial tendon. This tendon starts in the calf, stretches down behind the inside of he ankle and attaches to bones in the middle of the foot.

The posterior tibial tendon helps hold your arch up and provides support as you step off on your toes when walking. If this tendon becomes inflamed, over-stretched or torn, you may experience pain on the inner ankle and gradually lose the inner arch on the bottom of your foot, leading to flatfoot.

For those of you who are toting around 100-500 plus pounds on your body and consider yourself "healthy" because you don't have high blood pressure, heart disease or diabetes, think about how much extra pressure you are placing on your bones, joints and connective tissues like the tendons and ligaments. Check out this excerpt from The Importance of Foot Orthotics:
The human foot is a marvelously complicated yet efficient machine, comprised of over 100 working parts, including as many as 28 bones working in conjunction with ligaments, tendons and muscles. All of this supports and balances our entire body, and in the course of normal walking bears up to 1.5 times our body weight on each foot. This pressure is enormous, and with the average foot traveling 1,000 miles a year, it is no surprise there are many injuries.

The feet act as shock absorbers for the entire body, and in the course of a one-hour strenuous workout will cushion nearly one million pounds of pressure. As a result, many people feel the pain of this stress, usually caused by foot imbalance. This pain shouldn’t be ignored as it is not a normal result of foot function.


The passage above is talking about people who are at a normal body weight. Extra pounds places extra pressure on those 28 bones and 100 working parts in the feet. At 400 pounds, I was asking my feet to carry a lot more than what it was designed to do. In addition to that, I was born with very little arch in my feet. I remember feeling the arch in my right foot collapsing when I around 10-11 years old and playing baseball in the backyard. It doesn't feel good. But I ignored it, which is what the article says a person shouldn't do.

Over the years, I gained more and more weight, which added even more pressure to my weakened arches. Finally, when I was about 26 years old, I felt a tendon snap in my right foot. I didn't know that was what happened. But I've learned more about what's been going on with my feet over the past six months, and now I can recognize when the tendon is tearing. And it's been doing that a lot these days.

Now, I'm a visual/audio learner, so seeing pictures helps me to conceptualize new material. I don't know if this helps you, but I appreciate the graphics available on the Internet that have helped me see what my podiatrist has been talking about. The first picture is a normal foot and arch. Here's the medical description of it from www.arthroscopy.com :
The navicular bone is a key structural component in the formation of the arch of the foot. When this bone is in the proper position, the arch is maintained. However, if this bone moves out of position, towards the bottom of the foot (plantar surface), then the arch begins to sag and disappear. As this occurs, the patient develops a flatfoot deformity.
















And now, a picture of the foot that has begun to develop a flatfoot deformity. (Mine looks worse than this on the MRI.):
The posterior tibial tendon is essential to the normal functioning of the foot by maintaining the navicular bone in the proper position. By doing so, the arch of the foot is maintained. However, if the posterior tibial tendon fails to function properly, the navicular bone begins to drop, the arch falls and a flatfoot deformity begins to develop. When this occurs, the foot may develop pain with weight bearing.















This is kind of what my feet look like right now (picture courtesy offootankleinstitute.com):




And this is how bad it can get without surgery (from the The Institute for Foot and Ankle Surgery at Mercy):

With increasing deformity of the foot, the joints in the foot get very stiff, and little in and outward movement of the foot is possible.

Obviously, I want to have the surgery before my feet become badly deformed and essentially useless. I asked my podiatrist if I would be able to walk if the tendon completely ruptured. He said that I could, but I wouldn't want to. I understood what he meant immediately. The pain would be excruciating. No, thank you.

This is yet another example of the wreckage of my addictive eating past--it has wrecked havoc on my body in ways I never could imagine. Even though I've lost an awful lot of weight, I'm still paying for the damage done. As bad as that seems right now, it could be so much worse. I could be still into the food, gaining even more weight, and becoming one of those people that you see on programs like "Two Ton Mom".

If you are suffering from morbid obesity, you HAVE to lose weight in order to get the treatment you need for the various health problems that incur as the result of out of control eating. I strongly recommend this program: Food Addicts in Recovery Anonymous
The life you save will be your own.

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