in which we test the Australian medical system

My feet hurt. Not when I abuse them during exercise, oddly, but a bit when I’m going down stairs, and a lot if I apply pressure to the top of either foot.

I assumed for a long time that it was just a sore muscle or strained connective tissue. I took four weeks off while I traveled, and the pain subsided, but it returned with exercise. Four months later, I thought perhaps it was time to see a doctor.

He was a bit puzzled at first; I knew I hadn’t dropped anything on both my feet, and he ruled out stress fractures, but light pressure on most metatarsals produced sharp pain. I was skeptical, but went for an MRI of one foot: AU$345 from a private clinic, about a quarter what it would have cost me in Boston.

The MRI turned out to be the perfect diagnostic tool for this case. The white areas indicate fluid within and around the bones that hurt when pressure is applied, which is apparently a typical response to major stress. An x-ray wouldn’t have told us anything.


left: healthy bone / right: big problems

I asked if things would stablise here; if I don’t mind the pain, can I just carry on as usual? The answer was unambiguously no: if I don’t let them heal, I am reliably informed, stress fractures are imminent.

As a result, I am prohibited from stressing either foot for twelve Earth weeks. He gave me orthotics that are supposed to reduce stress when I walk, but so far it feels like they’re doing more harm than good. Given how slowly they make me limp around, I think I’ll move faster if I scare up a set of crutches.

Interestingly, according to this article, it seems to be a common affliction among basketball players, and is only being diagnosed prior to stress fractures now that MRIs are widely available. I also find it mildly alarming at how much more complete the oedema appears to be in my films, compared to those shown in the article.

I no longer, it seems, have the body of an eighteen-year-old.

1 Comment »

  1. George said,

    August 10, 2009 @ 05:21

    Phil! Sorry to hear about, and see, the pain. How hard was it for you to get these images from them? I always wish I’d gotten copies of my CAT scans I had for my sinuses.

    Incidentally I have the body of an eighteen year-old stashed in the freezer, if you really need it. I can ship it to you for about one-third of what it would cost you in Boston.

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