As I am currently laid up with another bout of severe tendon tearing pain, I have decided to write about my journey with PTTD.
For those of you who don't know what the above stands for - here goes - Posterior Tibial Tendon Dysfunction - a term that has become so very familiar to me in recent months, and has definitely become a part of my conversations - even the ones I have with myself!
To get the ball rolling, I reckon a quick overview of what a posterior tibial tendon is, and how its dysfunction causes so much distress in the life of an individual (me basically) who is suffering from it.
The posterior tibial tendon is responsible for creating the arch in our feet. The fact that Ive had flat feet for as long as I can remember means that the tendon has always been a bit uncooperative to say the least.
The image to the left shows the tendon and what it does. Basically acting like a sling. Apparently, my tendon, approximately 2 years ago, started to tear. I am not aware of having done anything suddenly, but the pain started off and increased as the months went on.
I have suffered with different problems with my feet over the years, especially since I do have such flat feet.I have since discovered that this is due to having hypermobility in my ligaments, which has allowed my bones to move around too much, hence overstretching the tendon. I have had plantar fasciitis which was excruciating, and apparently I have a heel spur, which is a common enough complaint of someone who suffers with flat feet.
I have, for years, worn expensive orthotics - except, I will admit, when I haven't. I suppose, in all honesty, the times I haven't are when I have wanted to have free feet - summer time - resorting to flip flops, crocs, sandals, etc. When I was able to walk I was very very careful about wearing my trainers with the insoles, so I did something right.
I reveled in wearing heels if I was going out, but they never lasted very long without some pain! I always insisted on going somewhere that I could sit down.
As the pain started in the summer of 2012, I struggled on. I got difene gel, took anti inflams, paracetamol, etc. I struggled to do my usual walks without ending up in agony. I actually remember the day I went for my last walk - I walked for less than ten minutes down the road and hobbled back in tears.
My partner and I went on holiday for a week - to Puerto Rico, the hilly resort of Gran Canaria. I remember trying to walk up and down those hills - in wedges some evenings. My ankle was constantly so swollen, I got very little relief from the pain - (vodkas helped at night!).
When we got back I begged the doctor to send me for an x-ray as I was convinced I must had fractured a bone or something. This was when the heel spur showed up. The GP administered a cortisone injection into the heel and sent me on my way.
Funnily enough, whatever way the cortisone went it did actually relieve the pain on the inside of the foot for a short time - enough for me to find work as a Care Assistant in a nursing home - my dream job. I was working as relief staff from November 2012, and loved the job - apart from the pain I had in my foot at the end of each shift. I was vigilant about wearing my orthotics, bought different shoes and runners to try and support the ankle, wore an ankle support (still all this time not having a clue what the pain was about).
My last day in the nursing home was at the beginning of February 2013. I had just finished a 12 hour night shift and was in absolute agony. I got home, stepped out of the car and my leg went from under me with the pain that shot through it. I cried and cried, and went to the doctor. She prescribed me with tramadol, paracetamol and valium as my back was really at me too. I only ever took a few of the valium, but started taking the tramadol fastidiously even though I had a fear of "strong" meds.
The tramadol did help with the pain, but I still wasn't pain free. I was hobbling about on a crutch, and feeling very down about the whole thing.
By the summer, I had decided to pay to see a consultant privately. I needed to find out what was going on with my foot. I paid for an MRI, my GP made the appointment with the private consultant and off I went.
The consultant I saw was lovely. Spent the time explaining what was going on. Referred me for painkilling cortisone injections, and to take it from there.
I have to say, the injections did help a bit. Not much but a bit. They cost me a fortune as well, and really for what I got, it probably wasn't worth it.
At this point, I had no more money to go private, so I asked this consultant if he could refer me into the public system, which he very kindly did.
I also got referred for more cortisone injections at the new public hospital (Cappagh Orthopedic Hospital). This time, I was injected all over the foot, and boy it hurt. BUT, it did the job, and after a few weeks, the pain was minimal again.
I eventually got to see the Public Consultant - Mr Moroney in February 2014. I had spent the last year hobbling around, and looking after my feet as best I could. At this stage, I had never heard of PTTD, and to be quite honest, it was only after googling symptoms that I actually found out what it all was - the consultant didn't tell me, but after looking at x-rays, my MRI and consulting with his registrar, he said he would be referring me for surgery - 9 months from that date. I have since discovered the reasoning for this - our wonderful health care system, the HSE, decided to cut back on surgeries in this hospital - from 40 a week to 10 a week, BUT, if a patient is kept on the surgical waiting list for more than 9 months, the hospital get fined from Brussels.... what a wonderful system! At the time of seeing Mr Moroney, I had been having trouble with my left foot hurting, in the ankle area. I spoke to Mr M about this and he said that the left foot was probably going the same way as the right, and referred me for an MRI on that foot as well. So, the surgery I would be having - CALCANEAL OSTEOTOMY (http://www.footeducation.com/calcaneal-osteotomy/)TENDON TRANSFER/ LENGTHENING THE ACHILLES TENDON.
Anyway, after having the second round of injections, my foot wasnt so bad. I couldnt do any long distance walking, and even short distance - more than 20 mins, would cause pain, but at least I was able to get around.
I applied for a job working with people with alzheimers in their homes, and this was part time and suited me down to the ground. I loved it. I then got a call from another elder care agency asking if I was interested in some hours with them, and of course I jumped at the chance.
I had been working away, juggling work and home life, and loving it, but then, disaster - my left foot started to hurt really badly. To the extent I was really hobbling around. It went downhill over the course of 2 weeks, and strapping it up in an ankle brace didnt help. The pain was excruciating and as I had come off Tramadol the previous Autumn because it was making me feel so sick, I was reduced to difene and paracetamol.
On Monday of this week I was back at the hospital for another consult. I didn't see Mr Moroney this time but one of his surgical team, who is the doctor who told me about the waiting list fiasco as I tried to beg him to bring the surgery forward. The one thing was that I learnt that I will definitely be having the surgery in October, and also, he referred me for more cortisone injections, which I know will relieve the pain for now.
So, that is where I'm at today. Ive been on bedrest since Tuesday - Today is Thursday - 3rd day, and already I'm cracking up.
I love my job, I didn't want to have to take time out, but until I have had the injections, I may sit tight. Boredom has set in big time, and aches and pains - in my back, and my legs ache. I took tramadol yesterday to help. And they do. Is it a small price to pay for the Tramadol hangover?? Not sure..... The fact I havent taken any today is perhaps the answer.
So, here I am today, wonky feet, binge watching series on Netflix, and trawling the Internet. People, including myself, often wish for time to be able to sit on their backsides and do nothing. We fight going for a half hour walk to get a bit of exercise.
But I can honestly say, if the surgery I am going to be having is successful, I will walk with glee every day, whether it be raining or sun shining...... we only miss what we have when it is taken away from us.
