Thursday, March 15, 2018

Pushing My Luck

It took a long time for the drugs to kick in.

With the first round of steroid injections for my feet, the reaction was quick. I received the shots in an operating room, with a surgeon, an assistant, and two technicians in a sheltered room. A live x-ray showed everyone the best place to inject the pain killer.

The level of osteoarthritis in both feet is quite severe, so precision is paramount.

Two days after those first injections, I arose from bed and, for the first time in decades, I felt absolutely no pain. Nothing. Not even those initial effects of stiffness. It was as though I was in my late teens again, able to do anything.

I was so happy that I nearly cried.

But the relief was short-lived. While I was told, before entering the operating room, that the steroid shots could last as little as six weeks or as long as six months, or could not work at all. By the seventh week, I could feel a bit of stiffness return and, by the eighth week, the drugs had completely worn off.

It was depressing to return to a state of constant pain. And because the pain was at 100 percent at the eighth week, I discovered just how much pain I had been enduring over the decades. It was significant.

I had to wait a minimum of three months between injections because that was the margin of safety for such a drug. As it turned out, I had to wait 12 weeks—after the drugs wore off—to receive my next appointment.

The pain was bad: I managed it with heating pads, creams, acetaminophen, ibuprofen, codeine, and alcohol. And any combination thereof. When my appointment was postponed by a week, because of a fire at the hospital, I almost cried, almost wanted to jump into a fire.

Lying on the operating table, I told the surgeon that the first round of injections had only lasted for eight weeks. She told me that she could double the dosage, which would be the maximum dosage that could be safely injected. But even though she could increase the amount of steroid, there was no guarantee that it would be any more effective.

We rolled the dice and crammed as much of the drug as would fit in the narrow crevasses of my feet.

Two days later, I arose from bed, hopeful that these new injections would take the pain away, much like the first round. But it wasn't to be. My feet were as stiff and sore as any other morning, and by lunchtime, my feet were in more pain than before I walked into the operating room. I spent the rest of the day, sitting in a chair with my feet elevated, watching programs on Netflix.

The pain persisted for two weeks. In that time, I went through a dark time, not being active, thinking dark thoughts, looking for that bridge that could end all of my troubles.

But then, gradually, the pain subsided. When I found a comfortable pair of shoes, the pain all but vanished. It wasn't a complete suppression of aches, but on a scale of 1 to 10, in terms of severity, I went from 11 to 2 or 3. On a good day, the pain measured a measly 1.

I gained confidence, walking more, taking up a spin class, and, last weekend, braving the slopes at Mont Tremblant, spending a day of skiing.

That's when I pushed my luck.

When you ski, your feet are clamped into tight boots that have absolutely no give, and that's a good thing if you want to maintain control while your body hurls down a steep slope. When I put on my ski boots, I feel a bit of pain when I wiggle my feet into place. But once I'm clamped in, I don't feel much.

Before, I could ski until my arthritis reached its limit. With the injections, I hoped that the drugs would keep that pain at bay. And, in truth, they did.

But what I forgot, while on the slopes, was that I also suffer from a degenerative foot disease, called Kohler's. And although I had reconstructive surgery in my 20s to correct my right foot, my left foot remains untreated. I still have a pressure point in my left foot, where the Kohler's disease can cause me the most discomfort: it's on the upper side of my instep, right where my foot meets a pressure point in the ski boot.

When I cut a right turn on my skis, I lean in on my edges and my foot presses hard against the boot. While ski conditions at Mont Tremblant were near perfect, there were a few spots where there was bare ice and deep snow. On the ice, I had to cut especially hard, but I also turned hard in deep snow. All of these turns pushed my foot, at it's most tender spot, against an unyielding boot.

For the first couple of runs, I felt nothing. I was in high spirits, thinking that I was going to have a good day of skiing. But by my third run, I could start to feel a bit of pain where the Kohler's resided. Nevertheless, I continued to ski.

By the time I had a half-dozen runs, the pain was significant. Also, my quad muscles were starting to tire, as I haven't been exercising as much as I had. Not having been on a bike in a long time had its price. And, skiing down one run at Mont Tremblant was the equivalent of skiing anywhere from three to six runs at the ski hills in the Ottawa-Gatineau area.

By noon, I felt that my legs could hold up for another run, and the pain in my left foot was substantial. Even sitting still, I could feel the throbbing in that spot. We decided to stop for lunch, and give me a rest.

The pain in my foot eased, a bit, but I knew that as soon as I was back on my skis, the pain would return to full strength. "I'm done," I told DW and DD14. The trouble was, we were having lunch at the peak of the mountain, and we had a long ski ahead of us to get to the bottom of the village.

I seriously considered riding in the gondola to get down the slopes, but that's not how I really wanted to end my day. I decided to do just one more run.

We got about two-thirds down the hill, when we came to a small cable car that had reached its terminus: it had started at the top of the Tremblant village. I stopped and told DW that I would ride this car down, and maybe ski the short distance to the base of the village.

By the time we got down, I decided that I was spent, and we walked to the Cabriolet, and were carried to the base.

I spent as much time, for the rest of the weekend, off my feet. Even today, I can feel where my foot pressed against my boot. If I press lightly on the tender spot, I still experience pain. But it's slowly subsiding and my arthritis doesn't seem to be affected.

I pushed my luck, but I think it was worth it. I don't want my feet to hamper my quality of life. I still want to be able to be active. And, when I finally have my surgery, in conjunction with working steroid shots, I thing that I can return to a somewhat normal life.

Still, I have more day passes for Mont Tremblant. I may suck it up and do it again.

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