Sunday, October 16, 2011

Effects of Cortisone Shots, One Year Later

My injured foot today.  The scabs are from when my dog accidently stepped on my foot.  I would not have had broken skin except for the weak skin after cortisone injection.
This is my healthy foot. 
It's been eleven months since I first noticed my foot injury.  As you will remember, I noticed a shooting pain in my foot while running after running a half marathon in 2010.  I had been trying to change my stride and I think it put strain on my foot.  I had been running about 20 miles per week for 6 months and was running regularly for 9.   In October 2010, I stopped running because of the shooting pain, iced it, and even tried using a brace.
pronounced peroneal tendon.  the podiatrist told me this tendon is very weak.
this is the same area on my healthy foot.

  I went to a chiropractor, who recommended I get the foot xrayed for a fracture by my primary care doctor.  The primary care dr told me I had a flat foot and recommended me to a local podiatrist.  
these are my feet,side by side. Inured one on right.

Being more interested in a therapeutic approach, I found a podiatrist in Everett who seemed to lean that way.  He looked at the xrays and diagnosed me with hyperlaxicity of the tendons, meaning my tendons are too stretchy, so my bones aren't in correct alignment.  He told me I had a bunion related to that.  He popped my foot into correct alignment, taped it so it would stay, and told me to rest and do ice.  I did all of that.  The foot popped back to how it was, and the shooting pains continued.  He also told me the bumps I noticed on my ankle could be a ganglion.  He did this one or two more times, and told me to do some exercises to strengthen my feet.  I did the exercises and continued to experience the shooting pains.  He told me to get shoes with removable insoles and he taped a specially cut support inside, so weight would be taken off the foot.  When I overheard the doctor telling a lady how to do the same exact exercises I was told to do every day for the rest of my life, I figured the doctor had a cookie cutter way of practicing, and decided to try someone else.  

Side view of injured foot.  The 3 scabs are from the dog stepping on it a few weeks ago.  It is taking FOREVER to heal.  
I went to the original podiatrist my primary care doctor referred me to.  He did Xrays.  He also had the records from the other doctors.  He said nothing was wrong with my feet, but that there was probably inflammation and maybe bursitis at my ankle.  He said that without an MRI (I couldn't get one without insurance at the high price tag)  The only option, he said, was cortisone to reduce inflammation.  Maybe my foot could then heal itself.  By this time, my foot had been in pain for two months.  I didn't get to hike Diamond Head while on vacation in Hawaii.  I had heard from my mother in law that my father in law had a cortisone shot in his foot, and was fine.  So I thought maybe cortisone shots aren't so bad.  I was also desperate.  I didn't care about running as much anymore.  I just wanted to walk without pain.

After the first cortisone shot, the pain subsided for a little bit, but within a month, I was back for a second one.  The shooting pain seemed to go away, but I noticed the skin seemed very thin, sunken, and old-person like.   It also peeled and cracked painfully, so that if I didn't moisturize, it hurt very badly.  My menstrual cycle went haywire, giving me 2 periods a month, and I began to have night sweats.  I was not told that any of this could happen, and I thought I might be going crazy, have cancer, or something else.  When I began to read about the side effects of cortisone shots, I knew why it was all happening.  

I got angry and tried yoga for stretching, strengthening and exercise.  I tried biking.  None of it alleviated the stiffness I now experienced in my ankles, knees and hips.  I got wide running shoes at a store recommended by the podiatrist, but they hurt my feet.  Finally, I decided to wear only flat sandals, and my feet felt stronger.  

In August, while getting our goat to fair, she stepped squarely on my sunken cortisone damaged foot.  It became radically inflamed even though I had washed it and put antibiotic cream on it.  I am sure it got infected.  I did hope that all that attention of my immune system to the area might heal it, but alas, no luck.  I couldn't believe how badly infected the foot became, and how long the two little cuts took to heal...one entire month.  

Eleven months after the first cortisone shot, my ankle is still sunken and there is a sunken area that seems to be traveling up my leg.  My achille's tendon is sore where it attaches to the bone.  My plantar fascia and bunion are sore.   I started to wonder if I had muscular dystrophy.   I started to drink an herbal tea called Yerba Mansa, which reduces inflammation, but it's not making a difference.  I went to a naturopath, who told me the muscle may be atrophied.  She referred me to xrays, which again revealed healthy bones, and then to a podiatrist who also works in orthopedic surgery.  

This podiatrist sat with me for an hour and puzzled over my foot.  She thought it could be RSD...reflexive sympathetic disorder, which happens as a result of a trauma.  I only had one sign of it though, and that was the muscle atrophy.  Then she heard about the cortisone shot, and how the doctor had told me he had done it around the nerve on purpose, in order to reduce inflammation.



I am pushing in on the area that is sunken.  It leaves a mini canyon all the way down to my foot.

I side lit the foot so that the sunken area could be seen.

My healthy foot.

She said that my issues are classic symptoms of cortisone damage, especially when the injection is given around the nerve.  The site of injection can have difficulty fighting infection, will thin, there will be decreased blood flow and decreased fat and collagen.  I have since learned that cortisone can lead to tendon rupture, and collagen is what our tendons are made of.  She also said there was whitening of a vein that travels up my leg, indicative of cortisone damage, which would explain my hormones and whole body reaction to the cortisone. She told me that we needed to deal with my problem quickly, and referred me to physical therapy.  The urgency is in order to retain as much foot/leg function as possible before further damage is caused by the myriad problems I now have.  Since that appointment, I stepped on an uneven bit of ground and noticed that same old shooting pain this all began with.  Needless to say, the cortisone did not work.  It masked the problem, then gave me about a billon more.  I may be more sensitive to cortisone than other people, but I cannot in good conscience recommend that ANY living being have this fake hormone injected into their bodies.  It is not worth it.




3 comments:

  1. That is simply awful. =( I hope it doesn't get even worse and that the physical therapy brings back some of your former strength.

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  2. Have you had any luck since you posted this? I am going through a similar thing right now and am looking for any hope I can find!

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  3. I think the muscles around the atrophied muscle are building up a tiny bit so that it;s not as visible, but I still have to do major stretching in my achilles to be able to even jog a mile. My plantar fascia get tight still too, and the skin over the area is far more sensitive and gets dry and cracked when exposed to sun and dry weather. It looks old. The hope for you is that I don't hurt every morning like I used to. I do hope still that I can improve it so I may run farther than a mile at a time.

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