I was put in an aircast for 6 weeks. At my second follow up appointment he told me the bone had healed and cleared me to run and wear heels again.
Dr Blake's comment: Rarely, maybe this fast, but typically 3 months in removable boot, and 1 to 1 and 1/2 weeks to wean out of the boot into protective orthotics and shoes.
He gave me no instructions regarding how to safely get back into running. I tried to ease into it slowly by run/walking short distances with a stiff soled shoe insert he gave me and an ace bandage with a gel cushion under the ball of my foot.
Dr Blake's comment: I like dancer's pads much better, minimal under the sore bone, and more under the 2nd to 5th metatarsals.
That was late October. I ran a little here and there throughout November and early December 2013. The dull discomfort was less noticeable than before the boot, but it came back after I'd run a mile or so. I stopped running and decided to see a different podiatrist.
My questions for you are:
- What is your assessment? Dr Blake's comment: Listen to your body for we need to protect these bones. I am happy to look at your MRI by mailing to Dr Rich Blake 900 Hyde Street, San Francisco, CA, 94109.
- Can a sesamoid bone with supposed AVN be healed? If so, how? Dr Blake's comment: An AVN is still fixable if the bone does not collapse. Bone collapse can be helped with bone stimulator, pain free protected weight bearing, calcium and Vit D3, contrast bathing and icing daily.
- Will a bone stimulator help at this point? I had not used one before seeing any of these doctors, but a co-worker offered to lend me her Exogen device. I started using it 20 min-daily a few days ago. Dr Blake's comment: Definitely 2 sessions of 20 minute with the Exogen for the next 9 months.
- Even though the doctors say I can go back to running, I have chosen not to in hopes that my bone just needs more time/care. Is there any benefit to be gained from staying off my foot, or am I wasting my time with a dead bone that will not heal? Dr Blake's comment: I will try not to discuss Lazarus from the Bible, but no one can be certain that this bone is dead. Treat it as if it were dying due to lack of blood flow and go from there. As long as the MRI shows that the bone is not fragmenting and degenerative, you have a good chance a saving it. I downloaded the xray image below and it showed a fracture, but the MRI will be a better way to interpret. The radiology report of the MRI talked about AVN (dead bone) and fragmentation, so let me see how severe.
Thanks again for your time. It is much appreciated.
All the best,