Sometimes You Have to Take the Bull by the Horns ;-)

© www.freewebs.com - © DNC

OK. So I got myself to a PC and popped in the CD given to me by the hospital where I got my mammogram done. It was very easy to go in, get the image to display via the Dicom Viewer, and use the tools to make measurements. So at least I have proof of what I suspected and am asking for from Dr. East.

Wait to you hear the latest. ;-)

After figuring to leave things as they were, (accepting that Dr. East truly knows nothing about DICOM)... it really bothered me to then hear that the program he has, TigerView, can actually output what I'm asking for.

So I went onto the TigerView website and submitted an inquiry in their contact page. Asking for the steps on how to produce DICOM images from their software. Someone emailed me back right away, asking me for personal info to better help me. The info they wanted was based on them thinking I was a customer who had the program. I replied with a simple reason why I was asking and my phone number.

A day later I was called by a Rep from TigerView who asked me what I needed exactly. He understood and asked for Dr. East's name and location. He then seemed to be able to pull up Dr. East's account. He told me that he would "activate the module" needed free-of-charge so that this request could be facilitated for me. YAY!!! (This leads me to believe that Dr. East, in order to be able to provide any further request of this kind for his patients, would have to pay for the use of this particular module.... what an education I'm getting ;o)

The Rep said he would be contacting Dr. East to walk him through it.

I thanked him greatly and told him that I in no way wanted to upset Dr. East, but really needed this. The Rep called Dr. East and left a message on Friday. No response. I then gave him Dr. East's email address because Dr. East seems to answer very quickly via his Blackberry. An email was sent out on Monday to Dr. East stating the reason for the contact and I was CCd. It's now Tuesday. Let's see if Dr. East truly meant it when he said he really wanted to get me what I needed.

Tootles! ;-)

Anita's Success!!! Yay!!

This is Anita, the young girl from Spain I posted about last month. She's such a sweetheart! These are her new xrays. You can see where her new bone growth is be external fixation. Her 4th metatarsal surgery was a success on her left foot. Yay Anita!

(Note: you can also see her first metatarsals
do not have the deformation mine do. Bunions.)

My Education on DICOM (xray format you should know!)

© DNC -
www.brachymetatarsia.blogspot.com

Yesterday was a back-and-forth-day with both Dr. West and Dr. East. (This is actually the short version... Many emails. ;o)

I sent a third request to Dr. East via email asking for my xrays in the DICOM format. (Having to pay for such an expensive visit with him and then having to pay for another set with another doctor just didn't make sense.) Part of my email: "...It is normal and legal practice for xrays to be provided on CD as DICOM images along with the "reading" software. Not TigerView, but with the PC AutoPlay DICOM Viewer....."

He called me back within 20min. He was not rude, but seemed confused. He expressed not knowing what I was asking for. He barely let me get a word in, going on about his confusion. I had to actually ask him to give me a moment.

The result of his call?
He's only able to provide: TIF, JPG, either of those placed in a MS Word doc, or a paper printout. I thanked him, but expressed 1. I could do all that myself, and 2. It was not what I needed.

He asked, "what are you trying to do?!" I repeated what I had said before: "I want any hospital/physician to be able to make measurements."

He said he had never heard of DICOM..... blah blah. Also stating, "Most podiatrist don't even do DIGITAL xrays as we do." I left it at that and thanked him (for nothing).

I contacted Dr. West via email with the following:

• While I have an upcoming appointment with him in two weeks, I was still trying to get the xrays from Dr. East.
• I informed him of the unfruitful results with Dr. East.
• Researching I discovered 2 things
    1. I can save out a TIF into DICOM format (.dcm) with
        Adobe Photoshop
    2. There are free DICOM Viewers he can download
        online to then view them.

       (FYI: a Dicom VIEWER is sort of like Adobe Acrobat
       READER. The acrobat program cost something but
       the READER does not.)

• I sent him two .dcm files
• I sent him a link to a free PC downloadable DICOM Viewer (I had tried this myself on my Mac and was able to view the DICOM files in the Mac version of a Free DICOM Viewer.)

He got back to me very quickly (meaning he probably did not download the viewer and try it at that time.) He informed me however that:

"You can convert the TIFFs to Dicom via Photoshop, but the original file must have the proper registry. Therefore your file will not work accurately and can't be used for surgical planning. By the way, TigerView does produce DICOM images." cosmeticfootsurgery.com 

I had already been thinking about my call with Dr. East and decided to give him the benefit of the doubt, that he really was unfamiliar with the whole DICOM thing. Even though based on Wikipedia, it seems like a standard thing 'now-a-days'.

I thought that I should send Dr. East all the info I had gathered on this so he could be informed and ready for other clients who may request the same. I mean, if it's something his fellow physicians know about, perhaps he should too. (Seems strange to me. His website really gives you the impression that they have "state-of-the-art" equipment, yet he doesn't know about the DICOM format or its practice.)

leepodiatry.com

But now Dr. West was telling my that TigerView (The program Dr. East uses) is able to save out files in DICOM format!! Uhg.

© DNC -
www.brachymetatarsia.blogspot.com

I was still waiting for Dr. East to reply to a request for my left-foot xray without his red markings on it, when I sent him another email informing him that TigerView can be saved out the files as .dcm format!

I asked that he do this and I sent along with it:

1. a TigerView toturial/ statement pdf I found online about how to do this. (pg7?)

(I wasn't going to just take Dr. Wests' word for it. I looked it up.)

2. A link to a webpage mentioning DICOM and TigerView in the same breath

I received an email from his office stating:

"At the moment we are unable to process your request. As our prior conversation, here is your left-foot image as a jpg. Thank you."

I'm not naive, I'm inclined to believe this email was sent by one of the receptionist from Dr. East's office. They know how to save to jpg and email I'm sure. He had called me before from his cell, so I'm sure he was off-site at the time.

I can only hope that he'll look into my request further and be pleasantly surprised that he could do it all along.??  It would be great if this would happen in two weeks before I leave. If he never replies back then he knew all along or is not inclined to be in-the-know?

In any case I've done all I can at this point. What will be— will be. ;-)


One last thing, I did notice that Dr. West's office as a whole stays out of things. They kept quiet and never told me about the difficulty I'd have finding a local doctor to take xrays (yet they knew I would); while I explained all the difficulties in getting the xrays in a format they wanted, they really never went out of their way to help me get them from Dr. East. I will say, my emails were never completely ignored, in time they did answer them all at this point.


But I guess I was hoping that maybe they'd write something out to help me ask for them properly (I did request this)— in the right medical verbiage or something. Or maybe go the extra mile and call Dr. East to get what they needed. But they never did that. They stay out of it. You have to fend for yourself.

Here are some things for you.

You and your image records

TigerView and DICOM

I'm pooped! ;-)

Shoes In My Future ;-)

I've decided that I will have a shoe-buying-problem in about a year. LOL. ;oD I will be making up for years and years of never being able to purchase what I felt was lovely and feminine.

My next place will have a walk-in-closet to accommodate them aaaallllll. ;-)

© www.stylehive.com

Because of my bunions, thin

high heels have been a thing of the past.

After I heal completely I will be sticking to
1" heels, maybe 2" with a very thick heel.

I can't wait to be able to wear sandals!

I remember as a young girl in Puerto Rico, I wanted so badly to be able to wear the flip-flops that were in style then. I am so going to get them! ;-)

The straps were leather and they said Puerto Rico on them. Silly, but it's a childhood thing.

I'm so excited, this time next year I'll be enjoying open toe shoes as well as long walks on the beach... barefoot. Yay!

© liquidacionesptr

Education on Xrays

© www.localwin.com

So I've been waiting for Dr. West to send me some information which would lead me to take another set of xrays. (In the meantime, I received an invoice from my insurance company. They will pay half of the bill for the 1st set of xrays from Dr. East's office. I will have to pay over $300 out of pocket! That means the visit and first meeting at Dr. East was about $700!) I would probably not mind this so much if Dr. East were to give me the proper files I could send to Dr. West. But he has refused stating he can't provide what I need.

This is against the law by the way. A patient, by law, has the rights to their records. You may have to fill out a request form, pay a small handling fee, but they are yours by law. Dr. East has basically given me my xrays but in a format no other doctor can use to measure to make diagnoses, etc.

My research taught me about the files being needed in a specific format. (After all I've been through I am very disappointed with Dr. West and his assistant, that through several emails of stating my difficulties, not once did they give me the proper format name for the files they needed. I had to research and learn myself.)

Fortunately, (I think ;-) I just had a mammogram and decided I would ask for copies of my xrays to see what they would provide. (A sort of test to see how hard this would be.) I had to fill out a request form. On it they asked what they would be used for. I wrote that I wanted to be able to take them to any other physician as well as for my own records. I waited about a week and a half, but they did provide a CD.

© DNC -
www.brachymetatarsia.blogspot.com

The files are in the format that my research indicated they should be. Something having to do with DICOM. (I'm on a Mac. DICOM is mostly used on PCs. I will test the CD tomorrow on a PC and let you know how it turns out.)

Anyway, as fate would have it, I have to make a short unrelated, impromptu trip out West! So of course I called Dr. West and set up an appointment to have him take another set of xrays. Terrible that I have to pay another bill on this. I'm inclined to try and contact Dr. East one more time and mentioning the actual format names I've learned and maybe say that I've spoken legally to some organization to see if he would then release the xrays in the format any other Doctor can use?

I feel if I do, he would claim he never got the email, or make me wait a terribly long time for them. But I'll stay positive and be thankful that in two week I'll be face to face with Dr. West and hopefully make up for lost time with Dr. East.

Oh and remember, this all hinges on my job. Being granted the many weeks to work off-site.... across the country? My company is going through some changes and I really don't want to be out of sight. But if all works well outside of that, I think I'll take the risk of being out of eye site. I work a bit from home already anyway for their pilot testing.

To say the least, I'm very excited. ;-)

NOTE: Aiming to provide all the details of the process may put out a gray tone, but please don't think that. (Giving all the detail I can will allow you to anticipate some possible things and hopefully avoid them if you can in your own corrective journey.) Anything worth doing will come with red-tape and with things that don't go your way. ;-)

But I'm happy about this as a whole! 

Dr. West, Dr. East, and my Xrays

© www.stoneybrookvets.com

It took over a week to find out that Dr. West's office received my package. Anyway the issue now is that he can not accept the hi-rez TIFF files from Dr. East for my xrays. They stated that he needs the digital files along with the program (software) that will allow him to measure bones, etc. (A phone consultation can not be done until he has the proper xrays. OY.)

I had suspected this was going to be an issue because I had read this specification in Dr. West's package he emailed to me several weeks ago. ;-(

I called Dr. East's office and they stated they could not supply software that they had paid for. (TigerView) So I related this to Dr. West's office. Then they explained that they never expected the TigerView software. I asked how this has been handled in the past with non-local clients. "Surely I can not be the first to be going through this difficulty." His assistant, (we'll call her Brenda), told me that it isn't the easiest thing, but that she has received CDs with the xray files without the software, yet when opened they are still able to make measurements. I asked her to tell me what format those files have been in, she was unable to say for sure. Uhg.

So I'm a bit stuck. Dr. West needs to be able to make measurements to determine if I am a candidate for the one-stage Brachy surgery. He offered me another option to get xrays he can measure. (To protect parties, I will keep this solution to myself.) While it's wonderful to have another option to manage Dr. East's uncooperative manner, it means more time I have to wait to get a second set of xrays done. Not.

I had hoped to have had my consultation with Dr. West by now. Oh well.

As you may recall Dr. East's first reaction to seeing my foot was that I may be a candidate for the one-step method. Then after measuring the xrays he said I was not. His measurement was 1.2 centimeters. He stated I had just missed the candidacy. (He also seemed to mention that if I still wanted the one-stage it would mean the short metatarsal would not be the same length as it appears on my unaffected right foot.

Dr. West's informational package states that he can perform the one-stage method up to 20mm (2 centimeters!) So there seems to be a conflict to me in what each of them considers to be the cut-off mark for candidacy.** But this is my pure speculation at this point. I will not know for sure until Dr. West is able to have xrays he can actually measure. (Dr. West can not make medical determinations based on another doctor's measurements/practice— and I don't want him to either.)

**I wanted to point out that Dr. East uses a cadaver bone while Dr. West says he harvests the bone needed from the patients own heel. I'm not sure if this is the reason for the difference in measurement-candidacy between both practitioners.??

Bye for now! ;o)

Dr. East Refuses To Provide Referrals

© www.alcohol-addiction-info.com

Over 2 weeks ago I sent Dr. East one final inquiry email. (asking for referrals) A week went by, so I called his office to let them know I had not heard from him. (He has always answered my emails almost immediately and mostly by phone.)

He called me right back saying he never got the email. So I resent it. Today I heard back from him... via Email.

"unfortunately your requests are not possible, due to privacy reasons and that your case is not common. I would be happy to answer any questions and proceed when you are ready."

I had already addressed the privacy issue in my request so I don't really accept that answer. (I told him, "I have no problem with privacy of your patients, if necessary my contact information can be given to them so they can call me. Thank you. I really appreciate it.")

And not for nothing, but I'd be happy to be a referral for any of my doctors if I were happy with them. (Especially when relieved from a deformity.) His patients shouldn't feel any different. And his address to my case being 'uncommon' would help anyone assume that is his way of stating that he has never done Brachymetatarsia and Bunion surgery on the same foot. (In his office he verbally told me he had.)

With this I also noticed that he nearly always called me back when I emailed him. That of course impresses patients. It's a good thing, but it also means none of his answers can be proven because he never wrote them in an email in black and white either. (Yet, he did not call me today to tell me he would not provide referrals... he emailed instead. Interesting.)

For the record, I like Dr. East. He's spunky and positive. But this is feet we are talking about here. While one can appreciate a nonchalant, easygoing demeanor, it can also lend itself to diverting some important things. Expectations and limitations can be misunderstood and then there are disappointments and anger later. The old, "But you never asked that?" or "But I didn't think you meant such and such."

I do know that I am over cautious at times. I'm learning to let some things go and take some risk here and there. But feet are really important, it's your mobility. I am a mobile person and have no one to take care of me, so I have to dot my I's and cross my T's when I can in this process without being overbearing.

The recovery of these surgeries are challenging enough without a botch-job by an inexperienced doctor who wants to practice on you, or increase his numbers on a rare surgery. I don't want to have CORRECTIVE surgery for my surgery!

So that's the deal on Dr. East. Till next time, tootles! ;-)

Package Out to Dr. West

© www.lowendmac.com

On Friday I sent out the required preliminary items to Dr. West so a phone consultation can be scheduled. It was a Holiday weekend so let's see how long this will take. 

I also sent an email to Dr. West and his assistant yesterday to let them know they should receive the package today. ;-)

Things are moving along.Yay.

Q & A with Dr. East

© www.123RF.com

In an effort to help those seeking to have reconstruction for their Brachymetatarsia (and Bunions), here are the results from my 1st visit with Dr. East.

This is quite lengthy, but VERY informative! (I hope.)

At first glance Dr. East thought both my Brachy and Bunions weren't too bad. He stated I might be a candidate for the "one-stage" method instead of the external Fixator. (I was surprised that he said this because his website only mentions the Fixator method. He may be lacking in Brachy surgery experience compared to Dr. West, and I would think even more so with the one-step method?)


After viewing my digital xrays and doing some measuring on them, he stated that I missed the candidacy for the one-step by a smidge. Turns out my conditions are actually worse when looking at the xrays. He showed me before and after photos of some of his patients. He mentioned that if I did do the one-stage, my fourth toe would not be exactly as long as the normal one on my right foot. With the Fixator however, the exact normal length could be achieved.


Dr. East uses a cadaver bone to lengthen the metatarsal. This is acquired from a "bone-bank" for about $1,000. The bone bank tests it for just about everything. But is there a chance you could get something from it? Yes, no one will guarantee anything in the health industry, and the chances are so slim they feel it's 'almost' nonexistent. The bone is dead. Has no marrow and looks like a piece of coral reef.

Sample of "a" bone
from "a" bone-bank.



My questions were as follows:




1. How many Brachymetatarsia surgeries have you done?

"A couple dozen. No one will be able to tell you that they have dome hundreds of these. But just this year I've done three."

(So let's say he's done about 30 at this point?)


2. Would I be anesthetized or would my foot be numbed?

"Both. Anesthesia would be administered as well as having your leg numbed."

3. You have a secondary location you work out of at a limited schedule. Could the surgeries be done there too?

"Yes. Either location."

4. Would you be doing the surgery or would another doctor from this office do it?

"I'll have assistance, but I do the surgery. Sometimes it's another doctor or an intern."

5. Are these surgeries usually covered by insurance?

"It's covered."

(I want to note something here. It is not a doctor's responsibility to know if your insurance covers any procedure. It is yours. DO NOT take a doctor's answer on this. Insurance companies find reasons to deny coverage AFTER a procedure all the time. Do the homework on YOUR insurer the best you can as to what is covered and what isn't. You will most likely have to pay something out of pocket.)


While he said "it's covered", that really doesn't translate into what actually happens because my coverage states they cover 90% of out-patient procedures. (and the rules may change even further if I have this surgery done out-of-state.) There are deductibles to consider and Annual maximums that will be reached, etc. Do your homework.


6. How much do the surgeries go for?
He would not answer this question at all. We went over it several rounds, but he wouldn't disclose a figure. I explained that I do not have credit cards, and being that my insurance company will not cover 100% of it, I was trying to gauge the portion I would be responsible for. He would not give a figure, saying insurance companies find reasons to change rules, etc. I expressed that I understood and in no way wanted to hold him to a number, I was just trying to be responsible with my portion of it. I didn't want to enter into a surgery where I can't afford to pay even the 10%.


After several rounds he said, "I'd be surprised if your responsibilities were more that $1000.00 (US)"

Which brings me to the question I never asked him, because I thought of it later....

7. He informed me that removing the External Fixator IS a separate "surgery". (several times)
This means I would have a total of three surgeries (billable that way, I'm sure) on my left foot:

• the Brachy
• the Bunions
• the removal of the Fixator

I would have to go under anesthesia twice for this foot. (and once for my right foot, IF the Bunionectomy doesn't require a Fixator too!)

So I'm now wondering if the $1,000 he mentioned was for the surgeries as a complete total, or was he talking about one specific surgery, Brachy for example? 


In the west, Brachy surgery goes for about $8000. I think it safe to say NY is more expensive. I'd venture to say maybe $10,000? Thus perhaps making his $1000 judgment reasonable. Which of course would mean that was on one of the FOUR surgeries I'd be having.(My out-of pocket just for surgery alone would then be $4000. Medications and post-op care would be more?)


8. How long would the Fixator be in?

"Four weeks. Your foot would be swollen the entire 4 weeks, and even 4 weeks after it's removed."

9. Would I have a hard or soft cast?

"Hard for the one-stage. No cast if with the Fixator."

10. How many visits would we have post-op?

"Once a week. Xrays would be taken at every visit to make sure you're turning the Fixator correctly and that the bones are doing what they are suppose to do."

11. What medications would you be prescribing?
"Vicodin, Celebrex, and Duricef."


12. Have you ever had an unsuccessful Brachy surgery?

"Yes, not often but yes. It requires another surgery to remedy things."

(I have actually read that this does happen with Brachy surgeries. Sometimes the toe springs up even after being the proper length. I think that is one of the reasons for being 'under' to remove the Fixator. That's a time when perhaps adjustments ca be made?) But let's be clear here, he didn't specify what went wrong with his surgeries.


13. Would my fourth toe still have the same mobility I have now? I have very good mobility now. It bends with all my other toes.

"I'm afraid not. You may lose that."

14. He showed me 2 demos on YouTube of Bunionectomies.

"If you choose the Austin (more popular), it's easier on you and the doctor. But you choose the one you want, don't worry about me. I'll do whichever. (He was sincere while saying this.) But in your case, if you've dreamed of always having a straight line that won't be possible with the Austin on your Bunions.

The Lapidus involves much more. More painful, etc. but it will give you that straight line."

Which one has a larger percentage of re-occurrence of a bunion?

"The Austin"

15. For the Lapidus, where would you do the incision? Top or side? 

"Top"

(He also mentioned to me during a phone call after our first visit, something about not being surprised if I wake up with two Fixators on my left foot. The Lapidus, after he goes in, may require that. Example below.)

© www.youtube.com/user/Big1531Lefty

Lapidus
I'm thinking this is sort of what he means. I have sent him this video so that he can confirm this for me. I'll keep you posted. (FYI, he never answered this.)


16. I also have Bunionettes on the outside of each foot. They are extremely painful when I wear flat closed shoes. Can these be addressed as well?

"Those we can just shave down a bit."

17. How long would I be on crutches?

"Six weeks?"

18. Have you ever had surgery on your feet?

"I've had surgery on my..."

(Sorry I can't remember his answer somehow, but it wasn't his foot. Something on his leg... having to do with a muscle or sports or something. lol.)


 -----------------


If you're wondering, I did go in with a list of questions. This is feet we're talking about here. It's important. I appreciate my appendages you know. ;-) But I made sure to be upbeat and funny. I'm a big believer in getting the best out of teachers, doctors, etc. when you demonstrate some trust. It's important not to come across as paranoid and mistrusting.


We laughed during our visit, but I don't think he blamed me for trying to get my information straight. I will try to provide a checklist of questions for you in the future if you think it might be helpful to you. (See the " DR. Questions: tab at the top of this Blog.)


ONE LAST THING. I have also asked him to provide me with 4 referrals. (Including at least 2 patients with Lapidus and 2 who have had Brachy and bunion surgery on the same foot.) Patients who have had these surgeries in the last 36 months. It would help me a lot to be able to casually ask them about their experiences.


I told him, "I have no problem with privacy of your patients, if necessary my contact information can be given to them so they can call me."


That's enough for now. Thanks for following! ;-)

Brachymetatarsia Surgery is Getting More Popular By The Day!

I found this girl out of Spain! Amazing how years ago there was little on Brachymetatarsia.midedocorto.wordpress.com

© Anita G. www.midedocorto.wordpress.com

This is an 18 year old girl who used a doctor who had never done this surgery before. And he had to account with a second surgeon, and a third party who knew more about external fixation. Together, they honed their skills to get this done for her.

Her external fixator was on for a very long time! (I had a consultation and I was told something quite different. I'll have to find out if it's due to her doctor's inexperience or US doctors just being too much in a hurry. ;-) I will be posting all I was told by Dr. East soon!

Anyway, she tried walking successfully for the first time with full bearing-weight on her foot, on her 105th day! On her 110th day, the fixator was removed.  This is quite recent, but so far she is very happy with the results. ;-) YAY Anita!

INSPIRATION— Susan's Story

© Institute for Limb Lengthening &
Reconstruction - © Daniel Mendelson

In my research I've come across some interesting videos. This was one of the good ones.

If Brachy was my only condition, I would at least get a consultation here.

If you search on YouTube for Brachymetatarsia or similar conditions, you will very quickly realize someone out there has it much worse than you. It's always good to remember, "You are well in so many other aspects of life." Thinking on this often is how I'm able to wear exposing sandals to the post office or while I walk my dog. ;-)

Life just isn't that bad, at least we have feet. I try to keep my condition in its proper perspective as much as possible. I'm not 100% up about it, but I'm not usually down about it either.

These photos do me a world of good. As I looked through them I felt so very happy for each of these people. They were far worse off than me, but that's not why I felt good. I felt happy for them, that they finally received the reconstruction they needed to live better quality lives. Happy, because they look so happy.

Before and After Photos

I was amazed at how old one of the patients was! I mean, she lived so long with her malady. Hallelujah! You're never too old to live better! We may see little difference in some of these photos but to them and their doctors, there is a world of difference.


Enjoy!

Sandal Season

So yeah it's sandal season for the rest of the world. But for people with Brachymetetarsia, it's: sweat-in-your-closed-shoes season. ;-) Those who don't have this just don't know, Sorry ;-( 

Friends and loved ones can be kind, and look at our feet and say, "It's just not that bad." And for the most part I get that. I mean, it's how I feel when someone else offers up their own physical impediment to me. While I can truly understand about personal unique pain, many times I feel their dilemma isn't that bad. Not insulting, just that I don't feel as badly as they do about their condition.

So I get it when people close to me have said that. I understand. I know from what vantage point it's being said. However, on the other hand just try putting a Brachy-foot (a WOMAN'S Brachy-foot) in a delicate sandal! Yeah, those same nice friends wouldn't trade places with you for all the tea in China! ;-)

Those of you who don't have Brachy, well you're in for a treat. You'd normally never see this because we keep it hidden, but I'm all about offering up some treats—in the name of opening up some understanding. (If you've seen my first post, you'll know this is not my foot.)

 

All I'm saying is, it takes some guts!

So kudos to this lady.

Meanwhile you're standing next to someone who's sporting this!


Just a little hard to compete. While my 'comparison-days' are over (thank God!), I'm at the point where I'd like to not live in physical pain AND wear a delicate sandal for once in my life, thank you. ;o)

Choosing— Podiatrist vs Orthopedic Surgeon

In 1999 I began looking into this. (Once I found out there was actually a name for this.) There was a doctor out West that seemed to dominate in this surgery. Now, there are more surgeons [in the east] listing on their website that this is a surgery they can perform. (but as of 'right now' I feel he still dominates, let's see if that changes.)

I am learning that not all Brachy-surgeries are created equal. Podiatrist seem to dominate this surgery when Googling, compared to Orthopedic surgeons. In 2008 I did reach out, via email, to a Podiatrist here in the East. He was kind enough to answer back via his blackberry. For the most part he was upbeat and ready to have me come in whenever I felt comfortable. I could in no way take 3 months off from work, per foot, for these surgeries, so I left it at that.

With the possibility of maybe working remotely for my company on the horizon, I am now looking into finally getting my feet reconstructed. I've done a descent amount of homework. I started off favoring the "West" doctor, (I favored his Experience) but I know I should get more than one opinion on my conditions. That's when I put the "East" doctor on my radar as well. My plan is to have a consultation with both. Dr.West will have to be by phone. BUT his office has already sent me a preliminary packet to know the steps required for a phone consultation, all that is involved to fly down for the surgery, the stay, etc. For right now I am working on getting to them a packet of all the forms and insurance information they need. I have to send xrays and photos too. Then I will be able to meet with him by phone and ask all my questions.

Dr. East is a little easier. He's local. In fact, I have already met and had my first consultation with him. For now I feel he is nice, but my decision won't be made upon niceties. I don't think he is as experienced in Brachy-surgery as Dr. West. But I may not be able to stay in the West for the moths of post-op. My employer is having its shaky times and I can't afford to be jobless. Going out West may be a bit too much to ask. Going and staying for that period of time proves quite challenging with a dog in toe as well. ;o)

The question of Podiatrist vs Orthopedic surgeon in uniquely mine as Brachymetatarsia is not my only condition. I also have bunions and bunionettes to add to the mix. There are claims that Podiatrists do lousy jobs on bunionectomies compared to Orthos, but I've read the opposite as well. To me my findings were equal. I've looked up the difference in their education requirements, law, etc. Because I have Brachy with my bunions I have decided to go with Podiatry. (If I had Bunions alone, I would have a consultation with both a Podiatrist and an Orthopedic Surgeon.)  

I feel both doctors on my radar (Podiatrists), have the opportunity to do good work. But which one will do the best job? Once I have a consultation with the 2nd podiatrist I'll have to decide

Tootles! Smile, Jesus Loves YOU! ;o)

Getting Xrays Proves Difficult

I will document all I can so that those of you considering surgery, won't have to be as lost as I was/am in doing these things as a first-timer. (I mean how many times do you actually do this in life?)  ;-)  I don't want you to feel alone. Hopefully by following my blog you won't feel that way.

I've done research off and on for years and am reasonably sure of the surgeon who will perform my surgeries. (more on that later.) He is not local. Therefore, I have to get xrays taken here and send then to him.

I want to tell you that getting someone to take my xrays has proved very difficult. Once I explained what I was doing, what I needed the xrays for, I was rejected. I called several offices and they all said "No".

I then called the surgeon I plan on going to ask for help, to see if he had a solution. I discovered they pretty much expected me to have this difficulty (would have been nice if they would have told me that from the get-go) and recommended I just make a consultative appointment with a local podiatrist and not share my plans.

I had xrays taken this week. Not only was I surprised at the severity of my bunions, but the podiatrist was as well. (Dr. East—more on him later) I carry my bunions well I guess, but the xrays show quite a severe case.  

Anyway, I'm hoping that I can document all I'll go through so it can help somebody out there. I know the information is needed because when I went searching 10 years ago there was barely nothing available. And now you get sort of just bits and pieces here and there online. So I'll be as transparent as I can.  Thanks for following! ;-)

LEFT FOOT

These are my xrays. (digitally done)

© DNC -
www.brachymetatarsia.blogspot.com

RIGHT FOOT

(The "Normal" xray on the right, is not my foot.)

© DNC -
www.brachymetatarsia.blogspot.com

My Brachymetatarsia Journey Begins

(GEES THIS TAKES GUTS. OY.)

By now you have a good idea of what "Brachy" is, so I'll move on to my personal view and experience. I've lived with this for 30+ years. It has affected a few women in my family. My Aunt, my father's cousin, my sister, and my cousin. In our family it starts at about 7yrs of age, when the 4th metatarsal bone (inside the foot, not inside the toe) stops growing. It seems the skin continues, but not the development of the bones.

I'm used to it by now. I don't wear flip-flops or open toe shoes on dates or anything, but when I walk my dog or have to make a quick run to the post office, I grab my favorite "brachy-sandals" and go. (I like them best because they hide my bunions. ;o) I don't feel 'shame' as some Brachy-ers do, but I don't think one should feel shame for feeling shame, if that makes sense.

My Brachy sandals

Family and close friends have seen my feet, so no big deal. But what bothers me at this point in my life is that I can't wear a nice low-heel, feminine, strappy sandal. I just want to do that. That is what has lead me to my final decision for correction.

As an artist I'm use to being the quirky one so this sort of fits for me I think. ;o) Growing up it did do damage to my self esteem, and as an adult I discovered it did play a reasonable role in my lack of social skills. There were no pool parties, walks on the beach, sports (locker rooms), pedicures, sleep overs, shoe shopping, etc. I avoided being involved in anything that would even have the chance of exposure. Kids can be cruel. (Let me explain that I went to 13 different schools. I was always the new kid. And was bullied because I was a new target. That being said, I never showed my feet as to not give the bullies yet another reason to pick on me. So with every move I started from scratch again. I never had a chance to develop long-term friends to build trust with.)

Anywhoo, I work in Manhattan, and before the real hot weather hits, all the girls are pedicured and flip-flopped— so are many others who don't care for their feet in the same way. I've had a front row seat on the subway to some amazing deformities. So I look at myself and figure I'm just not that different. Many have it far worse than I. Someone in a wheel chair would give their right eye to have my feet and legs. So in that context, I no longer feel cursed or emotionally bothered as an adult.

I have other blogs and if you sift through them you'll realize I'm not consumed with my feet. But this blog IS about my experience with Brachymetatarsia so it will seem all consuming as you read it.

At this point, a bit of a door to have my feet reconstructed has cracked open. It might be possible that I may be able to work remotely from home in the near future because my job has been piloting this now for 6 mo. Without this, the reconstruction will not be possible. I must work. I don't have the luxury of not earning an income for the long post-op needed for recovery.

© DNC - www.brachymetatarsia.blogspot.com

My feet are completely flat. No arch. In fact, so flat that they act like suction-cups on humid days in the sandals above. ;-) My problem at this point in my life is the physical pain caused not only by my Brachy but by the two bunions on the inside and the two bunionettes on the outside. I nurse my inner bunions now-a-days by avoided 80s-like heels. But even when I wear flat closed shoes the pain from my bunionettes is excruciating.

© DNC - www.brachymetatarsia.blogspot.com

I also have thick calluses on the bottom of my Brachy foot. In my sandals, my feet just don't look that bad from our birds-eye view. But from a healthy podiatrist vantage point— they are an absolute mess.

So here starts my new journey! ;o)