Sunday 28 September 2014

The CT Scan: A journey through time...

Siemens CT Scanner
When I was first informed that I required a CT Scan on my foot I was not worried.  Many years ago I had a scan performed on my left ankle and I have no negative memories of it.
I know that in simplistic terms CT scans produce computerised images of inside the bone – lots of little slices through the bone rather than just the surface like conventional x-ray images.  I envisaged CT Scanning equipment that looked like a giant x-ray machine and as I lay there it would silently capture images of my insides.  I was prescribed a CT scan to determine an “abnormality” within the big toe joint of my right foot which had been seen on previous conventional x-rays.

The actual CT Scanning machine looks like a giant doughnut and the subject is positioned inside it dependant on which area of the body is being scanned.  In my case I was laying down looking straight at it with only my foot inside the actual “doughnut”.
As I looked at the machine around my lower leg I was instantly reminded of scenes from science fiction films where people are transported to other worlds and parasitic aliens try to invade human bodies.  I laughed at my active imagination and blamed it on all the Patrick Lee books that I have been reading recently.   I had just about composed myself when the noise started…

The actual Stargate....
When the CT machine started working it  took me by surprise.  I was not prepared for the noise and to be honest I felt very scared.  The noise reminded me of the noise that the portal gate makes in Stargate SG1 when it starts dialling into another world.  My imagination went into overload and I could see spinning symbols and wormholes appearing through the giant ring….
It was over in minutes and I am glad to report that I was not transported into another world or attacked by aliens!  However, something amazing did happen, I was transported back in time…..

I am not sure at which point it happened, but I suddenly accessed a memory of an incident that happened a very long time ago.  This incident is now the biggest suspect in the quest to determine what the problem is with the bone in my big toe joint.
As I emerged from the scanning machine I looked down at my foot and saw that the scar across my big toe was still there.  I had forgotten all about the accident, wiped it from my memory and not once had it entered my mind during all the investigations
and recent medical developments with my foot.

When I was a young teenager one day at school a desk fell on my foot.  It was a heavily built wooden style desk and the edge of it landed on my right foot, the big toe absorbing most of the impact.  It hurt like crazy and there was a nasty little wound.  I remember the teacher telling me that it was nothing serious and all it needed was a little plaster to cover the bleeding wound. 

The accident with the desk happened at a time when I was getting a reputation for being someone who “pretended” to have a sore ankle as I would limp one minute and then be fine the next.  (This ankle injury would ultimately live with me for the rest of my life and take two decades to find a doctor that actually believed me. Three operations later I still frequently find myself limping one minute and then running very long distances the next….) 

I couldn't find a photo of the desk...
Anyway, I basically ignored the problem with my big toe as my ankle was more painful and a greater concern.  Once the wound healed up I ignored it and eventually it went away or certainly was no longer a problem until about ten years ago I started feeling pain in it.  The pain was intermittent and I never worried about it, just assumed that it was due to over compensation when my ankle was hurting.  

Then about two years ago it became a significant problem, causing a lot of pain and inflammation when I was running and significant distance.  The pain intensified as time passed, like really bad toothache deep in the joint.  I saw a foot specialist in 2013 who diagnosed the problem as hallux-valgus for which surgery was recommended in early 2014.  The surgery involves bolts and screws in the bone and the recovery is very long, not something I was keen to pursue unless absolutely necessary.  I would also need to have a 6 week period of no running at all and taking daily anti-inflammatory drugs before they could perform the operation.

I decided to postpone the surgery as I was able to manage the pain and control the swelling and to be honest my ankle was more of a problem earlier this year.  Plus there were other priorities in my life such as realising my sub 4 minute mile dream with Spike.

A very special Husky and "his" beer
My plan was working until July of this year when suddenly the pain in my big toe became unbearable.  It was so painful that I could not even walk and had to resort to serious hobbling and walking on the outside of my foot.  The doctor prescribed very strong painkillers and anti-inflammatories, based on the hallux-valgus diagnosis.  I then developed a strange pain further up the foot and was advised that it was due to over compensation, which made sense as I walking in a very weird way.

Then one day there was a really loud crack and the pain was worse than ever.  It took two days to convince the Doctor to send me for an x-ray at A&E, where I was advised that I had two fractures – one at the top of the shaft on the second metatarsal and one in the big toe joint.  The second metatarsal fracture was almost definitely a stress fracture, but there was something weird about the bone structure of my big toe, it looked like an old fracture.

When my consultant viewed the x-rays and compared them with all the x-rays that have been taken in the past two years this “fracture” appears in all of them.  My consultant cannot explain it neither could any of the Radiologists that were shown the images of my foot.  Hopefully the images from the CT Scan will identify what it is and my consultant will determine how best to treat it.   
In seven days’ time I will hopefully have the answer and a way forward that will allow me to walk again and lead a normal life.  I have been disabled for 2.5 months and as each week passes it becomes harder to manage. 

The experience yesterday was a revelation that I did not expect and has given me a renewed hope for the future.   

The CT Scan may have helped me travel back in time yesterday and ultimately provide a solution to my pain, but I don’t need a time travelling machine to show me the future, I have my dreams for that….

(Photos courtesy of Siemens, Stargate Command & Ian J Berry)