This Little Piggie

So my big toe is super sore and I was convinced that it was an ingrown toenail and so I went to the podiatrist.  Amazing how sometimes the smallest thing can cause the worst of pain.  Like a papercut.  Or a sore toe that makes your whole body ache from the effort it takes not to use it as much. 

 

I have to admit that I don’t have much faith in podiatrist.  The 2 prior experiences I have had with them have not been that great and left me thinking that I could do better on my own than with their medical “expertise”.

Case in point.  Many years ago, 12 at least, I went to a podiatrist because I was having such pain in my foot that I could barely walk.  After looking at it, he decided that I had inflamed joints in my foot cause by “whatever” and began me on a series of weekly shots that even with insurance were super expensive since I had to pay a co-pay each visit and 20% of the shot with the insurance I had.  Now this was during a time of stress for me that was off the chart. I was in the midst of a divorce I didn’t want, had just started a new job,etc.  I was so heartbroken, stressed out, angry, you name it that I didn’t really even notice that my foot was hurting until one day I just woke up and the pain was intense.The shots would work for a day or two and then the pain would be back and I’d limp until the next apt. At some point, the podiatrist told me that since my pain was getting any better, he thought that maybe I needed surgery on my foot.  What kind I don’t know.  I just know that all I could think of was the cost of it.  About that time, I stepped in a hole in the back yard and sprained my ankle.  Off I went to the bone and joint doctor to have it checked out. After taking an ex-ray he asked me “how long ago did you break your foot?  WHAT?  All those shots, the talk of surgery, etc and my foot HURT because it was broken.  It had healed to some extent, so much that a cast at that point would not do any good. I returned ex-ray in hand to the Podiatrist the next week and asked that he refund my money for all those unnecessary shots.  If he had done a simple xray it would have saved months of pain and lots of money.  He said that I should have known my foot was broken.  Maybe so.  But you think he would’ve noticed it on the xray he took on the first visit.  Live and learn.  Now as to how I broke my foot?  Well that’s a story for another time…lets just  say that when you have your foot under someone’s tire so that they won’t drive off while you are still trying to talk to them, and they tell you “move your foot or I’ll run over it”, Move your foot!  

 

My 2^nd Podiatrist experience was not quite as bad insofar as the visit but the cost was atronomical by the time I was done.  What is it about feet that make them so “pricey” to deal with.  After my very first pedicure, which I reluctantly agreed to because frankly I don’t like my feet and I really don’t like having someone else mess with them, I got a toenail fungus.  I’m sure that the fungus was from that because it was the first time in my life I had had a pedicure and the first time in my life I had had a fungus.  After trying various over the counter things, and all the home remedy tips…soak your feet in Listerine, put vicks vapor rub on your toenails before bed, soak your feet in vinegar and lemon juice among others, I gave up and made an appointment.  What it is in that little bottle of medicine that makes it worth $300 I don’t know.  It required lab before the prescription to check liver function which made me a little leary.  How strong is this stuff I wondered?  And so after the lab co-pay, and the med co-pay, and the monthly visits to check the progress to the podiatrist for the 3 months it took to clear, it turned out to be a pretty costly pedicure.  

 

The last time I had an ingrown toenail was in 1987.  I remember because I was pregnant with Andy at the time and the doctor wouldn’t give me anything to numb the pain before he cut it out because of that…though thinking back I’m questioning that logic..Surely a little med in the toe wouldn’t have caused any damage to the baby.  Though the pain was excruciating (only slightly less painful than natural childbirth), it was a quick procedure and I have not had an ingrown toenail since.  I think that maybe those few minutes of pain were worth the 25 years of a pain free toe.  And since it wasn’t a podiatrist but a regular doctor that did it, it didn’t cost as much.

 

So off I go on Tuesday, for what I’m sure will be a repeat of the pain I felt in 1987 only on the other big toe, and hopefully with some numbing agent injected before the knife this time.

Now, granted I should have asked for a recommendation for a podiatrist instead of choosing the closest and most convenient one so I wouldn’t have to miss any work.  Had I thought to ask around beforehand I would have known, from co-workers who had made the same, well he’s close choice” that it would be a mistake. 

 

30 minutes after entering the office I was back in my car feeling like I had just been in an infomercial for specialty shoes.  The doctor mashed on my sore toe which cause me to cry out in pain…then pronounced that it was not an ingrown toenail but a sore toe from wearing “cheap tennis shoes” when I walk.  He went into a lecture about shoes and fashion and price which culminated with him handing me a list of shoes that were the ONLY ones I should be wearing, especially since I’m diabetic.  I looked at the list, pointed to the New Balance shoe that I wear, watched the wheels turn in his head to see how he could get out from under that one. 

 

He immediately said that sometimes it’s not the shoe but instead the padding inside.  This started another lecture about how worthless the Dr. Scholl, and any other over the counter pads were.  According to him, the only way to get rid of the pain would be to get a cast of my foot made, have a custom made insole made from that cast at a cost of $350. Little did he know I had fallen victim to that line of reasoning from the last podiatrist and had forked over some hard earned money for a cast and insoles that are currently in my “crappy shoes” (which aren’t crappy at all.) and pretty much worthless in my opinion. I have had better luck with the cheap gel things.    SO I told him that I had already done that and that it obviously didn’t help that much.  He then said that perhaps it was because they were old insoles and my foot had changed.  I lied and told him they were less than a year old after he said that the life of those is about 5 years. 

 

Now I had successfully shot down his kickback on the shoes (did I mention that he told me the shoes on the list that he gave me were only available at a certain store in town that a friend of his  owned?) and refused the casting procedure and that didn’t leave him with much.  I was waiting for him to suggest toe surgery LOL when he decided to switch tracks and concentrate on the diabetic aspect of my feet.  Out came a drawer with multiple products that he recommends for people that are diabetics from blood flow stimulating socks to compression shin guards.  Add to that a special cream made just for diabetic feet, a nail file that was supposedly for diabetics that looked no different than the file I got a the dollar store, to this little ball thing you massage your feet with while watching tv.  I didn’t bite.  Told him that I had not problems with my feet at this point, that my doctor had told me 2 weeks ago that my feet were in excellent shape, especially for someone with diabetes.  Strong pulses, no swelling, etc.  He then told me that I had something that he liked to call “diabetic brain rot syndrome”.  Then  he laughed and explained that he had coined that phrase for people like me who had diabetes but were in denial about the importance of foot care.    Actually, I said, I am very proactive about my diabetes, I’m here aren’t I?  Now, can you tell me what’s wrong with my toe or do  you have more products to sell?  That shut him up.  I felt bad about being rude but I was close to walking out by that point.  

 

Finally, he got down to business.  No more recommendations for shoe stores and diabetic products that his friends and family owned businesses for. He pulled out a wooden foot and proceeded to show me how all the bones and joints work together.  It felt a little like he was practicing for Career Day at the Elementary school but I suffered through the demo, even asking couple of questions and saying “I see” a couple of times.  At the conclusion he pronounced that the reason my toe was sore and throbbing was because of the pressure put on my nail during my walks and the ensuing nerve inflammation around my toe.  He said the best thing to do was to use a prescription balm that he would write a script for me for and some “oil” that he sold on site. I asked about the oil, to find that it was super expensive.  When I balked at buying it, he said “fine, you can just use olive oil, it’s the same thing really.  Apparently, olive oil is good for softening AND inflammation.  That might be the only valuable piece of info I got in the the 30 minute visit. 

 

I then asked about the medicine he was going to prescribe.  Turns out it is a special compounded prescription that I would have to get from a “specialty pharmacy”.  When I inquired about the cost of this knowing from my hospice experience that compounded meds are usually pretty expensive he replied, well less expensive than amputation.  Your choice.  What a jerk! 

 

I told him he could fax it in but they needed to call me first with the cost because my insurance has a $500 deductible on meds and I haven’t met it. And that I would take my chances with an over the counter med with similar ingredients if I had to.  He said they would call before they made it to let me know.  I left the office wondering if this “jerk” had any repeat customers.  He was undoubtedly one of the most rude and arrogant drs I have ever come across, 2^nd only to the dermatologist in Muskogee I went to for a mole. 

 

When the pharmacy called to tell me that my prescription was ready to pick up (not how much the medicine was gonna cost as I had requested) and I asked how much they told me that my insurance co-pay would be $365.  I told them that I would not be picking the med up, that I had told the foot doctor that I would need to know the cost in advance, .  And that I would rather have a sore toe than spend that kind of money on a toe treatment.  She put me on hold, came back on the line and said, “the pharmacist said you can have it for $60.  Now, part of me was thinking YES!, a little pricey but I’ve seen worse (diabetic meds are not cheap)….and the other part of me was livid that had I said ok, fine an insurance company would be being billed for a lot of money for a $60 medication.  This is what is wrong with our health system in a nutshell! Next time you get a premium hike in your medical insurance premium, chalk it up to the racket that is known as pharmaceutical companies and their co-horts. 

 

And though $60 was a “bargain” by bedtime I had decided to forego the  fancy medication and just treat my toe with Cortaid and other otc creams with close to the same ingredients.  That is until I got up in the middle of the night and stubbed my sore toe.  By this morning it was throbbing.  You could take my pulse in that toe. The one ingredient that the over the counter meds don’t have that the prescription does (according to my expert nurse co-workers) is a drug that numbs the pain that diabetics can have in their feet.  SO on my lunch hour, I drove to the pharmacy and picked up the medication.  I rubbed it on my toe and got immediate relief.  I think in this case, it might be worth it. I’m wondering if it works on other body parts like knees and calves and shins.

 

My piggies are happy again.  Since my big toe is numb and not hurting, I am using it again and the 4 side kicks are back to doing their usual work load.  When my mom used to get frustrated she would say Well,  Foot.  I thought about her today and yesterday.  Her feet would hurt so bad sometimes with her diabetes that she would be in tears.  Thankfully, I have not suffered that degree of damage to my feet from diabetes.  I plan to avoid Diabetic Brain Rot (how rude!) and face the facts, knowing that denial is not going to do me any good in the long run. 

 

I just glanced at the list of APPROVED casual shoes that the Podiatrist gave me.  I hadn’t heard of any of the brands.  I googled a few.  For 199.99 I can get a clearance pair of Wolfy sandals that are uglier than dirt. Think I’ll have to forego that advice for a while.  Frankly, this little piggy says HOGWASH!