Adventures in Medicine

My right big toe started to hurt back in 2007. It got a little bit worse in each year thereafter, especially when I raced on the track, until early this year I decided I needed to get it checked out. An MRI showed that I had a bone spur that was probably related to arthritis in the joint. By then the spur was so large that my toe could not flex backward at all. You never realize how much you need your big toe to run until it stops working!

Surgery would be required to fix the problem. After consulting with my doctors I decided to have the procedure done in early September, in the last month of my pregnancy, when I would not be running much anyway. This would make the recovery least disruptive to my training. But a few weeks ago I developed a problem in my low back that forced me to take a break from running, so I decided to move the surgery up to last Thursday.

Normally, general anesthesia is used for this type of operation, but because I’m pregnant I couldn’t be knocked out, so I had a choice between an ankle block that would numb just the foot that was being sliced open and a spinal block to numb the whole right leg. An ankle block can cause permanent residual numbness in the foot, which is not a good thing for a professional runner, so I chose the spinal block. Fateful decision!

It’s funny how the needles used to administer pain-blocking drugs often cause tremendous pain themselves. The injection in my spine stung, but minutes afterward I could feel my right leg going numb from the top down. Before long the entire leg was numb—except my big toe!

“I can still feel my big toe!” I told the anesthesiologist, terrified by visions of being cut open with full feeling in “this little piggy”.

“Are you sure?” he said, prodding it. I felt the prodding.

“Yes!”

The anesthesiologist told me to wait a few minutes and see if the toe didn’t lose feeling. I waited. It didn’t.

So he had no choice but to administer a second spinal block. This one numbed my left leg and, at last, my right big toe.

Being awake for an operation one one’s body is a strange experience. I could feel a tiny bit of pressure but, thank heavens, no pain as the surgeon worked on my toe. I could hear drills drilling and saws sawing, but they might as well have been applied to a piece of wood for all I felt. I could have watched the procedure if I’d wanted to, but I didn’t want to, so a sheet was positioned to block my view of the blood and gore.

The surgeon declared the operation a complete success. He said the spur was huge and its removal totally necessary for my career. He said he was impressed I was able to train as much as I had with it. That made me proud.

While the operation was a complete success, my short-term recovery was a disaster. I wasn’t allowed to leave the hospital until full feeling had returned to my legs and I was able to pee on my own. That took 12 hours. Not long after I got home I developed a splitting headache. I tried to sleep but it just kept getting worse. I woke up early in the morning convinced I was dying. We called the hospital and learned that I was experiencing a spinal headache caused by leakage of fluid from my spine—something that happens to less than 2 percent of patients who receive spinal injections. Lucky me!

The recommended treatment for spinal fluid leakage is lying flat on your back and consuming lots of caffeine. So I spent my entire weekend laid out, getting up only to use the bathroom, and drinking Pepsi. The headache gradually diminished and by Monday it was gone and I was able to get out of bed.

All in all it was a dreadful experience, but it came with a silver lining: By the time I was allowed to get up and move again, the pain in my low back was gone! It’s funny sometimes how things work out.