Sore feet

 Both of these feet are mine, the left foot’s swollen because I had to walk to a doctor’s clinic, today.
It was nice to get out, have some fresh air, listen to people talk and laugh. There were a couple of people in the doctor’s waiting room. Then she called me. It was my first visit to an arthritis specialist.

She ran a thorough physical exam, asked me all the right questions, then told me she was going to order an MRI and have me come back in six weeks. She told me I have a form of progressive osteoarthritis, related to hemochromatosis.

There’s a point where you tune out. You don’t do it deliberately but you’ve heard all these words before, from someone else or you’ve read them and they just become a jumble and they assume a trance like rhythm of their own.

You ask questions, you get answers, smiles are exchanged, nods are passed around, even handshakes, I put my hat on, the doctor lifts her pen. I go make my next appointment, pay for this one. I limp home. Life on the trail of hemochromatosis.

From Crack to Crock

Enjoying the crack is something that comes natural to us Irish, even if we’ve had to alter the spelling to the Gaelic version, craic, so it’s not mistaken for an illegal cocaine derivative. Unfortunately, after a life time of craic , I’ve turned in to a crock, thanks to this Celtic curse, haemochromatosis.

One of the biggest problems with haemochromatosis diagnosis is it’s hard to spot and is often treated for its symptoms and not for the condition itself. These days people are becoming more and more aware of HC, particularly doctors, so its indicators are more frequently screened than ever before.

Sixteen years ago, after complaining about pains in my fingers for at least three years, I found the clue that alerted me to whether my problems stemmed from an overload of iron in my blood. Typically, I assigned the finger pains to the rigours of tapping on typewriters, daily, rushing to beat deadlines. Although I’d been using laptops for years, by then, my early day typewriter training came from hammering on a monstrous, non-electric newsroom typewriter, usually with just two fingers, the index fingers of my left and right hands.

index1

Professor John Crowe, a distinguished gastroenterologist and then Master of the Mater hospital in Dublin, presented a paper to a medical conference in Dublin that highlighted the prevalence of this dietary iron disorder among Irish people and people of a Celtic origin. It was covered by a Dublin newspaper and in that report there was a simple list of the main indicators for hereditary haemochromatisis. Once I read arthritic pain in the left index finger and an unseasonal tanned look, he had me. I contacted my doctor who did a quick blood test, for serum ferritin, I found out, later.

Now my fingers were sore but the tanned look? Well, y’see I’d always tanned up deepy and quickly, come the summer and always had a complexion that, throughout my life, has had people wonder where I’m from because the typical Irish complexion is not so much white as ‘transparent.’ While I remember, as a child in short trousers in primary school being referred to, by other mothers, in the totally pre-PC days of the early ’60s, as ‘the wee darky.’

So the test results came back and the diagnosis confirmed and before I knew it, blood was being drained out of me by the half litre on a weekly basis.

The unfortunate thing for me, though, was the horse had long bolted from the barn. Within two years of that diagnosis, along with the diabetes that first manifested itself eight years before that, I began to experience serious problems while walking. It began with a dull ache getting out of bed. Within a year, running was out of the question and walking had become an assault course strategem.

You only realise how much you take simple physical activity for granted, when those simple acts become painful manoeuvres. Descending a stairs became almost as painful and perilous as climbing one. If there were steps to be climbed, I’d have to think out my route in detail and in advance so I could minimise the most challenging obstacles. I remember being so thankful when footpaths became wheelchair friendly. Crossing a street became something I had to plan, very carefully, particularly since lifting my leg high enough to negotiate a step became as calculated as an Olympic high jump attempt.

Pretty soon, I was being lined up for my first hip replacement as osteoarthritis was the cause of my motor difficulties.

Was I surprised? Yes, since I’ve always been an active person and loved walking and cycling, I was, as we say in Ireland, on a prolonged Egyptian holiday: I was in denial. For two years before I was told I needed a hip replacement, I visited chiropractors, physiotherapists and osteopaths. Then, after the diagnosis and a date was set for the operation, I refused to let it get in the way of a holiday trip I’d planned with a friend, to travel to the south of Spain, by motorbike.

Now the prospect of throwing my leg over a pushbike had already become an exercise that might entertain the Marquis de Sade, so getting my leg over a 1200 cc Harley Davidson Centennial for a marathon road trip, well, that was my tribute to the notion of mind over matter.

The first thing I did was visit an osteopath in Tipperary who, I was told, performed miracles with injured professional jockeys. All I wanted was to maintain as much flexibility as I would need to help me make the trip. It didn’t quite work out that way. Getting on and off the bike turned in to a nightmare. We had to make stops along the way at intervals of 50km or so. This lengthened the journey. Happily, for my good friend and long suffering travel companion, Dave and myself, the trip, itself was great fun and, despite the pain, an amazing elixir.

on the road.aug 09

There are ludicrously memorable moments like the time we both pulled in to a motorway garage, all leathered up and ruddy faced, on this behemoth motorbike and Dave alighted, ignoring me, to fetch himself a drink. Then I started the process of alighting that involved, first, standing up, before easing my leg over the bike then sliding to the ground, crawling to the footpath and gently, crab style, working my way up to a standing position, to the bemusement of some watching locals. That happened more than once and soon we were taking a delight in the whole spectacle.

When I got back to Dublin, ten days later, I was ready for the operation. Within three weeks I was back on my feet and the absence of pain, the ease of movement was phenomenal. Two years later I was back in hospital for another hip operation. More recently, I’ve begun to experience ankle arthritis and, once more, mobility comes with a huge pain bill. These days they can replace hips, knees and even ankles but ankle replacement for me is out of the question, I’m not old enough and anyway, I have diabetes; there’s too great a risk of infection.IMG_3932

Since prevention is not a possibility until there are advances in stem cell research, so early detection and treatment is the best way forward. But that’s a story for another blog.