Daily Archives: May 15, 2020

a talus coalition and other stuck things

The neighborhood is looking pretty lush these days. I needed some serious cobweb removal in my brain after a late bedtime and tremendously loud storms that shook the whole house in the wee hours. My watch told me this morning that on this halfway point in May, Iā€™m only 109.1 miles away from continuing my monthly activity streak this year. May is just going to be the slow month and it needs to get used to that.

(I realize that jumping back in here with no context is confusing, so I’ll provide a bit: I’ve been in a walking boot on my right foot for two and a half weeks after suspecting a stress fracture in my heel from running. I haven’t had any structural issues with my feet following my surgeries over six years ago, but I thought the change in running patterns during quarantine might have caused it. Scans did not indicate a fracture, but instead showed some concerning variation from my 2014 scans, and so yesterday I saw a specialist to figure this out.)

Reasonably good news yesterday at the podiatrist – as in, nothing scary growing on my bone. But in my typical fashion, I have an atypical presentation of the fusion of two bones (very likely present from birth, but just now making its presence known), so again my head goes to metaphors. How many things are peeled away when the world stops and the cadence changes and the rhythms and patterns that provided fuel and fire, or comfort, or obliviousness, are stripped away? The doctor manipulates my foot as he talks – my heel moving side to side, my ankle top to bottom, the two together giving me permission to fly out of this stuffy room and this sweaty mask and into the park down the street where I want to be. He tells me this defect is usually discovered by adolescence, but I tell him I was sitting in apple trees with books in those years, not racing others around a court or track or bases, and so I never knew there was extra glue in my body where there should only be space. He tells me that none of the other characteristics of this fusion are present, and he can understand why my doctor was perplexed by what he saw.

I become aware of the fact that it’s been over two months since anyone outside of my immediate family has been this close to me. Even during my x-rays the week before, I had no physical contact with the tech. She gave me verbal cues, and I easily placed my foot in the correct position for the scans. And now I find myself with my foot in the hands of a doctor who takes his time in describing the mechanics of motion and I take my time in describing the mechanics of freedom and release and necessity and wait patiently for a plan. I no longer care what the plan entails beyond a description of steps with a clear beginning, middle and end. I am relieved that the plan does not appear to involve surgery, but I’m mostly relieved that it doesn’t appear to involve ambiguity. I had steeled myself for the first possibility, and was determined to accept the news graciously. I worried more about an ambiguous diagnosis – trying a little bit of this, and then maybe that, but maybe never feeling like things would return to the way they were. I don’t know if I can handle any more of that without breaking in two.

I explained how I had slowly built up to a ritual of running that worked for me. I would carve out 2-3 runs a week, and I’d lay down six, or eight, or ten, or more miles at a time, and I’d fill the other days with strength training or yoga that mellowed out the impact and lengthened out the muscles just enough to keep me moving forward. That pattern abruptly changed in March, and I tried my best to adapt to the seismic shifts around me. I was beginning to taper my longer runs in anticipation of a race that never happened, but I ran those miles anyway with no issues. Restrictions and closures continued, and so I tightened up my practice – running shorter and faster amounts on a daily basis to try and mark some sort of differentiation between work and non-work hours in a world where both existed in the same physical place. The mechanics of my running changed drastically in that time period – I shot out of my house as if I were literally gulping for air and movement. Within a half a block I was running at full speed, continuously shifting from side to side to avoid uneven sidewalks and intersections and people. I hopped as much as I ran, on and off curbs, around planters, across uneven stretches of ground, and over twisted tree roots just to feel cherry blossoms rustling overhead.

I had convinced myself that these changes had caused a stress fracture – a feeling I know quite well, and recognized here again. How could it be anything else, with the repetitive force that I was applying there each afternoon, a begging with each step for release, no matter the cost? How could it be anything else but the kind of fracture that doesn’t occur in an instant of unfortunate luck and timing and landing that you didn’t see coming, but the kind of fracture that you bring on yourself by not listening or paying attention well enough to ward off? Stress fractures are a particularly cruel diagnosis that reads “this is your fault, you caused this, why weren’t you paying better attention?”.

The doctor holds my foot in his hand and tells me that the seismic shifts in our world have not damaged my body, even if I might continue to struggle to accept a diagnosis with no ties to blame or guilt or malpractice on my own part. These shifts merely revealed something about my body that I never knew, and for forty-five years – including the last eight years of running – my foot had accommodated and adapted to in a way that defied most textbook explanations for how it should operate and move. They could surgically separate those two bones – this “coalition” – so that they work in a more typical fashion, but there’s really no need to do so. They’ve worked just fine before, fused as one, and with a little more rest, a little more intervention, and a little more grace, there’s no reason to doubt that they’ll do it again.

I leave the hospital and drive home through the park, lighter than I’ve felt in a long while. I loved the notes you left and sent yesterday and thought a lot of about feeling stuck and getting unstuck, and adapting when necessary. It feels good to work it out in words.