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Saturday, June 19, 2004

Ankle

At the end of the April I had a MRI scan on my right ankle, basically to try and find out what is wrong with it. The history of this is simple, in October 2000 I slipped on the punultimate step on a flight of stairs and ended up in an ungainly heap at the bottom. Since then my ankle has been causing me problems. Initially it was thought to be a matter of tendons. I first had physio in June/July of 2001 (that's right, 8 months after the initial injury - the wonders of a public health system). Did some good. Moved. Ankle had gotten worse again. More physio, no good. Get referred to Orthopaedic surgeon. More physio (surprise surprise) which was useless. So finally the guy decides for me to have this MRI.

Interesting device the MRI scanner. I talked to a colleague who is a Radiographer, and she said that one of the wonderful things about MRI (Magnetic Resonance Imaging) is that no-one really understands the long-term of effects of it, compared to say what we know about the possible effects of too frequent X-Rays or CT scans. Also it is noisy, very noisy.

On the 1st June I saw the consultant again with the result of this scan. In this case the waiting time between result and appointment was my responsibility - I went on holiday for a week in the middle. And what did the scan show? Well, blow me down it is not my tendons after all. It's something to do with my cartilege, which does not show up on ordinary X-Rays. And there is a possible chip on one of the ankle bones (the talus) but its difficult to tell on the MRI (more a suggestion of a chip). Also the bone is bruised (I didn't know bones could bruise). I have to say I felt rather vindicated. I've been telling any doctor-like person for the last 18 months that I didn't think this was a simple matter of tendons, but do any of them listen? No, cause here I am, only a human being perfectly capable to think for himself and able to make a couple of reasonable deductions. But who cares, I'm only the dumb patient who because of the extortionate taxes used to pay for the NHS can't go private.

I should make plain that I have never had this problem with my GP, who got quite angry after after my second bout of physiotherapy when the nurse told me I might have to accept this as a chronic condition (he felt that, whatever the truth of the matter - and he thought it a possibility - it was very much NOT her place to tell me, or make that assumption, when no one really knew what the problem was). He also had it X-Rayed, and that x-ray apparently showed some early possible arthritic changes (why the consultant decided to ignore this X-Ray I don't know).

Anyway, the Consultant has now referred me to another consultant in the same DEpartment. Why? Because ankles aren't his speciality. So I am now going ot see the Consultant that my GP originally referred me to. You could say that I am less than impressed with the Orthopaedic Department right now. However, looking for the silver lining, I must admit that I am pleased that this Consultant plainly knows his own shortcomings (for the record he is a joints person, but mostly in terms of replacement operations, and he does not specialise particularly, though practically I think this means hips and knees are what he knows best).

So I now have another appointment - in mid-August. I have a suspicion though the initial outcome of that might be another investigation. I got the impression that the MRI mainly just showed that there was something wrong, but was not terribly clear on precisely what. Some sort of endoscopy was mentioned, or perhaps other imaging.

I'll just have to wait until August to see. Great.

Note - I should explain that I was already turned against the NHS before the above sequence of events. That was when I was on a 22 month waiting list for a relatively simple operation. Trust me

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