What kind of Doc do I need?

[Tex Long 4511]

Have had a bad achilles tendon in my right leg for a few years, apparently brought on by a -floxacin scrip. Swollen up just above the heel. Not horribly bothersome, but sometimes sore enough to cause limping. Hasn't gotten worse, and was helped quite a bit by massaging "the sore place" on the calf. A few weeks ago, I suddenly developed "drop foot", which has dramatically altered my stride. I have to pick up the foot with a knee bend. The foot doesn't flop all the way down, but it also doesn't lift. Sitting flat-footed, and trying to flex upward, the big toe has almost no movement, although the other toes have about the same motion as the other foot. There is also a lot of numbness on the top of the foot. Now I'm seeing obvious swelling, mostly in the foot but a little up the ankle, too.

At 81, I'm not sure whether to chalk it up as just regular "falling apart" or what. I reckon I ought to let a specialist go over this. GP doesn't seem concerned by it, but I'm pissed off about not being able to walk more than a few dozen strides at a time, and pretty damned slowly, at that. What kind of Doc should I see?

[Mittens 8384]

Orthopod

Orthopedic surgery or orthopedics (alternative spelling orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system.^[1] Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.

[Dbeasy 15239]

31 minutes ago, Tex Long said:

At 81

[That Guy 977]

Oopph sounds like foot aids. That’s tough on old folks like you. 

[TwiceHorn 31695]

Actually appears to be a neurologist you're after.

But, this also sounds like something right down @ChiTownDoc's alley.

[thunderlounge 8038]

Well, at least you know to see a doc and get rid of it. 

[ChiTownDoc 21232]

2 hours ago, Tex Long said:

Have had a bad achilles tendon in my right leg for a few years, apparently brought on by a -floxacin scrip. Swollen up just above the heel. Not horribly bothersome, but sometimes sore enough to cause limping. Hasn't gotten worse, and was helped quite a bit by massaging "the sore place" on the calf. A few weeks ago, I suddenly developed "drop foot", which has dramatically altered my stride. I have to pick up the foot with a knee bend. The foot doesn't flop all the way down, but it also doesn't lift. Sitting flat-footed, and trying to flex upward, the big toe has almost no movement, although the other toes have about the same motion as the other foot. There is also a lot of numbness on the top of the foot. Now I'm seeing obvious swelling, mostly in the foot but a little up the ankle, too.

At 81, I'm not sure whether to chalk it up as just regular "falling apart" or what. I reckon I ought to let a specialist go over this. GP doesn't seem concerned by it, but I'm pissed off about not being able to walk more than a few dozen strides at a time, and pretty damned slowly, at that. What kind of Doc should I see?

You need an EMG.  I used to do shitload of them but not so much these days.  Drop foot can be caused from a pinched nerve in a multitude of places...distally in the leg or more proximally in the back if you have back pain/injury etc. or even more centrally after a stroke/brain insult.  The EMG is no rush because it actually won't show anything for a few weeks because the degree of muscle denervation (your muscles that hold your foot up - dorsiflexors lost their innervation, hence drop foot) that occurs after nerve injury can not be determined until Wallerian degeneration is complete and this usually takes at least a few weeks.  I'd make an appointment to see a neurologist/physiatrist asap but don't go to the ER because they won't do much of anything you need done anyway.   Of course my disclaimer if you had any sort of acute injury you didn't mention run to the ER, so I can cover my ass.  

51 minutes ago, TwiceHorn said:

Actually appears to be a neurologist you're after.

But, this also sounds like something right down @ChiTownDoc's alley.

Damn, how'd you know this is kind of what I used to really specialize in?  Place scares me sometimes...

[EE2B 1565]

I thought you specialized in boats and hoes.

[tx 3 putt 77951]

lay off the viagra

ask your GP for a referral 

[Gil Bang 26101]

2 hours ago, ChiTownDoc said:

You need an EMG.  I used to do shitload of them but not so much these days.  Drop foot can be caused from a pinched nerve in a multitude of places...distally in the leg or more proximally in the back if you have back pain/injury etc. or even more centrally after a stroke/brain insult.  The EMG is no rush because it actually won't show anything for a few weeks because the degree of muscle denervation (your muscles that hold your foot up - dorsiflexors lost their innervation, hence drop foot) that occurs after nerve injury can not be determined until Wallerian degeneration is complete and this usually takes at least a few weeks.  I'd make an appointment to see a neurologist/physiatrist asap but don't go to the ER because they won't do much of anything you need done anyway.   Of course my disclaimer if you had any sort of acute injury you didn't mention run to the ER, so I can cover my ass.  

Damn, how'd you know this is kind of what I used to really specialize in?  Place scares me sometimes...

In Chicago, maybe.  In smaller towns, those mofos are as scarce as the hot bi chicks that are willing to do a 3 way with an older couple. 

[royiv 9423]

Don’t they shoot horses with this type of injury?

[futureman 22565]

On 8/8/2024 at 8:51 PM, Gil Bang said:

In Chicago, maybe.  In smaller towns, those mofos are as scarce as the hot bi chicks that are willing to do a 3 way with an older couple. 

there's a shortage of physiatrists?

[ChiTownDoc 21232]

On 8/8/2024 at 9:37 PM, tx 3 putt said:

lay off the viagra

ask your GP for a referral 

Not sure @Tex Long is still hittin it at 81 but I’ve seen multiple patients on our stroke / brain injury units end up there 2/2 to Viagra or other erectile dysfunction meds.  Funny thing is nobody ever sues over that in our experience.  If you’re gonna go, may as well go doing something you love.  

[Gil Bang 26101]

On 8/9/2024 at 11:16 PM, futureman said:

there's a shortage of physiatrists?

No idea if it's a "shortage", but it's not a large group.  Googles says just over 15,000 in the country.   That's more than I would have thought, and I'm guessing that the number has grown significantly recently.  When I was a recruiter for surgery centers, I met exactly 1, and that was in SoCal. 

[Tex Long 4511]

3 hours ago, ChiTownDoc said:

Not sure @Tex Long is still hittin it at 81 but I’ve seen multiple patients on our stroke / brain injury units end up there 2/2 to Viagra or other erectile dysfunction meds.  Funny thing is nobody ever sues over that in our experience.  If you’re gonna go, may as well go doing something you love.  

 An occasional sildenafil 100 for effect. I'm a lifelong low, slow pulse guy with resting pr 55 sleeping 50, bp 125/75 both +/- 5. Hitting the boner pill or the flower drops those a bit.

My neuro is 165 mi away, haven't called for appt, betting 30-60 days out when I do.

"Call your Doctor if your erection lasts more than four hours" is the most brilliant bit of  advertising of all time.

[troph 24929]

On 8/12/2024 at 7:29 PM, ChiTownDoc said:

Not sure @Tex Long is still hittin it at 81 but I’ve seen multiple patients on our stroke / brain injury units end up there 2/2 to Viagra or other erectile dysfunction meds.  Funny thing is nobody ever sues over that in our experience.  If you’re gonna go, may as well go doing something you love.  

Someone or something amirite JD? 

[Gil Bang 26101]

so my GF had a work retreat in Cabo.  She wanted me to go, but I had a couple of deals closing and had to stay home.  As a "consolation prize", she bought Viagra at the airport pharmacy.  Came home, and the next day said "let's see how many times you can fuck me this weekend".  Sounded good, so I took one, and...

 

Never again.  I seriously thought I was gonna have a heart attack.  Flushed the rest of those down the terlet. 

[TwiceHorn 31695]

On 8/8/2024 at 8:31 PM, ChiTownDoc said:

You need an EMG.  I used to do shitload of them but not so much these days.  Drop foot can be caused from a pinched nerve in a multitude of places...distally in the leg or more proximally in the back if you have back pain/injury etc. or even more centrally after a stroke/brain insult.  The EMG is no rush because it actually won't show anything for a few weeks because the degree of muscle denervation (your muscles that hold your foot up - dorsiflexors lost their innervation, hence drop foot) that occurs after nerve injury can not be determined until Wallerian degeneration is complete and this usually takes at least a few weeks.  I'd make an appointment to see a neurologist/physiatrist asap but don't go to the ER because they won't do much of anything you need done anyway.   Of course my disclaimer if you had any sort of acute injury you didn't mention run to the ER, so I can cover my ass.  

Damn, how'd you know this is kind of what I used to really specialize in?  Place scares me sometimes...

We spoke in pm once, so not really that creepy. 

[Nice Guy Eddie 13554]

It also never hurts to see an internist where you speak to them of your overall issues. I'm going to assume the OP doesn't have a PCP or has hid this issue from them.