Wednesday, March 30, 2016

At the Podiatrist

Isaac was super good at the podiatrist today. I had him in a down stay on one side of the examining table and while the medical assistant was taking my vital signs and stuff, he stretched out and went to sleep. He was snoring, which the MA thought was hilarious.

Then, while I was waiting for the doctor to come in, I was reading a book and I had the leash in one hand but accidentally dropped it. So I woke Isaac up and asked him to get it for me. Which he did.

There was another patient across the hall, and she could see into the room where I was, and she called across the hall, "Your dog is so pretty!" I said thank you and she added "Smart, too."

Later, I had Isaac pick up my shoes and socks for me and she was super impressed with that.

 Also. None of the staff asked why I had a SD. Apparently they figured it was nothing to do with my feet and they didn't need to know.

The reason I was seeing the podiatrist was because I have been having muscle spasms in my feet for the past two months or so.  I saw my primary care doctor and he ordered some labs but couldn't figure out what was causing them.  

I saw my rheumatologist for a regularly scheduled appointment and asked her about it while I was there and she kind of blew me off, just said, "Oh, fibro can cause that."  But she didn't look at my feet or ask any questions and so I don't know how she could know if it was fibro or something else causing the muscle spasms in my case.  I mean, just because fibro can cause that doesn't mean that is what's causing it.  There are about a million things that can cause muscle spasms in feet.

So the podiatrist looked at my lab report and pointed out that my potassium is at the bottom of the reference range and told me that it can sometimes cause muscle spasms in feet when it's at that level. Something it seems like my primary care doc ought to have known, though I realize doctors usually know little about nutritional deficiencies. But since that's one of those electrolytes, it seems like he probably should have known that.

The podiatrist asked if I was having any muscle twitches around my eyes, which I do have but had thought was a side effect of my gabapentin, and he told me no, low potassium can cause that too. My primary doc didn't ask me about that and I didn't mention it to him because I thought it was just a side effect of the gabapentin.

The podiatrist said he does not think my muscle spasms are related to my fibromyalgia despite what my rheumatologist said, because while fibro can cause muscle spasms they are usually in the large muscles, not the small muscles. Um, shouldn't she have known that? Except she didn't ask me any questions or pay much attention to what I was describing to her.

She also told me that exercising more would help with the muscle spasms, which I thought was an odd thing to say since she didn't bother asking how much I already exercise first. In fact, I am exercising (walking) more now than I was six months ago and the podiatrist said the increase in exercise might be causing or contributing to the muscle spasms because it causes more lactic acid to build up in the muscles. Which does not mean I should stop exercising (how awesome would it be to be told I exercise too much? but no) but it also means exercising more is not the answer, at least not by itself.

I am not at all impressed with the rheumatologist.

So the podiatrist told me to eat more potassium in my diet and he gave me these temporary arch things for my feet. I go back in a couple weeks and if the arches seem to help, he is going to try to figure out how to get my insurance to pay for some inserts for my shoes that they usually won't cover.

I think I love my podiatrist. I think I might need a new rheumatologist, though.

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