“severe ensethopathy”

That’s doctorese for “your bone spurs are shredding your Achilles tendon, bro!” It’s exactly what I expected, but I also got a bunch of tests to rule out blood clots and gout. Now I’m scheduled for an MRI this afternoon to get the fine details, and once we work that out, next step is probably surgery. Yay.

One nice thing about living in a small town is that I called the clinic, they got me into an appointment this morning, I gave up a quart of blood for tests, got an X-ray, and got the conclusions within an hour. There’s a bit of a wait for the MRI, but it’s still same day service.

I recall taking my son into a clinic for a clearly broken arm in Philadelphia, and sitting there for almost 6 hours before he was treated. I show up here with a complaint that I’ve got an ouchie on my ankle and they whip me through like lightning. Maybe I’m just better at whining and complaining?


  1. anxionnat says

    #1–not necessarily. Depends if you have decent health insurance. Old and poor–>neglect.

  2. anxionnat says

    #1–not necessarily. Depends if you have decent health insurance. Old and poor–>neglect.

  3. Artor says

    They fear your wrath, PZ. You have a reputation around there, and they don’t want you sending your arachnid horde after them.

  4. EvoMonkey says

    Wow! That is fast. I injured my right hip two weeks on a Sunday night doing some exercises. I was in the Emergency Department of the local university hospital for 13 hers. It turned out I fractured the anterior inferior iliac spine on my right pelvis. Very painful.

    I’ve also had a bone spur on my right ankle. But not as bad as you describe. I hope you get better.

  5. says

    The human mind: I feel no different; I can do everything I did thirty years ago with no repercussions!
    The human body: You may test that assumption at your convenience.

  6. brightmoon says

    I can do a lot of what I used to do at 20 but I can’t do it for 6-7 hours like I used to . After 20 minutes I’m done

  7. magistramarla says

    That was fast, PZ. I hope that you get good care.
    We’ve found that small towns are not necessarily an advantage.
    We live in a small town in California, but the healthcare system here has been taken over by a large corporation.
    They control the local hospital, a huge group of doctors, the urgent care centers, ancillary services, such as radiology, lab tests, PT, and even the local hospice.
    The wait to see my PCP is usually a week or so, with follow-ups taking as much as 3 months.
    Getting in to see a specialist requires a referral and a wait of 3-6 months for an appointment.
    The worst thing is not being able to call in directly to a doctor’s office with a question or message.Every call is routed through a main call center, and I feel that the so-called “schedulers” don’t bother to forward most messages to the doctors.
    We’ve found that it’s not age, but gender that determines the level of care at this particular “healthcare” group.
    If my husband has a request, he gets “Yes sir, let’s get you in front of a specialist ASAP”.
    The same request from me is slow-walked, or just ignored.
    We’re lucky that we have Federal Employee’s insurance, so we often avoid the local mess and drive up to San Francisco for medical care.

  8. Reginald Selkirk says

    I gave up a quart of blood for tests

    I hope you are exaggerating for effect.

  9. microraptor says

    I live in a small town, too. Not as small as Morris but I can usually get seen by my doctor pretty quickly if I have a problem.

    The downside is that half the urgent care clinics in town are run by anti-vaxxers. And there’s one in a nearby community where the official stance is “covid does not exist.” Literally for the last two years, if someone went in with covid symptoms they would get told that they were imagining things and to go home.

  10. nomdeplume says

    Good news PZ (you really really don’t want gout!). Great to have a diagnosis and a potential cure. Now, if you lived in Australia you’d be treated at very little cost….

  11. says

    @7: After ten minutes my knees start using “more colorful metaphors”, to quote a certain Vulcan science officer. It sucks.

    @9: Having had blood draws, a quart sounds like a relatively light draw… 😬

  12. chrislawson says

    PZ, sorry for your situation and I hope it improves soon. Even worse than the pain, imo, is the restriction on mobility.

    The reason you got through so quickly is that it is a booked procedure while it sounds like your son presented to the emergency room which means there’s a lot of luck involved depending on how many other emergencies presented around the same time and whether they were higher priorities medically.

    OTOH, you’ve given a very good example of why US health care is so expensive. It is extremely unusual for MRI to be necessary for broken arms or Achilles tendinopathies. In almost all situations, all the clinical information necessary can be found with a plain XR or an ultrasound, both of which are much, much cheaper. Without knowing all the clinical details, I can’t say for sure that the MRIs in your cases were unnecessary, but in most parts of the world your son’s broken arm would be imaged with plain XR only and your heel pain would be imaged with ultrasound +/- XR and only progressed to MRI if there were significant clinical questions remaining. (Most Achilles tendinopathies don’t require imaging at all, but your level of pain justifies it.)

    Finally, just be aware that the standard story about bone spurs is mostly wrong (this is a common misconception even amongst doctors). The pain is not being caused by those spikes of bone you can see on the XR. The pain is caused by chronic tendon injury or inflammation, which then calcifies over time as part of the inflammatory response. That ‘spike’ is calcification in the root of the tendon and is not a knife sticking into surrounding tissues. This is not to say that the calcification does not contribute to pain — obviously it makes the tendon more rigid and prone to internal mechanical stress — but the core problem is the underlying tendinopathy; there is no great chisel of bone being driven into flesh. See https://www.physio-pedia.com/Achilles_Tendinopathy for more detail than you probably want, but it’s a good resource.

  13. says

    Hospitals where I am have press a button to get a number in the queue. They have a separate button for people over 50 called “warga emas”. This gets you to a shorter spot in the queue. “Warga emas” translates to
    “golden generation”. Getting old, sore and cranky does have its advantages.

  14. StevoR says

    Best wishes PZ Myers for as smooth and speedy a recovery as possible here.

    FWIW Recovering from an arthroscopy a couple of weeks ago myself & feeling much better than I feared & expected I’d feel.

  15. wzrd1 says

    Reginald Selkirk, no.
    No protection for PZ. it’s commie or something.
    And worse, defeats idiocy.
    While defending MAD.

    I grew up with it, not very fond of allowing my grandchildren to mature with it.

  16. chrislawson says

    @14– I gather you live in Malaysia. Medically speaking older people are more likely to have serious conditions when they present to ED…but having a special number so you don’t have to wait as long sounds like pandering to a demographic rather than triage.

  17. birgerjohansson says

    I am concerned as I imagine what surgery looks like. Do they scoop out the inflamed tissue and hack away the calcified bits with a chisel? Urrrrghh.

  18. wzrd1 says

    birgerjohansson, it’s actually via an incision and a burr tool, basically a Dremel grinder to remove the offending bone.
    My father went through similar surgery around 40 years before he died of old age.

    I’m working hard on old age, but I’m pretty sure I’ll die of fugly. ;)

  19. seversky says

    You never heard Trump complaining about bone spurs. Of course that may have had something to do with getting him out of military service in Vietnam. And not having had them in the first place.

  20. seversky says

    1 August 2023 at 8:56 am

    birgerjohansson, it’s actually via an incision and a burr tool, basically a Dremel grinder to remove the offending bone.

    McCoy : What is this, the Dark Ages?

    McCoy : My God man, drilling holes in his [heel] is not the answer! The artery must be repaired! Now, put away your butcher’s knives and let me save this patient before it’s too late!

    — Star Trek IV: The Voyage Home

  21. llDayo says

    I had to spend a year doing physical therapy (of which chiropractic care was considered part of) just to be able to qualify to schedule an MRI using my insurance, of which they paid about 35%, and it took a month to get in. Medical insurance sucks in Central Pennsylvania.

  22. birgerjohansson says

    IlDayo @ 29 Is this the “Romneycare” that Obama used as the template for his nationwide system? I hope Obama was more ambitious.
    There is progress in understanding how the axolotl can grow new limbs.
    I see a promising future application for mammals, PZ regenerating like Deadpool and cutting off offending limbs.

  23. llDayo says

    No, this is Blue Cross. It was a bad back issue (one that landed me in the emergency room at my wife’s push since I could barely even move). An MRI would only be covered to find out the problem after doing physical therapy. Problem is, an X-ray wasn’t really showing anything so I was supposed to somehow get something fixed without knowing the what the actual issue was. Great reasoning there. Turned out to be a double herniated disc which PT would only make worse.

  24. wzrd1 says

    llDayo, I’m in Harrisburg and well, your insurance really, really, really sucks.
    Hell, got a CT of my chest at UPMC within an hour of them thinking I had a heart attack, which I didn’t have, which cleared me of any blockages. Just the damned thyroid trying to kill me.
    I’d get my back looked at, but doctor incessantly gets distracted by little things that’d kill me. :/
    There’s a medical term for my overall condition – a train wreck.

  25. llDayo says

    Actually, the insurance has been relatively good (I work for the City of Reading), but it was just this one thing where I had to jump through hoops for no reason. Once the MRI was done, though, surgery and follow ups were done quickly.