My paralyzed foot and back problem

Some of you have heard bits and pieces, and I apologize to those that haven't heard anything yet...but here is the latest:

About a month ago I noticed I was tripping quite frequently and kicking a lot of rocks on the dirt-cobble streets in Tiraque. Eventually I noticed it was because my right foot was not flexing. Self-examination showed that I could barely flex my foot, and could not flex my big toe at all. No swelling, not a bit of pain, and I can move it in every other direction just fine. If I touch it on the top inside, it feels like it is asleep, but otherwise, feels normal. The wierd thing is that, if I don't look at my foot, it feels like it works normally, but when I look at it, trying to flex it, I can see that it is not moving. (and this explains why I was kicking the ground a lot, and subsequently suffered a minor sprain playing soccer).

The doctor at the Jesuit mission clinic sent me to and orthopedic doc, who immediately sent me for X-rays of my lower back and an Electromiograph (EMG), confirming my suspicions that the problem was with nerves, rather than muscles or bones. The X-rays suggested a problem with the discs in the lumbar region of my back, so they sent me for an MRI to confirm. And sure enough, a herniated disc.

From how I understand it, there is a possible treatment using anti-inflammatories to fix the herniated disc, and if that doesn't work (or if the problem is too advanced), then surgery is the next step. The sooner the surgery (which of course, I would go back to the U.S for), the better the chances of regaining feeling/use of my foot.

But when I went to see a neurologist for a second opinion (a logical step in a case where my nerves seem to be the major problem), he was quite confused. He said that always with herniated disc there is a lot of pain. In the back, and often in the leg and/or foot as well. The fact that there is paralysis in the foot could be due to the herniated disc, but if the problem is so advnced to cause paralysis, there should be pain as well. The fact that there is no pain at all (while on the one hand a good thing, in terms of my physical comfort), is something that the neruologist finds confusing. So, he suggested that there are possibly two separate problems, one in the foot, the other in the back. And in trying to figure out the one in the foot, we stumbled upon the problem in the back, unrelated.

And, after a second EMG this morning, it seems that this is the case, suggesting that the herniated disc is not very far advanced (given that there is no pain), which is a very good thing. It seems that I won't need to do anything to my back unless pain or numbness in my back or legs starts, and and it is possible that this never happens. Now, having determined that the foot bone is not indeed connected to the backbone, then, well, it just depends on what it is connected to before we have any idea what to do next.



The neurologist was able to isolate a spot on my upper calf/shin within a range of about 9 cm where the velocity of the nerve signal is slowing down, indicating that in that area, something is affecting the nerve. I have to go back to Cochabamba for more consultation, tests, and diagnoses this week, and it is still possible that I will need some sort of surgery on my leg, but maybe physical therapy can take care of it. It all depends on the details and cause of the problem, but all in all it is good news.