Cortisone Injection: Take 2

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Some of you may remember when I got a cortisone injection into my left pointer finger. If I am to play word association with “Left pointer finger cortisone injection,” the first thing that comes to mind is “PTSD, PTSD,PTSD, that was AWFUL.”

I will admit that I have had no problems with said pointer finger since that day that I try to block out.

When my doctor suggested that it was time to consider it for my left ankle, I think my stomach dropped out of my butt and I broke out in a cold sweat. I said I’d think about it…but inside, I was all HELLLLLLLL NOOOO.

You see, my ankles have never really bothered me RA wise. That is until roughly 3 years ago. I went to Target after work wearing foam bottomed flip flops, and slipped on unmarked standing water in the entry way in front of the service desk. I was lucky to be holding on to my cart; I wrenched my left ankle outward and landed on my right kneecap. Without the cart, I am pretty sure I would’ve smacked my head on the floor. My kneecap (knock on wood) gave me no problems after the bruise healed, but the left ankle just never healed completely.

Yes, I should’ve pursued it. Fail on my part.

Yes, the customer service geniuses at Target should’ve handled it better period. The handling I got? The kid looked at me and said oh so profoundly: did you fall? He actually asked me twice…I said yes and then went and hid in women’s seasonal apparel for a really quick ugly cry. It HURT.

Anyway, I digress.

Long story short: I didn’t pursue Target, I reinjured it twice after, and wound up having 3 inverse sprains in a 14 month period. True to RA, I started having some disease activity around the site of the injury. I’ve been working on rehabbing it and it has gotten much, much better. But it still wasn’t 100%.

The more I thought about the cortisone injection, the more it made sense. If I don’t get it to heal completely, surely it will cause issues with my knee and hip later on. I could tell I was walking funny to compensate for it. Are knee and hip problems at a later date really worth something that sucks for only a minute and costs a $40 copay?

When I said that out loud, I realized how dumb I would be to not do it.

So I called, made the appointment, and started the pep talk.

The day of the appointment, I decided the following things:

a) I am not allowed to just not show up and pay the no show fee. An attractive option, yes, but stupid.
b) I am not allowed to ugly cry, scream, and overall pitch a freaking fit. I am too old for such behavior.
c) I am allowed to produce a tear or two. Said tear or two must not be accompanied by any form of sound.

As I sat in the waiting room, I caught myself thinking “I’d so much rather have a pap smear today.”

They called me back and took me to the procedure room. The PA used the ultrasound machine to look at my ankle, take pictures, and put together the plan of attack. She took the time to let me watch the ultrasound and pointed out different features (even though they all looked the same to me.)

My rheumatologist joined us, and while reviewing the pictures/discussing where to go in, I apparently exhaled really loudly. They both looked at me and said “are we really stressing you out right now?”

Um yes. I just heard that a needle was going in the front of my foot all the way to the back underneath the leg bone. That is…stressful.

They had me lay down at that point.

My heart was racing as they cleaned the ultrasound goo off my foot. I made a few quick addendums to my list of things I am allowed to do:

a) scrap all things I’m not allowed to do
b) ugly crying is fine, noise if you must
c) just get through this
d) I can have Starbucks if I live

They sterilized my foot, sprayed it with the cold numbing spray, and told me they were going to do the Lidocaine injection. I tensed up, held my breath, and felt…a very small pinch. No burning, not really even any stinging. Just a pinch.

Huh.

They applied sterile ultrasound goo so that they could see where they were injecting next.

With the ultrasound in place, my doctor said they were going to start with the injection. I starred at the ceiling and realized…if he hadn’t told me they were putting the needle in, I wouldn’t have known. I felt nothing. No pain, no pressure. I did feel a few tiny “puffs” as they injected the cortisone into the joint…but not the searing, unbearable pain of the pointer finger.

It was over in a matter of seconds.

They wiped my foot off, applied a Bandaid, and I was at Starbucks less than 15 minutes later.

As with my finger, it took several days for the full effect to be felt. It was a little puffy for a few days. It’s still a little stiff and sore BUT it’s sore in new places. I was worried about that at first, until I realized it was sore in the places I haven’t used in a long time because I was actually walking correctly.

I am really working on building up balance, range of motion and proprioception right now. I can balance for almost a minute on my left foot now whereas before I couldn’t even do 10 seconds. Range of motion is still a little tight but getting better. Being someone who wants everything done now, I was a little concerned at first that it wasn’t immediately better. But we all know that immediately getting full function back after a long term injury…isn’t realistic. I am slowly but surely seeing progress, and that is fine by me!

I may be changing my word association on cortisone injections…although I hope I never have one again!!

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One response »

  1. I have found that having Starbucks Coffee or Chai is certain to give me an RA Flare up….I am soooo much better when I stay away from there……however sad it makes me…

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