“The good news is that you don’t have a stress fracture. The bad news is that you have a stress injury,” said Molly, my orthopedic PA–C. She is part of the Foot and Ankle Team, North Trauma Service at Panorama Orthopedics & Spine Center in Golden, Colorado.
I developed calf and ankle pain right when I was coming to Albuquerque and I thought it would go away if I rested for a few days. The acute pain persisted only when I walked despite leaving the trail and taking a side trip to DC. By the time I came to Golden, I knew it was more than just my ankle being mad at me for hiking 20–30 miles a day in the challenging conditions in the desert of New Mexico.
My friend Carrie took me to St. Anthony’s Hospital ER since Medi–Cal only covers ER visits out of state. Ah, I wished I was in Japan, a country of universal healthcare! At the same time, I felt very grateful and lucky to have Carrie who shuffled me between ER and her home. Not only that, I happened to stumble upon her place when she was leaving for her 2.5–week vacation. “You have your own Airbnb, Miho,” said Carrie, offering me her lovely apartment.
Given my pain and difficulty in walking, Tracy, the ER orthopedic PA-C, was concerned about a stress fracture. “The only way to confirm the stress fracture is to get an MRI. X-ray usually won’t show it and your X-ray came back fine. But we cannot order an MRI at the ER, unfortunately,” said Tracy. “We are going to treat you like you have a stress fracture. No weight bearing for the next 3–5 days, and follow-up with an orthopedist. They can order an MRI to get a diagnosis.” Soon after Tracy left to make a referral, a nurse showed up fitted my foot in a boot, and trained me on how to use crutches. I walked crutched out of the ER, thinking how different I was now from hiking 20+ miles a day with my 30+LB pack on the rugged terrain just a few days ago to not walking at all and crutching my way slowly in the parking lot.
In 2018, I shattered my left ankle in a climbing incident. I went through two surgeries and an intense recovery process to get back on the rock and trail. I have that experience under my belt and I thought this was nothing compared to that time. Every injury taught me something – patience, discipline, persistence, humbleness, self–love and a sense of humor are some of my takeaways. With these learnings, I am well–prepared to listen to whatever my body needs to heal.
After Memorial Day Weekend, I was able to make an appointment with Molly and I saw her yesterday. She heard me say that I am a thru-hiker, just happened to be in Golden and hoping to get back on the trail. She ordered an MRI right away and lucky me, I got it done on the same day. Today, she translated what the radiologist wrote on the finding report. Apparently, I sprained my ankle and had fluid build up in the bone marrow, indicating that it was a stress injury. After she delivered the good news and bad news and explained to me what was going on with my foot in detail, she said, “I think we can get you back on the trail and have you continue your hike. It’ll be challenging but manageable. Here are three things we could do. First, I can give you a steroid injection in your ankle joint. That relieves pain and reduces inflammation. Second, I can prescribe you pain medication and you’ll keep taking that for a month. Third, you will wear an ankle brace that would fit in your shoe. The brace will give you stability and prevent spraining your ankle again.”
I took a deep breath. I had a gut reaction of “no,” and then so many feelings and thoughts came up. My first two feelings were wonderful and terrifying. It’s wonderful that I could just go back on the trail and start hiking. My ego and white supremacy culture attempted to convince me that it is urgent and I need to get back on the tail ASAP no matter what. I quit my dream job for this and I could suck it up to make it to Canada. My humanity said it was terrifying that I would completely disconnect myself from the signals that my body was sending to me. The CDT will be there. Nobody is telling me that I must complete it NOW. What about the long–term impact on my injured ankle? I want to be hiking in my 80s or even in my 90s if I am still alive and able then! I said to Molly, “I am not an Olympian who has a game tomorrow and has to win a gold medal. Or a marathon runner who races this weekend and nothing after that. What would you say to an athlete who needs to hike a marathon a day with a 30+LB pack on their back almost every day for the next 4 months on the Continental Divide Trail?” “That’s a good perspective and an excellent question,” said Molly. She paused for a moment and without hesitation said, “Take a month off so your ankle can heal, and do physical therapy so you can get your strength back. I will make a referral to our PT department now so you can get started as soon as they can get you in. I will also give you medication instead of the injection. If you still think you need the injection after a couple of weeks, just come see me and I will do that for you.”
It’s a miracle that I was able to make a physical therapy appointment this evening. I met Andrea, a physical therapist who is skilled, friendly, fun, and easy to talk to. She took some measurements, made assessments, and noticed my tight calf muscle right away. She began her manual therapeutic massage and within 5 to 10 minutes, my calf started to loosen up. It’s incredible how our body responds to the hands of a skilled physical therapist. I was in good hands. She sent me home with exercises and things that I could do to take care of myself until I see her again next week.
On the way home, it was later in the day so hitchhiking was challenging. Since I don’t have a car and I am still acting like a thru-hiker, I have been hitchhiking in Golden ever since Carrie left. Some people in Golden probably never saw a hitchhiker and they get confused when they see me on the road with my thumb up, especially as I am wearing a boot and standing with crutches. Usually, within 10–15 minutes, I have been able to get a ride. It’s been fun to meet people and make friends in this way. Some people gave me their physical addresses, and phone numbers and asked me to stay in touch with them if I needed any help or something. Tonight, I stood on the side of the road for half an hour. Finally, a Jeep pulled over and it was Aaron, one of the PT technicians who talked to me while my foot was in the icing machine at the PT office. As I was getting into his car, he said, “I told you I would pick you up if I saw you on the road. I never picked up a hitchhiker before!” He gave me a ride and I was relieved when I entered Carrie’s home.
What a great day! I’m grateful for the fact that I was able to get a diagnosis done and physical therapy right away. This is probably the best medical experience I have ever had since I moved to the US, knowing that it is very difficult to get an MRI diagnosis and care promptly. It takes weeks, sometimes months, or a year to get an MRI. I know the answer and what to do to heal myself. I am most proud that I stay connected to myself. My body is a temple. I chose to listen to and respect the signals that my ankle was sending to me. My body is begging me to pause, pay attention to the pain and heal. Even though I stopped hiking the CDT, I am still on the journey of connection, healing, and building relationships.
For the next month, my focus is to listen to my body and do everything I can to heal. I trust that the universe gave me this injury to learn something. Whatever that is, I trust that the teaching will come and I will go back to the trail when I am ready. The only job that I have right now is to continue using my senses to tune into the world to receive the lessons. I have people cheering for me and helping me. The best gift I could return is to get better and stop pushing for the sake of a sense of urgency.
And, ego, certainly.
Appreciation: My (Carrie’s) neighbors – Brook & Tamara, and Tyler & Allyssa for the ride to the Golden Library, Erin for a ride to Boulder so I could see my friends, Alex and Matt for the ride to the orthopedic doctor’s appointments, and Bob & Rhonda and Maryann for the ride home from the appointments, and Justin, a free local shuttle driver, for picking me up on the side of the road and teaching me local transportation services that are available to me. Tracy and Molly, my PA–Cs, for listening to me and making a caring decision that honors my truth. Andrea, my PT, for working with me and putting me on the healing path. Last but not least, Carrie for letting me stay at her cute apartment, a sanctuary where I feel at home
Best learning: Practicing remedies of white supremacy culture is relevant in our everyday decision–making. One of the characteristics of white supremacy culture is a sense of urgency. In her article White Supremacy Culture – Still Here, Tema Okun mentions that a constant sense of urgency reflects our cultural habit of applying a sense of urgency to our everyday lives in ways that perpetuate power imbalance while disconnecting us from our need to breathe and pause and reflect. It makes it difficult to take time to think and act long–term, and/or to consider the consequences of whatever action we take. Although this article was written in the context of social and racial justice, all of the characteristics are pervasive in how we think and act in our everyday lives, including how we treat our bodies and injuries. If I had not been aware of this cultural norm, especially in a thru-hiking culture where I found it competitive and quantity–oriented, I may have chosen to get an injection, pop pain meds every day like vitamins, and get going even if my gut reaction said no
Challenges: Navigating medical insurance. It is exhausting to make many phone calls after phone calls to get the correct information, understand what’s covered and what’s not, and make decisions based on the information. It takes healing energy away from the patient who needs to be taken care of. I dream of a day when we have universal health care like what we have in Japan
Disappointment: Seeing atrophy on my right calf so quickly! I was just getting my “hiking legs” which takes a month or more of hiking to develop. Muscle is use it or lose it!
Exciting moments: Whenever someone pulls over and asks me, “Do you need a ride? Where are you going?” Erin, who gave me a ride to Boulder, said, “It’s not that hard to be nice to people. I am going there anyway.” When Molly said I don’t have a stress fracture. It would put me off the trail for at least 8–10 weeks if not longer. Having my friends in the Boulder and Denver area and seeing them. Figuring out how to be in a community where my only connection is Carrie and I had no intention to stay. I found that Golden Library is a lovely place to hang out, the Community Center is equipped with a gym, pools, and many free exercise programs to maintain my strength, Ore Cart Golden Shuttle Service is free for anyone, and a wonderful mobile social hub, especially when Justin is driving, and RTD, Regional Transportation District, has FlexRide, something similar to Uber or Lyft, as a low-cost public transportation. I was excited and relieved when I was approved for a disability discount RTD monthly pass! I am thriving and living in Golden like a resident!
