Lopsided

My personal trainer Nick was the first one to tell me my left hip and lower back hurt and my right foot was numb because my femurs are two different lengths. He said I needed a lift in my left shoe. 

Of course I ignored him; if the answer to my pain was so simple, surely my internist would have figured this out by now.

Nevertheless, I told my massage therapist Jess what Nick had said while she was working on my lower back one day. Jess paused to compare the length of my femurs.

“He’s right,” she said. “You’re noticeably off.”

So I went to my internist and said, listen, I think all these pain problems are because my legs are two different lengths, and she said well, it will take forever to get you into Sports Medicine because you’re a middle-aged woman without an acute injury, but we can try.

And lo, the pandemic arrived. I worked out with Nick by FaceTime, and as I complained about my hip and back pain, he said, several times, one of these days, you should try a lift. And I saw Jess again when we all decided masking could work well enough, and she said you should try a lift.

But I thought things could not be that simple. Still, Sports Medicine would not call me back.

Fast forward to a visit to my internist's office for more back and hip pain. The P.A. said well, let’s try calling Sports Medicine again. They’ll want x-rays of your bones to measure the lengths, she said, so let’s get that done.

They zapped me and soon sent back the report that I am off by 6 millimeters. That doesn’t sound like a lot but I've since been told that anything over 3 millimeters is enough, by your mid-50s, to put you out of whack.

I finally got in to see the Sports Med doc. She turned out to also be a middle-aged runner, thank goodness, because she understood I don’t compete but I also don’t want to hurt. She liked the shirt I was wearing – “Middle-aged woman presents with…” – and asked me for one to wear to see her own doctor.

“They didn’t need to expose your lady-parts to x-rays,” she said with frustration, "because as soon as you walked across the room for me I could see your legs are two different lengths.”

“What do we do?” I asked.

“You go to the running-shoe store” (the one where I always go) “and you ask them for the 3 millimeter lift. It’s a little rubber pad you put under your heel in your left shoe. Then you use that for six weeks and if you’re feeling okay, you go up to the 6 millimeter lift. Then you wait a few weeks and come back and see me.”

I came back, gave her the shirt she had asked for, and exclaimed to her that I had no more hip pain and no more back pain, and why oh why didn’t I listen to Nick two years earlier? And she smiled and called me a poster child for a lift and said that I might want to go see this magical wizard specialist in orthotics for runners on the other side of town.

But why was my right foot still numb, I asked her? She said it might just be the nerves had to grow back right, or it might be something else.

Eventually it became obvious it was something else. So back to the internist, who said you need to see neurology, but you’re a middle-aged woman without an acute injury so it will take forever. And it did: seven more months.

The resident was great. She listened and pondered. I said to her, before we get all fancy in terms of looking for some terrible underlying cause for my foot being numb for three years, I think I might just be low on vitamin B-12. I have this friend who has the same gut problems as me, and I recently learned her feet go numb when she is low on B-12. I think you should test me for B-12.

The attending physician came in, a putz of a man. He saw this middle-aged woman with a boring problem, and said to me, you cross your legs when you sit and that’s why your foot has been numb for three years. Nevertheless, he wanted to do painful tests on my nerves to see if I had something bad.

I said can’t we just try seeing if my B-12 is low first? And he pooh-poohed me – B-12 deficiency causes bilateral problems, not unilateral, he said – but the resident ordered the B-12 test.

When the results came back, she called me very excited (I think because she disliked her attending as much as I did) and told me I was right! My B-12 was so absurdly low, she was surprised I was functional.

I wasn’t so functional. I was sleeping 2-3 hours in the middle of the day, often feeling what I called “bone-tired,” like I could barely make it across a room. On top of that, it had become almost impossible to read more than a page at a time in terms of comprehension, and I felt like maybe I needed to give up driving, what with the brain fog.

One B-12 shot – ooh, better? Two weeks later, another B-12 shot. Two weeks later, a third B-12 shot, and I asked how it could be that everyone else is not more productive if THIS is the energy level that is NORMAL? I stopped taking naps for the first time in 40 years. I felt confident driving again. I could read! Books!

Between the lift and the B-12, everything came back online, even my right foot, and running became incredible, like I was flying.

So then of course I ran too much and I tore a calf muscle in my right leg. When people asked me why I was in the boot, I said “celiac disease,” which wasn’t exactly wrong, if you think about it. (Gut problems, low B-12. Fix the B-12, run too hard, tear a muscle.)

The worst thing about the boot? It made me totally asymmetrical. Yep: hip pain, back pain.

The muscle healed and I went to the orthotics wizard in the hopes I would not tear the calf muscle again. She had me sit and stand and walk. She used an ink and paper technique to figure out the way my feet meet the ground, and she made careful notes of all this. Then she went off to make me orthotics and eventually called me back in.

She put her cork-based creations in my running shoes and said go walk around the hallway and tell me how it feels. And I came back and said to her: I can’t believe it.

I could immediately feel my hips rotate forward into the correct position, into the position I have tried for years to obtain and maintain because everyone (Nick, Jess, the internist) has told me I arch my back and I have to rotate my pelvis forward to stop my back pain.

And this little wizard smiled and said, “Amazing – you can feel that?” And I hugged her and said, “I can FEEL that!”

So I started flying again, though at first with caution out of fear of tearing another muscle, and I kept up the B-12, but my internist said to go to every month (down from every 2 weeks) with the B-12. But if I did that, it was too far apart.

The blood tests proved what I could feel: that after just two weeks, my B-12 level would crash back down and I would be back to long naps and a numb foot.

The internist looked at the blood results and said okay, I believe you, go ahead and inject every two weeks. But we should try to figure out: where is all your B-12 going? What is chewing it up?

By then, my gut was such a mess and my B-12 kept crashing and I got a referral to gastroenterology: an eight-month wait. For a video appointment.

I just couldn’t take it anymore. So I asked my internist-spouse to please make some calls – the thing I never do because I want him to know how hard it is for “normal people” (without connections) to get medical care in mid-Michigan. But I was so desperate.

So he made the call and I was with a GI at Henry Ford in Detroit within two weeks. She listened and said we’ll test this and that and the other thing, but I suspect you have SIBO: small intestine bacterial overgrowth. And the bacteria are chewing up all your B-12 and causing your other misery in your gut.

A few weeks later, she spit-roast scoped me – a tube in each end – and found nothing scary and said okay, try the SIBO hydrogen breath test. So I did the prep for that and did the breath-capturing test at home and sent it back to the lab.

I went off to visit my mother while waiting for the results. My phone finally pinged with a notice from the lab, so I opened my chart and read the results.

And I thought: that can’t be right. The methane level was ten times what counts as “too high.” I started looking for what could cause such a high level and I couldn’t find any literature on numbers that high, so I figured it had to just be wrong or I was reading it wrong.

Not ten minutes had passed since the results had come in and my phone rang, and it was the GI. The numbers are real, she said. “You must be so incredibly uncomfortable.”

It’s nice when the tests prove what you’ve been saying – when the x-rays show your legs really are two different lengths and the blood test shows you really can correctly “read” your own B-12 level by your exhaustion, numb foot, and brain fog, and the breath test shows your gut really is a total mess and you feel like you're carrying around a nine-month fetus made of gas.

“You’re basically a cow,” she said, not laughing. “I mean in terms of your methane level, you’re like at cow levels. We have to give you a special antibiotic treatment to beat this back.”

So she did, and the bacteria died back, and my B-12 started to not disappear so fast, and I started to feel like other people must feel.

Of course, now, a few months later, the bacteria are growing back and we’ll have to do it again, I guess. But for now, I am facing my annual birthday six-mile run with legs in a matched length and my pelvis correctly rotated forward, and enough B-12 home injections to feel pretty normal, and it all just seems so much simpler. Like I'm not trying to run up Mt. Everest.

But when I hear people say, “Anyone can run – you don’t need any special equipment, just a pair of running shoes!” I think of all the specialists I have needed just to run, and all the people who don’t have decent medical insurance and can’t afford to pay for orthotics  wizardry, and it’s just not true. To run at 59 (which I will soon be) is a sign of extraordinary privilege. And when I run, I think of that, and each run, I feel grateful I have had one more.

I asked my mother in the car a year or so ago, “Did you know I was born with two different length legs?”

“Oh yes,” she said, “they made us bring you back to the doctor several times because of it. And then I guess they just decided it was no big deal because you learned to walk.”

“Why didn’t you tell me?!” I asked, imagining how much easier life would have been if I had gotten the lift and the orthotics so many years earlier.

“I did tell you!” she said.

Having wracked my brain, I think this is what happened: I remember over the years my mother saying this to me on occasion:

“Do you think you would know if you had two different length legs?”

And I always answered, “I think so,” because I thought she meant “you” editorial:

“Do you think one would know if one had two different length legs?”

It never occurred to me she was asking me personally if I thought I myself would notice if I still had two different length legs.

When writers beget writers, and they don’t check to see which version of the second-person they are employing, unnecessary pain may result.