Dr. Hanscom's Blog My Feet on Fire

My Orthopedic Training

I began my orthopedic surgery residency in 1981. I had an unusual path into this specialty in that I had completed two years of internal medicine residency in Spokane, WA prior to moving to Hawaii. Most orthopedic residents have had one or two years of general surgical training prior to specialty training. My fellow resident was extremely talented, which made the situation more intimidating. He also was of tremendous help in getting me through that first year.

In retrospect, I was not mentally ready for the switch from medicine to surgery. I could barely tie a knot, much less make an incision. My stress levels went through the roof.

The Burning Begins

I began to notice a slight burning sensation on the balls of my feet as I went for a jog. I did not think much about it and thought that it was a combination of the warm pavement combined with the jarring associated with running. Years later it became more constant and clearly was not due to the heat of the pavement. As time went on, it never disappeared but never bothered me that much.

Feet on Fire

I moved to Sun Valley in 1999. It was a difficult time for me personally. The warmth in my feet was still minimal. One night that abruptly changed. I had experienced a particularly difficult day and become extremely upset.

Within 12 hours the burning dramatically increased. I had never considered my feet more than a nuisance. I now felt like they were both in a toaster oven. It did not matter what I did the pain would not abate. Seeing patients usually distracted me from the pain. Now, it didn’t help. The only time I did not experience the severe pain was during surgery. For six months this persisted.

It strikes me as I am writing this how frustrating it is to describe your pain to other people. Words really cannot convey the severity of this pain and the absolute frustration I felt being trapped by it. I can sense this same frustration in almost every patient who is trying to convey his or her suffering to me.

I knew how angry I was at life. I intellectually knew that my anger was a problem but I could not let it go. I had every possible diagnostic test performed—all of which were normal.

The “Abyss”

I continued to sink into what I now term the “Abyss.” I define the abyss as anxiety multiplied by anger multiplied by time. I could not see a solution or the possibility of one. I completely lost hope. I also had no clue as to any link between anger and pain.

Understanding My Victimhood

It was on Mother’s Day 2002 that I realized what a victim role I had placed myself into. Prior to that moment I honestly did not understand what a victim was. I was always frustrated and was quick to blame anyone close by for my problems. As I felt so “right” in having these emotions, I thought it was just a normal way to be.

I also realized that there was no compelling solution. Being a victim is a powerful role and there is nothing in this life that will persuade you to willingly give it up. I had no choice. I just made the decision to not be a victim.

Relief

Within two weeks the burning began to abate and within three months it returned the baseline nuisance pain I had experienced for over 20 years.

I have had two flare-ups in the last couple of years. Both were related to extreme stress and not sleeping very well. The intensity of these episodes was severe. I also had fallen off of the wagon and quit using the tools I had learned to stay connected to my day. Both episodes resolved within five to seven days using these basic strategies.

Pain and Anger

The link between anger and pain pathways is absolute. I don’t know anyone who is happy about receiving a painful impulse to his or her brain. This linkage is also the reason it is essentially impossible to have pain relief unless you can truly process and let go of your anger. It has to be your deepest anger. As there are abundant opportunities to experience frustration and anger this is the most challenging part of this whole process.

I am still and always will be a work in progress on this one. Life does keep coming at me and I go into the victim role multiple times daily. I just don’t stay in it very long. I have some writing I need to do today. Ask my wife…