Two weeks without wearing the boot after four weeks with it. In general, the ankle is worse now than it was before I wore the boot. Before, after the first few days where it hurt a lot, the pain subsided and it mostly did not hurt, except for one night in my sleep I turned my foot wrong and the pain woke me up, so I went to the doctor. Now, it hurts on and off when I walk or drive. Some days are very good, some are very bad, some are on-and-off pain. On the very bad days I wore a certain pair of suede "comfort mocs" from LL Bean with Superfeet insoles in them. On the other days I have worn sneakers with Superfeet insoles. At this point I plan to wear sneakers every day indefinitely. I have two old pairs of the same New Balance running shoe, one white and one gray; I just ordered a new pair of the same model in dark blue and plan to order new pairs of the white and gray soon. So I'll have three pairs of brand new sneakers that should be as comfortable as I can get.

I am very angry and frustrated and worried that it is worse after wearing the boot.

I have an appointment to see the doctor early next week. I am already planning to seek a second opinion. Today I went to the website for the surgeon in NY who performed the original surgery and sent a message via the "contact us" form, asking if they could recommend a doctor with expertise in posterior tibial tendon dysfunction in DC/VA/MD. I included a brief summary of my history (surgery in 1993, excellent results, no pain until recently.)

Whatever happens next, I expect that this is going to cost $$$. In addition to the copays to see the doctor (and possible second or third opinions from out-of-network doctors) I may be facing an MRI, custom orthotics and physical therapy. My health insurance includes a series of $1000 deductibles on durable medical equipment and PT as well as limits on the number of covered PT appointments. And a $200 copay for an MRI.

Last week I rode 40 miles on the indoor trainer and on Sunday I did a flat 30-mile bike ride; both times my my ankle felt fine. Tonight I'm going to try a short ride with hills. Even if it doesn't hurt at all, I am very worried that the doctor will say that I can't ride my bike anymore. Also worried that he will say I can't drive -- if I have to be trapped in my apartment with the stomping elephants upstairs and no ability to exercise I will go completely insane. For the first time ever I am using cruise control in the car. It seems to help, though often there is too much traffic to use it. (Also it feels weird and I can't figure out where to keep my foot while it's on.)

I know more than one of you knows what this is like. Maybe it will improve over time, I hope so. But then again I went through all this before and ended up on the operating table with a long recovery period.

Sigh.