If you’ve been following Ciao, Cancer! over the last few days, you know that 1) I spent some time kayaking and hanging out with my family last week on Orcas Island; 2) while I was there, broke my foot; 3) asked people for help (which I don’t normally do); and 4) got some exercise ideas from Captain Quinn to discuss in my then-forthcoming appointment with my orthopedist. I saw Dr. John Kennedy at the Hospital for Special Surgery yesterday afternoon, learned that I’d previously been misdiagnosed (with potentially significant consequences), and went home in an aircast.

As it turns out, I did not break any bone, which sounded pretty good to me until Dr. Kennedy explained what had actually happened. The bone in question is the sesamoid. We have them around several joints in our bodies — in our feet, knees, and hands. Sesamoids are tiny, pea-sized, but because they affect how our joints function, problems with them can hamper our movement and cause serious pain. Another thing about sesamoids: not all of us have the same number. For example, adults usually have two sesamoids in each foot under the big toe. We start out with four in each foot as babies, but in most people pairs of them fuse together. In my foot, like 15% of the population, one of the two pairs did not fuse together into a single bone. They stayed next to each other, and fibrous material developed in-between them to hold them together.

What most likely happened is that when I started working out more seriously six weeks ago, the sesamoids in my right foot became inflamed. But when I was lugging that kayak up from the beach last week, I most likely misstepped, and the result was that the connecting material was cut in half. This, apparently, is not good. Why? Because there are tiny blood vessels that feed the sesamoids. When the bones are broken (or detached, in my case), pressure on the joint (from walking, standing, etc.) can cut off blood flow to the bones, which subsequently die. And that permanently affects joint operation (and movement as a consequence), often requires surgery, and, as many sprinters and football players (both American football and soccer) apparently know, causes considerable, chronic pain. Had I continued working out, or even walking without support, as the first doctor said was perfectly fine, that could have been my plight.

When Dr. Kennedy finished explaining the diagnosis and treatment (an aircast, ultrasound stimulation of the affected area using a nifty portable electronic device, and later, physical therapy), I asked him about the fitness suggestions that Captain Quinn had put together for me. Dr. Kennedy said that I should go ahead with all the muscle-building exercises, but that for the time being the only aerobic exercise I should pursue is swimming. Anything else, even biking, could put strain on the sesamoids, and that’s no good.

I’m going to order the workout equipment today that Captain Quinn recommended. And this weekend I’ll head over to the Y and jump in the pool. Altogether, a setback, but hey, no big thing.