In 2003 I had a bunionectomy for pain. I also had arthritis in the big toe joint. Unfortunately, it was not a good outcome. My big toe was overcorrected . I had a large screw placed and that was bothering me for many years. I had my shoes fitted with a full steel shank so that I didn't have extension or flexion in the toe. The shoes that I could take apart from an orthotist were my hiking shoes. Otherwise I would buy many different brands hoping to find something that I could wear for work. Ultimately, Birkenstocks were my go to shoe for comfort. I have spent thousands of dollars on shoes and then giving them away because I could not wear them. I was always hopeful...And I did NOT want another surgery.
The last couple of years I had the toe injected with a mixture of Marcaine and steroid. This would allow me to continue with my exercise routine and other activities. I started doing a rigorous class with TRX and circuits. This required a lot of burpees, jumping, lunging which put pressure on that joint. I also hike, bike and ski. My foot always felt better in a rigid ski boot which I modified or bike shoe. Over time my low back would start to gnaw in pain as I was compensating for my pain in the foot. I began to see a podiatrist and orthopedic doctor through the last 2-3 years.
As I became more frustrated, I started to think about having surgery to remove the first screw and have a fusion. I looked into a joint replacement, but in the toe/foot this would need to be replaced after time (5-10 years). I really did not want to go through more surgery if I can help it.
Finally I made the decision to GO FOR IT. My husband was also very tired of listening to me complain. I also had a lot of anxiety going into the surgery. I usually do not worry about much in general. My personality is more of a straight line. It takes a lot for me to lose sleep over an issue. But for a few months I was really nervous about all the possibilities. The first hurdle is infection. If a patient is going to have a wound infection it happens in about 7-10 days after surgery. The next hurdle is chronic pain. I am very familiar with this and am hoping the surgery will "fix" the pain. Time will tell.
Intra op after fusion
Post op day 3
Post op day 7
Post op day 14
Post op day 20
I had the procedure done at a surgery center connected to my podiatrist's office. I was able to wear comfortable clothes ( PJ's) and simply roll my pant leg up. I had an ankle block with IV sedation for anesthesia. I had a nurse anesthetist, not a doctor as my provider. He was very nice, but over medicated me with sedation. That probably happened because my doctor knew I was a basket case for 3 months before the surgery. The funny thing is, that I calmed down about 2 weeks before, as I accepted my situation . I had made the commitment to heal and be the best patient EVER! I cancelled my office hours and surgery for 6 weeks! I am determined to make this work and be compliant.
The surgery was about 1 1/2 hrs. I was back in the car headed home in a few hours after the surgery. The ankle block lasted about 12 hrs. I was given Percocet for pain. I started taking that as soon as I was aware that I was feeling my foot! The key to pain management is to stay ahead of the pain. I used ice on and off my foot for at least a week after surgery. I had a continuous ice machine from a previous knee surgery that worked great. I used an ace wrap to hold in place, along with a towel in between. You don't want the ice to be too cold to cause ischemia . Also, you don't leave the ice on for too long. But ice is very helpful for pain and swelling.
I stayed in bed with my foot up for as long as I could. If I had to get around I used a knee scooter. I live in a one story house with wood floors, so it was perfect to scoot around. I had a boot that the Podiatrist recommended, but my foot felt much better with the dressing and big sock to cover it. I did a lot of hopping and holding on to walls. I didn't use my crutches very much as I stayed inside for almost 2-3 weeks. Surprisingly, I thought I would go crazy out of boredom and inactivity. The opposite was true. I was very content to relax, read, think, rest and repeat. My life as a Urologist is non stop and I have thoroughly enjoyed stopping everything for a while. Soon enough I will be back to the treadmill of my life.
