#8 ~ Week Five and Extra Checkup

March 2017

Recap of my injuries [from post #7] after surgery

The first time I fell was at home about 3½ weeks after surgery: my toes hit the floor with force. The second time I fell was on concrete porch steps a few days later: the bottom of my cast thudded down on the cement. I had become quite active on one leg before my falls: vacuuming, cleaning the floors with a Swiffer mop, going up and down the stairs, showering at least twice a week with a bag over my cast, yoga, and more. Both times that I fell were a result of being careless, rather than from doing too much. Neither fall happened when I was performing any type of feat; I was standing in the living room next to the knee walker the first time, and I was going up two porch steps the second time. I had done both of these things numerous times before.

Pain

The pain and tingling in my foot was much worse after my second fall. The fall itself did not hurt as much the second time; however, the pain got worse as time went on, rather than better. In fact, a few days after this, I took a couple of Norco pills I'd had leftover after surgery, since I had not taken them all then. My foot throbbed when I first got up in the morning, and it throbbed within five minutes anytime I got up to move around. I could no longer bend my big toe without using my fingers, and I had been able to do so before my falls. 

Initially, I thought the pain and tingling was just a setback in my recovery because of the trauma to my foot. After the third day, I thought the pain felt worse than it had after surgery. It was actually difficult to judge the pain for sure, since I had been taking Norco for three days following the surgery, which dulled the pain. I called the doctor's office five days after my second fall, and they scheduled an appointment for two days later.

#7 ~ Week Four, Injuries, Second X-ray (third checkup)

March 2017

Blue-gray toe color and exercises

My fourth week started out great. I had increased my toe exercises, and I was keeping the blue-gray color in my toes under control. My toes still got discolored after I had been on my feet for over 30 minutes, and the color returned to normal after I did the leg and toe exercises. After I whacked my toes (details under next heading), my toes turned purple within 5 minutes every time I got up. The color still returned to normal after the exercises. Before my [first] injury, I had started to wash my big toe area as best I could around the stitched area with a cotton ball, and I was applying petroleum jelly or aloe to the toe. This helped with the cracked skin feeling I had when I exercised that toe (part of the reason I was afraid of scarring). I also continued yoga daily, except for two days following my toe injuries. I was afraid to do much of anything after my falls.

Injuries ~ twice this week!

I felt like I was doing very well, and then I got overconfident and careless. One morning, I misjudged the location of the knee walker, and was not able to catch my balance in time. My toes hit the floor with tremendous pressure and all of my weight before the rest of me then hit the floor. Even though I was on carpet, I should have had the walker locked, and I should have been looking down at it before attempting to drop my knee onto it. The fall was painful, however, the pain was overshadowed by the extreme fear I had about whether I had done any damage inside my foot. I stayed on the floor about 20 or 30 minutes - gingerly checking my toes and foot as best I could, and praying. I was not uncomfortable on the living room carpet, and I was not unable to get up. I was just afraid to move. The most pain I felt when it happened was in the arch of my foot, except when I tried to move my toes. My big toe was very painful when I tried to move it back and forth. I also felt mild pain in the ball of my foot (more than just the discomfort I had been feeling), and in the knuckle of my big toe. This fall/toe stubbing happened only a couple of days after my last post, when I expressed how carefully I had been taking care of my foot! I guess it was a good thing I had a cast on after all. 😓

#6 ~ Week Three After Second Checkup and Cast On

March 2017

Pain, swelling, and comfort

The minimal pain I had been experiencing did not change much. Since I could now move my toes, and the doctor had told me I should, I started toe exercises. I must have overdone it the first day, because in the late afternoon I had a lot of pain and tingling along the top of all of my toes, which also extended up the top of my foot from my big toe. The pain lasted for about an hour. I had thought about putting ice on my toes, but then the pain subsided before I did. I had a similar feeling the next day or so, although not as severe, since I cut back on the exercises a bit. After this, the only pain I felt when exercising my toes, was with my big toe. The entire end/tip of my big toe hurt when I bent it, along with the area where my big toe connects to my foot. It looked like a cut had been made almost all the way around my big toe in this area. This is visible in the last photo in this post, and in previous pictures of my foot with the bandage removed.

The cast was initially uncomfortable around the ankle area, and on the second evening with the cast I noticed a new problem. I loved that my toes were exposed so I could move them; however, I had not thought about the comfort of where my cast ended until I experienced the discomfort 24-hours later. The cast ended at the start of the ball of my foot, when it seems like it would have been more natural to extend to where my toes connect to my foot. The purple in the photo below is the cast. A full cast photo is visible in previous post #5. The cast was made by the doctor hand-rolling the cast wrapping around my foot, so it seems like it could have been made to fit my foot. You would not think having something rest on the edge of the ball of your foot would be bothersome; however, after a length of time it is! In fact, I considered going back to the doctor a couple of days later, as I was not sure I would be able to stand it for two weeks. Even though I was not standing on my foot, this end of the cast pressed against my foot at all times, even when my leg was elevated.

Underside of my cast

My ankle no longer felt swollen at the end of the third week, and this area was not bothersome. The top of my foot was uncomfortable instead. Even though there was soft gauze around my foot under the cast, the top of my foot was sore. It felt raw, as though the tender stitched area was rubbing against the rough cast. The ball of my foot where the cast hit underneath was also sore, as if this area around my foot was now swollen instead of my ankle. I did not understand why my podiatrist had chosen to fully cast my foot when I saw many more comfortable looking foot wrappings online. If you do an online search for "foot cast after bunion surgery," you will see many options. I thought the type of covering in the photo below looked the most comfortable. This would not be as protective as the cast; however, I would have preferred it. I was extremely diligent about the care I gave my foot, and about not putting any weight on it. I had not thought to research foot coverings, and I had not specifically asked my doctor about what kind of foot cast I would have before I had the surgery.

Photo from Margaret River Correspondent blog

Exercise

I continued the same yoga and leg raise routines, along with the added toe bends. I did the leg raises more frequently, and I added a few more leg exercises after my toes turned blueish gray in color (more about this under the next heading). I did about 10 minutes of leg exercises every hour or so. After my toe pain the first day, I initially cut back on the toe exercises, and then I gradually increased the amount I did. I did not stretch my big toe as much as the others; not only because it was painful, but I also wondered if the activity might increase scarring from the cut around this toe.

#5 ~ Week Two, Second Checkup, Stitches Removed, New Cast

March 2017

Pain and swelling

My foot pain was minimal the second week. Sure, I could feel discomfort on the top of my foot where the stitches were, and I am sure it would be painful, if my foot got bumped; however, I did not experience continual or severe pain. It was mildly painful when I wiggled my toes, which I had a difficult time with. Just like the first week, most of my discomfort came from the wrapping around my leg and foot. It felt like my toes were all scrunched together, especially my pinky toe. This contributed to me being unable to wiggle them much. The gauze between my big toe and first toe was extremely uncomfortable, as was the wrapping over the top of my big toe around the knuckle area. It felt like my ankle was still swollen at times, causing discomfort in this area. I could not wait for my second checkup to have the wrapping removed! The firm backing/support behind my leg was too tall for me, and I planned to ask the doctor to cut this down, if my leg was going to be wrapped the same way. I continued using an ice pack under my knee for a few days, which felt like it helped the swelling initially. It did not feel like this was helping after a few days, so I did not continue to use it regularly. Instead, I raised my leg higher or did leg exercises to help reduce the swelling and discomfort.

Activity

I continued with yoga daily, and I did the leg exercises about 5 or 6 times a day. Since I was moving around more, I did not do the leg lifts and bends as frequently as I had the first week when I was more inactive than active. I thought (or, hoped!) maybe my belly would become rock hard from the leg lifts and bends everyday. I did them for 5+ minutes each time; about 50 leg lefts and bends on each leg each time, and I did not see any evidence of this yet. I did, however, feel as though my leg strength was increasing.

We went out to dinner the second week. I am sure my husband wanted a break from all the dinner prep and cleanup! 😉 I did not have too much difficulty getting around with my crutches, and sitting in the restaurant was comfortable enough. I thought one of the most difficult actions was going up and down steps - Not the carpeted stairs to our basement that I schooched up and down, but the two cement steps from the porch in front of our house, and the restaurant steps with no railings. I had to be strong enough and stable enough to hop up and down each step, and then move the crutches. The drive/ride was just over a half hour one-way.

#4 ~ The First Week and First Checkup

February 2017

I had read about many different experiences that people had with this type of surgery, so I was not sure exactly what to expect. Some people said they had no pain, and others said they were practically bed-ridden in severe pain the first two weeks, or longer. Possibly, the different experiences may have to do with the doctors and procedure type, the severity of the person's situation, and/or the person's health. 

A brief reminder/summary of my situation: the bunion itself was not painful, although it caused other problems as my big toe pressed against my other toes; my surgery took less than 1½ hours, my bunion bone had been shaved/cut, and I had two screws in my foot; I am in my mid-50s, and I was healthy and active before surgery. Additionally, I had twisted my ankle falling on the ice a few weeks before surgery. My ankle had healed in terms of walking on it; however, it was still a bit swollen at times. My primary physician had told me this is normal, especially since I have a bit of arthritis in my joints.

Pain and swelling

The places where I felt pain from the surgery were the top of my foot closer to the ankle, and around my big toe. My greatest discomfort, however, was around my entire foot, just below the ankle and heel, where the foot connects to the leg. This area around my entire foot (not just the top part) became especially painful and throbbed when I exercised my leg. When I went for my first checkup, I found out this is because my ankle was so swollen. There is more about this under the checkup heading father down in this post.

#3 ~ The Day of Surgery

February 2017

At home in the morning

We needed to be at the surgery center at 6:30 a.m. My instructions said to wash the foot I would be having surgery on with anti-bacterial soap for 5 minutes. My body was also supposed to be free of all nail polish, jewelry, and any lotions or scents; including deodorant. I took a shower that morning, and then did not apply any lotions. I used my usual shampoo and conditioners on my hair, which did not cause any issues at the surgery center.

Since I would not be able to get jeans or similar pants over my leg after surgery, I opted to wear a calf-length sweater dress, which easily slipped over my head. And remember, I could not consume anything - not even water. I had been specifically told to spit out any toothpaste, and not to swallow any water, if I brushed my teeth. Which, of course, I did! Along with mouthwash, too...

Prep for surgery

At the surgical center, we went through the basic admitting process: insurance info, questions about my identity and what I was there for, confirmation of any allergies and medications, and so forth. I was in the operating room with my two physicians and assistants before 7:30 a.m. 

#2 ~ Preparing for Surgery

February 2017

Pre-op exams

I had an office visit with both my foot doctor and regular physician a few weeks before the scheduled surgery date to make sure I was healthy enough for surgery. I have always been a healthy person with nothing out of the ordinary, and the only experience that was new for me during my pre-op exams was that I had an EKG at my doctor's office.

My foot doctor gave me three prescriptions to fill: Norco (pain killer for after the surgery), crutches, and a knee roller. I asked him if there were any exercises I could do beforehand that would assist with the healing process, and he said no. He said that since I am quite active (yoga, walking/hiking, biking, etc.), I would already be ahead of many patients. Even so, my projected recovery time was 6 to 8 weeks non-weight bearing with 3 to 4 months total recovery time. Yikes! I guess there are two types of bunion surgery, and mine was the more severe kind, needing two physicians to perform the operation.

#1 ~ The Decision

Fall 2016

Is bunion surgery right for you? Why I decided to do it ~

My previous physician had always advised me not to have bunion surgery. She said that it is very painful, and that if I was not having problems, I should just live with it. I have always thought the bunions were unsightly, although my husband assured me they did not bother him any. So, I lived with them for several years.

A few years ago, my doctor transferred to a different area of medicine, and I had to find a new physician. The doctor I started seeing then had a different opinion. She said that if I was going to need surgery eventually, I would be better off to have it now, while I am healthy and active, because the healing process would be quicker than when I am older. I thought about this, as I discussed it with her a bit more, and then I asked her for a referral. 

My situation was that the bunions themselves were not painful; however, I did have other problems: difficulty finding shoes that fit over or around the bunions, and the bunion made my big toe crooked, pushing it into my other toes. This caused me to get blisters between and under my toes when I walked a lot.