3-Day Post-Op Visit After Hardware Removal

October 2018

Blood seepage and doc visit

I am posting a brief update for those of you that have questions about blood seepage after surgery. I wrote in my last post about how I was concerned with all of the blood on my bandage, since I had not experienced this after my first two surgeries. There are photos showing the amount of blood lost in my previous post. According to my doctor, this sometimes happens, and he did not seem concerned. There were two spots on my incisions that had fresh blood spots, which he dabbed, and then wrapped my foot back up. 

I thought my foot looked pretty gruesome when the bandage was removed. My stitches look more like frankenstein than they had before! I am afraid I am going to have some nasty scarring after this heals. My doctor had said I was going to have two small incisions, and I have two large nasty-looking ones.

I removed the photo of my foot showing the stitches that I originally shared because I had a complaint--even though this blog is meant to provide information and not to provoke disgust. Feel free to contact me, if you are interested is seeing a view of the differences between dissolvable inside stitches and exterior stitches. The scarring that I have from these two incisions with exterior stitches is worse than what I have from the dissolvable stitches on my other foot. 

Bunion Hardware Removal and Scraping

October 2018

After my last post in May 2018, my right foot healed pretty much the same as my left had in 2017. The only difference I noticed, is that I had more stiffness in my big toe than I recalled with my left foot, and my foot did not feel like it stepped down correctly/flat on the ground. I am writing this post two days post-op, and this 3rd surgery experience is even more different than my first two. Starting at the beginning...

Pre-op visit September 2018

I have been seeing a different doctor in the office, since my checkup in May when my original doctor had me return to get a second opinion. I am much happier with this doctor. He shows me the X-rays and explains everything, and he is more observant. For example, I had noticed two things after my second surgery, which he discussed with me before I had a chance to bring them up. One, is the way my foot set on the floor, and the second is that the bunion protrusion on my right foot was still pronounced; more so than my left foot after my surgery on that foot. It was kind of like they had not corrected that area as much on my right foot, as they had on my left foot. This is more visible in the photo if you click on it to enlarge it. The problem I have with my big toe pressing against my first toe is that I get blisters between these two toes when I walk or hike a lot.

My feet 2 days before surgery

Four Weeks Post-Op [second foot] and Third Checkup

March 2018

Pain and swelling

My swelling remained minimal. My foot mainly just swelled up from the weight of the boot, when I used the crutches instead of the knee scooter. I kept my foot elevated when seated, and I applied ice several times during the day. During week 2, the cold ice had made my veins feel painful, and then during week 3, the ice made my foot pain lessen. I looked forward to applying the ice bag, because it made my foot feel so good. You can see in the photo below that I still had quite a bit of bruising on both my feet at 3 weeks post-op. My right big toe is also bruised, although that is not very visible in the photo.

Both feet at 3 weeks

After 3 weeks, the only pain in my left foot occurred when I touched the top of my foot, or when exercising the foot. When I exercised that foot, the skin felt tight and tender across the top. The top of my foot was tender enough that I had to wear loose shoes, or shoes that did not touch the top of my foot.

The pain on top of my right foot remained; it felt like a heavy, rough, hard surface was pressing down on my foot. When exercising, I felt tingling, rough/ripping type pain along the top of my foot and through the inside to the toe. Occasionally, my right foot felt painful or throbbed when I went to bed, although the pain was not enough that it kept me awake. My big toe knuckle was quite sore, and I wondered if more bone had been shaved off this foot than the other one. When I had asked my doctor about any differences, he said the two procedures had been pretty much the same. He said that even if I had had both my feet done at the same time, I would probably still have different feelings between my two feet.

By week 4, the pain in my right foot had lessened to just the big toe and knuckle area, except when I was exercising. The shooting, tingling, scraping pain was worst when I stretched and bent my toes backward toward my body, or when I tried to point my toes.

Exercises

My doctor had told me that it is best to bend my toes even if it is painful (after I asked him, of course, since he never offered any information on his own), so I did this every hour or two throughout the day. After 5 days, I noticed fresh blood around the incision on my right toe. I cleaned the area, and applied Neosporin and a bandaid. I then discontinued toe exercises on that foot for a few days.

Along with flexing my toes and ankles while seated, I did floor exercises every couple of hours; about 5 to 8 times per day. This was extremely painful when I started the following routine 2-weeks post-op. I gently stretched, flexed, etc., and most of the pain lessened as time went on. I think the leg exercises are especially beneficial in getting the oxygen and blood flowing throughout the body. I found that some of these exercises eliminated the tingling, scratchy pain in my foot and toe knuckle. The pain did not stay gone, although it did dissipate during movement.

For informational purposes, I am sharing the exercises I did, and my results below. Please remember: I am not a doctor. Readers should always consult with his or her physician about matters relating to ones own health.

First Two Weeks after [second foot] Bunion Surgery and Second Checkup

March 2018

Recap, in case you are not reading every post

In February, I had bunion surgery on my right foot, and I had two large screws removed from my left foot (bunion surgery on that foot last year). My right foot is non-weight bearing for 6 weeks, and I left the surgery center with my left foot wrapped and in a walking shoe.

My feet after wrappings removed at doctor's office and 
stitches snipped. Photo can be enlarged by clicking on it.

Second checkup at 2 weeks post-op

An assistant removed the wrapping and bandages from both my feet, and she snipped the stitches. All of this was painful, as the bandages were stuck to my feet (you can see the material indentions in the photo above if you enlarge it). The stitches must have been tight, because it felt like she was going to puncture my skin in the process of trying to snip the ends. When she finished, I noticed a hole in my toe, circled in the photo above. I do not know if this was caused by the instruments she had used; I did not notice it before my visit. When I looked at my feet after she had finished, I said, "Oh, I have a hole in my toe." She did not say anything.

When the doctor came in, he said everything looked good. He put steri-strips over the incisions, and then said he was going to put my foot in a cast. I asked him if he had talked with the other doctor about me getting a boot instead. He gave me the impression he prefers a cast, although he did not say why. He did not explain any advantages or disadvantages of either one; he merely stressed that I still could not put any pressure or weight on my foot. The assistant asked him if she needed to get a tall or short boot, and he said tall. She returned with the boot, which she put on me, and that was pretty much the extent of my visit. I had to specifically ask if I could remove it to shower, or anything else I wanted to know.

Getting around with a cast on my leg verses a boot

I have not decided yet, if I prefer the cast or the boot. I have noticed pros and cons for each (listed below). I think the boot I received is too large for me, which makes moving around difficult, and a bit dangerous. I made an mild remark about the size and weight when I was in the office, and the only response I received, was an agreement that it is heavy. I actually feel like my doctor gave me a heavier, larger boot than I need in an effort to make me realize that the cast is a better option. I got the feeling a cast is his preference, and a boot is the preference of the other doctor in this office. Now, I am trying to decide if I want to tough it out until my next appointment in 2 weeks, or if I want to go back this week and request a smaller boot. 

This is the boot on my leg. My foot is 100% hidden inside. I
rolled the top down after I got home, so I could bend my knee.

The boot weighs 2½ lbs.! That may not sound like much until you look at it this way: 2½ lbs. equals about 39 ounces of liquid. So, take a 46-oz. jug of V-8 juice, pour out a 7-oz. glass, strap the jug on the back or side of your lower leg above the ankle, and then try to walk around on crutches--making sure that your foot never hits the floor or anything else. This is not an easy task. It is especially difficult to get up off the floor (something I have to do every hour or two after I exercise my feet and legs) without letting my foot touch the floor.

#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.