Tadahhhh, Finally I'm BUNIONLESS!

So the surgery went off. I was under for half, if not even less than half the time of my left foot. I came out of the anesthesia much clearer too. I actually remember getting dressed this time!  ;o)

Same as before, my right foot had to be marked before surgery.

And again, I added a little foot humor to hopefully keep them laughing in the operating room. ;o)

The IV went in and I waited around a bit before my anesthesiologist delivered my cocktail through the IV. Then I was wheeled away into the operating room where there was some happening music being played. Then I conked out. 

I didn't know if the fusion pain-pump was just for the Brachy last time, but it turns out I have it this time too. (one tube this time though, instead of two.)

Without the ace bandage, you can see the seeping of blood. Eeew.

I'm not to remove the dressing. That will be done by Dr. West when I see him in 3 days.

The bruising that I can see is on my big toe.

Here are my lovely friends again. ;0) I won't need the Roxicet until after the pump comes out. Most definitely for travel back home. (Again, I was given a prescription for a 4th drug to reduce nausea. Again, I didn't fill it cuz my stomach is pretty solid.) FYI: These medications keep me awake.

Making the breakfast smoothie the morning after at mom's. (the hospital didn't tape the tube to my leg this time, so I had to do it. ;o)

I'm suppose to only have my leg down for 5 minutes at a time, and only once in every hour. That is very hard to do.

For now, I feel more pain in my 5th bunion than my first. (pinckie toe)

Later.

Surgery Time Again!

Waiting to board the plane

I'm out west. The trip was good all things considered. (If I could have, I would have taken some ibuprofen to have been more comfortable.) 

I'm going in for surgery in 3 hrs, but wanted to make this post in connection to my last one.

I spoke with Dr. West about the Bunnionette. He said he didn't do what I asked because it's part of the joint and shaving it down is just not good. (the joint has cartilage. I would imagine this would affect it's range of motion considerably.) (update: But even with this, he DID DO IT for my right foot. I was in more pain, but he managed it and I lost no range of motion in my pinkie toe. So now it's done on my right and not my left. ;o/ )

Also, he acknowledged how low my 4th toe sits. He mentioned that there is still time for healing and things to improve. I have to continue the toe exercises, and that there is surgery he could perform that would loosen up the [tendon?] there, but then the toe may not grip the floor at all. So I guess I will continue to do the toe exercises, cuz after today... no more surgery for me!

I did actually show him the images in my last post of how the stem of that toe touches the floor and is uncomfortable. I showed him the xray image of how low my 4th metatarsal bones are compared to the others. He said that is absolutely normal. That all feet are like that. Hmmm.


I also got to meet Eddie, the insurance & scheduling guy at Dr. West's office. We have emailed but never met. I had mentioned that I would like to meet him this time around. So he actually took the time to come around to meet me in person yesterday when I was having my pre-op appointment. That was so sweet! ;o) It really made me happy to meet the person who was putting up with all my emailing. ;o)

I also got to see Barbara again, Dr. West's assistant. She welcomed me back with a smile. The entire office personnel there are just really nice people. It was great seeing them all again.

Ok, I gotta go. See you all later!

Brachy Toe FUNCTIONALITY

I'd like to talk about the actual function and alignment of my fourth toe with this corrective surgery. I think it's important and seems like no one is talking about it. As I stated in my very early posts, I wasn't just interested in an esthetically pleasant looking toe. I wanted to know about functionality, but no doctor really had abundant specifics on that. They are just sure not to promise anything. And if you don't ask about certain topics, they won't bring it up either.

So let's get to it. My take on it at this point is that Dr. West went a little overboard with "over-correcting" my toe. My best guess is that from his medical perspective of how the foot functions, toes are your grippers and offer a great deal of balance for the body. If he had to choose between a floating toe or a toe that grips the floor too much, he would choose the later. BUT, that's giving him the benefit of the doubt.

There is no doubt that I've done my exercises, etc. I even took Dr. West's advice about wearing heels after surgery to help gain range-of-motion (mostly for the Bunionectomy he did.) (See that post here. Once there, scroll down to the bottom  and read the short blurb starting at: "Other things...")

Bottom is BEFORE wearing the heels,
Top is AFTER wearing the heels.
(I'm reclined forward in both shots.)

This image shows my fourth toe after wearing that heel for about 3 hours. In the top image, my fourth toe isn't pressing against the floor more than the other toes as in the bottom shot. But then my 4th toe settles back down and is like in the before image, which is set too low. imo.

You can see here, when I lean my body forward, the fourth toe shows a great deal more pressure onto the floor than the other toes. (See the yellow tip of the toe?)

This photo shows you how it is set too low. As you know, it was even lower 10 weeks ago. The exercises have placed it up this high. But now at my 20th week, it seems this is as good as it will get? Thus, Dr. West went too crazy with the over-correction. (Remember, this is my opinion.)

The imprint of my foot on my flip-flop demonstrates what I'm talking about. My fourth toe is pressing against the floor much more than my other toes.

So why does this matter?

I'm glad you asked.;o)

It causes several difficulties. 

1. I'm not so sure it is healthy for the bones in that toe to be under this constant 'resistance' pressure.

2. Being set so low forces the entire 4th toe to touch the floor. That's not normal.

The stem of your toes do not usually touch the floor consistently. There isn't enough meat (cushion) in that area like the tip of your toes. The tips of your toes were designed to touch the floor consistently, not the stems. If they were, you'd have more meat there to deal with the pressure of your bones against the floor.

So that is what is happening to me. The stem of my fourth toe is being forced against the floor by the way the bones are set. This causes discomfort. I can't walk barefoot without discomfort so I have to keep foam flip flops near by.


Before my surgery the 3 bones to my fourth toe were in a curved high position (see "B" below). Also, the 4th metatarsal bone that was elongated, seemed to have a portion of the bone, that by nature, protruded downward. (See "A" below. Orange.)

This is verified in "C" below when you look at the shape of those bones. (Orange) 

And now all of that has been set downward. Too downward. Look at the bones for the 1st and 2nd toes in "C" (black and pink). The bones for the 4th are way too close to the floor now inside my foot. Perhaps this is the only way to get a Brachy toe to stop levitating?

*Double-click for larger view.*

3. Another thing it causes is the stem of the 4th toe to press against the skin of my foot, trapping moisture.

I learned in my 20s, when I had my Brachy toe, that I had to be sure to keep the skin under that toe very dry. Otherwise I'd get athletes foot in that one little area beneath the toe. The moisture would sort of eat away at the skin and cause a wound. 


Well I guess I'll have to watch out for that now too with the stem of that toe trapping moisture because of the way it's pinching the skin. ;o/

"Trade-off" is a topic more of us need to address with this surgery. You gain some things you wanted, but you also have chances of gaining some things you don't want too.

I'm seeing Dr. West in a week for my right foot. I need to gather myself and see what is worth mentioning to him and what is not. I think he is a good doctor. But this condition, being addressed by doctors, is a new thing. 

My job is linked to the medical community. I know all too well the mind-set of doctors. It's a whole different world. Even good doctors practice keeping silent about things they feel are 'touchy' areas.

There is something I do want to mention to him and need to find a constructive way to do it. The Bunionectomy he did for my bunionette is disappointing. He missed the mark completely to what I had complained about in my consultation with him. The bone I needed him to shave down, due to pain in shoes, wasn't touched. Instead he worked on the "profile" of the bunionette. He did what he called a sort of "tuck" with the skin. Which looks real nice. ;-) It makes my foot look narrower. I really like that— I want him to do that to my right foot. BUT I think it's unacceptable to go through all this and still have the bone I initially complained about still be a pain issue. (turns out he did miss the mark and unless I go under the knife again, I'll have to live with it.)


I do have a small suspicion that perhaps it was not done because it can't be done. You know, like it's part of the joint kinda. But I have to talk to him about this cuz there needs to be understanding between us before doing my right foot.

I think it's important to extend grace to people who are trying to help you. I don't want him to think I don't trust him, cuz I do. I wouldn't travel so far if I didn't.

I have no idea if Dr. West will volunteer to fix what he missed last time on my left foot. It would have to be very un-invasive  because I need my left foot to bare all the weight while my right foot is healing.

Anyway, I'll see how it goes. It's important to be gracious and demonstrate understanding. He may not volunteer to fix what he missed. I need to be prepared for that.

On a good note, in a week all my surgeries will be over. Thank God. ;o)

Tootles.

The Big SCIATIC Post

I didn't even know that sciatic was a nerve, or where it was. I mean, I've seen people grab the back of their hip and complain about sciatica, but that was it. Unfortunately I am now much more educated with it.

The stuff I found online doesn't seem to apply to me though. Much of the sciatic issues mentioned stem from lower back problems and disc issues, which I have none. I think it's possible that I might be able to help someone out there by sharing what happened and how I'm dealing with it.

"The sciatic nerve is a large nerve fiber in humans and other animals. It begins in the lower back and runs through the buttock and down the lower limb. It is the longest and widest single nerve in the human body." [wikipedia.com]

After going through this pain, reaching out to my doctors, and getting nothing that has actually helped me, I was forced to take matters into my own hands. ("I" even had to ask to be sent to physical therapy.)

My online search and my doctors had advised the following exercises. However, they only gave me very temporary relief. I always ended up back at square one within a few hours.

I thought I had hit the jackpot with this one,
but it offered no permanent or growing relief.

This did nothing for my sciatic nerve. It helped stretch my heel cord (tendon)
which I need too but nothing for my sciatic pain

After weeks of no help, I started to pray. It then dawned on me that perhaps it's the way in which I'd been sitting that was aggravating the nerve. I had a congestion issue in my leg and was sitting in a position that helped that issue (A). I began to sit up (B). While I had to deal with the congestion in my leg (it was better that 3 months ago), I started to feel relief of the sciatic pain.

So it seems to me that my sciatic problem happened because of the way I was sitting for 3.5 months. (update: as time passed I realized the nerve must have been aggravated during surgery.) It put pressure on my nerve for an extended period of time. Sitting up began to help, but did not solve all of the pain. 

I kept praying. The following two exercises came to me out of nowhere and have been offering me growing relief at a slow pace.

I do these without the band

This one was on my mind for a long time.
But I was afraid it would aggravate the nerve. It's helping though.

I'm now taking either ibuprofen or naproxen twice a day to keep both pain and inflammation, if indeed it's an issue, at bay.

After being able to start getting relief I canceled my physical therapy appointment because I asked Dr. Yes if physical therapy would make me do stretches I'm already doing. He said that was probable. ;o/

However, I'm going out soon for surgery on my right foot. I'm curious to know if they have anything further to offer. So I will be going to at least one physical therapy appointment to see if they can lend anything additional that will help me RECOVER from this and not just manage it.

I'll keep you posted.

Hope During the Pain

Photo Credit: DevineMusic.org.uk

I'd like to offer some hope about any pain you may have at this time. I found that when I experienced difficulties with my tendons and other things, I felt like it would be here forever. It felt that way because I just didn't see how my flexibility would improve. I felt permanently damaged, you know.

But just know that it does get better. ;O) You will not stay with the difficulty forever. It may be a slower recovery than we would like, but you do get better.

At this time I'm not pain-free— yet. But I have less pain now then I had 3 weeks ago. That's how I measure it to keep myself focused on the right thing.

I hate how fast my foot gets tired & achy from just walking the dog, but I remember when I couldn't walk the dog, or drive my car! So focus on the little bits of progress. Smile and say, "Hey I couldn't do such-and-such 3 weeks ago!"

SMILE

Week 16-17 Post-Op Summary

"Foam soles" seems to be
the comfiest thing right now.

Hi everybody! Ok let's get to it...

The biggest thing in the past two weeks is that the pain in my leg was persistent even with all the stretching I was doing for my sciatic nerve. As you recall I sent out an email asking for help to both my doctors one weekend. I'll spare the details and say that ultimately neither was of help to me in this matter. "I" even had to ask to be given an Rx for physical therapy (PT). 

When I asked if PT would have me do stretches I'm already doing on my own, the answer I got was, "It's probable." It was also said, "Patients your age usually do good on their own. It's older patients that seem to need the motivation of a three-times-a-week commitment to stick with it."

Nonetheless I decided to have my doctor give me the Rx anyway because I'm going for surgery soon for my right foot and need this pain addressed now! I made an appointment to go in a week (the only opening they had).

The pain was miserable and led me to pray quite a bit about it. Feeling alone in the matter I asked for wisdom of what to do about the pain to relieve it. Sure enough 4 days ago a notion entered my brain. I asked myself what had I been doing for 4 months because of this surgery that isn't part of my normal routine. "SITTING" is the word that came to mind.

I felt like a broken record in my posts, with my doctor... and my friends, with my: "I can't sit upright yet! I have to sit reclined with my legs up because of the congestion in my leg." Well it occurred to me that my manner of sitting was putting pressure on my sciatic nerve, aggravating it. Working 8 hours a day, 5 days a week now, in this position may be increasing the problem.

I immediately sat upright with feet on the floor! It felt odd at first and of course I felt the congestion setting into my leg, but it's certainly not as bad as it was 2 months ago. I really wanted to give this a go so I forced myself to stay upright during my work day. I FELT BETTER! Three days later 80% of my sciatic pain was gone! Praise God for giving me this inclination!!

Any sciatic pain I feel now I believe is just the nerve inflamed for what it's been through and my lack of exercise. As I continue to sit upright and let things heal I'm convinced it will totally go away. I will be canceling the physical therapy for tomorrow. From what I've gathered, I will be made to do stretches I'm already doing, inconvenience my work schedule 3 times a week, and cost me $120 a week in copay fees. So I'll do it on my own. (see newer posts... I ended up going to one PT session.)

Other than that, I still have the regular pain that comes along with this surgery at this time by practicing walking again. (and swelling) I'm doing stretches to regain flexibility in my tendons, muscles, etc.

The thing I found that helps the most in this matter is to not be annoyed that I'm still in pain at 18 weeks in. Instead I look back to see what I couldn't do 2 weeks ago. When you look at how you can do something now that you couldn't do 2 week prior, it makes you feel real good. It's important to celebrate progress. Not the amount, just the fact that you're progressing. ;o) I've learned to say "YAY FOR ME!"

MEDICATION

I'm taking either ibuprofen or naproxen to address any inflammation.

I'M NO LINGER USING MY BOOT OR CRUTCHES. I did get a cane though because I went to an outing where there was a lot of people and I wanted to visually tag myself as someone to be careful around. ;o) (Now that I'm beginning my 18th week I've stopped using the ace bandage altogether. My foot is now bare and in sneakers or foam flip flops.) Walking barefoot on floor is still too uncomfortable.

I can only walk short distances before the pain makes me stop and rest. ei: I can walk my dog in the morning and then go to a doctor's appointment, by the time I get home, my foot is in quite a bit of pain and I have to sit and lift my foot up for a bit. But in a very short period of time I feel fine again. ;o) YAY!

Pretty.

I couldn't resist these! They are actually really tight. But I have a theory, that they are tight in all the right places based on the fact that "pressure" is the best thing for hypertrophic scars.

I'll wear these around the house to stretch them out.

You can see my right bunion sticking out! That is going away in three weeks!! ;o)

I got these to help me look forward to my surgery in three weeks and my vacation cruise in 4 months!

Now a member at DSW! Yay for me!! ;o)

Tootles!

What I Feel When I Walk

Walking on the floor with bare feet is too painful at this point. I use nice cushy open shoes in the house, and my new sneaks outside. (with ace bandage around my ankle.)

While these plates do not exist in my foot, this is what it feels like if I walk barefoot on the floor. It feels as though I have these two platelets under my soles. It hurts as if there isn't enough 'meat' under my soles to cushion them. They feel sharp and it hurts.
__________________________________________________

This is a visual representation of the hardware actually in my foot. 7 screws, (there is a narrow plate used with the 6 screws) for the bone graph.

Bunion Comparison

Surgery on Left foot only here.

This picture IS worth a thousand words, no? ;o)

Hey remember, there is a ton of information in the right column. Check it all out! 


If you're looking for a particular subject and don't want to go through the Archive list, try the Label list!


Ciao!

LET'S HEAR IT FOR MY RIGHT FOOT!!!

I just want to take my hat off to my right foot, and leg! It has worked serious overtime in the past 15 weeks. And it still bears more weight than it should as I'm still not fully vested in my left side.

So take a bow! You deserve it! ;o)

Week 15 — Post-Op Highlights

Howdy.
A picture is worth a thousand words right? I'm definitely visually adept, but there is more going on than this photo can tell. So I'll tell you. ;o)

IN A SNEAKER!

Saw Dr. Yes last week. I've graduated into sneakers. Went out and got a good pair. I choose a men's (I need the extra width) Nike Air Max Run Lite +2. They were the most comfortable to me out of the selection. I also choose them because I would be able to add some comfort insoles in them without a problem. I needed a sneaker that would have enough space top-to-bottom (vertically) in the front.

I got 2 kinds of insoles. One for Heel pain relief and the other for the Sole.

I wanted them both in a men's size for the extra width, but was only able to find one. ;o(

Nothing seems to take the pain I feel away, but this is better then just the insole that came in the sneaker from the manufacturer. ;o)

Because the ace bandage would be too bulky, in a sneaker my Doc gave me this snazzy TIGHT sock. It does my scars good. (Remember the post I made about pressure being the best thing for scars?) 

My ankle and foot need the support (especially while driving my stick shift) so the sock is a good thing. But I do find that my foot starts to ache after about 5 hours. It's too snug after that time.


But I still wear my ace on top of that for ankle support.

PAIN
Let me be clear, while I am now out of my boot and off crutches, I'm walking with a great deal of pain and discomfort.

There are three things going on in the pain department:

    1. Both front and back of the sole of my foot
        are quite painful when I walk. It feels as though have metal         plates there, right under the skin of my soles.

     2. The Achilles tendon (Heel cord) is very tight

     3. My sciatic nerve

I had complained of this pain maaaany weeks ago and after describing it again to Dr. Yes this past week, he simply told me what it was. GO FIGURE! He gave me stretches to do.

The exercise was to stand arms-length away from a wall. Place palm of hands flat on wall, lean into wall by bending elbows... bringing the body toward the wall while heels remain on the floor. I found that this addressed the Achilles tendon, but not my sciatic nerve pain. 

I knew nothing about the sciatic nerve so I looked it up. I found this stretch was the best one so far:


For me however, I need more than this stretch. (The pain is persistent.) I have sent an email (because it's the weekend) to both of my doctors explaining the pain even though I am doing all the stretches, and requesting actual physical therapy. I'll let you know what they say. (In the meantime I've started taking Advil for the Ibuprofen. I'm hoping it relives the inflammation.)


WALKING

Stretching the Achilles tendon (heel cord) is Soooo necessary. With effort, I am able to go up stairs one foot in front of the other like normal (need bandage on).

But going down stairs is a totally different story. There is no limberness in that tendon. Until this happens to you, you never realize how it actually helps you go down the stairs.

I'm working daily to stretch this out. While I do not have permanent improvement in my sciatic nerve, I do experience permanent improvement in this tendon with my stretches. ;o)

There are stretches on YouTube for this tendon, but I find they aren't the best for those of us who have had Brachy surgery because we can not fully put weight on the foot yet. This is what I came up with that works best for me:

SLEEPING

I'm now enjoying full sleep through the night! YAY! ;oD

CONGESTION
This is improving also. (See: STRANGE)

NUMBNESS

(the images used to show the numbness areas in this post are old images of my foot. Just the highlighted sections are current status.)

Week 13 & 14 — First Steps!

Howdy! I thought I'd start off with something funny. Check out my toes! The toes on my left foot try real hard, but I can't spread 'um. ;o)

Last 2 weeks have been a bit of a whirlwind for me personally, but things are progressing. (videos below)

Let me get right down to it. Normally your doctor will give you instruction as to how to start walking. Each person is different, it also depends on the method of correction. My doctor kept me on crutches and my boot for week No.13— partial weight bearing. For week No.14 I could try ditching the crutches only in the house.

But I really ended up not following doctor's orders and overdid it. I wish I could tell you how week 13 would be for you, but mine was really not normal. I made personal decisions that kept me on my foot waaaaay too often and let's just say it was more than partial weight. But those were "my" personal decisions I made to spend time with some family.

I do not recommend planning outings or entertaining during this time! So I don't know what it would feel like to ease into walking.


PAIN
So I went from having trickled down on the pain between wk 9-12 and now I'm back up again. The pain is different. It is very difficult to explain. You feel pressure in areas where you feel weakened. You feel like there is a bruise under your heel. Your foot aches and your ankle swells a bit too. And walking is short lived because of the discomfort— you'll prefer to sit. 

But I have just kept going. Living alone all this time makes me grateful that I can finally get up, get something, and carry it back in one of my hands (been using only one crutch, yay). I would love to be pain free after 12 weeks of great discomfort and trial, but I tell myself I've only been putting weight on it for two weeks.


I still can not sit upright with my leg up and be ok. My leg starts to hurt after about 30min. So I have to sit 'reclined' with my leg up. (I sound like a broken record with this! I wish walking-pain was all I had to deal with.)

But this is all passing. Just like the hard times during the 12 weeks passed, this will too! ;oD

Anywhooo let's get to the good stuff!!! 

Week 13—
This is what an bird's-eye-view photograph can not show you! ;o)

Week 14—
First Steps... Crutch Free!

Brachy Physical Therapy

I've been wanting to get this video out for a long time. This is my physical therapy for the Brachy toe after one-stage surgery.

I cut myself off at the end LOL. I'm no videographer! ;o) 

Here is another important thing to do:

I CAN BARELY RESIST!!!!!!!!

OY! In two days I will be in Dr. Yes' office WALKING! I can't stand it! I'm so tempted to just try it here at home.

But I know I can't take that chance. He will take xrays first. If all looks promising then I can probably take my very first steps (WITH CRUTCHES).

I'm not going to be running, or walking around at the track even, but its PROGRESS dog gone-it! ;o)

Some people reach this point only to have the doctor say, "you need another 2/4 weeks". That sure is disappointing, but I've heard them say, "Heck if I did 12 weeks I can do 2 more!" That's the best way to look at it I think.

I have a strange suspicion that Dr. Yes is simply going to follow Dr. West's automated instructions for this process. (He hasn't seen me during post op. We don't really have a choice. I have sent him pictures of my progress though.) Not that he'll let me walk if he sees something very odd. He is a conscientious doctor after all.

Having been homebound as much as I have I really feel like a different person. I feel very caged and am glad that I started working from home this week. It has served as a good distraction.

I don't know what I'll do once I'm decently mobile! I think I'll go everywhere! LOL. Oh yeah, I booked my vacation today. YAY FOR ME! I'M GOING ON A CRUISE! I so needed something to look forward to. In 7 months I'll be sailing... WITH flip flops!!!! 

I know for a fact that my foot will feel weird on the floor when weight is applied. It will feel as though something very hard has been placed where my 4th metatarsal is. I can feel that already when I'm laying down, feet on the bed, knees bent towards the ceiling.

I wonder if it will dissipate or if it will stay, and I'll just get use to it.

12th Wk — Post-Op Summary!!!!!!

Tadahhhh. I made it!

Take a good look as to where things use to be.
(double-click image for larger view)

This 12th week felt different for me. My leg and foot just felt better. (I wonder how much of that was due to the placebo affect ;o) In any case it felt wonderful to feel wonderful!!!!

This was my first week back to working from home too. It was tiring, but nice to have something to do to help pass the time. I do miss my coworkers greatly and will enjoy when I'm back in the office gain. (Hopefully sporting some great flip-flops ;o)

I saw Dr. Yes. He took xrays. All looked well and as instructed by Dr. West, I took my first steps! My first steps were with my boot on, and my crutches.

This next week (wk 13) I am transitioning out of NW (non-weight bearing) to PW, (partial-weight bearing). I will walk with my boot on, and crutches.

Then on wk 14, if I feel well, I can just use the boot without crutches— BUT just in my apartment. When I go out, I will still have to use both the boot, and crutches. Doctor's orders.

12 WEEK COMPARISON

(double-click image for larger view)

LENGTHENING

My measurements tell me I received 10 millimeters of lengthening!