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My Excellent Toe Surgery Adventure - Hallux Rigidus, Plate/Screw Fusion, and Osteotomy - Page 47
Glad your doing well and off the pain meds. The plate and screws are pretty standard. I'm actually having some lingering issues that the surgeon thinks is the hard ware. My surgery was 18 months ago so the fusion is completely healed so he recommended removing them. I'm trying custom fitted orthotics which seem to be helping but long term is probably not the answer.
It's been a while since I've been on here. Hope everyone is having continued success in their healing and as always I enjoy catching up on how you are all doing!!! I'm at 12 weeks now (think I got my weeks confused a few posts back, sorry) and saw the Dr last week. I told her I felt fine in the boot but had some pain when trying to walk in any shoes. I was sent for a CT scan in addition to the xrays and then resentenced to another 3 weeks in the boot. My fused toe is showing signs of healing but not as far along as hoped. My foot is still a little swollen and showing sign of bone loss in other areas (from inactivity in the cast and boot). Not enough to worry about yet but something to keep an eye on. Not exactly the report I wanted but could always be worse. For now, I'll just keep trucking along in the boot and hope for the best at my next checkup! Take care all!
Golfing Queen, once I got into shoes at 11 weeks, I wore my Brooks all of the time. The first few days, though, the insoles were removed and laces were loose. The doctor told me to wear enclosed shoes inside of my home also, not just when I went out. This was to help reduce swelling and for protection.
BrookeB, sorry to hear that you have more time in the boot. Are you in a cam walker or a surgical shoe? Is your gait affected?
Tin man, What kinds of issues might the hardware cause?
PJP45, are your stitches out yet?
I hope that everyone is doing well.
This was today at my two week appointment. Needless to say, my skin isn't healing as well as hoped and very swollen. Only a couple of stitches were removed at the bottom of the toe. I am starting on antibiotics and have a follow-up appointment next Thursday. Yes, that is necrosis at the top of the scar which is disappointing. I may be switching to a wet to dry dressing but time will tell. The good news is that the x-rays today show that bone placement and healing on the inside look good! Still having pain which stinks. Thankful that my doctor is not stingy with the pain meds!
Cindy, I was the one who's hardware wasn't sterilized when I went in. Luckily, they just had me go home for the three hours it took to sterilize, then I went back as the last surgery of the day. I would have had to wait another week, otherwise, and I had my schedule all planned out, so didn't want that to happen! Glad your second surgery went well. Can't believe you were posting coherently the day of surgery!
Pjp, That blood rushing to your leg thing happened to me when I had my cheilectomy. It was worse than any of the other pain, imo. I was really worried about it for this surgery but for some reason it didn't happen at all.
Earlybird, the pain the first couple of days after surgery wasn't as bad as I thought it would be. I got all nervous for nothing!
I'm 9 weeks today. Still having trouble with the top of my foot. I swear there is one place where a screw is coming out, but it will probably end up being more dissolving stitches trying to work their way out. I hope so! I have a recurring scab where I assume a screw is placed, and the area is red and hurts when my boot rubs against it. I've been pretty much wearing a bandaid all the time.
Today I had a huge rehearsal - 1 1/2 hour drive to the site, then rehearsed from 9 am til 4 pm with an hour for lunch. I've been having to use my left foot on the piano pedal, so that throws my back a bit out of whack, but it's not too bad. My foot was KILLING me before the day was over. I suppose I still keep it elevated a lot at home, since I sit sideways on the couch with my feet up when I'm watching tv or on the computer. I have the same rehearsal schedule tomorrow, followed by a concert in the evening, so an even longer day. I'm thinking of taking my crutches with me. Even though I didn't walk too much (as far as I can remember) it might be helpful to stay off my foot. We'll see.
i go back to the Dr. next Tuesday. Shoes, maybe? Crossing my fingers!
Hi All, Just wanted to say a huge thanks to Bob and all of the subsequent posters who have kept this very informative forum alive. Other than my surgeon's advice, this was the most valuable resource for me to inform myself so I could weigh my options and make decisions that were right for me.
I had what I thought was a bunion on top of my right foot for the past 6-7 years. I'm a very active hiker, cyclist, runner and cross country skier and have been able to continue doing all of those activities without any discomfort until the past couple of months. I didn't have any pain, but the discomfort of my footwear pressing on the growth, and forcing me to adapt my gait to accommodate, motivated me to see a podiatrist.
I was very surprised and disappointed when he told me that I actually had a huge bone spur created by significant arthritis in my big toe joint.
My options were: just having cheilectomy, which was likely to be only a very temporary solution, given extent of the arthritis in the big toe joint (85% of the cartilage gone); joint replacement, but I would then certainly require another joint replacement or other procedure in 7-10 years when the replacement wears out, given my desired level of activity; or fusion of the big toe.
The surgeon was confident that I could ultimately return to all of my activities eventually and, reading this forum, I'm very cautiously optimistic that will happen.
I wanted to have one procedure if at all possible so I can hope to minimize my time in the medical system over my lifetime......so I decided to go with the fusion and had the surgery yesterday.
There are so many different techniques being described on this forum! My surgeon used a local anaesthetic only. He offered me a Xanax, but I declined so that I was alert and awake throughout the procedure. He removed the bone spur and then inserted 2 pins. The whole procedure took less than an hour.
Since the surgery, I've taken the prescribed anti-inflammatories and nothing else. I was not prescribed any narcotic pain meds and, although it's still early on, I haven't felt any pain yet. I've been following Dr's orders carefully....for the next 4 days, I'm to keep my foot elevated as much as possible and ice during waking hours 30 minutes on/30 minutes off. They gave me a very useful Aircast Cryo/Cuff which is a soft boot for your foot that fills by gravity with icewater through a connected hose from a small cooler unit; it's well-designed and makes it easy to ice as the cooler unit keeps the icewater cold for 10-12 hours.
When not in the soft boot, I'm to wear an Aircast hard boot to protect my foot and I'm to be non-weight bearing on my right foot for 6-8 weeks. I'm very comfortable on crutches so am using those to get around, wearing a backpack if I want to carry anything when I move locations within the house.
The pins will be removed in the dr's office at 4-6 weeks.
The plan is that, after the NWB period, I'll start to ease back into wearing running shoes and some weight bearing activity.
I recognize that not everything always goes exactly to plan, but as I said, I'm cautiously optimistic that it will as long as I am a patient patient!
Thanks for all of the tips and advice!
At 11 days post-op I'm elevating, icing, and sitting on the couch. My stitches should come out on Friday. I have a "Cast Cozy" to keep my toes warm when I make the rare trip outdoors. The toe sock fits over my toes and the strap velcros around my heel; then I put on my cam walker. So glad that I don't live in this year's snow belt!
Saw the doc today. He did x-rays and everything is where it should be. He said the raised area is most likely a stitch issue. He peeled the scab off but there was nothing underneath, so he was a bit confused by that. And.... wait for it... I get to put on a shoe! He wants me to wear the stiffest soles I have at first, and only walk until it hurts, then put the boot back on. I took a little 10 minute walk in tennis shoes with the dogs when I got home from the appointment, then went back into my boot. My calf hurts! I wore the boot the rest of the day, but wore a shoe to a music rehearsal this evening. I play piano, so sit through the rehearsal, but I did use my right foot on the pedal. It hurts now, but I can deal with it.
The best part is that I have no swelling at all, and my shoes fit!
Something to remember for the summer - doc told me if I was at the beach to put lots of sunscreen on the area around the scar. If that area gets tan within the first year it will stay darker than the rest of the skin.
He also said that I would probably want the hardware out, but he won't do that until I'm one year post-op. We shall see. Maybe I'll be able to tolerate it just fine.
Happy healing, everyone!
Hey All! I haven't been on here for awhile. Brooke, sorry to hear about your regression. I have to be honest. I'm approximately 14 weeks into this and I thought I'd feel better than I do. I expected the swelling, but am having soreness on the side and top of my big toe. I'm still walking with a slight limp after my foot tires. I've been in a shoe for over a month. I can't remember who said this in an earlier post, but I remember it being said that the big toe joint would eventually fill with arthritis and would fuse itself. I am going to keep walking, waiting and see if this procedure was worth it. After another couple of months, if my surgery toe doesn't feel a lot better, I'll probably just let my left big toe fuse itself with the arthritis. After all, I think that what makes the walking painful is the arthritis beginning to fill the joint, while there is still movement of the joint. Shout to GrandmaC, NevadaSue, GolfingQueen, pjp45 and Brooke B. I've read everyone's posts and still find it interesting how everyone heals differently. I'll check back with everyone soon. I hope everyone heals well.
Do you think the pain could be from the hardware? My pain seems to be where I think the screws are. The fused joint only aches a little when I walk too much, but the top of my foot hurts in a couple of spots.
NevadaSue, I'm not sure yet. Like I said, it's sore on the side the length of the plate and where they place that screw in to hold it in place. going up around the top, to where the actual plate is. I'm going to wait and see if the soreness subsides and if it doesn't I might have the hardware removed. That's why I said that I don't know if I'm going to have the other toe done because it's in the late stages of Hallux Rigidous. I wanted this to be more than trading one pain for a different pain.
Hi All of you great support folks! I am SO glad I found this post. You've all been so helpful in my decision and recovery! I am 2.5 months post surgery. Walking daily in a few "normal" shoes - athletic, Crocs, and Birkenstocks. We leave for the Caribbean for a 2 week vacation this week. My cute sandals do not feel good at all. I'm taking a pair of pool slides (that adjust with velcro across the top of the foot) and 1 pair of flip flops (not much support but I think I can manage short distances). Guess my Birkies will be my mainstay - so cute with a dress! Hubby is insistent I wear my surgical boot in airport and on plane to protect my toe ... I think it's a good idea. I still "list" to the outside of the foot. My toe is a full finger width off the floor still. Is that normal? Got my toes painted pink - looks great with my purple foot! My hubby even mentioned this to some friends today. 3 weeks more of being careful then I can start increasing activities. Cannot wait to see how that goes. My impression from following all of you is to still exercise patience - right?
I am not at all questioning my decision since I am virtually pain free since after the first week after surgery! Yeah! Just some aches and annoyances associated with walking weird and overdoing it.
What is life like after 6 months? I am starting to plan to have the right foot done. Hubby threatened to be deployed to an overseas assignment (and he's not even in the military!).
Thanks for everyone who contributes. I find this so very helpful.
Best wishes to everyone. It's a tough decision but I think overall a good one.
Hi, Bob Peters,
I happen to check in as well and saw your post asking for info. I had my left foot done October 2013, the right March of 2014. I had them both doen back to back to try to minimize my total down/recovery time. So the spread was the minimum time that the DR would do the 2 hallux rigidus surgeries planned. I know your recovery was much easier than mine, so here is some additional info.
I had to "unexpectedly" have 3 additional surgeries total and ended up having all the metal removed from my feet. One of which because one screw was a little too long (Dr said based on the xray, it wasn't too long and I 'shouldn't' be feeling it) yet, it felt like I was stepping on them every time. Removing the metal was the best thing for me. Despite the metal being titanium, it was affecting me (overall) and I felt much better immediately after it was all gone.
I do have some long standing issues that haven't gone away. One big toe digit sticks up at the end, and despite PT, MT, etc. it doesn't seem to want to stay down. So, the end of the toe hits the top of my shoe. Never had that sort of issue until after the second surgery on that foot. At this point, it looks like there isn't much to be done. Some days are better than others. The good news is, it is only on one of the two feet.
The other thing that I wasn't told about is how much it would affect running and jumping for me. It is more obvious now that I consider the mechanics more thoroughly, not having a big toe joint anymore, and only having the digit on the end of the toe to push off with. The difference for me is considerable. I have short toes, so that may be part of it...but others have posted they notice no difference at all.
The last thing I have an issue with is when hiking, or doing stuff out of doors on very uneven surfaces. Things that would not have bothered me at all in the past to traverse as I still don't trust that I have the correct balance or ability to recover or ability to land a leap across a chasm (no matter how small), part of that is because I can't leap (jump) as far as I used to. Hiking poles help with that some. The rest is the difference in balance/recover ability without the flexibility of the big toe.
Pain wise, things are all good. I can hike, xc ski, cycling, etc. again. Before surgery it had gotten to the point that I would be in pain for 3 days after a short hike. I'm wanting to to everything the way I used to and it's not happening sometimes. I don't regret getting it done, as otherwise, I wouldn't be able to do much, if any, of my long range outdoor activities.
Hope this finds you well, Bob! Thank-you for starting this thread as it was helpful to know someone else had been through this before.
Anyone else have any favorite shoes? I tried on several pairs of Dansko's...they don't work for me at all. My toe is absolutely flat on the floor. I was told it would be fused at an angle but so far doesn't appear to be.
Hope everyone is doing well!!!
Golfing Queen, don't forget to keep LOTS of sunscreen on your foot. My doc told me the operated area would really soak up the sun, to the point that it would always be tanner than the rest of my foot. Hope you have a great time - I'm jealous!
My big toe doesn't even touch the floor. Doc said it would come down as I walk more on it - we'll see. I don't like that it rubs on the top of my shoes, like Sgloon said. That has been one of my main irritations since the surgery. As the nerve heals, it feels better, tho.
I've overdone the walking a couple of times - it's odd that you think you're doing ok, but don't realize you've overdone until it's too late. As for shoes, I have one pair of tennies that are a little stiff on the bottom, so that's what I wear. I tried on a pair of Clarks that seem to be ok, too, but don't really want to walk too long in them because they're a little tight with the thick socks I wear to protect my foot. I haven't tried on my hiking boots yet. (I forget where I put them, lol!) Walking in my Crocs is comfortable but I think puts too much stress on my foot what with gripping the front with my toes.
All in all, I'm pretty happy about how things are going!
Hi all! Well I am just over 4 weeks post op. Because of the problems with my skin healing (necrosis) I have been seeing my doctor weekly. It is slowly getting better and less painful but still looks awful. Foot still very bruised and swollen as well. My next appointment is in two weeks so stretching out time between. But still cannot get foot wet so I haven't had a "real" bath or shower yet which is driving me crazy. I fell off of my knee walker this past Monday and stepped hard onto my foot. Talk about pain!! Luckily my kids were home from school that day and came to my rescue. Yesterdays appointment showed that no damage was done thankfully. Doctor said I can slowly start putting weight on my foot and walk very short distances as tolerated. With the use of crutches last night, I took eight steps. OUCH!! The first step felt like an electric shock shooting through my heel and intense pain. Anyone else have that sensation when first starting out? Needless to say, I relied on my crutches a bit more for the rest of the steps.
Also, a question for you that are further along than I am......Once you were given the ok to start walking, how long did it take you to be able to just get up and go? I have read that many of you are in a boot/cam walker. I am only in my post op surgical shoe and I believe my doctor thinks this is enough. Should I ask for something that would provide more support? My medical leave is scheduled for 6 weeks off of work which is only two weeks away. At this point, I cannot see me returning and being able to do my job. I am a nurse in a pediatric office and run patients all day. I am just curious to hear if others made tremendous progress in their walking in the two week time frame I have left. Any advice would be great!! Thank you!
BrookeB, for walking shoes, I like New Balance - and they come in everyone's size, very wide to very narrow, etc.
pjp45: I came along very quickly one released. I had longer without walking at all initially, so had to do some PT to get my stride corrected again, but it was quick and easy for that. I think if I hadn't been off my foot for so long it would not have been an issue at all. That being said, sounds like your job might be intense, so I would ask your Dr. And the least you can get away with for support, is probably better for the same reason. All the different Drs appear to have their own strategies. As long as you won't be doing activities that will cause you to fall or hit your foot hard with the sandal, I would think you would be fine. And your bones are typically healed in 4 weeks anyway, and all that metal will hold really well unless your bones weren't good to begin with(I only mention that as there were a couple people on here that had degenerative issues besides).
Thank you for the feedback sgloon, Grandma C, and Tinman. I have been walking more each day but still with the "electric shock, burning sensation" with each step. I also still struggle at night. Because of the skin issues I have, I have a dressing and ace bandage on my foot. Before going to bed each night, I make sure to change the dressing and loosely wrap the bandage. But at least twice each night I awake in pain with my foot throbbing and ace bandage tight from foot swelling. And I am still sleeping with it elevated on pillows! My doctor doesn't seem concerned and has told me several times that "foot surgery is no joke." He said he doesn't anticipate my fusion to be complete until week 9-10. He is more concerned with the skin necrosis.
I do plan to discuss my medical leave with my doctor, but I realized that my next follow-up appointment is March 3rd and my medical leave paperwork shows a return date of March 2nd. Luckily, I checked my paperwork and the return date does say "approximately March 2nd based upon follow-up post op appointments." My doctor is great and I know if I tell him I'm not ready to go back or just go back for shorter days, he will be fine with that.
Grandma C., I wasn't given specific instructions about how long to elevate on pillows either. Like I said earlier, I still do at night just for comfort but not so much during the day. With that said, I do always have it propped up on something like the ottoman, in the recliner, or the benches in the gym when I go watch my son's basketball games. My foot doesn't feel great when it just hangs down.
Msdivinedc, you go! That's really great that you can race again.
Tinman, my doc told me that if he removed hardware I would be walking in a surgical shoe until the stitches came out. Probably two weeks, then back to normal.
I just noticed the angle of my big toe the other day. I had my boot off and my foot flat on the floor and couldn't feel my big toe. Then I realized it didn't touch the floor at all. I'm sure it's something you get used to, but it's weird! The pressure on the top of that toe drives me nuts. I have to take off the boot after a few hours - it aches a lot. Does that feeling get better? I hope so, because if I can't stand it with just the boot pressing against it, how's that going to work with shoes?
Having SO much trouble sleeping at night. I don't notice it during the day, but I am constantly moving my foot inside the boot to relieve pressure in different areas. I'm not able to fall asleep until 3 or 4 am. It was much easier to sleep in the cast! I hope my inadvertent movements (including pressing down with the front of my foot) aren't compromising the fusion.
Enjoy your cruise, Cindy!
Mo hope you are feeling better now Nevada Sue! Neither of my fused toes touch the floor. I have 2 screws in my right toe but when my surgeon operated on my left big toe she used 7 screws so I can no longer fit in to some of my shoes, but all in all, I'm very happy with the results. My last fusion was in Dec. 2012.
- My Excellent Toe Surgery Adventure - Hallux Rigidus, Plate/Screw Fusion, and Osteotomy
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