by Matt Basso | February 2015

A WOMAN WHO WOULD NOT ACCEPT A LIFE OF CONSTANT PAIN

I am so incredibly lucky to work with such amazing people everyday.

A few years ago when my awesome friend, and now client Lindsay decided to have surgery on both of her feet she took the time to document her entire experience. When I asked why she would bother to do this (most wouldn’t) her answer was inspiring -

“When I was making this huge decision I couldn’t find any helpful information about what it would feel like and how it would impact my life. As I was going through the trials and tribulations I thought if I documented my experience maybe it could help someone else”

In my personal opinion this is amazing.

If you are thinking about bunion surgery or know of someone who is, this is a must read!

 

                                My Funny Feet

 

Note: This is an account of my experiences after having a Lapidus bunionectomy and mini- tightrope bunionectomy. The following includes post-operative photos that may be considered graphic for some. I am not a physician and do not have the authority to encourage others to make the same decisions that I have made. This is simply a first-hand look at my personal experience.

I don’t remember a time when I didn’t have bunions. My feet were always different from everyone else’s. Actually, I remember the first time that I ever saw someone with feet like mine, I was shocked. I must have been in junior high school and she was old. I don’t mean old, like “my parent’s are old”, I mean old, like this woman could’ve been my great grandmother – over the years all the people I had seen with similar feet happened to be old. Once I saw a young woman in a magazine with feet like mine, but I think that was the only time.

By college I learned to put being self-conscious aside. I had a wonderful boyfriend (soon to be husband) and family; who cared about my feet? Even if I felt uncomfortable with my feet out in the open, I pushed the feelings aside and just dealt with it. I rarely wore certain types of shoes, like heels, and a full day on my feet was pretty painful – but I sucked it up. I wasn’t going to let my feet get in my way!

After college I started working in a casual office. I could wear flats, sneakers, jeans, etc. and rarely had to dress in full business, so I thought my condition wasn’t being exacerbated. I don’t know when it started, but over the next few years my feet started to hurt all of the time. If I walked on the treadmill, they hurt. If I sat at my desk, they hurt. Sandals, barefoot, heels, sneakers...all hurt. I learned to deal with the pain for another year or so and accepted it as my current reality. I don’t know what happened, but one day it hit me: how can I, at 25, accept a life in constant pain? I decided I was too young for that mentality and chose to take action.

I researched bunions, bunion procedures, and doctors for about a year. I learned that a bunion itself is not genetic. The genetic component is the malformation of the mechanics of the foot which cause bunions to develop (thanks mom!). The process was difficult and time consuming, but after obtaining a fair amount of knowledge, I found a practice that I was comfortable with and made an appointment in August of 2011. When I had my consultation, my doctor sat with me for at least 20 minutes to discuss the procedure and to make sure I didn’t have additional questions. She explained that the bunion was being caused by a slight twisting of the first metatarsal which was pushing the bone outward, which is why the boney protrusion on the side of my foot formed. That process was causing my big toe to begin to twist and turn inward towards my other toes.The procedure on my right foot was to be a Lapidus procedure, which entails two cuts in the bone, one near the big toe joint and one at the base of the foot. I would have hardware in my foot to help the bones heal and also prevent future bunions. We chose to do the right foot first because that one hurt me the most.

 


My feet pre-surgery

 

October 7, 2011
Day of First Surgery – My Right Foot

I woke up early that morning after having a light sleep; I was nervous and anxious...I was slightly excited too. I had excitement at the thought of being able to actually do things one day. I’d be able to wear shoes, walk barefoot and exercise without pain. No more crossing my toes in my sleep (as my feet often did naturally). My feet were going to be fixed and it all starts today. This is the beginning of my journey to reclaim my life.

The surgery was at an outpatient surgical center. I must add that everyone on the staff was exceptionally nice. They all made me feel as comfortable as possible. And then before I knew it, it was time for surgery.

The anesthesiologist put me under twilight anesthesia, so I was under but still responsive (not
that I could tell!). The first thing I remember when I was waking was the doctor lifting my leg up to wrap my foot in the cast. I looked to my right and saw that there was an x-ray of my new foot. I saw the plate and pins where the doctor had told me they’d be (at the base of the first metatarsal), but then I saw a pin through my big toe, something that we hadn’t anticipated. I learned that the surgery that should have taken 1 1⁄2 hours actually took 3 hours.

Since it was an outpatient procedure, I went straight home after I was cleared to leave, but living over an hour away from my doctor’s office and the hospital definitely made the ride home difficult; the roads were bumpy and there was traffic. I got home and made my way up the stairs, with the assistance from my family, into our den. Since my bedroom was up another flight of stairs, we agreed I’d make the den my residence until I could get up to my bedroom.

October 8, 2011 Day after Surgery

The pain today was excruciating! If you’re reading this because you’re considering this surgery, please don’t let me discourage you, but I don’t want to sugarcoat the truth. Most of the stories that I read online made it sound like it was manageable pain. I couldn’t take it, and maybe I have a low pain tolerance, but it was absolute torture.

To make matters worse, the Vicodin that the doctor prescribed gave me minimal relief (I was taking the maximum dosage and it didn’t feel like anything). We called my doctor and she called in a prescription for Percocet, which definitely took the edge off. The discomfort was so bad that I couldn’t get up to use the bathroom because there was so much pain when I would lower my foot (the blood rushing to my foot increased swelling), so my wonderful husband went out and purchased a female urinal from the drug store. Getting used to this was certainly a life adjustment.


October 9-14, 2011 Week after Surgery

My sister came over on the 9th and 10th to take care of me; what a blessing! I was in so much pain that I needed her help. On the 11th, my brother took me into my doctor’s office because it felt like the hard cast was too tight. My doctor cut the top half of the cast off and wrapped the rest of my foot in an ace bandage to keep the cast together. That relieved a lot of the pressure that I was feeling and, although I was still in pain, it made it more manageable. This was the first time I could see my foot and it was bruised and swollen. It looked so sad! Originally, I wanted the doctor to do both feet at the same time and she strongly recommended against it. At today’s appointment I thanked her for not doing it because I don’t know that I’d be able to handle both feet in that much pain at the same time. I was so happy that I took her advice!

 

My right foot 4 days after surgery (the blue on my ankle and foot is from the surgery. The doctor has to mark the foot that they will operate on).

October 15-24, 2011

I started working from home on October 17th. As a result, I stopped taking the Percocet and began taking three to four Ibuprofen tabs every four hours to relieve the discomfort and keep my head clear (the Percocet definitely messed with my head and made it so I couldn’t focus). Working from home, when you’re not used to it, can be challenging. I had all of the tools to get the job done, but between icing my foot, managing my pain and trying to care for myself, focusing was trying at times. I was determined to muster through it to prove that I was able to keep up with work from home.

October 25, 2011
First Follow Up Visit (right foot)

After my doctor removed the rest of the hard cast, she took x-rays to see how the bones were healing and how the hardware was setting. According to my doctor, everything looked good, although I still had a fair amount of swelling. She noticed that I had little to no dexterity in my big toe, so she advised me to go to physical therapy twice a week for four weeks. I was given an air cast to wear in which I could place my heel on the ground (yay!), but was advised that my foot was non weight-bearing. I could also get my foot wet, which means that I can wash it – which it desperately needs!

October 26, 2011
First Physical Therapy Session

I went to physical therapy for the first time today. The therapist took time with me and we discussed all that the doctor had done and her recommendations for the therapy. My therapist said he’d start off gentle, stating that his goal was to reduce swelling in my foot because that’s going to help the healing process and also minimize pain (the more swelling, the more pain). To do so, he gently massaged my foot to begin recirculation of the fluid in my foot. It felt weird at first, but wasn’t painful.

October 27, 2011

So much pain!! My foot was swollen today...it looked like my toes were fighting to get away from each other! No matter what I did, I couldn’t seem to bring the swelling down. I ended up taking a Ziploc bag of ice and wrapped it onto my foot and that minimally relived the pain. I can’t take too much cold where the hardware is because it’s a little sensitive, but I did as much as I could.

November 1, 2011

Today was my third physical therapy appointment and my therapist said that the excessive swelling from the first session was likely due to the removal of the hard cast and the massage and that I shouldn’t get that swollen after our sessions. During my second session I learned some ankle exercises, which I continue to do each day as I can. Today we did toe exercises...I didn’t like it one bit! I was ok right after therapy, but a few hours later my foot got a little swollen and the joint in my big toe hurt. Agh! I know it’s only going to hurt more before it gets better.

November 4, 2011

I had another follow up appointment with my doctor. She said that I’m healing and the steri-strips covering my incision will start to loosen. If they don’t come off by weeks 6 or 8, then she’ll remove them. We took some more x-rays and she showed me how the bone is healing. The incision on my big toe is almost invisible, meaning that it is mostly healed (yay!). The incision at the base of my foot (on the first metatarsal) is still quite visible, so that one still needs a couple of weeks. My doctor advised me that I can begin to put more pressure on my foot when walking in the boot. If I can get up to 50% of my weight on my foot, then I’m going to go into surgery for the left foot on the 18th.

November 7, 2011

Physical therapy today was so painful!! My therapist was stretching my big toe back and forth and then I had to do some different exercises, including weight bearing which made my foot swell up more than it has in almost two weeks. I was so happy to go home, all I wanted to do is put my foot up. I have to keep reminding myself: “No Pain, No Gain!”

November 14, 2011

Today in physical therapy we did some toe/ankle exercises, but my therapist wanted to do some strength and stretching exercises. I’ve lost a lot of muscle in my calf and my quads, so some of the exercises were hard, but the stretching was WONDERFUL!! My hip has been bothering me for a number of weeks, so the stretch was incredible.

November 16, 2011

Today’s my last session of physical therapy before my next surgery (which is scheduled in two days!). My leg/hip was sore yesterday from the exercises at my previous session, but it was manageable. I also went into work yesterday for the first time since before the surgery. It was hard and I got tired really quickly, but it was nice to see everyone.

I’m a little nervous about the surgery on Friday. I am partial weight bearing on my right foot in the walking boot. My doctor said that, when I come out of surgery, I’ll be partial weight bearing on my left foot and in a walking shoe. I’m scared to do it so soon, but I know that if I don’t do it now, it’ll never get done.

November 18, 2011
Surgery Day – 6 weeks after surgery on the right foot

Unlike for my right foot, the surgery today on my left foot was scheduled for 1:30 pm, so it was definitely difficult to get through the day without any food/water, not to mention the fact that my surgery started at 3:00 pm because some other surgeries at the ambulatory center took longer than anticipated.

I was pretty nervous. My doctor came into my room and explained the surgery again and how different it would be from the procedure in my right foot. They would cut the first metatarsal only towards the front of the foot, affix it in place with a staple and would implement a surgical tight- rope at the base of the metatarsal to prevent the bone from shifting again. Because I researched so much before my first consultation, I remembered hearing that a lot of patients experienced fractures after having the procedure. My doctor assured me that wasn’t a concern, as no patient of theirs has had a fracture when the procedure was performed that far back on the bone.

So, finally, it was my turn to go. I got myself onto the table, with my right foot still in my walking boot, took a few deep breaths and was ready to say goodbye to my left bunion.

I awoke in recovery and was very groggy, unlike my last surgery. Even though I was partial weight bearing on both feet, it was very difficult for me to walk. My right leg had lost so much muscle from the 6 weeks of inactivity that it was hard to balance. But alas, I got home (eventually – rush hour was a nightmare!) and slept.

November 19, 2011

I realized today that the pain level for this surgery isn’t even close to the level of my first surgery. I mean, yes, it is painful, but it is manageable. Family that came to visit me even noticed a dramatic difference between the two surgeries. On a separate note, the skin on my right foot is disgusting. It’s peeling and kind of scaly looking. If you’re thinking of having this surgery, please don’t peel the skin. I know it’s so tempting to do, but you want the skin to come off naturally. I’ve been washing my foot and moisturizing it with vitamin E oil regularly. The skin will come off eventually. The scab on my incision pretty much all came off, so I just have one really long, pink incision on the inside of my foot. My big toe is still not moving, but while I recover I am doing my Physical Therapist’s recommended exercises to strengthen my ankle and leg.

November 24, 2011

Happy Thanksgiving!

I’ve been having trouble getting myself to get up and walk around. My foot hurts and I have a lot of trouble balancing. Instead of spending Thanksgiving with my family, my (Saint of a) husband made dinner at home and his uncle came over. The three of us had a very quiet and delicious dinner. I was a little sad about missing my traditions, like watching the Macy’s parade with my mom and siblings and midnight shopping with my sisters after dinner at my aunt and uncle’s house, but I realize that missing just this year will allow me to get around better, with less pain in future years. This year, I’m thankful for a husband who is understanding, patient and loving.

November 26, 2011

I tried to go to the bathroom today (I’ve been using the female urinal because of the trouble I’ve had getting around). I got four steps with my husband standing behind me, because I’m so wobbly I often start to tip over, and it hurt so bad that he had to carry me back to the couch. I
cried hysterically for ten minutes in so much pain and frustration. I thought for sure I’d never walk again.

November 29, 2011

I started working from home yesterday and found it to be difficult to focus on the Percocet (just like from the first surgery), so today I switched to Ibuprofen. The switch seemed to work and minimizing my pain and reducing my inflammation.

More exciting than that is my success for today! I was alone and got myself onto the floor, put my walking boot on, and scooted on my butt to the bathroom. I was afraid to walk again, for fear I’d fall, so I figured scooting was best. It was much easier for me to lift myself onto the toilet this time around, which is what I’ve been doing when I needed to move my bowels. That method is really difficult and, so when I was done, I figured I’d try something new. Instead of scooting back to the couch on the floor, I stood up and balanced myself against the wall (I don’t recommend doing this – I realize it was dangerous to do without my crutches). I walked from the bathroom to my couch and was ok. It wasn’t comfortable, but I didn’t cry or fall!

November 30, 2011
First Follow-Up Visit (left foot)

Because I live in the suburbs of New York City it can be quite difficult for me to get around (finding parking in the city can be frustrating at best). I was able to walk better today than I did yesterday and was forced to tackle the stairs for the first time. It was hard, but I did it! I walk at a snail’s pace, but at least I was walking again.

At the doctor’s office we unwrapped my foot and took x-rays of both feet to determine how they were healing. At first, I was surprised how small the incision was. I spoke with my doctor more about the surgery that she performed and she seemed pleased with the way things were healing. She said I could go back to physical therapy for my right foot starting next week (so in total, I took two weeks off from physical therapy). She wanted to see me in about 10 days and if all goes well, I can start physical therapy on the left foot too (assuming I have stiffness akin to what I am experiencing on the right foot).

My left foot during the first follow up appoinment

 

My feet during first follow up appointment after the surgery on my left foot.

My feet all wrappd up later that night...They look so helpless!

 

December 5, 2011
Back to Physical Therapy

I started Physical Therapy on my right foot again today. It wasn’t as bad as it’s felt in the past, but my therapist says that we’re going to start doing more exercises to loosen the joint. We used heat therapy for the first time, in hopes that would help improve dexterity in my big toe.
I’m curious as to what my doctor will say on Thursday about the progress in my left foot. My foot’s been pretty swollen all day and the incision feels irritated/tingly, but I attribute that to the healing process. I can’t wait until I can start washing my foot again!

December 8, 2011

I went to the doctor today and she had me stand barefoot for the first time. My left foot didn’t swell that much (3 weeks post-op) but my right foot became very swollen (9 weeks post-op). She moved my toes and I didn’t have as much pain as I did the week prior. And then she said it...I could wash my left foot and start wearing SNEAKERS!! I’ve been longing for her to utter those words!

My doctor said that I could start wearing a sneaker on my left foot and may need to ease into wearing a sneaker on my right foot. After I’m comfortable in shoes on both feet, she said I can try to walk around with a cane or one crutch. Finally I feel like I’m finally improving. YAY!!

December 9-16, 2011

I picked up a pair of sneakers on the 9th. I never realized how much you have to bend your toes to put shoes on – now I’ll never forget it! The shoes that worked best for me are the New Balance 1123’s. New Balance makes sneakers in a variety of wide widths, so it made finding the right size pretty easy. I ended up getting a size 7 1⁄2 (I actually wear a 6 1⁄2) in a “D” width. The 1123’s have a lot of support with a very thick sole and flexibility at the upper part of the shoe, which is essential when putting the shoes on or taking them off.

I’ve been wearing the left sneaker, and it definitely takes some getting used to. I still wear the
boot on my right foot when I leave the house, but in the house I’ve been wearing the right sneaker. The last time I went to the doctor, she said that I am putting too much weight on the outside of my feet (which could be because of overcompensation from not wanting to cause more discomfort after the surgeries), so the sneakers should help me learn how to walk properly again. I hope I’ll be able to walk around next week in just the sneakers, inside and outside of the house.

The New Balance 1123 sneakers

My former footwear

My feet ( 9 weeks for the right foot and 3 weeks for the left foot)

 

December 22, 2011

I went to the doctor today for a regular follow visit to see how I am progressing. She said everything looks good. I asked her some questions from my Physical Therapist (they didn’t want to push me too much without her approval because I still have a lot of limited motion in my big toe). I also asked how long she expects me to be in the sneakers and when she thinks I can start to drive. She said that, based on what she sees, I can try to start driving now. She said to take it easy and see how it feels (we don’t want to find out the hard way that I can’t hit the brakes because of discomfort!). I am going to start wearing toe spacers between the first and second toes when I am relaxing to help guide my toe from angling inward, they’re not super comfortable, but it’s a necessary evil. My doctor also had me walk barefoot and said that I can try to start walking around my house in slippers in an attempt to add more pressure to the front of the foot. All in all, good news!

 

5 weeks for the left foot and 11 weeks for the right foot


January 6, 2012

I drove up the driveway today – it was my first attempt. I think I still need to practice because it felt really weird and I was too hesitant to put pressure on my feet. I think I’ll try again next week.

January 12, 2012

I went back to the doctor today. She said I was healing really well, except she doesn’t like that I’m still so limited with the movement in my big toe, especially on the right foot (the first surgery). She believes that there’s a lot of scar tissue around the joint which is what’s causing the limitations. I had two options: 1) she can inject my joint in with a pain killer and manually move the joint around (I imagine that would be really painful after the pain killer wears off) or; 2) I can go into the office multiple times per week for a number of weeks to have a laser therapy treatment. We decided that the best option is the first one, since I live so far away from the office, but I’d wait until my next appointment in a month so we can see what kind of progress I make in physical therapy. My physical therapist has been saying that he’s going to push me a little bit harder, so hopefully that’ll help. She also wants me to start wearing shoes that have less cushioning so my toes have to work harder – time to break out my old flats!

January 17, 2012

I drove to work today! Driving feels weird, but absolutely liberating. I feel like a functioning member of society again. I went to physical therapy yesterday and he pushed me harder. It hurts, but it’s so worth it!

February 14, 2012

I went to the doctor for another follow up visit today (Happy Valentine’s Day!). She said that she was happy with the progress I had made - I had increased flexion from 19 degrees to 30 degrees, so she didn’t want to manually manipulate the joint like she said she might have to. I was relieved to say the least! I still can’t wear all the same flats and sneakers that I used to, but I’m taking it day by day.

February 20, 2012

My physical therapist measured the flexion on the big toe on my right foot to see what kind of changes there were. I’m now at 40 degrees, and my doctor said that 60 degrees is normal --- I’m more than half way there!! Downside is that I realized that I gained an extra 10 pounds over the last 4 months, so I have some work to do. I practice exercise on the Wii Fit (some yoga and balance exercises) and my physical therapist has me doing low impact cardio. I can’t walk on a treadmill yet, but I’ll get there.

February 2015

As my life began to normalize, I must have stopped tracking my progress – a good sign, I guess! I have almost no pain in my left foot and still have a dull, achy pain in my right foot – especially when I overdo it. On those days, I massage and soak my foot, wear hinged splint (Google: “Bunion Aid Hinged Splint”), and relax.

Heels didn’t re-enter my life (because of the recovery on my right foot) for 2 years post-op – but there are some really cute flats out there! I hope I didn’t scare you with my story; I just believe in honesty. I am SO happy that I went through with these procedures. If I could live my life over again, I would choose this path. I have no regrets about making this decision.

I only have one piece of advice: know in advance that you have to rely on others. I have spoken with some who have decided to pursue this option and have urged them to do the same. You must be ready and willing to ask for help (even if you have to hire someone – do it!). My husband helped me do such basic tasks, like bathing, and I wasn’t prepared mentally to have to rely on someone for such things. If you choose to do this, just know that even though it’s really hard at times, it will get better. Your life will be better. Find a doctor whom you trust and be ready to not be in control of everything. When looking back at my recovery, the pain wasn’t the hardest part; it was admitting that I needed help and that I couldn’t do everything on my own. I wish I didn’t have so much pride back then.

I hope this was helpful to you. Please know that your decision, whatever it is, will be the right one.

 

NOTE: I can say based on our training that Lindsay has great function in her feet. Everything we do to strengthen her feet and the rest of her body can be found in my DBX3 Program. I won't have Lindsay do any jumping exercises so we avoid those. Other than that everything from squatting to bench pressing helps Lindsay activate her feet and further stregthen them.

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