Bunionectomy: Before and After

First, I’m gonna warn you.  There are some pictures of my foot here that might gross you out a little.  It’s not bloody or anything, but my foot looks really super-weird post-op.  They took the bandage off and I kind of freaked.  The medical assistant said it looked totally normal and really good, and the doctor kind of eased my fears, but I’m just sayin’, the pictures ain’t so pretty.  Chef didn’t think it looked bad, but he might have just been saying that to make me feel better.

Okay, so let’s review.  Here’s what my feet looked like before surgery:

Here’s the x-ray of my feet before surgery:

You can see that the first metatarsal on each foot (the bone in the foot under the big toe) is not parallel to the other metatarsals.  That causes a deformity in the joint between the metatarsal and the big toe, resulting in a bump on the side of the foot, and the big toe angling inward and pushing into the other toes.  That’s what the surgery was meant to fix.

I went in to the surgery center on Friday, August 27.  It was my parents’ 44th wedding anniversary, which has nothing to do with the surgery but I thought it ought to be noted that my parents still love each other and are committed to each other after 44 years.  (Yay, Mom and Dad!)  Surgery was scheduled at noon, so we showed up at 11:00 as directed.  Chef was with me, and the staff went through a bunch of paperwork with me and finally took me back.  The nurse gave me a hospital gown to change into, put an IV into my arm (just saline to start with), and then invited Chef to come back and wait with me.

A little later, the anesthesiologist came in and talked to me.  A lot of what he said is fuzzy to me now because he eventually sedated me, and I have trouble remembering the order things happened in, and exactly what happened.  (Apparently, I told Chef, “I’m not responsible for anything I say while under sedation.”  And then about two minutes later, I said the exact same thing again.)  I know that the doctor put some sedation medicine in the IV, and I remember that he wrote on my right leg, which I assume is to help make sure that everyone was working on the correct foot.  I turned over on my belly, and the anesthesiologist injected a numbing medication in the back of my thigh.  And that really, really hurt.  I was making sucking noises with my mouth, trying not to cry out.  I do remember him saying I was a “trooper.”  He helped me roll over to my back again, and by this time I was really drowsy.  I remember that the doctor had said that he would have to give me a second injection in my foot because the injection in the back of the leg numbed everything in the sciatic nerve group, but there are some parts of the foot that are connected with the femoral nerve group.  Chef told me later that it was pretty gross watching him inject the foot because he was moving the needle around a whole lot in my foot.  Good thing I was pretty much out of it by that point, because I didn’t feel it.  Or at least if I did, I don’t remember it.

I think Chef kissed me goodbye and they wheeled me into surgery.  I don’t remember a whole lot during that time.  I dozed through the first part of the surgery, waking up every now and then.  I couldn’t see what was going on down there, even though I admit I tried a little bit.  I remember feeling a vibration throughout my leg and realizing that the doctor was probably cutting through the bone at that moment.  I also remember seeing him put the screws in.  He was doing it by hand, and I thought it was interesting because I had figured he’d have a surgical screw gun.  But when I thought more about it later, I thought they probably do it by hand to make sure it doesn’t go too fast and splinter the bone.

I thought I saw the doctor stitching me back up, but I later discovered this was wrong because he didn’t use stitches; he used staples.  They took an x-ray, which I could see, and I thought I saw the two screws and four staples.  This also was wrong, because I actually had 16 staples.  I remember saying, “Are those staples?”  And they said yes.

The nurse wheeled me to recovery where I became alert pretty quickly.  She gave me instructions about icing the foot, keeping it elevated, and not getting it wet.  She gave me prescriptions for pain medication and an appointment for a follow-up two weeks later.  She and Chef made sure I was okay on the crutches and got me out to the car.  Chef took me to get my prescriptions filled.  We did this at the pharmacy inside the doctors’ office where I work, and the girls at work couldn’t believe I showed up.  I said that I was totally numb from mid-calf down, so I didn’t feel anything.

Medications in hand, Chef took me home where I got myself all settled on the couch with my foot elevated and iced.  The foot was all wrapped up.

I had a shoe to put on over the bandaging, to protect the foot when I was moving around.

The nurse had told me to take my first dose of pain medication when I started to be able to wiggle my toes, or when I started to feel pins and needles in my foot or leg.  I started to wiggle the toes around 9:00 that night, and I took my first dose then.  I spent most of Saturday and Sunday on the couch.  Saturday morning wasn’t bad, but Saturday evening through Sunday afternoon, I had a lot of pain.  I was allowed to take the pain meds every six hours, and after five and a half hours, I was definitely counting the minutes until I could take the next couple of pills.

It might have been ridiculous, but I went to work on Monday, just for a couple of hours.  The pain wasn’t as bad by then, though I still had a lot of trouble with swelling, which made my foot feel hot and tight.  I worked for a few hours Tuesday and Wednesday also, and was up to six hours on Thursday.  I’m really thankful that my friend Sarah was able to provide me with a nifty machine that helped to ice the foot.  I mean, it’s pretty difficult to keep an ice pack balanced on a foot, plus the ice pack didn’t seem to get the right parts of the foot cold.  Sarah brought over a Game Ready with a foot and ankle wrap.  It looks like this:

This thing was amazing.  You put ice and water in the console and then the cold comes through the cord (I don’t pretend to understand how), and the wrap compresses around the foot like a blood pressure cuff, and it’s niiiiiice and cold.  Wonderful.  Sarah promised to get that to me on post-op day one next time.

As a side note, let me just mention that taking a bath was really interesting, because I couldn’t get the foot wet.  Washing my hair was especially difficult as I had to lie down in the tub to get my hair wet while having my right leg straight up in the air.  I’m glad no one was watching, but if they had been, I’m sure it would have been pretty humorous.

Thursday, Chef took me to my sister’s house, and on Saturday she and her family drove me to my parents’ house.  (My 16-year-old permit-holding nephew drove most of the way!  He’s a pretty good driver, and made me nervous only when he’d forget to check his blind spot when changing lanes.  I’m not worried though — I used to forget all the time, too, but now I remember.  He’ll get the hang of it.)  Sunday was a family reunion, and Chef came after he’d finished all his ice sculptures and deliveries for the weekend.  Monday, which was Labor Day, we returned home.

I was able to work full days all that week (which is this week).  Today, which is Friday, I went to the doctor for my post-op check and to get the dressing and bandage off.  And boy was I glad because it was itching like crazy.  I broke my hand a few years ago, and the itching under my cast was nothing compared to the itching under this bandage!  I felt ready to claw my way through the dressing.

Okay, now here’s your second and final warning, because here’s where the photos come, and I personally think my foot looks pretty gross.  If you’re squeamish, you might not want to look at the next couple of photos, but if you really want to look, you can’t blame me if the room starts spinning or if you toss your cookies on your keyboard or if you lose consiousness.  I have warned you twice.  You are responsible for your actions.

The medical assistant unwrapped the bandage, and my foot looked like this:

Sorry the image is blurry, but perhaps that’s for the best.

There’s a long incision on the side of the foot, and a small one more in the center.  The mark on my ankle is where the anesthesiologist had marked my foot to be sure they operated on the correct appendage.  And this is when I realized that I had not four staples, but sixteen.

Now, a lady I work with had told me (in a very UN-encouraging way) that when she had foot surgery, it was absolutely the worst pain she’d ever had in her life.  But she said that getting the staples removed was nothing.

Wrong.  Wrong, wrong, wrong.  Oh my gosh.  Getting those staples out hurt so bad.  The first couple were okay, but the more she did it, the more it hurt like the dickens.  I admit, I whimpered.  I was trying to just breathe through the pain, but the whimpers were there.  Wowza.  It really, really hurt.

The next photo is after the staples were out, and it’s also a little blurry, and it’s also a little gross, so you if you have someone reading the text to you, don’t open your eyes yet because this photo might send a sensitive person over the edge just as much as the last one did.

All right, that’s the last icky photo.  I promise.  So as soon as your reader can get scrolled so that you can’t see that one, you’ll be okay to read on your own again.

Let me say here that I thought about helping you out and making all the photos on the blog completely benign, and making the icky photos clickable so that you could really choose to look or not, but I just couldn’t figure out how to do it.  Plus, this particular post is much longer than I anticipated, and I’m kind of running out of time here.

The medical assistant called for x-rays, and the x-ray tech took me to have a few pictures taken.  Here’s the best one, which shows how that first metatarsal is now parallel with the other metatarsals:

You can also see the screws in the bone.  Cool, huh?

One of the things I was a little freaked out about was how big a space there was between my big toe and my other toes.  (Refer back to icky pictures, above.  I was not stretching my toes or purposely making space there.  That’s just how it looks.)  Dr. Herbst said that there are a couple of reasons for that.  First, he purposely over-corrects when he does the work because the toe will naturally shift back a little bit.  At least, that’s what I think he said.  I know he said he over-corrects, but I can’t remember for sure if that’s the reason why.  Second, the smaller toes have been pushed to the side for so long that they’ve just grown to angle distally.  You can see that in the x-ray — the bones at the bottom of the toes are still angled outward, the way they’ve been pushed for years.  He said that they would probably go back straight again, but he also said he’d give me a splint for those toes to help the straighten out.

He re-wrapped my foot and showed me how to do it.  I can take the bandage off and wash my foot now (HOORAY!) but he wanted me to know how to put the bandage back on.  After he was finished with me, the medical assistant came in again and put the splint on my next two toes.  So now it looks like this:

Here’s the bottom of the foot (as much as I could get when taking the picture myself — have you ever tried to take a photo of the bottom of your own foot?) so you can get a better idea of the splint:

Okay, I know I’ve been writing for well over 2000 words now, but I promise I’m almost finished.

I’m to go back in four weeks, which is Friday, October 8.  For now, I’m still permitted weight only on the heel and the outside of the foot, but I can start putting a little bit of weight on the ball of the foot in three weeks (October 1).  At that next appointment, they’ll take more x-rays and probably release me to full weight on the foot.  (I was hoping for sooner than that because I’m really sick of the crutches, but I’d rather have crutches than to mess up what was done with the surgery.)  At that time, I will also transition into regular shoes again, though they’ll have to be roomy shoes (like tennis shoes), so my stilettos will have to stay in the closet for a while longer.

Dr. Herbst said I’ll still have some pain and swelling for up to six months or a year (What?!) because that’s just what happens with foot surgery.

But I’m hoping — really, really hoping — that a year from now (preferably sooner than that!), my feet will be much happier and that I’ll be back to running again.

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15 Comments (+add yours?)

  1. Amy
    Sep 10, 2010 @ 17:06:03

    I would say your yellow toenail is actually the grossest part. And it clashes with the purple marker.

    • Karen, the Small Town Runner
      Sep 13, 2010 @ 06:59:49

      The yellow is from the iodine they put on the foot for surgery.

  2. Tracy
    Sep 10, 2010 @ 18:52:50

    You definitely are a trooper! So glad to hear that things are progressing along well. I’m sure all the pain will be well worth it in the end!

    • Karen, the Small Town Runner
      Sep 14, 2010 @ 10:59:02

      I’m confident it will be worth it! The pain really hasn’t been bad except for those couple of days. The real difficulty for me is being so immobile.

  3. Michelle
    Sep 10, 2010 @ 20:05:26

    Actually, I think your foot is beautiful!! All the “icky” stuff will disappear in time. It looks so much more a “normal” shape!

    • Karen, the Small Town Runner
      Sep 13, 2010 @ 12:55:13

      I will definitely post pictures when it looks prettier. The incision isn’t so puffy now as it was in the photo, and I’ve washed most of the iodine stain off my foot. That marker is stubborn, though, and I’m not willing to scrub the incisions. I’ve nearly scrubbed off the initials on my ankle, though.

  4. riTa
    Sep 11, 2010 @ 07:56:20

    Very informative and I was not grossed out.
    But, a whole year without stilettos?! Don’t know how you’re going to handle that! 😉
    So, no walking five miles next Sat. either. We can live with that.

    • Karen, the Small Town Runner
      Sep 13, 2010 @ 12:56:17

      Yeah, I was probably deluded thinking I could do that. Oh well. Next year.

  5. Kim
    Sep 13, 2010 @ 07:06:36

    Even though I tend to be a bit squeamish, the photos weren’t TOO bad 🙂
    Amazing what a difference between x-rays!
    I, too, hope and pray that you won’t experience pain and swelling for as long as the doctor said is possible. That would NOT be fun!

    • Karen, the Small Town Runner
      Sep 13, 2010 @ 12:55:53

      I’m glad you didn’t pass out or anything. And yes, the x-rays really show the difference!

  6. Talley Mac
    Sep 13, 2010 @ 18:17:47

    YAY!!! XRAYS AND PHOTOS! I feel so lucky! 🙂 I got to see the gory detail! i love it!!! HA!

    And just so you know, Matt’s was way out like that at first too, like he was spreading the two toes and it did eventually relax into a more natural position. Swelling is definitely normal in the first year especially with rainy weather and barametric pressure change. Unfortunately Matt still swells pretty bad but he also has poor circulation in his footsies (and he doesn’t walk to shunt the blood and fluid through the lymph system) so don’t be surprised!

    you’ll be so happy once everything is done and in place for both feet, you’ll just have to get used to walking with normal toes! But i think it looks great!!!

    xoxo

    T
    T

    • Karen, the Small Town Runner
      Sep 14, 2010 @ 10:57:48

      Thanks for telling me that, Talley. That’s good to know. I mean, I didn’t have the surgery for aesthetic reasons, but it sure would be nice to have pretty feet anyway. And hey, if my feet tell me when it’s going to rain, maybe I can better achieve my goal of being an amateur meteorologist!

  7. Calinda Lam
    Oct 09, 2010 @ 05:52:30

    Very informative, thanks. My feets are a lot worse but no pain. Have been advised to take operations but too scared to go ahead.

  8. Andrea
    Nov 07, 2010 @ 21:24:00

    When were you able to resume your regular activities? I am considering doing the surgery in early August/late July when I am off and then return to work mid-August. I dance-zumba/ballroom/contra/International Folk-how long following surgery can I realistically resume these activities?

    • Karen, the Small Town Runner
      Nov 08, 2010 @ 07:55:45

      My doctor said that at 14 to 16 weeks post-op, I would be able to ease back into running, etc. I’m 10 weeks post-op right now and am walking very well, though if I’m on my feet too much, I do get sore and swollen. The doctor stated that I could have soreness and swelling for up to a year. Icing the foot with the GameReady has certainly helped reduce the swelling, so if you do have the surgery, ask your doctor if he will prescribe one.

      If you have surgery in late July or early August, you will not be dancing again mid-August. Based on my experience, you might be able to do some dancing by mid-October, but nothing that would require you to wear heels or be up on your toes, and nothing high-impact, and even then you might be pushing it.

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