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Old 09-18-2005, 02:59 PM   #1
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Considering bunion surgery

I been lurking and reading a bit here, and see that many of you have or are having bunion surgery.

I've had a bunion noticably developing since I was about 13 yrs old. I am now 32 and in a fair amount of pain. IF I never wear shoes, I am the queen of flip-flops, I do ok. Enclosed shoes of any kind, after any amount of time are painful as is being on my feet for an extended amount of time. Example, my dh and I tried to start a regular walking program a couple weeks ago. After walking, my bunion area is sore and tender, pains shooting up my foot, ankle discomfort, etc. I really had no desire to continue because of the pain.

I consulted a Pod about 2 weeks ago, also had weight bearing xrays done. I know I'm not going to be clear here... lots of info swimming in my head... He measured the xrays, the only number that's sticking w/me is 18, I know that whatever # that was for is beyond the normal range. Basically, he had told me that he'd hoped to do a more simple procedure, but upon reviewing the xrays, that isn't possible, I need something more complex. I believe he'll need to cut about mid way down my foot, remove/adjust a tendon, create a little hinge so that he can reset the placement of my big toe w/screws etc. He told me that he could place a wire bracket/screw sort of thing that would actually stick out of my foot on top- but would allow for weight bearing mobility faster... But, he then said that many people are very put off by having "hardware" sticking out of their foot and opt for a more traditional cast and less mobility. Obviously he gave me a lot of info to absorb. Before I make any decision I will consult w/him several more times and get a second opinion. Understand the procedure more clearly, etc. I swear all my anatomy knowledge is escaping me

Now, I am a mother of 3 (11 yrs, 8 yrs & 3 yrs) and I own a dance studio. It's not a large studio, I only teach about 10-12 classes a week. He would recommend doing it immediatly following my spring perf in May. He was straight up about the fact that I would need all summer to re-coup. He also mentioned phys therapy.

I have never had surgery and am scared to death to even consider it. The idea of being out of commission is very un-nerving to me. Then again, I am dreading starting my dance classes the first of Oct... the pain is going to be horrible- especially until I get back into the swing of things and learn to work thru it again.

I'd appreciate your thoughts, info, and opinions. Is it realistic to think that I can go back to teaching dance about 12 weeks after this surgery? Thank you.

dplusmom

 
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Old 09-18-2005, 03:01 PM   #2
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Re: Considering bunion surgery

Wanting to add that my big toe is drifting over my first toe and that I have numbness at the end of my big toe as well.

dplusmom

 
Old 09-18-2005, 06:08 PM   #3
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Re: Considering bunion surgery

Hi there. As someone who has gone through bunion surgery on both feet twice (the first surgery failed), my most important piece of advice is to get educated and to research and and interview your docs very carefully. My first doc was an orthopod who didn't have enough experience doing bunionectomies and though his basic approach to my problem was on target, his technique obviously wasn't, as I wound up worse afterward than before. I would highly recommend sticking with a podiatrist but one who is very experienced in surgical procecures of this nature. After my first mishap, I probably saw 3-4 other pods before making a final decision as to which doc to go with. Ask how many bunionectomies they do a year, their success rates, their typical recovery times, even if they can talk to patients who have already been through the procedure. I also went with a doc who was in charge of residency programs at teaching hospitals, as they obviously have significant experience.

As to timing your procedure, this is definitely critical. Since I was having both feet done, I had my in-laws come stay with me to help out with the kids and with me (bring meals, handle household chores, etc)--as i was really laid up for the first 4-6 weeks. Even with one foot, you will need help, so see if you can arrange for that, especially since you have young children. If you won't have any help, you might want to consider waiting another few years until your kids are a bit older. I know this sounds harsh, but with a 3 year old...For me, I waited a long time to take the plunge and do my bunions and I'm glad I did. You have to stay put and ice and elevate during those first few weeks. It's really important. As for pain, with a good surgeon, you might not find it's so bad. My first surgery was worse than my first and even then, only just the first few days required pain meds. I do not have a high threshold or anything but if you are staying elevated, you won't have the kind of excruciating pain you've heard about. Of course you will need meds, but it's amazing how much less you'll need if you keep that foot up and iced.

As for the procedure itself, most bunionectomies involve removing a wedge of bone from the big toe and then fixating the toe in a straight position, either with a pin or a screw. Also shaving off the bony, protuding portion that sticks out on the side of your foot. Generally they also release some of the ligaments that are pulling the big toe in toward your baby toe. The typical procedure is called an osteotomy.

I hope this is helpful. Best of luck!!

 
Old 09-18-2005, 07:44 PM   #4
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Re: Considering bunion surgery

Well thanks for your reply... Lots to think about...

Would like to hear from more of you...

dplusmom

 
Old 09-19-2005, 05:39 PM   #5
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Re: Considering bunion surgery

It actually sounds like your pod is giving you some thorough information, which is a great start. I had both feet done this year: the left (more severe one) in January, and the right one in May and I'm completely up and about and have been for a couple months now. You should really allow yourself three months, and that's including some PT, depending on how long your doctor has you non-weightbearing. With my first foot, I had a base wedge bunionectomy, with a total of three cuts (breaks), since he also straightened my toe.

The second foot was a different procedure, called a "Scarf Bunionectomy" - they don't actually take a pie-shaped wedge out of the bone, but they make an "s"-shaped cut and re-position the bone. It's a much faster healing time, but if your bunions are at all severe, it's not recommended.

The important thing is to be prepared with helpers and strategies for everything. If you're on crutches, figure out how to deal w/the bathroom & shower while non-weightbearing. Figure out stairs (up w/the good foot, down w/the bad), etc. and do all of this BEFORE you can't put your foot on the floor.

If you teach dance, I'm assuming you're in pretty good shape, but even so, get yourself as strong as possible before the surgery, and do everything your doctor says. If you have a 3-year old, go for the cast instead of the wire-bracket thing. You need your foot protected. The biggest mistake you can make, and plenty of people on these boards have made it, is to try and walk or do too much too soon. It takes 6-8 weeks for bone to heal no matter what you have done to it, meaning breaking it by accident or having the doctor break it for you.

Physical therapy is crucial, and once you're out of the cast, there are ankle exercises you can start doing immediately.

Good luck with whatever you decide. I love my new feet and am so happy I did it!!

 
Old 09-20-2005, 10:29 AM   #6
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Re: Considering bunion surgery

Just a note that I did not have PT but did some stretching that the my doc suggested and this was all that I needed. Pulling the toes up toward the leg and the back in the other direction (but that comes much later!!). IMHO, PT is not a requirement.

Second the point about how long it takes for bone to heal. Slow and steady is definitely the way to go with bunionectomy recovery!

 
Old 09-20-2005, 01:05 PM   #7
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Re: Considering bunion surgery

Well thank you again. I'll be getting a second opinion sometimes in the next couple months from another foot/ankle specialist that my daughter has seen since she was 3 yrs old. I'll look forward to his opinion as well.

More info and opinions appreciated...

dplusmom

 
Old 09-20-2005, 02:03 PM   #8
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Re: Considering bunion surgery

My pod specializes in dance medicine & works specifically with actors and dancers to get them back on their feet and working. If you make a living from being on your feet and demonstrating steps and combinations, I'd say PT is mandatory. I had basic stretching exercises, but my PT routine got me up and doing it twice a week, out of my house (where I could just tell myself I'll do my exercises later), and doing strength training, balance -- when you're off of your foot for so long, your body goes out of whack, and the other side of your body takes the weight & does all the work. You have to gradually regain the strength and even up your right and left sides again. Aside from my 1.5 hour routine (backwards walking on the treadmill at a high incline, recumbent bicycle, calf stretches, trampoline presses, weight distribution exercises, high-stepping marches, tiptoe-walking, and I could go on), the most important thing you get from physical therapy is the hands-on, harder-than-you-can-do-it-yourself scar-tissue breakdown by massage. My therapist was ruthless when it came to breaking down my scar tissue, and I'm so grateful.

I find it interesting that mediamom has had bunionectomies TWICE, but never needed physical therapy. If my doctor said I didn't need PT after something as major as foot surgery, I'd run out of that office -- good for your doctor for recommending it.

 
Old 09-20-2005, 04:38 PM   #9
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Re: Considering bunion surgery

I guess I'm lucky then! No never had PT and though I had a neuroma and just had my third foot surgery to remove it, my recovery from my last bunionectomy was easy enough. My pod offered me the option of PT but frankly, I didn't savor the idea of going to yet another apppointment each week and walking seemed to get me back in the saddle. Then again, I'm not a dancer so I didn't need the kind of rehab that someone in the line of work might.

 
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