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Old 02-02-2008, 04:19 PM   #1
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surgery for Big toe bunion & overlapping toes?

Sorry this is so long.
I hope I can get some advice from those who have had a similar problem.
About four years ago a bunion near my big toe on my right foot that I had since a kid but it was very small then, started to grow much bigger causing the big toe to lean over toward the second toe. Now the bunion is very pronounced and very painful when it rubs my shoes. Even with a thick bunion pad/bandage.Then the second toe begin to move toward the big toe and lay right up against it ,and lifts up, crosses over and lays on top of the big toe when I begin to walk. The second toe that is lifted and overlapping rubs the top of my shoes and a hard bump is forming on top of the joint of it it. Also my third toe is now leaning way over toward the 2nd toe.
I went to a Podiatrist who wanted to remove the bunion and straighten the big toe and then cut wedges of bone out of the overlapping toes and put pins in them . I was set to have the surgery done ( no insurance but taking it out of our savings. When on the last visit to discuss details, the Dr surprised me by saying he was going to do a fusion on all the toes. He hadn't told me that on my two previous visits.
So, I went home and looked into fusion articles online and read it was kind of a last resort mostly reserved for patients with arthritis .Not done that often by DR.
I'm 49 and don't think I have arthritis in my toes. If I do it doesn't hurt much. What hurts is that the bunion sticks way out and rubs on all but two pair of super wide stretchy shoes I own, that are ugly but I can wear them without pain. Not pretty to wear with my church dresses. At home I must go barefoot or wear slippers or flip flops due to the pain from the bunion.
I had read with toe fusion you must wear orthopedic shoes or flats. No kind of heels at all. Be careful about standing up on your toes and that you can have trouble walking up hill. That toes can get very stiff after fusion and even develop arthritis due to not being able to wiggle your toes anymore to keep them flexible.
I like being able to wiggle my toes and I would like to, once in a great while wear at least 1 1/2" heels (with a wide toe box or open toed).
This problem is hereditary as my dads side had a lot of foot problems and I only wore heels to church ( for 2 hours, 1 day a week) and immediately took them off to go barefoot when I got home. And they were never over 2" heels at the most. At the store or other places I always wore flip flops or comfy sandals.

I would still like to get surgery as I love sandals and thong shoes and my bunion and toes look so bad now on my right foot that I don't dare wear shoes that can show it. But I am NOT crazy about fusion. An elderly lady in my church with my exact same problem recommended me to this DR and he did her bunion removal and crooked toe surgery without fusion, and she came out fine.
She even wears pointed toe shoes with heels and goes dancing a year later, which I wouldn't do,( wear pointed toe shoes.)
When I asked him why he wanted to do fusion on me, he said so the toes could never go back to being crooked or overlapping.
I've been on various foot forums and it seems most of the people posting about similar surgery have not had good outcomes. They complain of severe pain even up to a year after surgery. Toes that now point straight up instead of overlapping. And they can't even wear shoes with wide toe boxes now due to the toe sticking straight up. Even some with fused toes going back crooked or sticking straight up.
A friend at my church said maybe a lot of people have successful surgery for my kind of problem, but only the ones with problems are posting. Still, it's enough to make me worry, as once it's done, it's hard to undo the damage is the outcome isn't good.
I had read an article by a Podiatrist that said the feet don't really take that well to surgery, being tampered with etc, like the rest of the body might tolerate and he recommends it for people with severe pain only.
I'm sorry this is so long. Can anyone who had my kind of problem tell me if they had a good or not good outcome and if they could do it all over again, would they? We'd be using our savings for the surgery $ 10.000 and I was told in a few years my left foot will need the same done to it as the bunion is getting bigger and the toes are starting to lean into one another on that one too.
If it gets screwed up, we won't have the money for a re-do.

Any advice would be appreciated. I try not to be vain but when I look at my deformed looking foot in the mirror I get depressed.
I used to wear sandals and paint my toes and like them being in the open air. Now they are ugly and I have pain.
thanks
Cheryl

 
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Old 02-02-2008, 08:08 PM   #2
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Re: surgery for Big toe bunion & overlapping toes?

Here's what you need to do. You are between Tampa and Orlando so I don't know which city you prefer. Whichever it is, call the front office of the pro football or basketball team (Tampa Bay Bucs or Orlando Magic) or the athletic dept at USF or UCF and ask who they use for foot problems. Go see that doc for a second opinion. You'll be glad you did. I've found that sports med docs want to get you back to where YOU want to be and the others want you where THEY want you. That's a big difference.

 
Old 02-02-2008, 09:11 PM   #3
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Re: surgery for Big toe bunion & overlapping toes?

All of your concerns are legitimate and I think you're wise not to rush into the fusion surgery-- I agree that a second opinion would be a very good idea. Since your other foot has some of the same problems, maybe you should also ask about whether it would be feasible to have that one fixed at the same time. It would be more expensive than just having one done, but less than having it done separately later, especially if the condition continues to deteriorate and more toes are involved. Why does your doctor think you should wait a few years to deal with the second foot? I don't think I agree with the article that said to have surgery on your feet only if you're in severe pain-- I believe that if you wait until the pain is severe, it's possible you've waited so long that the foot is harder to repair-- and if surgery is probably inevitable anyway (as it generally seems to be with significant bunions), you spend time suffering that could have spent with "normal" pain-free feet-- and, as a bonus, wearing "normal" shoes! Of course, surgery on the feet is not easy and I would agree that it wouldn't be wise to do it for cosmetic reasons, but it IS a great bonus! Best wishes on getting the information you need to make the right decision.

 
Old 02-03-2008, 12:30 PM   #4
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Re: surgery for Big toe bunion & overlapping toes?

Thank you so much for replying so quickly.

My main concern is that I like to walk. I love walking. It helps me when I'm feeling depressed and it's helping me to lose weight. If it turned out that well after the recovery period it was still too painful to walk much that would really depress me. I don't drive so walking is my way of getting out in the fresh air and it just makes me feel good mentally and physically to take walks. We have a lake and country roads close by. I love to walk around the lake and look at the wild flowers and wild life as I walk.
I would also like to be able to wear shoes sometimes, maybe 1-2 days a week that have a bit of a heel. 2" and under.
I'm nervous that something could go awfully wrong and then even my ability to take daily walks in the future could be hindered. As it is now I can walk 1-2 miles a day IF I wear the wide toed shoes I have with the memory foam inserts that stretch at the bunion area. They're getting kind of faded looking but I have no pain when I walk with those.
I can't even slip a regular wide shoe on my right foot without pain right away from the stupid bunion and over lapping toes. My left foot is uncomfortable in regular shoes but not real painful as of yet.

if I had the surgery done I kind of prefer one foot done at a time first in case the Dr did a crummy job or my feet didn't respond well to the surgery. I had a couple people tell me that they had both feet done at once and it went badly and they wish they had done them one a time so they had less pain, and needed less help getting bathroom etc, and could at least came out of it with one foot that didn't hurt so much, as they were worse off after the surgery, as far as pain was concerned.
I'm hoping I'm not one of them.

When I called the Dr in Winter Haven, to cancel my surgery that was to take place in one week because I told him I didn't want a fusion unless I learned more about the pros and cons of it, he said, "Dear, fusion is NOT going to hurt you, it will keep your toes from going back and overlapping again." I said I had heard it can get in the way of some activities. Then he said it wouldn't impede me much at all as far as being able to being more active in the future like I want to be, some dancing (in a careful way) , hiking, biking, walking etc.
I had told him the last two appointments that I would like to still be able to wear 2" or 1 1/2 " and under heels now and then and that now I read that with toe fusion I would need to wear flats and it could very well impede some of the activities I want to be able to do.
He poo pooed it and then said, "So, you're not going to get the surgery, after all I did for you concerning paper work, giving you a discount and also getting you a discount with the outpatient clinic for the use of the facility and anesthesia"?

When I told him I still wanted to look into it more, he said, "I think you're just scared and have cold feet, and you also put me through a lot of trouble for you, but good luck"
That was the last I talked to him. I paid the $ 600.00 DR bill for the x rays and two visits and now I'm still wondering what to do.
I don't like it when Dr's try and make you feel guilty by not doing what they want. I'm the one who will have to live with the results, not him.
That's why I'm trying to do my research and asking those who have been through it the pros and cons of bunion/overlapping toe surgery.
Thanks so much for giving me insight.
Cheryl

 
Old 02-03-2008, 12:44 PM   #5
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Re: surgery for Big toe bunion & overlapping toes?

Thank you Titchou also for the advice about contacting a Sports Med DR for a second opinion. I am about 45 mins drive away from Tampa, FL and about 1 hr 15 mins drive from Orlando. And it would be worth it to have my hubby drive me either way to get a second opinion with someone more "in the know."
With the economy going the way it is, I know if it's to be done, we better get it soon ( while we still have a savings to dip into.
Problem is my hubby is Chinese and he is of the thought that sometimes it's best to just leave some things alone. He thinks Americans run to the Dr too much and often end up worse then before. He thinks my foot isn't that bad as I am not in pain if I am not wearing regular shoes that compress the bunion. And ugly feet don't bother him I guess. I'm okay in those wide stretchy shoes or flip flops. Even if it's unsightly to see a big red bunion and overlapping toes. So, I hope if I get it done I don't turn out worse off then I was before the surgery, down the road, or I'll never hear the end of it. I don't have medical insurance but he loves me enough that he would take it out of our savings, that he saved for 10 years from his job. IF I ask him to.

Now I'm going to look into a Sports Podiatrist and hope they don't charge too much ,as I don't have health insurance.
If I thought it would pay for my foot correction surgery, I'd try and get it but I think they would call it "pre existing" and refuse to pay.
Thanks again. This is giving me some encouragement.
Cheryl

 
Old 02-04-2008, 12:25 PM   #6
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Re: surgery for Big toe bunion & overlapping toes?

i am so sorry to hear this. no matter what, you have to get health insurance. this may not qualify as a pre-existing condition. you must go to another dr-you cant rely on 1 opinion. i learned that the hard way. try to get insurance first.

 
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