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Old 01-31-2010, 08:23 PM   #1
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Podiatrist or orthopedic surgeon for bunionectomy?

Hello all, I'm new here, and just wondering about whether those who have had bunionectomies have used an orthopedic surgeon or a podiatrist? I am a nurse, and know PLENTY of orthopods who will do this procedure.... but I just feel that a podiatrist will give a more cosmetic effect. Also, I'm finding that those who've used podiatrists may also weight bear sooner and have better recoveries.

Also, just wondering.... anyone who has had the procedure and works a job that they are on their feet for most of the day (i.e. a nurse, doctor, salesman, hair stylist).... what was the soonest you were able to go back to work? I'm just concerned with taking 8 weeks off work, and then being on my feet for 12-14 hours a day when I go back. I am looking to have bilateral bunions done. Thanks all!

 
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Old 02-01-2010, 10:26 AM   #2
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

I had my big toe fused on October 28th. I know this is a different procedure, I decided to comment because it is the same joint.

I had the choice between an orthopod and a podiatrist. I chose the orthopod because I would not have to pay for it. I had thought that someone who specializes in feet might be a better option, but I think I did make the best choice. The podiatrist recommended an option that I believe would have been temporary at best. I would have still had to have had the fusion at a later date. Since I am not in the habit of wanting foot surgery, I'd rather have the one and get it done and over with.

I used to be amazed that people would want to have both feet done at once. I know someone who had a bilateral bunion surgery and she did it because she could not afford to take more time off. I was recently checked for a bone infection, and that sometimes involves surgery (in the worse case scenarios). The thought of another surgery now, three months later was crappy and scary. Now I understand why getting done at the same time is a good thing.

I think it would have been about two months before I could have handled a job that involved being on my feet. I am not sure I would want to deal with 12 hour nursing shifts even now, but I could do it.

Good luck with your decision. I think leading up to the surgery is worse than the actual event. I am very glad I got my foot fixed.
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Old 02-01-2010, 01:29 PM   #3
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

I had surgery performed by a podiatrist and am very happy with the result.
I had bunion and bunionette surgery on the right foot with osteotomies and temporary pins. I will need to have the same surgery performed on my left foot sometime in the future, and hope to have the same doctor (if he doesn't retire before then). I think there are good podiatrists and orthos, and bad ones too. Since you are a nurse, you may have the best information available, or maybe too much?! My best advice would be to continue your research, and ask friends/co-workers who have had the surgery what their recommendations would be. Meeting with the doctors will also be helpful.
Regarding standing on your feet all day after 8 wks of recovery: I only had one foot done, and probably could do a day or two at a time, but I'm not sure how I would have felt after a week of working that schedule. Your feet will be your guide. Good luck.

 
Old 02-04-2010, 07:17 AM   #4
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Hi everyone! Hi Jane, long time no see, Happy 2010!

As Jane said, there are both good and bad apples in each profession. The bottom line is: It's not what they can do but what your feet really need. I know some surgeons who know one or two techniques, so it doesn't matter what your feet need, they may still perform what they know on you. Being a nurse, you definitely have the advantage to know the good ones. Get a few consults, and see if they all reach the same consensus in the procedure to improve your feet.

Northwind, I hope you won't need surgery for your bone infection. I will send positive energy your way!

Here is my 2c When I was considering bunionectomies, I never thought about which specific profession (orthopedic surgeon vs. podiatrist) to choose from but worried more about the experiences, techniques and results of the doctors. I researched quite a bit about the possible techniques and its complications in bunionectomy and then figured out which one I would/could have based on the degree of my deformity. It just turned out that my final choices for surgeons were all orthopods. Two surgeons wanted to do Scarf and the other one suggested Chevron. I researched those techniques more in depth by reading podiatry textbooks and reading the doctors' forums I am thankful that I had a good surgeon. He is an orthopedic surgeon, but using the Scarf technique (which was originally invented by a podiatric surgeon). You will likely not find orthopods in US doing Scarf procedures. I disagree that Pods will do it more for cosmetic reasons or patients be able to bear weight sooner. i think it all has to do with which procedure was performed and the severity of the problem.

As for time off, I think 8 weeks off work is sufficient for most people. It also depends on how good of a patient you are. I think feet elevation and patience are so important in the beginning (I never iced). I had both feet done (scarf osteotomy) but no Akin [in my knowledge, bunionectomy with akin (toe involvement) generally takes longer than simple bunionectomy]. I think I was a perfect patient (more like paranoid ), and really had my feet elevated except during bathroom runs and follow-ups for the first 3 weeks! NWB was my goal, and I was lucky to have the use of wheelchair during that time. I think I was NWB for 5 weeks total. I am really surprised I didn't gain much weight being such a complete couch potato !
I was travelling and did a lot of walking/sightseeing on my 6 week post op, feet were definitely swollen, even more so at the end of day. And again at 8 weeks post op, but by then the swelling had gone down considerably compared to at week 6. It all depends on which procedure you will be doing and how the swelling was controlled from the get go. I know people who were up and about after 3 to 4 weeks and wearing their own shoes! I massaged my feet a few times everyday since the sutures were removed and did isometric exercises. I think the toughest part for me was learning to walk again, but I am really glad that I had both feet done, so I had to learn to walk with both feet instead of favoring one foot which could cause other issues. My OS didn't think Physio was necessary as long as I did the above, but I still ended up doing physio at week 7 post op so that I could gain more confidence in walking "naturally"


How time flies! Today is exactly my 8th month post op I am so happy I had both feet done eventhough I am not at my 100% yet. My feet are pretty much back to their size, not much swelling to speak of, unless I drink OH lol The good news is I don't get the same pain that I did before surgery! *knock on wood*

Good luck in your search of a great surgeon!

Cheers!

 
Old 02-04-2010, 07:32 AM   #5
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Hi earthworm, it is nice to hear someone else did not ice. I could not even bear to try that, since cold really irritated that joint pre-surgery.

I have been given a verdict of no bone infection. My GP and I will monitor it, and she has given me a requisition so I can get another x-ray in a week or two. Yay! I am hoping next x-ray shows it is healing well.
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Old 02-04-2010, 07:53 AM   #6
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Yaaaaaaaaaaay!! Cross my fingers that you will only receive good news on your next X-ray visit.

Cheers!

 
Old 02-04-2010, 06:33 PM   #7
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

I had bilateral 5th metatarsal bunions done by an orthopedic foot and ankle doc. I made that choice because I had been to see podiatrists and was not impressed. My right ankle has been through a lot and the pods didn't even address my concern. Love my doc. He just did my ankle surgery in December.

I'm a teacher so I am on my feet. I'm not one of those to sit and let the students come to me. With my foot surgery I was NWB for 6 weeks on the right foot, but I could have made it through work on crutches at about 4 weeks. I had the entire 10 week summer break to recuperate. I went back to work at 9 weeks still in a surgical shoe. Swelling was a problem the first week or so and then it settled down. With my recent ankel surgery I went back to work 3 1/2 weeks post op PWB in a cast. Same as before, swelling was an issue at first, but got better once my body was used to being up and moving again.

Everyone is different. Some people can tolerate the swelling and do fine on crutches. Others have to keep their feet elevated and struggle with mobility. I have the upper body strength and balance to be very comfortable with crutches. I tolerate swelling for a while and then have to elevate. Good luck.

 
Old 02-06-2010, 11:46 AM   #8
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Quote:
Originally Posted by setla02 View Post
Hello all, I'm new here, and just wondering about whether those who have had bunionectomies have used an orthopedic surgeon or a podiatrist? I am a nurse, and know PLENTY of orthopods who will do this procedure.... but I just feel that a podiatrist will give a more cosmetic effect. Also, I'm finding that those who've used podiatrists may also weight bear sooner and have better recoveries.

Also, just wondering.... anyone who has had the procedure and works a job that they are on their feet for most of the day (i.e. a nurse, doctor, salesman, hair stylist).... what was the soonest you were able to go back to work? I'm just concerned with taking 8 weeks off work, and then being on my feet for 12-14 hours a day when I go back. I am looking to have bilateral bunions done. Thanks all!
Dear Nurse,

Hi, I have not had to have that procedure, but my friend is the sister of a top MD surgeon in a Harvard teaching hospital and she is the daughter of a (late) professor of physiology at a famous medical school, and a long time medical social worker: So I listen to her when she is trying to find a good doctor for her feet.

I have worked in hospitals, too, but am not a nurse.

Listen, as you know, the word gets around who is good and who is so-so. You talk to other nurses or doctors you know. Well, believe it or not, my friend's surgeon brother (chief surgeon) at this top Boston hospital asked around and found a great, gifted podiatric surgeon who in turn did a complex job on my friend's (genetic problem) twisted toes, bone work and all of that. She absolutely loved his work and he sounded magnificent. So, IMO, you can get a great podiatrist but you need to find one via top references. Also, perhaps a top podiatric school that trains podiatry surgeons could be a good place to start.

I would ask a foot and ankle orthopod who is good and they might refer you to a great podiatric surgeon.

Good luck.

Martha

 
Old 02-11-2010, 03:51 AM   #9
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Hi Nurse. I had bilateral bunion removal by a orthopod. at the time i never even considered a podiatrist i suppose ignorance. on my part.

I was off work for 14 weeks because my job entailed me being on my feet all day and my pod would not sign me of until he knew i would have minimal swelling. I totally agreed with him and im glad i waited.

Good luck with your decision.
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Old 03-07-2010, 04:03 AM   #10
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

hey everyone!!! It's funny- I felt all 'at home' seeing these familiar names weighing in on this topic!! ;-) How are you- earthworm, pearl and northwind!!?

To answer the question (in my opinion)- I had bilateral scarf bunionectomy- and I say- ORTHOPEDIC SURGEON for sure!! mine was a foot and ankle specialist, and even though he had the communication skills of a mute, his reputation (for doing a great job) was brilliant, and I trusted him completely!! And I must say the truth is in the pudding as they say- as he told me at my 3 month check up that my feet looked so good I didn't need to come back for the 6 monther (unless something dramatic happens).
AND I must admit I have heard1 or 2 horror stories about people who had a POD do the surgery.....sorry- that's just what I have heard!
Feet are way to important to not put them in the hands of people who have studied something so specific for 10+ years.... that's my opinion anyway...BUT the key really is the type of surgery ...and I must say - someone may prove me wrong here- but in Australia (where I'm from) I'm just not sure pod's doing full on surgery is as common....Pearl are you from Aus? Would you say that was true? I have had some great pods in my time but I would not let them anywhere near my feet with a scalpel;-)

I had a desk job so- so 4 weeks off work was perfect for me!! To be completly honest I could have gone back after 3 (but I milked it) shhhhh don't tell anyone ;-)

I did need to elevate it at work for a few weeks though (and as I could 't ACTUALLY elevate it above my heart while typing) it took some time to feel better-
My guess is- if you went back to a standing job after 3 weeks you would be throbbing like mad by the end of each day.... I would allow for as much time as possible and if you get to go back earlier it's a bonus!!

------

I wore heels for the first time since my op ( 4.5 months ago) LAST NIGHT-and it was much better then I expected- sure my toes felt quite tired at the end of the evening, but all things considered it was very encouraging!!
I think I really need to accept a life 95% in flats though
In my opinion I don't really think that there would be a difference in terms of the cosmetic result- i don't think orthos would like a reputation of being a slasher (word gets around) ;-)


As I have said before, running and wearing heels (with less pain then I had pre-op) were the 2 things left for me to achieve-

Well I can run and wear heels now- but sadly it is not with out painÖ.interestingly it is a different kind of pain (as obviously I havenít got bunions getting in the way any more) but they just donít have that flexibility- and they get very crabby if they get pushed to far!
Surgeon says that by the 1 year mark I will be 100%- so I guess I have a good few months to go- with that in mind I have happy with my progress!! I just canít wait for the day when I am running along and itís my fitness that makes me stop, not my feet burning up !!!

Anyway- enough of me- take care everyone!!! xxx :

Last edited by aimski; 03-07-2010 at 04:24 AM.

 
Old 03-22-2010, 06:33 PM   #11
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Hi Aimski
How great it is to hear you excited about your feet you sound like you have nearly got your old feet back again. I do agree with what you said about pods doing surgery here in Australia for bunions it is very rare. What state are you in? and if you are in Sydney who was your surgeon that did your feet.
I have a small lump on one of my feet on the top about the same position as it would be if i had the bunion on the side.It aches sometime but more surgery frightens me.Other than that i cant complain im much better of without the bunions.
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Old 03-23-2010, 06:07 AM   #12
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Hey girls! So good to see everyone here! Aimski, it is great you are improving and yes, it takes time for you to get used to being in heels again..there is still the slight nagging inflexibility and it's not the 100% we are looking for initially, but it will come with time as your doc said.

I am almost at my 10th month post-op, and I can't believe how well my feet look and how good they feel. I am still hesitant to put on my 3 inch dance shoes ...so I will at least wait for the year to be up, but I just started taking belly dancing classes....barefeet! hehe....more like elephant stomping across the floor..but who cares! The feet are holding up pretty well, so I am relieved in that regard. I still have scars on the side though (I am prone to hypertrophic/keloids scars....so I was prepared), but I am not worried about them, as long as I get 100% function of my feet with no pain

Pearl, sorry to hear about that little bugger on top of your foot, hopefully it will reduce with time as well. I can understand your worry about another surgery, so hopefully it's nothing serious and time will take care of it.

Happy feet everyone!! Take care.

 
Old 03-23-2010, 09:26 AM   #13
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Re: Podiatrist or orthopedic surgeon for bunionectomy?

Hey everyone, it is good to see feet are healing and everyone is doing well. setla are you still here? Have you made a decision?

My foot is doing awesome. I went for a really long walk last week. We walked about an hour and a half, and probably covered 4 or 5 miles. My foot did not hurt at the end. It was wonderful. I do not remember the last time I could walk without pain. This past Saturday I danced the two step and similar and the foot felt good. I didn't polka when that music came on though......that might have been pushing it a bit.

According to my last x-ray the foot is fusing, and there is no infection for sure. I am going to get another x-ray at the six month mark (end of April) to see what is happening.

Now I am wondering why I was so freaked about the surgery......it was an excellent choice. I should have done it sooner.
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