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Old 01-29-2013, 08:19 PM   #1
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hallux rigidus concern... help!!!

I am 41 and have been suffering from mild to extreme pain in my big right toe. I have been to my podiatrist 3 times done x-rays and been recommended to have surgery, due to the HR. The Cheilectomy surgery was recommended. I decided to get a second opinion last year from a local orthopedic doctor who is highly recommended. He said absolutely do not have surgery for as long as possible...20 years!
I stopped working out as much and only played tennis...my passion! I could not wear traditional tennis shoes because they hurt my feet so bad and used softer running shoes instead. The pain was bearable most of the time unless I had a long intense match.
Now that it is cold outside the pain is worse and if I stand for too long or wear a heal my foot is very unhappy.
I decided to consult my primary care physician. I asked for an orthopedic practice that worked with a lot of professional athletes.
I met with Dr. Richard Pike from Northeast Georgia medical and he took a new xray and gave me the choice of surgery or no surgery. Said if I could not take the pain then have the surgery, but if I could play tennis then I should not have the surgery. Now I am totally confused. I have no idea what stage my HR is and did not think about asking in the office because I was so taken aback by my lack of good options. The surgery is said to be only 75% successful and will most likely need a fusion at some point down the road. I can keep the pain down if I am completely inactive, but that is nearly impossible for me. I have 3 children and enjoy being active.
My instinct was telling me that if I go ahead and have the surgery, I could start the healing process and hopefully get back to a more active lifestyle. Once I met with the doctor I felt like I was back to square one because even the orthopedic surgeon is suggesting to wait until it is unbearable. I can hardly bend my toe and do not want to have to have a fusion because I let it go too far. How do I determine my stage of HR and at what point is it time to have the surgery? Is there a study of successful and unsuccessful results after a cheilectomy?
Thank you!!!!
Courtney

 
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Old 01-30-2013, 04:57 AM   #2
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Re: hallux rigidus concern..help!!!

I've had a cheilectomy in both great toes. The left one was done about 11 years ago and that joint is a little painful at times but not that often and usually only when I spend hours dancing.

The right one is another issue. I had it 2 years ago and, frankly, I waited too long. there wasn't much cartilege left. It was fine for about a year but I can see from recent x rays that there is no cartilege left - the bones are jammed up next to each other. I had a cortisone shot at the end of November for it and it has really helped. It needs to be fused at some point but I just haven't committed to that yet. I can't seem to get any definition on how high a heel I can wera afterwards and since my closet looks like the second coming of Imeldo Marcus in terms of shoes (about 70 plus pairs), I am not ready to part with some of them. I know that's vain but as long as I can stay at the point I am now, I think that's what I'll do.

So, if it's keeping you from doing what you want to do, then have the cheilectomy. That's my advice. Shaquille O'Neal had one while he was with the Lakers. Mark Ingram of the Saints had one last year. Any number of athletes have had them. (It's known as turf toe in football).

 
Old 01-30-2013, 04:56 PM   #3
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Re: hallux rigidus concern... help!!!

Courtney, you seem to be getting a lot of contradictory info. And we all know what it feels like.

Like you, I'm a tennis player (or I was). Now all I can do is work out in the gym. I'm surprised you can still play. It may be that you are only Stage 1 or Stage 2, and that is why some of the docs are telling you to wait.

I'm Stage 3, have very limited flexibility, and can't play tennis without pain, so I plan to have a cheilectomy in April.

From what I've been told, we are all candidates for possible fusions in the future. The question we always wonder is "When?" And the answer, I have to assume, is "It all depends on the condition of your joint." Hallux Rigidus is affected by numerous factors, and among them are bone spurs, joint compression, cartilage damage, arthritis, and anatomical anomalies. So, we will all respond to procedures with differing degrees of success.

If you do nothing, you may risk losing the chance to restore some of the mobility a cheilectomy can offer. Though, I had one doctor who candidly referred to a cheilectomy as a "kick the can down the road" procedure.

Seems to me, the best thing you can do is to educate yourself on the stages of Hallux Rigidus, write down every question you have, go back to the doctor whose expertise you trust, and have a very frank discussion about the current state of your condition and the best course of action moving forward.

Hope that helps.

Last edited by JohnOffTheCourt; 01-30-2013 at 05:03 PM.

 
The Following User Says Thank You to JohnOffTheCourt For This Useful Post:
Fearinhoschton (01-30-2013)
Old 01-30-2013, 05:21 PM   #4
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Re: hallux rigidus concern... help!!!

Quote:
Originally Posted by JohnOffTheCourt View Post
Courtney, you seem to be getting a lot of contradictory info. And we all know what it feels like.

Like you, I'm a tennis player (or I was). Now all I can do is work out in the gym. I'm surprised you can still play. It may be that you are only Stage 1 or Stage 2, and that is why some of the docs are telling you to wait.

I'm Stage 3, have very limited flexibility, and can't play tennis without pain, so I plan to have a cheilectomy in April.

From what I've been told, we are all candidates for possible fusions in the future. The question we always wonder is "When?" And the answer, I have to assume, is "It all depends on the condition of your joint." Hallux Rigidus is affected by numerous factors, and among them are bone spurs, joint compression, cartilage damage, arthritis, and anatomical anomalies. So, we will all respond to procedures with differing degrees of success.

If you do nothing, you may risk losing the chance to restore some of the mobility a cheilectomy can offer. Though, I had one doctor who candidly referred to a cheilectomy as a "kick the can down the road" procedure.

Seems to me, the best thing you can do is to educate yourself on the stages of Hallux Rigidus, write down every question you have, go back to the doctor whose expertise you trust, and have a very frank discussion about the current state of your condition and the best course of action moving forward.

Hope that helps.
YES! That is exactly how I feel and thank you for your response! I spent all day doing research and have obtained a lot of good doctors to start interviewing in my area. I am worried about whether to use a podiatrist or orthopedic surgeon if I end up doing surgery. The podiatrist seem to have a better bed side manor but my fear is all the tendons and cartilage and nerves...etc..I want to ensure that the surgery is as successful as possible.

The ortho I saw yesterday told me there are not "stages" of hallux, but he also rushed me out the door and acted like I was wasting his time. Is there a web site that describes the different stages?

Thanks, Courtney

 
Old 01-31-2013, 09:10 AM   #5
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Re: hallux rigidus concern... help!!!

Hi Courtney -

I feel your pain, but no more! 18 months ago I had surgery for a grade 3 (the diagnosis before surgery - after surgery, the orthopedic surgeon said it was worse).

I posted quite a bit both in original posts and as replies to others, so do a search for my name Grace404 and find my posts and see if that might help with some of your questions.

The post about the actual surgery is this one http://www.healthboards.com/boards/foot-problems/861078-hallux-limitus-rigidus-surgery-report.html (Hallux Limitus Rigidus surgery report)

Grace

 
Old 02-03-2013, 08:12 PM   #6
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JohnOffTheCourt HB UserJohnOffTheCourt HB User
Re: hallux rigidus concern... help!!!

Quote:
Originally Posted by Fearinhoschton View Post
I am worried about whether to use a podiatrist or orthopedic surgeon if I end up doing surgery. The podiatrist seem to have a better bed side manor but my fear is all the tendons and cartilage and nerves...etc..I want to ensure that the surgery is as successful as possible.
Courtney, the best advice on this came from my primary doc. He told me to find the best doctor. He said there a good and bad podiatrists, good and bad orthopedic surgeons. He said, the more questions you ask, the more you'll begin to sense how much knowledge, experience, and success a doctor has had.

Quote:
Originally Posted by Fearinhoschton View Post
The ortho I saw yesterday told me there are not "stages" of hallux, but he also rushed me out the door and acted like I was wasting his time. Is there a web site that describes the different stages?
I'm certainly not qualified to say your doctor is wrong, but the tone of his response suggests that you shouldn't listen to anyone but him. There are countless sources that discuss the different stages of Hallux Rigidus, but they don't all agree on the characteristics of each stage. So there's no real definitive source that I've discovered, but you can do a search and find plenty of descriptions.

 
Old 02-04-2013, 12:01 PM   #7
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Re: hallux rigidus concern... help!!!

I strongly suggest you find a sports med ortho who is foot and ankle board certified. Find out who the Falcons and the Hawks use. Those will be excellent options.

 
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