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Old 07-02-2004, 06:30 PM   #1
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carreg HB User
Red face 18 Days Post-op: Couple Questions

I am now 18 days post-op bunion/hammertoe and metatarsal resection on right foot. When I went to my doctor this past Tuesday, he said he wanted to start trying to move my big toe more. However, it seems my big toe has a "mind of its own"! Whenever, I try to move it downward, my foot starts "quivering". I cannot more it upwards at all. Anyone have any suggestions/similar problem?
Also, I'm in the boot that puts no pressure at all on the front portion of the foot. I've been able to walk around without much swelling to the foot. However, this evening after going out to eat for my son's birthday, my foot is very swollen and hurting like crazy. My husband drove me right up to the door of the restaurant and I was seated right away. Is this going to be a common occurence when I try to walk more than just around the house? I really don't think I overdid it but it sure feels like I've run marathon barefooted right now!!!
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Old 07-02-2004, 08:01 PM   #2
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Re: 18 Days Post-op: Couple Questions

Hi!

I had a different procedure than you had, but I hear you loud and clear.

On May 25th, I had an Achilles tendon lengthening, subtalar fusion, calcaneocuboid fusion, and two bones that had fused together were shattered and reconstructed with a spacer put in so they wouldn't fuse again.

I can recall my foot having a mind of its own until just recently. My surgeon encouraged me to move my toes, but it seemed that when I did that, no matter in which direction, my entire foot would shudder. Actually, it was more like the front portion of my foot would just flap up and down, like a restless foot out of control. A strange feeling would start on the top of the middle of my foot and it would feel like waves of movement from there down to the toes. Or I would get little twitches in various places that were involuntary. Now, almost six weeks post-op, I still get this uncontrollable jerking of the foot where the foot jerks outward and my Achilles still jerks sometimes, too. It must be the nerves either healing, waking up (nerves are very slow things to wake up and rebuild), or having a "what the heck...!" kind of reaction.

I was told there was a nerve that my surgeon could not reconnect, so I'm wondering how much of it is that, but I was told that all I might feel from that was some numbness on the top of my foot, which I can't tell if I have or not because I'm stuck in a cast, nonweightbearing still.

I don't get as much swelling anymore, but I'm currently nonweightbearing until July 12th, so I can't help you when it comes to walking and swelling. It does swell just from being gently rested on the ground for too long, but it subsides pretty quickly upon elevation.

Sorry I can't be more helpful, but I thought I'd share.

 
Old 07-02-2004, 09:37 PM   #3
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cmptrwun HB User
Re: 18 Days Post-op: Couple Questions

Quote:
Originally Posted by carreg
I am now 18 days post-op bunion/hammertoe and metatarsal resection on right foot. When I went to my doctor this past Tuesday, he said he wanted to start trying to move my big toe more. However, it seems my big toe has a "mind of its own"! Whenever, I try to move it downward, my foot starts "quivering". I cannot more it upwards at all. Anyone have any suggestions/similar problem?
Also, I'm in the boot that puts no pressure at all on the front portion of the foot. I've been able to walk around without much swelling to the foot. However, this evening after going out to eat for my son's birthday, my foot is very swollen and hurting like crazy. My husband drove me right up to the door of the restaurant and I was seated right away. Is this going to be a common occurence when I try to walk more than just around the house? I really don't think I overdid it but it sure feels like I've run marathon barefooted right now!!!
I had an Austin-Akin bunionectomy 30 days ago. What you describe is completely normal- you just need to keep trying and you'll find that your toe will start to "obey" you over time. Also, you can gently move the toe manually with your hand- google for "bunion surgery exercise" and you'll find a Kaiser-Permanente site with good exercises on it. If you use Google, it should be the second item in the response list. I would just give you the link, but these boards don't let people post *anything* that points to another site.

Anyway, just keep at it. I've been religiously "wiggling" my toe and my range of motion is already surprisingly good because of it.

As far as the pain and swelling, my surgeon actually kept me on crutches for a little over two weeks, then put me in a surgical shoe, and as of today's checkup and x-rays, I get to wear tennis shoes! I really did not have swelling until I started wearing the surgical shoe and walking a lot, and I've found that keeping the foot wrapped and elevated as much as possible helps immensely. Ice it if you need to, and when it starts to ache, take a break. When you ride in the car, prop your foot up, and do the same thing at restaurants. Don't let your foot rest on the floor if there is any way at all that you can elevate it.

And wiggle that toe! I honestly think that that has been the biggest factor in my recovery going so well. At thirty days post-op, I can move my toe in all directions with varying success, but the more I move it around, the looser it gets and the more the pain subsides. At this point, I really don't have any pain, although it will get a little sore if I wiggle it for a long time and really push it. My other foot, which has not yet been fixed, is *far* more painful than the one I just had sliced & diced.

Also, once your incision has healed and you're allowed to submerge your foot, alternating cold and warm foot soaks will help immensely. Warm water loosens the muscles and increases blood flow, and cold water decreases the swelling. I will soak my foot in cold water for a few minutes after I've taken a shower and it feels *great*.

 
Old 07-02-2004, 10:36 PM   #4
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Re: 18 Days Post-op: Couple Questions

I am 5 months post op a fusion of my big toe, and I still get some swelling. I was told that the swelling can last from 6 months to a year. That may not be what you want to hear, but each day it gets better. I also found that it took a while but once I began to do things more consistently the pain began to decrease.

JDM

 
Old 07-03-2004, 05:39 AM   #5
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squirrelmom HB User
Re: 18 Days Post-op: Couple Questions

Hi Carreg,

I'm now exactly 2 weeks postop for a bunionectomy. I think I must have had a less aggressive procedure than you, since I was weight bearing almost right away and have been able to walk and even exercise (as long as I keep the foot flat and there is no impact) since day 4 or so. On day 3 my surgeon gave me toe exercises to do: holding the foot with both hands, gently bend the toe up as far as it will go, then down as far as it will go, being careful to bend it at the second (big) knuckle, not the smaller knuckle close to the top of the toe. Repeat this for five minutes and do the exercises three times a day. At my appointment to get stitches out a couple days ago, she said my toe flexibility was extremely good, and very unusual for the two weeks mark.

However, I think my toe flexibility was pretty good all along. The exercises help, no doubt, but I don't think they get all the credit.

Also, given you had a different procedure from me, it would probably be wise to check with your doctor to see if he/she wants you to do these exercises at this point or not...

I still cannot flex the toe as much as I was able to before the surgery, and there is a little hesitation there before my toe obeys me when I try to wiggle it without help from my hands...but I think this will certainly improve as the swelling continues to go down and the stretched nerves heal (my toe is still very numb all over).

Even though my recovery is going so well, I also have times when the swelling increases a bit, or have occasional sensations of having blood rush to the foot if I have kept it down for a long time. I notice it's worse if I'm standing but not walking or putting weight on it. Any kind of weight bearing movement makes it feel better. I think this helps the circulation. I also elevate whenever I'm sitting.

I'm sure all these things (toe flexibility, swelling, blood rushes) will get better for you. How long it takes probably depends on how extensive your surgery was, and what type of bunionectomy it was. My best suggestion would be to increase gentle, non-impact activity as much as possible to keep your circulation going...but also listen to your foot and if it's too much stop and scale back. Always elevate the foot when you're not walking on it. And use anti-inflammatories (Ibuprofen) round the clock as long as the swelling bothers you and you can tolerate taking them.

 
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