I am amazed at how fast I am recovering from this! T recap my story, posted some months ago: 51, former runner, started noticing stiffness and pain in right great toe about 2-1/2 yrs ago. Consulted a podiatrist in the States who diagnosed Hallux Limitus in both toe joints, more advanced in right. gave me orthotics (never helped a bit). I then moved to Austria and consulted a sports orthopaedist in Salzburg. X-rays showed a fairly narrow joint space in right toe and significant spurring. He recommended a resection arthroplasty a la Keller-Brandes. Read up on this and thought it a strange rec. for someone who is not *that* old and fairly active. Plus it looked like I still had some cartilage left. Consulted a new orthopaedist in Vienna who recommended a traditional cheilectomy. Decided to go with this least dramatic intervention.
I was given a local and twilight intravenous sedation. I have no memory of the surgery. The foot remained totally numb for about 9 hours after surgery. I received Lornoxicam (a NSAID) and Xantac by mouth and a drip pain killer for the first night. It was not too bad and I was able to sleep. The next day I had to ask for another drip in the evening but the pain was still quite bearable. This doctor swears by a cool "boot" that is continuously filled with chilled water and wraps around the foot. I liked it and think it helped but my own homemade ice packs work at least as well. I did not receive any antibiotics, which the doctor thinks is over-prescribed for such surgeries in the U.S.
My doctor told me that there was no cartilage left on the top of the joint but still a decent amount on the lower part. He removed the dorsal bunion and bone spurs, cleaned up the joint and trimmed a bit on the sides of the joint. He says the joint looked inflamed from the constant jamming.
So far so good with so signs of infection or inflammation. Swelling is basically non-existent but I have been keeping the foot up and iced regularly.
I am to start rotation of the joint 4-5 days after surgery (tomorrow) and physical therapy when the stitches come (two weeks after surgery).
I may eventually need a fusion but hopefully this will buy me some time.
Day 6 and there has been constant improvement. My gait is almost normal in my ortho sandal. Last night I began ROM exercises and find that dorsally there is almost no pain, even pushing the toe up pretty far. Bending it down, though, is another story. I can't even imagine trying to pick up a pencil! The toe is generally stiff but I feel like I want to move it, at least a little.
Maybe when the stitches come out it will be easier. I am off pain meds except one Advil morning and evening. I am icing just before bed and once in the a.m. and that seems enough. By the end of the day, with a fair amount of walking, I feel the burning sensation in the toe, which means it is time to put back on the ice pack for a while.
Not sure how often to do the ROM exercises at this stage. I do them whenever I think about it (today perhaps 3-4 times) but maybe I should do more? I am trying to ease into this since I don't want to overdo but also want to preserve as much degree of movement dorsally as possible.
Tomorrow noon will be one week. I can't believe I am doing as much as I am!
Sounds like you are doing normal for this procedure. I was walking from Day 1 in the surgical shoe. No pain meds after about day 4 and none if I was driving...which I did on day 3.
(got to have that manicure!) I wasn't allowed to do any exercises till the stitches were out at 2 weeks so I can't address that issue. But at that point, I was told to do them as often as I could throughout the day. One thing that will help at that point is that you will be able to get it wet. Then you can soak it in very warm water to sort of warm the muscles up so they move better. That's what I did and it really made it much easier. I still don't, after years, have as much plantar movement as in the other big toe but heck - how often do you need it to bend that way anyway? When you walk or jog, it doesn't bend down, just up. But I can pick up a pencil or wash cloth with it so I guess that's enough!
Day 11 and I have noticed a big set-back. I stopped taking any NSAIDs on Thursday night to see how I would fare without. I also started some mild rane of motion exercises and found I could move the toe up a little bit but hardly at all down without pain. It, the whole joint and the stiched area, feels tight, stiff and burney-achey. I want to have the foot up all the time and icing still helps, even though I only do it at night and in the morning for a while. I can walk almost normally (if slowly) for some distance but find I still want to walk on the outside of the foot. My whole front foot area is black and blue, maybe this bruising is part of the problem.
Today trying to do ROM I can barely get any movement in any direction without pain.
Am going to see my surgeon day after tomorrow to get the stitches out...which I am not looking forward to. Just the thought of anyone touching my foot sounds horrible!
I'd keep taking the NSAIDs...in fact, 6 years out I still take 2 Aleve every morning and 2 in the evening if I'm going dancing.
I'd take Vioxx if it was still on the market! It's not going to hurt you and once you get the stitches out you can be more agressive with the rehab and that is going to hurt - no way out of that! Sounds like you are doing fine though.
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