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    Old 03-24-2008, 04:53 PM   #1
    wmkcolors
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    Not healing well....very frightened

    I had a standard bunionectomy, on Dec. 27th. 2007. I am 12 weeks post op and I am still barely PWB. I had progress at 8 weeks, but, as I became full weight bearing, the pain became excruciating. I had to switch doctors, because, when I expressed my concerns to my podiatrist, he started yelling at me. I was in shock by his outburst am not even sure what he was ranting about. I was horrified. I am now with an orthopedist, who takes a much more conservative approach. She has me fully NWB again, with no range of motion exercises, until she is sure the bone is fully fused. I fear my to will become permanently stiff, though I expect I'll do intense PT, within 6 weeks or so. She took an xray and said there wasn't good fusion for weight bearing or PT, whereas my podiatrist had encouraged me to start walking on it, at 8 weeks, after his earlier xray. I am very afraid. Has anyone taken longer to heal and to start walking normally? I am still shaken by my surgeon's reaction to my pain, especially since he did the surgery. The orthopedist doesn't think it's nerve related. Did anyone keep their "hardware", i.e. screws, wires; etc. in their foot permanently? Did your incision itch, even weeks postop?

     
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    Old 03-24-2008, 07:44 PM   #2
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    Re: Not healing well....very frightened

    Hi wmkcolors:

    I didn't have bunionectomy, but some similarities with other things....

    I had PTTD (posterior tibial tendon dysfunction) surgery on 12/27/07 for the second time -- same day as your surgery. My first surgery was 12/1/06.

    I had a failed first surgery from being "up and running" too soon -- for me anyways (5 weeks WB and 7 weeks physical therapy). My first surgeon told me my bone graft was "almost" fused when he ordered me into PT at 5 weeks. I guess the word "almost" should've been a warning sign, huh?

    My second surgeon is much more conservative. I didn't bear any weight whatsoever until 8 weeks this time, and then only with a hard cast. I got an Aircast (removable) at almost 10 weeks.

    My foot is stiff too. I was supposed to start PT last week, but my foot looks a bit like it's trying to flatten out again (flatfoot is one indication for PTT surgery), so PT has to wait 'til next month they say. Upon my doc's prescription, I ordered $$$ orthotics that will be delivered in about 2 weeks and have to wear those instead until my next appointment. I hear my case is unusual (I personally don't think any of this is "usual," however.) so my current surgeon has been more cautious... and PT waits....

    I have seven screws in my foot and unless they become too uncomfortable, they will remain in my foot. My doc tells me about 40% of PTTD patients get the heel screws removed. So far, mine feel okay. And....just this week, my foot has been itching like crazy. Maybe it's part of the healing process. You and I are both at 12 weeks post-op.

    Any time a doctor yells at you or becomes impatient, that's the time for a new doctor. I think you did the right thing by switching. One of the reasons I switched from my first doctor is because he didn't tell me some test results and then decided he didn't want to see me during regular office hours... I don't think he knew what was going on and got a little frustrated and impatient too.

    Also, I think podiatrists are fine for very many things.... but sometimes you need more.

    Last edited by hey19; 03-24-2008 at 08:21 PM.

     
    Old 03-25-2008, 04:39 AM   #3
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    Re: Not healing well....very frightened

    wmkcolors, Sorry to hear about the difficulties you are going through. It seems that not Drs are created equal. I don't think I would have tolerated any Dr yelling at me out of frustration about how the surgery he/she performed either.

    I have not had any where near the problems you are having, mine is actually going well. But I think one thing is not everyone heals at the same rate, especially bones. Mine have seem to heal well, so I think I am one of the lucky ones, at least for a 50 year old guy.

    So far I still have the screws in from my first surgery 3 years ago, and the screws from this one will probably stay in too. I have 3 screws from the latest surgery, 2 in the metatarsal and 1 in the big toe, he said the ones in the big to tend to bother people more and may have to come out.

    My latest surgery is pretty much the same as the 1st surgery except he cut and straightened the toe too, and I WB on this foot 2 1/2 weeks earlier on this foot than the 1st foot. My guess is things healed better this time, doesn't make sense. It was the same Dr but this time it was at a facility that he prefers to do his procedures at. He ought right refused to do it at the previous facility(I work there and get a much better deal from the insurance), stating he felt he just couldn't do his best work there.

    I can get a good range of motion from the toe but it stiffens up shortly after I do the ROM exercises. The 1st foot was the same and after about 6 mos it finally came around. I don't have a great range of motion on the toe, probably around 50 degrees or so, plenty to walk comfortably. The 2nd foot has better ROM than the 1st but still stiffens up, so I guess I just need to have patience with it.

     
    Old 03-25-2008, 06:44 AM   #4
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    Re: Not healing well....very frightened

    Sorry to hear about your foot. It is good that you switched doctors. It sounds like this one will be a good one for you. I know it is very depressing when you have a set back (I had to have surgery again after five weeks from the first), but just try to be patient. It will be worth it in the long run.

     
    Old 03-25-2008, 08:29 AM   #5
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    Re: Not healing well....very frightened

    Hi wmcolors,

    I think we've talked on a different thread, so you know my issue with my scar. I was told by my pod at three weeks, when both my pins were removed, to start putting weight on the foot. It was extremely painful to do this and I told her so. She told me "You have to stop guarding your foot. You have to push past the pain." Come to think of it, she began telling me this at two weeks when I still had pins in. It didn't seem to matter to her that walking with pins in my feet was like having someone jab ice picks into your feet at every step. I told her that as soon as the foot stopped hurting, and the pins were removed, I would be more than happy to start putting weight on my foot. Again she pushed me to put weight on the foot and move the toe. Well, the more I worked on my foot, the more swollen, more painful, more stiff it became. I've left it alone now for a couple of weeks....less swelling, less pain, still stiff. I did not have screws put in. I was given the two options. I told her if she thought I needed screws when she got in there, then put a screw in. Otherwise I preferred not to have anything in my foot at all....didn't want to go back to have them pulled out. My scar is still painful, still doesn't close up....I'm 8 weeks out. I have two small holes that continue to open every time I work on my foot. Then I spend a couple of days not moving the thing at all to reduce pain, swelling, and waiting for the scar to seal back up. My scar does itch, but I think it is part of the healing....unless you had dissolvable sutures and some are still inside and you are having an allergic reaction. I had that type of suture and my foot swelled terribly and was bright red. Pieces of suture started coming out. The minute they did, a lot of the irritation subsided. I am very concerned that I was not told that there was a very good chance of not having much mobility in the foot once you had this type surgery. I was also lead to believe that by 6 weeks I would be up and around with shoes on. I'm no where near that. I *was* very active. Oh, my bone healed in 3 weeks. When the doc took the xray she said, "I can't even see where the cut was made." By the way, my doc cut the tendon between the big toe and the next toe. I was told by 4 weeks it would be healed. I'm still having terrible burning pain between the toes....anyone else have this issue???

     
    Old 03-25-2008, 09:20 AM   #6
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    Re: Not healing well....very frightened

    Scott: I'm 50 years old too. I never thought that sounded old until I read other posts and realize I could be "mom" to some people who write here.... lol. You have six screws in your foot and they don't hurt? That's very encouraging to me. I got seven put in on 12/27 and haven't felt them so far... maybe I never will!

    Why did you have to have a second surgery, taterbug?

    lcweiden, what kind of surgery did you have? Maybe you have an allergy to those sutures? Are any sutures still in your foot? Have you had other opinions? That sure doesn't sound right to me... I'm not a professional or anything, but there's got to be some answer for a wound that's having that much trouble healing after 8 weeks.

    I had some issues a couple of weeks ago after being in an Air cast for just a week, but I seem to be doing better now... barely any swelling and/or pain. My foot still looks like it's trying it's hardest to flatten out, however, but hopefully when my $$$ orthotics get here next week, I'll get the arch support I need. In the meanwhile, it's great to have moral support from everybody who posts on these boards.

    Last edited by hey19; 03-25-2008 at 09:22 AM.

     
    Old 03-25-2008, 09:39 AM   #7
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    Re: Not healing well....very frightened

    After an ankle injury I went to a Dr. who diagnosed a sprain and sent me to a month of PT. After that month I came back to tell him that I was still experiencing alot of swelling and pain and he told me very bluntly that I should have cancelled my appt. - that I was wasting his time on something that would just take time to heal. I felt dumb and so suffered with my foot for a year. Finally, I couldn't stand it and went to another OS who in 30 seconds by actually listening, and by taking an x-ray, diagnosed me with a Stage V fracture of my talus. Over that year my foot bone had become necrotic and had a huge cyst in it. I'm glad I switched Dr.'s but I wish I would have done it a lot sooner! I'm glad you switched, that kind of lack of compassion, listening, is totally unprofessional.

    Quote:
    Originally Posted by lcweiden3132 View Post
    Hi wmcolors,

    I'm still having terrible burning pain between the toes....anyone else have this issue???
    I'm 8 weeks out on an OATS procedure and have constant burning on the top of my foot, esp. my big toe. I guess it can take a while (6 mo to a year) for nerves to settle down

    Last edited by akirka; 03-25-2008 at 09:44 AM.

     
    Old 03-25-2008, 11:47 AM   #8
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    Re: Not healing well....very frightened

    I sure do agree with you, akirka!

    My first surgeon, Surgeon #1, was quick to diagnose and cut, which I thought was okay at the time because I figured he was right and I was ready to get it over with. BUT, when he started trying to rush me through appointments because his waiting room was full, I began wondering about this guy. I finally requested that he take an MRI (my first MRI throughout any of this). The results came back and he never told me what the report said, other than there was "some bony outcropping." When I asked what exactly that meant, he got a little irritated and repeated the same exact words (same effect as speaking louder to a deaf person, you know?). So, I went and got a copy of the report myself -- because every patient is entitled to his/her own test results -- and that's when I learned (after deciphering some words) that the bone graft had actually failed. Here this guy's telling me that all I needed was more aggressive physical therapy. Yeah, right... the bone was solidly fused in a deformed way by this time. The next surgeon, Surgeon #2, actually had to break it and rebuild my foot to get the result that Surgeon #1 said I could have achieved with therapy! If that wasn't enough, Surgeon #1 tried to schedule my followup appointments either before hours or after hours because I "asked too many questions." Within days I picked up my records and got more opinions before selecting Surgeon #2. I'm soooooooooo glad I did that!

    It's understandable to be frightened by your condition, your impending surgery and/or your recovery.... nothing is certain in that regard. You should certainly never be afraid of your doctor, however. I think the measure of a good doctor is when he/she does his/her best to help you feel confident that you're receiving the same level of professional care and respect they would administer to their own family members... and then deliver it. When you receive less than that, it's time to weigh your options...

    I'm glad you switched, that kind of lack of compassion, listening, is totally unprofessional.

    Last edited by hey19; 03-25-2008 at 03:58 PM.

     
    Old 03-25-2008, 11:57 AM   #9
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    Unhappy Re: Not healing well....very frightened

    I don't know the exact name of the surgery....I had the bunion shave down and the big toe broken and realligned. The tendon was cut between the two toes. I had pins (in an "X"...one in front of the toe diagonal from top left to bottom right, one in back from top right to bottom left) that stabalized the toe. Both pins were not pushed through and therefore were sitting on nerves and creating horrible nerve pain. I demanded that one of the pins be removed within the first week as I couldn't put my foot in any direction to relieve the excrutiating pain from the nerve. This also caused my foot to twitch and jump voluntarily sending pain up to my knee. The second pin was removed in the third week. The only pain I had from the procedure was from the pins. Once the pins were removed I had zero pain....except for the scar healing. Now the only pain issue I have comes from the scar itself. In our family we keloid. I also build up LOTS of internal scarring. The combination of the two has made for a very ugly, very raised, very swollen, very painful scar. And also very very stiff internal scarring from the top toe joint down the length of the scar and from bunion side to second toe on the foot. This band of internal scarring lies right on top of the joint which is why it won't bend. It is stiff as a board, hard as a rock. The doctor snipped the skin where the two pins were so that they would fit comfortably into the foot. So, instead of on straight line scar down my toe, I have "t" shaped scar. VERY UGLY. When I stand on the foot, the foot turns purple, the scar turns black. I absolutely agree that I am allergic to the sutures. What didn't come out on its own, I pulled out with tweezers. I know for a fact that there is a knot of suture right under where it won't close, and I have told my doctor about it. She refuses to go in and remove it, saying it will dissolve over time. In the meantime, I cannot put shoes on because each and every shoe not only flexes right where the scar is, but also the tongue of the shoe and laces are attached to the body of the shoe right at that point. So, no matter what I do, the shoe presses right on the scar.VERY UNCOMFORTABLE. I am 8 weeks out and still only in socks. My foot is not flat, my toe doesn't bend. And, I'm beginning to wonder if I made the right decision. I don't know about other opinions as the surgery did what it was supposed to....smoothed the bunion, straightened the toe. A second opinion can't fix how my body heals or doesn't heal. All the xrays taken show no abnormalities. I used to walk every day. Lovely long walks. I *thought* I was going to be able to walk with out pain after this. Now I can't walk at all. Never thought I'd be disabled at age 43.

     
    Old 03-25-2008, 12:34 PM   #10
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    Re: Not healing well....very frightened

    lcweiden,

    We have had radically different surgeries but if it helps, I'm also 8 weeks out and my Dr. says that is very early in the healing process. I still have 3 weeks before I can put weight on my foot. I think most foot surgeries take a year before you feel normal again. Hopefully for all of us, that year will be worth it in the long run!

    Be of good cheer!

    Abby

     
    Old 03-25-2008, 01:08 PM   #11
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    Re: Not healing well....very frightened

    For those having issues with the scar not breaking up and being tender. I have some hand lotion with Aloe Vera in it and I rub and I mean rub vigorously on the scar every couple hours with hand lotion. I probably rub it for about 5 -6 minutes each time. For me it seems to desensitize the scar and start the process of breaking the scar tissue down. I have been doing that since the bandages came off and it breaking down very well and also doesn't bother me at all. I hardly have a lump at all where the stitches were and we are talking about 6 weeks post op. I might be imagining some of this but it seems to help the swelling too. I did that with the 1st surgery too and you can see the scar, but there is no lump at all.

    I am not sure if it will work the same for everyone, but it seems to help me.

     
    Old 03-25-2008, 02:09 PM   #12
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    Re: Not healing well....very frightened

    hi wm, i dont know what to tell you, but you should be weight bearing now. i am glad you switched drs, but i dont know what answer this dr is giving you or if you have other problems with your foot and thats why it wont heal. 3 and a half years ago i had a standard bunionectomy and the 2nd toe was cut for the hammertoe i had. i had bunion surgery on my right many years ago and it went perfect. so i went back to the same dr only this time the bunion and hammertoe surgery did not work. i was able to walk, but the pain in my big to was horrible. both toes never laid flat. i never changed drs and i went to pt. last year my big toe was fused due to the pain i was experiencing. in hindsight, i wish i went to an ortho instead of a pod. there is no going back from a fusion. hopefully this new dr will help and you may want to get a 3rd opinion. i dont want to scare you, but try everything you can to get back to weight bearing. i hope it doesnt wind up to be fusion. keep posting

     
    Old 03-25-2008, 02:45 PM   #13
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    Re: Not healing well....very frightened

    A second opinion can be for many other things... like ways to find relief from what's already been done. If you're not getting that at this point, maybe somebody else can help. Just an idea....

    I hope you can walk one day soon without pain too....


    "A second opinion can't fix how my body heals or doesn't heal. All the xrays taken show no abnormalities. I used to walk every day. Lovely long walks. I *thought* I was going to be able to walk with out pain after this. Now I can't walk at all. Never thought I'd be disabled at age 43."

     
    Old 03-25-2008, 03:52 PM   #14
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    Re: Not healing well....very frightened

    I was walking fairly well, FWB, at 8 weeks, in a wide shoe, and I was PWB from 3 weeks postop. On hindsight, I think I should have been NWB for a full 8 weeks. At 8 weeks, the PT was bending my foot and toe fairly aggressively and I was doing the same at home. I noticed all the irritation setting in then.... The othopedist, the new doctor, feels, at that point, I had partial fusion, as her xray showed, and I ended up disrupting the newly fusing bone. Thus, she wants me NWB for another 3-4 weeks. I see her next week, so, I hope she'll okay some PWB. She says some feet take 6-12 months to heal. I've now realized PODs are much more eager to do this surgery. Orthopedists only do a bunioncectomy if it's absolutely necessary. On my xray, with the othopedist, at 8 weeks, there was an obvious line still, where the POD made the cut, to realign the big toe; etc. The orthopedist said that the line disappears as the bone is more fully fused. What frustrates me is that the POD would have seen that line of partial fusion on his earlier xray, when he encouraged me to move it and weight bear. Right now, I'm trying to move past his unprofessionalism and hope I'll receive better news next week, with the orthopedist. Her advice, STAY OFF OF IT!!!! I'm not in pain, when I have the hard boot cam on, but I'm not doing much to aggravate my foot right now. No range of motion anymore, which I hope to start again soon. This is a setback and hopefully I won't need a corrective surgery in 6 months, due to some mistake the POD made. The Orthopedist says the alignment looks fine, though she would have used a different technique. She also keeps her patients NWB longer. Ugh! I plan to find a good PT who can help me work through the stiffness, once the orthopedist sees better fusion.

     
    Old 03-25-2008, 04:37 PM   #15
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    Re: Not healing well....very frightened

    Hi Wm,

    Sounds like a similar story to mine as far as being weight bearing too early (PTTD surgery). Surgeon told me my bones were "almost fused" at five weeks when I was then taken out of my cast and began physical therapy at seven weeks.... apparently too early for me. I didn't know any better at the time. I'm fortunate that I haven't suffered much pain and swelling since this began two years ago, but I'll tell you what... I did have excruciating, blinding pain twice when that bone graft must have been coming apart... once while they were working my foot in therapy.

    Hopefully your orthopaedist caught things early enough and you'll heal fine now. Mine wasn't caught early enough... The bone graft separated, moved over and up, and the bones then fused but in a very bad way. The second surgery a year later began with the new surgeon breaking apart the improper union and then reconstructing everything. Whatever you do, make sure you absolutely listen to that orthopaedist and definitely stay off that foot! You don't want to have to repeat any of this I'm sure.

    Last edited by hey19; 03-25-2008 at 04:38 PM.

     
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