Week 12

   I have spent a lot of time looking for wide-fitting shoes with arch support...this is no easy task. Wide shoes are just ridiculously hard to find. When I do find a wide shoe, it is often just plain ugly. I have bought and returned probably half a dozen shoes in the past 4 weeks. The shoe will fit ok in the store and then I'll walk around for a day and realize it's just too tight! I think that as the swelling improves more shoes will fit.
   I am determined to keep my feet in good shape and follow the advice of my orthopedic surgeon. But man, it is making my shoe-buying experience stressful. DSW had one pair of saucony shoes that were a wide in my size so I snatched those babies up. I also bought some flip flops from the walking company that have a medium arch. My orthopedic surgeon said flip flops are a no-no but how can I live in Arizona and not have flip flops! He also said not to walk around the house with bare feet because that also contributes to bunion formation since my arches just collapse and it puts a lot of stress on my feet.
   If I had known the mechanics behind my bunion formation I would have maybe just gone with orthotics to prevent my bunions from getting any worse. But now I've already done my left foot so I'm contemplating whether or not to do the right foot. These past 12 weeks have been hard. Feet just don't heel as quickly because of gravity and because they have to carry all of my body weight everywhere!
   Oh I wanted to provide an update on that nerve pain I was talking about in week 5. So it is still there, just between my big toe and second toe base. The nerve has continued to heel and the pain has decreased a lot, which I am very happy about. The numbness on the left side of my big toe and right side of my second toe and on top of my scar is still there and will probably always be there.
 
Here are my feet at week 12:

I have been using a toe spacer called Visco-Gel. It is very comfortable! I got it on Amazon for less than $10. I have also been using pedicure toe separators at night to help stretch out my toes after a long day in shoes. No matter what shoes I wear they always push my toes together a little bit so it feels good to separate them for awhile.

   From the above pictures you can also see that the scar is improving. The ScarGuard is great. The only issue I have with it is that it peels off sometimes and doesn't last the whole day.

Week 7 and 8

   I was unable to make my 6 week appointment so I got to wear my beautiful boot for an extra week! I've been continuing to stretch my big toe both passively (using my hand) and actively. There is a lot of stiffness in it and it definitely is sore when I exercise it. Sleeping without the boot feels wonderful! My toe isn't so sensitive anymore so the sheets and blanket don't bother me.
  At my week 7 appointment I was given the go ahead by my doctor to start weening off the boot. First for an hour a day and then increase an hour each day. I did this for a week and then completely took off the boot week 8. My foot is somewhat sore when I walk but it feels so good to walk normally. Because of the muscle atrophy in my calf and foot it feels like my leg is going to give out when I walk on it so I'm limping a little bit. I tried standing on my tip toes to test myself and was unable to do so with my left foot, too much pain and stiffness. My foot does swell mildly so I have had trouble finding any new shoes that fit. The surgery increased my shoe size from an 8.5 to a 9.
   I am trying to find shoes that have arch support as my doctor said the biggest reason I have bunions is from flat feet. I have been on the hunt for shoes that will support my foot and prevent pronating. With all the swelling, I've been unable to find a dress shoe for work. I'm limited to sneakers and sandals right now.

         

Did a bit of research to find the best scar minimizing solution. I've been applying this solution twice a day and am supposed to continue for 3-4 months. Will continue to post pictures and see if it really helps!

I was hoping that I wouldn't have any trace of a bunion on my left foot but as you can see from the pictures above, there is still a bump there. Not only that but my big toe has shifted over quite a bit, which I also don't like. From the many other blogs I have read, a lot of people have the same results. My doctor told me he left a slight bend in the toe so that it wouldn't be stick straight and then none of my shoes would fit. Makes sense so I'm ok with it.

Week 5

   Since my week 4 post was so long I decided to talk about one last topic this week instead. I noticed that the anterior side of my big toe (below my nail bed) and the right side of my second toe are numb. Also, when I put pressure on the sole of my foot just below where my second toe is, a sharp nerve sensation shoots up my second toe. I was told by my doc that the numbness is not permanent and will resolve but may take 6 months to a year. I didn't know about the nerve pain until I was massaging my foot in the shower. I'll have to ask him about that as well.

   I'm sure some people are concerned about permanent nerve pain/damage so I thought I'd post my experience. My doctor did say that the area just over the incision may have a permanent numbness to it because of the trauma of a surgical procedure in that area. That's not a big deal to me. When I prick the area near my incision with my nail it feels very dull but when I put pressure on it with my finger I can definitely feel it. So there is some minor sensation that is lost. To me it is a small price to pay for getting rid of that bunion.

   Oh and I just wanted to say I have never been so jealous of people walking. I absolutely miss walking and running and jumping. And I am still sad about watching my poor calf wither away. I am crossing my fingers that at my 6 week check up my doc gives me the go-ahead to take my boot off!

   One more week folks!

Week 4

   The healing process has really progressed in the last couple of weeks. I was very pleased when I had my dressings removed at the doctor's office. My doctor said my xrays look great (they take them at each appointment) and my foot is progressing as it should. I do not have any swelling unless I keep my foot down for very long periods of time (hours) without propping it up.

   I was itching to start exercising my foot and I had tried a few small things I read about online. My doctor gave me some exercises and advice about what I can and cannot do. I am bending my toe forwards for 10 sec. and then backwards for 10 sec. about 10 times. I do this in the morning, afternoon, and evening. That has really helped increase flexibility in my joint. When I first tried sleeping without the boot during week 3 my toe was so stiff and sensitive that just having a light blanket over it was too much tension. After doing these exercises this week I don't have any problems sleeping without the boot. Major relief! I'm so tired of sleeping on my back! I don't elevate my foot during sleep anymore as the doctor said I only need to elevate it at night if I have problems with swelling. I do elevate it when I am sitting. 

    I was very excited to see that my big toe and my second toe are a bit closer together! My foot had a "live long and prosper" kinda look going on at my second visit. The incision is looking great. At the recommendation of a podiatric surgeon I read from another bunion blog (we should have a support group:p) I have started to massage the site of the ex'd out bunion. The recommendation was to massage in small circles to help break up scar tissue. I don't have much of a bump where the bunion used to be but I figure it's good to do nevertheless. I also do a light massage over the incision with my middle and index finger in which I do a typing motion with medium pressure. It actually just feels good if nothing else! I don't want to disturb the site too much. My doctor also gave me permission to take a shower! Yipee!! I cannot soak the incision but it's ok to get wet. He said not to pick at the steri-strips, just to let them fall off on their own. 

   

   This is my foot at week 5. You can see that my big toe and second toe have shifted a little closer to each other. While I was relieved at first to have them shifting closer to each other, now I'm concerned that they are too close! So I'm surfing amazon to get some toe spacers to wear at night. I plan to ask my doc about it at my 6 week check up.

   I want to talk about peeling and shedding. LOTS of peeling and shedding. Yes it's gross but it's going to happen. Hadn't washed my foot for 4 weeks so the dead skin just had no place to go. When I finally took my first shower I took a wash cloth to my dry scaly foot and started scrubbing. Oh and I also recommend taking the boot off during the first couple weeks and scrubbing your calf because that same peeling and shedding process will happen to your leg as well. I like to keep my boot clean since I have to wear it for so long. Below are some close up pictures of the dry scaly foot (even if I lotion it after the shower it gets this way). Also a closer look at the incision. My doc said there is a binding/protective agent or something of the sort covering the incision so the dark line you see is not the actual scar. 

2 weeks post op: first check up!

   Today I had my first follow-up with my podiatric surgeon. I had X-rays done and my doctor said they looked great, healing is on target. I'm relieved about that. I've been doing everything they told me to. But now that I have seen my foot and my poor sad little excuse for a left calf muscle, I have bigger concerns:

• When can I start physical therapy (my own exercises at home)
• When can I take the boot off?
• When can I bear weight on the affected left foot?
• When will my toes come back together

   I have a huge space between my big toe and the rest of my toes. It was disheartening to see. However, the doctor assured me that the other toes will float back over by about 6 months or so. I checked other bunionectomy blogs and have seen that this does in fact happen. All of the dressings have also shoved my toes over and away from my big toe. Also, it's hard to see but my four little toes are pretty swollen. Surprisingly my foot was not swollen at all. I'll put a side by side of my foot before. So putting my embarrassment aside, here is the picture so far:

I apologize I have no good picures of "before". Wasn't thinking ahead!

   Now about my left calf. It has pretty much atrophied. This is quite normal. It only takes muscle about 2 weeks to atrophy. Luckily we are getting close to winter so I can hide it with pants. I'm sitting in a chair so it's hard to tell just how much muscle I lost but when I stand there is almost no definition in the calf. I was told I could start doing some exercises that don't jostle around my foot too much. Unfortunately I didn't get really any advice as the appointment was a blur. Oh well. I looked to other bunion blogs and orthopaedic surgery sites for some good exercises. The other issue is that you don't want your big toe to get too stiff. I've read about people that have permanent decreased range of motion in the toe. I've decided to go with this website for physical therapy suggestions. Given what I know about post-op rehab and fractures and what I've read about other peoples' experiences this seems appropriate: 

http://www.davidgordonortho.co.uk/patient-info/rehabilitation-after-injury-or-surgery/foot-rehabilitation/hallux-valgus-surgery-rehabilitation/

   I am told I can take my boot off when I am resting at home, changing clothes, showering, and sleeping. I am excited because I'm so tired of having my foot at a 90 degree angle. It is constantly making my foot feel a "pins and needles" sensation. I've still been icing my foot about every 2 hours (it feels amazing and it's my favorite part of the day). I've pretty much stopped narcotic pain meds and moved over to Motrin. I take 600 to 800 mg twice a day. I also still keep my foot propped up on 3 pillows at night. The doctor said I should keep doing this to help reduce swelling and help the wound heal. I try not to walk around or have my leg down for too long. After about an hour it gets sore from being down. I actually feel the pain more once I prop it up again. If I am going to be up a lot I use the knee rider. I have nurse practitioner clinicals tomorrow and plan on taking full advantage of my knee rider!

   Yay! My pedicure is still intact. It's the only nice thing about my left foot right now so I'm pretty psyched:) This picture also shows the difference between my edematous left 4 small toes and my normal right four small toes. The new dressing my doc put on is much lighter so my foot doesn't feel so cramped in my boot. I still wanted the ace bandage on to help with compression and moving fluid upward. It's also a nice barrier between the ice and my foot. 

   

   Up next is my 4 week follow up. Unless something interesting happens I will be posting then!

Keeping your boot and bed clean

    After 5 weeks I realized that I wanted to go back in time and make this little post. Luckily the magic of "scheduling" my blogs allows me to do this! When I was released from the research unit I was told to put a pillowcase over my boot at night to sleep so I don't get my sheets dirty. That just sounded kind of unsanitary to me and a lot of work. What if it comes off in my sleep? So I bought Clorox wipes. If I walk around anywhere except my bedroom I wipe my boot down before getting back in bed. Yes it takes some extra work but it also means my bed is clean:) I also bought 3 pillows that I dedicate to elevating my foot and which I plan to throw away when I am done with this boot.

   I don't want to go all RN-paranoid on you but when you wipe the boot down you should wait 30 seconds for it to dry and work it's magic. Otherwise, you aren't going to kill that flu virus on your boot;) 

1 week post-op

   I am finally at one week post-op. Yay! Pain is definitely been improving. I am only taking pain meds in the morning and evening. I've also been able to tolerate a little more walking/standing. I decided to actually make myself dinner today, stove and all. By about 20 minutes or so my foot started to get sore and throb. Had to sit back down and ice it. But it just felt good to get up and do something.

   I am looking forward to week 2 when I have my first follow-up where my bandages are changed. Finally get to see my surgeon's handy work! From here on out I will be posting every time I have a follow up so I can post progress pictures. There won't be much to report in between. If something significant should happen I will be posting:)

   I have no interesting pictures to post so I thought this would be enjoyable....

Day 5 - First day out of the house!

   It is Saturday night and I have just been so stir crazy I decided to go out with my husband. We went to a movie and dinner. I brought my knee rider and a few pillows to prop up my foot (no shame here). Turns out there is no comfortable way to prop your foot up when you are in a movie seat. It was pretty uncomfortable throughout the movie. Mostly because the blood was rushing down into my foot and pulsating. I assume it was also swelling. I barely made it through the movie. Probably a mistake.

   By dinner I was pretty pooped. At least I was able to prop my foot up in the booth. Had a lackluster conversation with my poor hubby and then headed on home. I was so happy to see my bed again. I immediately propped up my foot and iced it. Whenever I get up and walk I ice my foot when I come back.

   The pain is definitely still there. It is much worse at night and in the morning when I get up. It also flares if I walk around too much (i.e. go to the bathroom, wash my face, then change my clothes). Sadly, this amount of activity exhausts me. Pain meds are still working very well.

   I am starting to get tired of eating pre-made frozen food or processed food. But I have trouble keeping my leg down for too long. So I'll look forward to the day that blood rushing down towards my foot doesn't cause immense discomfort.

Day 4 - First Bath!

   I have been using my Percocet consistently and the pain has been pretty well controlled. I wouldn't say that I am ever pain free but it is manageable. When my foot swells the boot starts to put pressure on the edges of my foot, causing quite a bit of pain. Icing has really helped. I ice it every 1-2 hours while I am awake. Thank goodness my husband has been nice enough to run to the fridge every time I want to ice my foot. My husband found these really great ice/heat packs from Target. Here is a picture below.   

   Walking is a little painful, but it feels so good to get up! However, every time I walk, afterwards I do have pain. So I make sure to ice after every walking session. I think the most unpleasant thing for me right now is sleeping. I have to sleep with my leg propped up on 2-3 pillows and I can't sleep on my sides. I am a major side-sleeper. So it's been tough. Good news is the pain meds knock me out so well I don't usually get up at all during the night. 

One thing I am so glad I bought is this armchair pillow.

So comfortable and versatile. Especially laying in bed a lot. It is way more comfy than regular pillows. The arm rests allow me to work on my laptop more comfortably. It also has more support than pillows. I got one at Target for about $20. 

   I've never been so excited about bathing. I've also never taken so long to bathe. I made my makeshift boot cover with my trashbag and medical supply tape and it worked really well. I set my foot outside the tub on top of a laundry basket. I would recommend switching your shower head to the kind that you can retract into a handheld device. 

   
   Each day is a little better than the last. I'm surprised how manageable the pain has become after 4 days post-op. I hope that my pain is under control by the time the pills run out. Will have to cross that bridge when I get there. 

3 DAYS POST-OP

   At home and given a prescription for Percocet. The percocet has worked fairly well for me, decreasing my pain from an 8/10 to a 5/10. I have been elevating my foot whenever I am in bed. I have been instructed to "use it but don't abuse it" (referring to my left foot of course). So essentially this means to rest and elevate foot as much as possible but still get up every couple of hours to go to the bathroom/get food. Only doing what is essential. Also important at this time, continuing to ICE liberally, 20 min. on 20 min. off. It really does make a difference with pain and discomfort. The swelling of the foot plus all of the wrapping you saw in the picture I posted yesterday can make the affected foot pretty uncomfortable. Walking has gotten easier with each time I have done it.

   I've been doing assigned leg exercises every hour I am in bed to help prevent clots. Let me tell you friends, I've seen lots of clots in the hospital and they suck. Don't skimp on the exercises! The other thing I have been very careful about is tightening my boot properly when I get up to walk. The boot has a large heel so you cannot walk around barefoot or in a flip flop on your good foot. If you are a guy, an athletic running shoe will do the trick. If you are a girl and you want more options besides a running shoe, You can try a small wedge or a clog.

   This is the boot!

 I bought these comfy Teva sandals and they ended up being the perfect height for my boot. I hate shoes so this is great.

2 DAYS POST-OP

   Surgery went really well. I was given a nerve block starting at my left knee. I was also given an IV medication to help relax me during surgery. I was awake for the whole thing, which I had initially dreaded. However, maybe it was the medication given or just me surprising myself but I was strangely peaceful and chilled out during the surgery. It only lasted about 25 minutes. Each surgeon has different methods so you may not have this exact treatment plan for your surgery. Here is a picture of the popliteal nerve block in the back of my left knee. Was not painful when they put it in.

   I am just going to skip day 1 post-op because I participated in a research study in which I was given a nerve block for the first 20 hours. So post-op pain started on day 2 for me. Let me tell you - it was pretty bad. I would say 9/10. On day 2 I was still participating in the study so I was given an experimental drug. A certain amount of participants are given a placebo. I'm pretty sure I ended up being one of those participants. I was allowed to have two "rescue" drugs every 6 hrs - Tylenol and Toradol (an NSAID on steroids basically, and much more powerful than Ibuprofen). Neither really helped. So day 2 was basically me having 8/10 pain all day. I was bedbound except for using the restroom. 

   This will not be your experience, assuming you are going in for routine bunionectomy. However, I mentioned it because I did gain something valuable and relatable out of the experience. I know exactly how much raw pain the surgery causes. Some of the pain is caused by swelling of the foot itself. As I've learned as an RN, everybody experiences pain differently. Some patients have more pain post-op then others.

   Last thing I did on day 2 was take a short 45 foot walk. And oh boy, initially it was extremely sensitive and painful getting up and bearing weight on my left foot. But as I started walking I realized it just felt very good to be getting up out of bed. Warning, when you sit back down again your foot will be throbbing. I recommend taking your pain medication 30 minutes prior to getting up.

Day before surgery

   I decided it might be helpful to blog about my bunionectomy experience since it seems to be one of those procedures where some people tell you it hurts like hell and they would never do it again and other people say "meh, it was fine". I found reading other people's blogs about their surgery experiences to be very helpful. 

   I will be undergoing a bunionectomy surgery known as the Chevron procedure. I have moderate bilateral bunions. I am having surgery only on my left foot right now as I do not want to be in two boots! After surgery I am expected to be in a surgical boot for 6-8 weeks while my foot heels. Essentially the surgeon is fracturing the foot in order to fix the problem so think of it as a healing fracture. Normally you would have a cast so I think it's not a bad deal:) 

   I did a lot of shopping before hand (food, supplies, etc.) so that when I come back from surgery I can have everything within arm's reach. I also bought some medium sized trash bags to tape over my booted leg so I don't get it wet with baths. 

   Here is a before picture of both of my feet. I've had bunions since grade school. I am 28 years old and am a nurse in a hospital. My feet are always sore at the end of the day, particularly around my bunions. One thing I have been thinking about especially this past week is how nervous I seem to have gotten. I feel silly because I am a nurse so I'm around this stuff all the time. But I've never had a surgery before and I have to admit I am scared! I'm also kind of sad about my foot changing. I know the bunion is a deformity and a pain in my butt but I'm so used to seeing my feet like this. It will be weird when it's straight...

 

Preparing For Your Temporary Immobility

GETTING AROUND AFTER SURGERY:

• I highly recommend a knee rider. My sister has had foot surgery and made very good use of the knee rider. Crutches are difficult to maneuver and take a lot of upper arm strength - not me, lol. Although the doctor has encouraged me to bear weight on my surgery foot, the knee rider is helpful for going longer distances. 
• Before my surgery, I printed out a DMV handicap application for a temporary handicap placard. My surgeon signed it right after surgery and I was able to go to the DMV and get my placard the day I went home. This is going to be very helpful as I have have school, work, and will likely have errands to run. 
• If you don't already have a shoe with at least a one inch base you will need this. The boot has some added height to it and you don't want to have to limp all lopsided. 

SUPPLIES:

• large pack of water bottles to keep by the bed (pain meds will dehydrate and cause constipation)
• Some sort of TV tray stand to keep by your bed while you are on bed rest. 
• Miralax - almost no exercise, narcotics for a week = constipation. Miralax is something we use in the hospital quite often. I have found that it is pretty gentle and usually takes a few doses to start working. 
• Optional - dramamine. I get nauseated very easily. Norco, vicodin, percocet are notorious for causing nausea.
• Loose clothing from the waist down. I'm obviously not going to be slipping into my skinny jeans for awhile. Unfortunately I'm a skinny jeans kinda gal so I got a few loose workout pants and plan to make use of all my dresses and shorts. You aren't supposed to remove the boot at all for at least the first 2 weeks and then it's up to the doctor to tell you whether it's ok to take off for changing. To me, it's just not worth the risk of falling or doing something to mess up my foot!
• Easy food to grab or cook! I got lots of fruit, sandwich stuff, packaged frozen/non-frozen foods. I also have a nutribullet which I plan to shove lots of veggies into. Fiber!
• Lots of pillows (I use 3 good sized fluffy ones) to keep your leg elevated
• Things to entertain you! I have an ipad, magazines, homework, etc.
• Some method of protecting the boot while bathing. If you google "surgical boot" shower covers you will find many. After reading mixed reviews about several different types of covers I decided to go with medium sized trash bags and water proof medical tape (from Target). I wanted to make sure whatever I get fits over the boot and is comfortable.