It took me a long time to come to the decision to have surgery for the hallux rigidus condition on the big toe of my left foot. I found that reading the direct experiences of others who had the surgery was a big help both in knowing what to expect and in helping me make my decision. So although I am definitely a rookie at the blog business, I decided to share my experience as well in the hopes that it might help someone else. I realize that no two experiences are exactly the same but sometimes just knowing what others experienced can give the courage to either go ahead or to chose not to once one has consulted with the appropriate medical professionals.
I had my surgery yesterday morning. In today's entry I'll cover the day of surgery, today as well as a little of the history leading up to the need to have surgery in the first place.
On subsequent entries, I'll be covering things real time. I'll start with the surgery and following 24 hours and then follow with history and background for anyone interested.
Day of surgery
The usual prep. No food or liquid from midnight the day before for a 7am surgery. Also instructions on what medications to discontinue. They requested that I shower both the night before and morning of surgery.
I needed to be there by 6am for prep. Once there, I met with the anesthesiologist and the surgeon. My surgeon uses a block for the lower leg and a sedative, rather than a general. The surgery took 30 minutes. Once in the surgical room, they put in an IV and a tight cuff just above my ankle. I was awake--I can remember hearing music and hearing conversation but couldn't retain what was playing or being said. I remember commenting that I felt a slight burning sensation on the top of my foot when they first started but after that I felt nothing. It was just a calm, relaxing, peaceful rest. Shortly thereafter, the surgeon asked me to sit up and look at how my toes could now move. I was easily able to do that. My foot was nicely stitched up with about 8 or 10 stitches (I think) and he showed me how they could now bend like they were supposed to.
They bandaged up my foot and wrapped it with an ace bandage and then fitted me with a lovely black protective "boot." At 9:38 am I was on my way home. I was given crutches but told I could walk short distances in the boot if I could tolerate it. I was given percoset for pain.
Although my foot was definitely sore, it was nothing compared to about 5 bouts of serious stomach pain that I had throughout the day. Each only lasted about 10-15 minutes but were intense. Intense enough to make me sick to my stomach on the way home. (Thank goodness for the bag we had taken that had held my clothes at the hospital.) Later, talking to the physician's assistant, it sounded like it was a reaction to the pain meds. In recovery they had given me a choice of several things to eat. I wasn't hungry at all but chose some apple sauce since it seemed like it would go done easiest. That was, in retrospect, a mistake. I really needed something starchy like crackers to offset the pain meds. Once I got lunch and dinner on my stomach yesterday, I haven't had an issue with the stomach ache.
I was able to hobble around a little at home but definitely felt more comfortable on the crutches. Spent the afternoon and evening on the sofa with my leg propped up on a couple of pillows. Iced it for about 30 minutes every couple of hours. They had me ice the rear of my leg just above the ankle since the foot was wrapped up. Or they said I could ice behind my knee. They said either would cool down the blood going to the foot which I guess is a good thing. I was doing a couple of pain pills every 4 hours which was enough to take the edge off the pain and allow me to sleep. (Had only gotten a couple of hours a sleep the night before.)
Day 1
Spent the night in the guest bedroom since trying to keep my foot propped up and get the covers seemed too difficult with my husband in bed next to me. Plus, I was scared that if he thrashed around, it would be easy for him to accidentally bump my foot. Got a good six hours of sleep before the pain woke me up. But took some pain pills and was able to doze off again. Was awoken by soaked bedding under my leg and foot and realized the ice bag they had given me at the hospital and which I had put on when I was up earlier, had sprung a leak. Luckily the dressing on my foot stayed dry.
For some reason, my foot seems more sore trying to walk on the boot today than yesterday so have been mostly using the crutches for getting around. The pain meds (I think) are making me feel a little light headed although that may just be from lying down with my foot elevated. (How else do you get your foot higher than your heart?) Have been taking advantage of the situation by catching up on emails and starting this blog. (Okay, and at times napping.) Minimal pain as long as I take the meds every four hours and stay off my foot.
Was able to make my own lunch today including hobbling around to collect the ingredients although let my husband do the bigger tasks like unloading the dishwasher and taking care of drying out everything that got soaked with the melted and leaky ice pack.
Background/history
I am a 60 year old female. Average height and weight. In good physical shape. No major medical issues although my left foot is quite flat and does have a longitudinal tear in a tibial tendon which is a whole other issue.
Since I was in my early 20's, I worked in jobs that required I be in professional dress which at least for me meant wearing heels. I kept the heel height to about 2 1/2" which didn't seem to cause me any problems, at least at first. As I got into my 40's I started to notice a burning sensation wrapping around the inside of my foot just to the rear of the ball of my foot. It would come and go and although it was uncomfortable, it was never so debilitating to force me to look into it. I was a walker with flat feet who was quite used to having sore feet a lot of the time. At times the joint at the base of my big toe would be achy but I had just chalked it up to the high heels. And I never connected the burning sensation to joint issues.
In my early 50's I left the corporate world and since I now worked at home, rarely needed to be in heels. The pain for the most part when I was walking went away. What I started to notice at this time though was that a lot of dressier shoes both heels and flats were cut in a way that rubbed over the joint of the big toe which was quite painful. I addressed it by buying new shoes that didn't do this. It wasn't until 2012 when I was having issues with a torn tibial tendon on that foot, that I learned I had a rather severe bone spur and arthritic condition on that big toe joint. But at that time, other than certain shoes causing pain, I wasn't having any issues with that toe. If I were barefoot or in my walking shoes my toe was fine. At that time I was more concerned about the tendon tear and whether the pain from it would resolve on its own or whether I would need to do the rather extensive surgery and long recovery associated with that.
Fast forward to spring 2015. My tendon issue resolved. I'm back to walking about 3 miles a day and doing yoga a couple of times a week. Then one day doing a downward dog in yoga, I could feel something kind of crunch in the joint of the big toe and the pain immediately hit. Walking was painful. Anything on my toes in yoga was out. But the hardest part was finding shoes that didn't debilitate me just trying to get them on and off much less while walking. Even the slightest pressure on that joint caused tremendous pain. Luckily, it was unusually warm here and I was able to wear some loose sandals.
During this time I went in for my annual physical and my internist pointed out that I could only bend my big toe about 10 degrees on my left foot while my right toe could bend the normal 90 degrees. She explained that the condition was called hallux rigidus and suggested that I have it corrected since it can be very limiting to someone leading an active life. She recommended an orthopedic surgeon (who I had already seen years ago for the tendon issue) and who has an outstanding reputation for fixing foot and ankle issues. It was the end of July before I could get into see him but I decided it was worth the wait since he seemed to have done more of these surgeries than anyone else around. Of course by the time my appointment rolled around my toe was feeling better although the burning sensation was still there when I walked and the achiness would come and go.
He explained the surgery which seemed quite straight forward. Said it was a very common condition especially in people who were physically active. (I truly think mine was caused or at least initiated by the beating that joint takes from wearing heels.) Although at that time since I wasn't having a lot of pain, he didn't feel surgery was in order. He suggested I try a carbon fiber plate in my shoe to keep my toe from bending and then to push myself to do the things I wanted to do. And then, if I starting having pain have the surgery. At that moment, that seemed logical.
I bought the $70 carbon fiber insole. But when I put it in my walking shoes under my custom orthotic (which I need for my torn tendon) my toe joint was pressed so tight against the top of the shoe that the pain was awful. I put in my thinner orthotic for my dressier shoes and it was tolerable. But during my walk that night, I blistered both big and little toes since the edge of the carbon fiber plate was "reading" through the softer, thinner front portion of the orthotic. And now, the joint was sore again to boot. So much for the carbon fiber plate.
My husband had been on my case to get this fixed for some time. He's recently retired and we've got a lot of travel coming up. Neither one of us wanted to waste a big trip if the pain started up while we were far away and I ended up not being able to walk or at least walk in the shoes I had with me. I started to look at our travel schedule for the next couple of years and realized that if I was going to have a window to recover from surgery, it was now. I was tired of never knowing when this issue was going to flare up. Even more tired of having lots of beautiful shoes (low heeled) shoes that I couldn't wear any more.
I got on line and stumbled into a blog about cheilectomy written by a 40 some year old male. It was quite helpful as were many of the comments made by women as well as men. Didn't see anything that made me think that surgery wasn't the right thing to do. So the very next day, I called the surgeon and luckily got an appointment for surgery just 10 days later. Was just enough time to take care of things that needed me to physically move around, plus get a temporary handicapped parking permit (you'll need a letter from your surgeon), a waterproof cover in order to take a shower with my wrapped foot in its boot (I'll give a review on mine once I've tried it) , load up on library books, etc. without giving me too much time to second guess. And so here I am writing about my surgery and post op experiences.
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