Bunion, hammertoe, etc surgery

I wanted to document this whole experience. Maybe it will even help someone? HOWEVER, this is my story and it is unique to me, it is not advice for anyone—if you’ve had bunion surgery or considering one, always consult your treatment and available options with your doctor.

I don't know where they came from or why they got so bad. It happens a lot more often to women than men. My grandma had bunions and it is understood that genetics play a role. Wearing heels or shoes a size too small most likely didn’t help. My bunions deteriorated very quickly in pregnancy — I ran through all of it until the last day — so maybe it’s also hormonal (relaxin)? With baby obstructing my view, I didn’t realise how quickly the deformity worsened. I am a runner. I started running 25 years ago, ran in varsity cross country and track teams at Uni, and been doing avg 3,500km/year for the past 15 years or so — this surely didn’t help my feet.

Joint hypermobility is definitely a big factor too. If you can do this with your hand, that’s a sign.

I didn’t do the op when it was first recommended over 6 years ago. I didn’t trust the surgeon, I was too busy working (with regular travel), looking after little Max, and “oiling”. I could not face sitting on my bum for weeks and months, and somehow I hoped I could avoid surgery. Steroid injection made it worse because I could no longer feel the damage I was doing when running. Always keep in mind that steroids don’t treat the underlying problems! As the bunion in my right foot got worse, I dislocated the 2nd toe, which also became a curled-up hammertoe. The same thing happened in my left foot, although to a lesser degree.

I kept running daily through all this, sometimes in quite a bit of pain, mainly in the ball of my foot, under the 2nd toe joint. But, I was able to run, around 10km/day, and play tennis some days on top of it too. Running and sport, in general, mean the world to me so I was prepared to try anything to be able to continue. These are pics of what helped to manage pain during and after exercise. The metatarsal dome was a breakthrough discovery!

Left: Bunion correctors — I wore these at night; Middle: 3/4 insole with good arch support & metatarsal dome (Vasyli medical), Hoka trainers; Right: kinesio tape on 2nd toe

Swimming and ice-baths after exercise are great — water does wonders! Also, any kind of foot massage. My local podiatrist recommended kinesio tape to help stabilise the 2nd toe joints and Hoka One One shoes with a special sole to reduce the impact on the forefoot whilst running. I tested both in-depth— they do help (and the shoes are pricey)! On footwear: for some time, I’d not been able to fit my feet into anything other than comfy sports shoes or Birkenstocks. A couple of boxes of lovely heels and boots have been waiting for better times for years…

Pedography

Despite all my efforts, every time I looked at my feet, the bunions were bigger. I injured my left knee because I was compensating with that leg, as seen on this chart. Eventually, my deformed feet would likely affect my hips and spine too.

So I decided to do the op and went to see a highly recommended surgeon in London. After seeing my feet, he was reluctant to take it on due to the complexity and risk of complications and sent me away to a top surgeon in an NHS hospital in London. The 2nd surgeon was also rather reluctant and spent near enough an hour with me discussing all the risks including not being able to run again and losing the 2nd toe in my right foot altogether. To avoid such risk, he suggested cutting out the 2nd toe joint and sewing the 2nd and 3rd toes together. It sounded as if it might be better not to have surgery at all and the surgeon could not give me a straight answer to this question. I left that visit feeling sick to my stomach and demoralised. Finally, the third surgeon I saw (curiously they’re all men) gave me hope that it could all be fixed, although he was also in some disbelief at the level of deformity given my relatively young age. I decided that he would operate me.

This is my right (worse) foot a few months before the op:

As the surgery approached, I was more and more scared. I feared not only the long recovery, not being able to run and possible complications, but also the surgery itself, the (partial) anesthesia, and hearing the saws cutting my bones. I almost quit. But, all of it passed when I was wheeled into the operating room filled with people who clearly knew what they were doing. I don’t know whether they cracked jokes with me because they were so relaxed and in good mood or because they were making an effort to make me feel relaxed. Either way, I’m grateful! More importantly, they did a very neat job. Below are pics one day after the op.

I had 3 cuts — one long one for Lapidus procedure, one to correct the hammertoe, and one to fix the dislocated joint & metatarsalgia of the 2nd toe. The white ball coming out of my 2nd toe is a wire that will be removed after 5 weeks.

And here are X-rays before and after, with some heavy-duty hardware installed to keep the bones in place.

If you need to read xray images, try this.

I could walk to the toilet on my own legs just a few hours after the surgery (after I regained feeling in my legs — very strange process!), in these lovelies — the manufacturer could at least make them a bit more colourful! After two nights in the hospital, on various pills, drips, and injections to manage pain (the first two nights opioids didn’t do much!), I went home with a bag full of more meds and an order to keep my leg up for 2–3 weeks strictly limiting walking during that time…. How will I manage??

I re-discovered hopping on one leg which allows me not to put any pressure on the operated foot. On Saturday, day 5 after the op, I almost don’t need any painkillers anymore and I’m creating a workout regime to do something with the rest of my body, i.e. arms, core, left leg, and butt :-). It’s still a long way before I can walk any meaningful distances, swim, ride a stationary bike, drive or do anything else that involves my right foot. It doesn’t always take this long, but in my case it does. It can be frustrating, but none of it is as bad as the fear before the operation. I might change my mind later on..

Some training equipment ideas: kettlebells, dumbbells, pilates bands, core strength station. Next time, I’d avoid winter months and get a knee walker or some other help to be mobile and able to get outside soon after the op.

Ah, I also found this Facebook group for bunion op survivors — really useful resource also for those considering an op (warning: you’ll see a lot of things that have not gone right, but I don’t think that is representative of how often it happens reality).

Update 30 Nov 2021, — 1st control visit (8 days post-op)

At the first control visit, the doctor said to continue strictly limit walking for another 2 weeks. I asked about the possibility to ride a stationary bike — the response was a mixture of disbelief slight indignation I was even asking. That’s min 2 months in the future! Silly me — what was I thinking??

Update 15 Dec 2021 (3 weeks post-op)

Yesterday, I had the 2nd control visit. The surgeon has concerns bone healing. Not sure it was because of the x-ray image or the symptoms I described (pain in the arch of the foot)… I was instructed to continue to strictly limit walking until further notice, at the minimum until next visit a whole month away (original prescription was 2 weeks, then 3 weeks…) and to do Exogen therapy

for 30 days (NB it can be started as soon as the wound heals, c. 2 weeks post-op). Nonunion is THE major complication of lapidus procedure and it requires revision surgery. I want to avoid this at all costs as it means going through this hell all over again and having an even more complicated outlook. I have to stay here for two extra weeks, which means it will be near enough two months of not seeing Max and my partner, and dealing with the utter misery of Polish winter —it is cold, grey, wet, dark, long and makes everything look pitiful — whilst confined within four walls. I lost my cool — it’s hard to handle this mentally. Normally, I’d go for a run to try and catch my balance, but now I don’t even know if I’ll be able to run again :-( I left my parents’ flat and staying by myself. I need to be alone to pull myself together. May the Universe please give me patience. PLEASE.

Update 21 Dec 2021

First steps on i-walk. It’s a pain to strap it on and off so hopping on one leg is still better for shorter distances around the house (you need a strong leg to hop on!).

My i-walk arrived on 16 Dec and I’m mastering my penguin walk. I’m very pleased with this device as it allows me to go for a longer walk (like several hundred meters ;) not feeling like I’m messing up the foot. And my hands are free (not the case with standard crutches or a knee rover). I can adjust the i-walk for the left foot later on.

The night before last my 2nd toe with the wire running through it hurt badly and wouldn't let me sleep. I was worried about an infection, but it’s probably just the white end pressing on the tip of the toe. I was advised to unscrew it a little with a tiny hex key. Last night was much better — oh, the joy of sleeping pain-free in a comfy bed!

Update 7 Jan 2022

Nearly 7 weeks post the nasty foot op, I’m still not cleared to walk other than on my iWalk or just a few steps in the protective shoes, can’t swim (wire still in the foot) or ride a bike and can’t even dream of running. The i-walk allows me to go for walks outside, to shops for necessities, etc — fair to say it’s saving my sanity. I lost a lot of the right calf muscle as can’t use the lower leg at all. Arms and core work is pretty much the only thing I can still do — it’s always been a weakness and I don’t like it, but I’m up to 5 pull-ups now, from 2.5 just over a month ago (cheating only a little bit) :-)

A word on supplements for bone healing: in addition to Exogen, I’m told this is pretty much the only other help available, in addition to rest and good nutrition of course (and a bone graft if you’re having that sort of op). I’m taking pills with calcium, vit. D3 and K2 (someone in the Facebook group recommended this particular variety) and prescription pills with ossein-hydroxyapatite complex. Warning: smoking is a major factor in non-unions.

Update 11 Jan — 3rd control visit (7 weeks post-op)

The surgeon took out the wire from my 2nd toe so I’ll be able to shower my full body soon! I’m now cleared to walk and drive — still only in a funny stiff shoe and have to be super careful but, god it feels good to have my leg back! I’m going back to Spain in 2 days :)

After arriving in Spain, I gradually started to walk more, cycle and dip my feet in the sea at some 10 days after the last visit. I started swimming in the sea before the end of January. The sea temperature was 14.5 degrees Celcius — I’m told this is warmer than the sea on Scottish or Irish coast in the summer! The foot feels stronger every day and by mid-Feb I can even take a few jog steps.

25 Feb —4th control visit (more than 3 months post-op)

Back in Poland for the visit. Got in yesterday, as the war broke out. Everyone in the hospital is worried. This time instead of an X-ray, they did a CT scan, which showed that the bone is still fusing at the bottom, there are clear gaps that still need to be filled. The surgeon is not concerned, it just needs time. I get the go-ahead for surgery on my left foot on 14 March.

14 March — left foot surgery + correction of right second toe

2nd time around is so much easier. My heart wasn’t about to jump out of my chest from fear. The left foot was meant to have the Lapidus procedure as well (the worst type of bunion surgery), but at the end of the surgery — which I slept through on spinal block and some relaxing drugs — the surgeon happily announced that he managed to do a simpler, less invasive procedure that heals quicker as well.

15 March morning change of dressing

19 March

The op was on Monday, I was back home Wednesday, spent Thursday in a horizontal position with a headache, but on Friday was out for a short walk on my i-walk and didn’t need any painkillers anymore Fri/Sat night. I’m back to my exercises — can only do 5 chin-ups in a row, down from 7 just a week ago — although the foot has swollen and looks like an elephant leg — no ankle visible, slightly concerning…

TBC…..

Names of surgeons etc (private)

Disclaimer: Other than using their products, I have no relationships with and don’t receive any compensation from any of the brands mentioned here.

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Ada Z

Ada Z

I write rarely, mainly for self-therapy. I’ve nothing to sell to you.