Bliss Countdown

Today my girlfriend and I went to Bliss SF to get a fancy spa pedicure... I was having visions of a Hobbit foot once the bandages come off, so thought a lovely scrub/rub/polish/champagne (doc-approved) was the right pre-emptive approach and a good distraction as I was getting a little nervous about tomorrow.

Okay, so here's the Official "Before" Photo:

So I go in to the San Leandro Surgery Center at 7:45am Tuesday 12/1. The procedure starts around 9am or shortly thereafter, and I will be in recovery until 12-1pm. My husband will escort me to/from and get me set up at home. Wish me luck!

Pre-Op Visit

My doc scheduled a full pre-op visit last week to prepare me 100% for what to expect walking into surgery and the recovery plan. Upon arrival I received my "special" shoe and a shower-proof bag to keep my leg dry. And a ton of paperwork. I visited with the doc to review the X-Rays again, to review the game plan on the big day from check-in to anesthesia to procedure, and to learn about this very cool titanium implant that he may have to use depending on how bad the joint deterioration is once he "gets in there." We're hoping he won't have to use it, but there is a chance.

I'm told I will be non-functional for the first few days, but that he wants me up and walking around the house after that. I will be on crutches for a while and in that shoe for 6+ weeks (ew ew ew). After a week I go for a post-op visit to get new X-Rays and change the bandages, then at the two-week mark I have the stitches removed. At each visit we will gauge mobility/progress. I should be up on my feet (with crutches?) on Week 3. Hopefully driving at that time too.

When you read online posts or talk to people who have gone through this kind of thing they mostly say that recovery is much longer than expected and the pain is worse and longer-lasting than the doc tells you. I'm hoping that doesn't apply in my case and am opting to stay positive and believe everything the doc says. Really!

P.S. That orthotic shoe is awful - it smells so bad. I unwrapped it over a week ago so it could "off-gas" the fumes/treatments that were on it, and have soaked it with Febreeze a few times, left it in the sunny window, and put it outside for the day, but it just smells like chemicals. Bummer, as I have to wear it at all times for the next 2 months...

Ouch! Cortisone, the Calendar, and Google

I neglected to mention that Doc One administered a cortisone shot at my first appointment to see about taking down the inflammation in the joint. Man did this thing H U R T!   ER Pain Scale 7.5.  Whoa. The Doc suggested some ibuprofen and ice if it started hurting later... no prob. I went on my way running errands and and before long was howling in pain and noticing my foot swelling "through" my gym shoes. I got home and took a healthy dose of Advil and grabbed an ice pack and elevated for several hours. ER Pain Scale 8+.  I'm pretty good at dealing with pain, yet I was hoping this was as bad as I could expect it to get post-surgery.  The next day I was back to my normal daily pain level and wondered what was so great about the cortisone shot!?

To budget accordingly and determine my insurance coverage, I called the doc office to get the name of the procedure(s). And then I had the fancy doctor terms to Google about my surgery... "Hallux Rigidus," the "OsteoCure Plug Implant" (this thing is pretty cool, actually), "Austin Bunionectomy" and "Radical Cheilectomy." Hmm. Below are a few basic info links if you're interested...

• http://www.footphysicians.com/footankleinfo/hallux-rigidus.htm
  
•  http://tornierdx.com/osteocure/plugs.php 
•  http://www.aolhealth.com/conditions/big-toe-got-you-down-it-may-be-hallux-rigidus
  

I'd like to offer a disclaimer that "Google-ing" any medical procedure/symptoms/diagnosis can be dangerous if you are not a physician. And it can be gory, as search results don't include a warning like "this is a surgeon's page, not a patient's page" and you might just click on some graphic surgery images you really don't want to see.

I'm one of those "planner"-type people. I started the search on those terms to learn more about the recovery process and timeline. The surgery is one thing, but the weeks/months following is what I'm most anxious about.  I also wanted to figure out how much this is going to affect my husband and his schedule, as I'm really going to be relying on him the next few weeks. I am thankful for his support and preparation (and muscle strength, and patience of a saint) to help me get around during recovery.

What's the rush?
I opted to do the surgery right away, as I've been laid off for most of this year and didn't see job prospects suddenly picking up in December, aka National Layoff Month (I made that up), so will recover through the hiring-free holidays and get back to work early in the New Year. I also didn't want to start a new job and have to take  two weeks off for this for obvious reasons. The time is now!

I'd like to thank Via Spiga...

It's an honor just to be nominated, but to actually "win" foot surgery as a partial result of poor (read: fabulous) shoe choices? I couldn't have gotten here without the gorgeous ladies below...  Here are three of my faves that are on standby in my closet for the next six months until the swelling goes down enough for me to wear them again... with abandon!

(What kind of woman could have a pink blog site about a bum foot without including shoe pics?)

Diagnosis: Second Opinion

I had been favoring my foot in my yoga classes, where "toe tucking" is a basic action, and mentioned that I was having some trouble and would try alternate pose options until this surgery. Two women in the class stopped me on the way out and asked if I'd had a second opinion, and if surgery was really the way to go - their skeptical tone and urging prompted me to get a second opinion.
Second Opinion podiatrist was a very, very nice guy, funny and witty, and much lower-key than the first. I had two visits with him. In the first, he made what I called a "tape slipper" on my foot and told me to keep a journal for three days. Which I did. At first the tension it created, actually pulling my big toe to the left and allowing some air into the joint, felt pretty good. Though by Day Two the foot was still fatiguing while driving and basic errands, etc. and Day Three was completely uneventful either way. The follow-up on the fourth day included my X-Ray results (he referred to the one showing the bone spurs as "the money shot!") and offered the same surgery diagnosis and "some time in the next year or so" timeline as First Opinion. At that point I had to choose which doctor was going to do it.

I selected "First Opinion" doc to do the procedure. Somehow he just seemed a bit more intense and tuned in to it all which felt better to me than the friendly funny doc. And then I started asking my friends who'd had similar procedures a LOT of questions. And then I started looking it up on the Internet... yipes.

Diagnosis: First Opinion

So after years of throbbing feet due to, in my own assessment, making poor (read: fabulous) shoe choices, I got to a point with my right foot swelling and not fitting in shoes properly that I went to see a podiatrist. I truly thought he'd say "oh it's inflamed, here's a cortisone shot, wear flats, go on your way" or worst case, "you have a bunion, and we fix that by 30 min of using 'Yoga Toes' each day." What I did NOT expect was for X-Rays to reveal prehistoric-looking bone spurs on the first metatarsal joint (that's the big toe) and to learn that the spurs were restricting normal movement, had broken off and were jamming the joint, and that the 3mm-too-long first metatarsal bone caused grinding away of cartilage and normal joint formations. In short, I have filed away the good parts of the joint and had bad outgrowths akin to a spiked dog collar going around the perimeter of the joint. Very ugly stuff. I wish I had a copy of the X-Rays to show you!
My podiatrist, a very cool guy who clearly is into his job and what my films revealed, indicated that surgery is the best route for repair/recovery. That I didn't have to do it ASAP, but within a year or two at most, and that I was an ideal candidate due to my age and attacking this before arthritis and limited mobility set in with age.
So I walked out saying "OK, guess I'm having surgery," and scheduled a pre-op visit and surgery date of December 1, 2009.