Round 2 of 2

Day 1

Back to the Future Day

  I recognize that I have great and perhaps somewhat unrealistic expectations: the surgery, recovery and outcome had gone so splendidly for my left foot, is it realistic to expect the same for my right foot? 

  I was expecting a general anesthetic(G.A.) like my first experience but my lingering upper respiratory infection increased the risk of bronchial spasm so my best option was now a spinal block combined with sedation. "So, if the spinal block is less risk, why would one chose a general anesthetic?" I asked the anesthesiologist. She explained that some people don't like the idea of being awake, or having a needle put in their back and it is preferred because of flow. You can recover much faster from a G.A. than a spinal block = more surgeries completed. There was an irrational part of me thought that I could beat an anesthesiologist at their own game. You got me last time, so you’re not going to get me this time, I thought. "How do you feel?” my anesthesiologist asked as the fentanyl was entering my veins. “A little strange,” I said as she prepared to insert the needle. “Round your back like an angry cat,” the nurse said. I felt a small pinch and then she laid me down gently on the operating bed and put a sheet up vertically to block my view of my feet. “Can I see?” I asked as I crunched to peak overtop. “No,” the team answered assertively as I lay back down. Fortunately, my anesthesiologist knows better than I and my plan to stay awake didn't playout. I was nicely sedated for the entire event and woke up just in time to wave goodbye to everybody in the operating room. 

    "Can I please have some ice chips?" I asked the nurse since I was a now a pro and knew what I could forward to. "Not yet," she replied, "we need to wait until you get some feeling back, maybe another half hour."  Two hours later, their first attempt to switch me from the bed to a rolling chair was unsuccessful.  "Try to squeeze you butt and thighs," the nurse urged.  It wasn't happening and back into the bed I went. It took 4 hours for the feeling in the bottom half of my body to return. Wow, with my G.A. I was out within an hour last time; huge difference in recovery.  Dr. Brunet explained that the Lapidus procedure went as planned; however, he had to put a temporary pin in my big toe because my tendon was too short and it needed to be stretched. The pin is expected to remain for 3-4 weeks.
  I left the hospital painless, peppy and pleased with my first dose of acetaminophen and hydromorphone in my system.  "Have a look at my foot," I urged my Mom once I made myself comfortable at home. She removed the sock covering my foot and I think I was more shocked than she was.  There was lots more blood than I had seen at the hospital. It wasn’t long before my pain dramatically increased. I had the chills, nausea, vomiting and the clock slowed down so that I could feel every intense palpitation in my foot. By 1:30 am, after leaving a voicemail at Dr. Brunet's office out of desperation, I decided to double my dose of hydromorphone and take a sleeping pill.  Eventually, I was able to fall asleep and with Dr. Brunet’s approval, I was able to manage my pain more effectively.

Day 4
  Today, my pain has reduced significantly without the influence of medication. It’s amazing how fast the body heals. I expect to have my plaster cast replaced with fiberglass in two days and get a first glimpse of my new foot.

Notice the pin in my big toe. The Jays game is on!

Aerial view. Ready for Halloween.

31 Days and Counting

11 Months Post-op

  I am counting down the days until my next foot surgery scheduled for October 21, 2015. Now that I know what to expect, I am way less nervous and not an emotional mess like last time.  I plan to enjoy my long days with HBO, Netflix and a few borrowed DVDs.  I look forward to an early breakfast brought to my bedside by Tim (lucky me!) and sporting a variety of sweat pants for 60 days.  I will rediscover my morning routine of non-weight bearing exercise followed by a seated shower and cautious crutching down the stairs by noon. It won't be long until I get to ride in my fancy cycling shoes that have been sitting in my closet for two years. My hope is that my recovery will be similar but I understand that the results of my first surgery won't necessarly predict the healing pattern/outcome of my second surgery. It's hard to believe that almost a year has passed and I'm ready to do this one more time.

I'll soon be able to wear stylish shoes!

Don't let my scar Fool you

5 Months Post-op

  April 1st! Just past my five month milestone.  Improvements are now subtle as I journey away from my surgery date of Oct 22, 2014. To date, my experience has been better than expected. I can run, jump, pivot, climb and fly (wishful thinking). "A new foot and wings please, Dr. Brunet."
  There are still times that I limp after a long day in the OR but it's my bunioned right foot that bothers me most.  I had an incident, last week, where my I closed a door on my left foot which resulted in a bruised nail-bed. It hurt, of course, but self-inflicted pain has been my only hindrance.

  I went for my first pedicure last Monday.  I had been reluctant since the skin around my scar was still sensitive and numb in some spots.  "Surgery!" the pedicurist exclaimed, "I'll be gentle," he added. And on went the gloves and out came the tools. He had no hesitation putting his hands on my foot including my scar and I was getting ready to squirm from distress but I was fine. The only squirming I experienced was when the emery board tickled to bottom of my feet!

The crease beneath my big toe is slowly getting better

The crease beneath my big toe is slowly getting better

  I am actually proud of the scar on my foot.  I know it will always be there. It may not be the prettiest for sandal season, however, will remain a testament from my experience.  I can't wear flip flops or any shoe that requires a strap to go through my first and second toe since the toes on my right foot are so close together that they crunch on the strap. I'm looking forward to having surgery on my right foot so that I feel more balanced, and yes, can wear pretty shoes.  (Not heals though, don't worry Dr. Brunet, I won't wreck our work.) Instinctively, I put more weight on my right foot over my left.  It would be nice to wear bowling shoes without Paul Bunion sticking out and rubbing on the side.  Well, at least he waves!

28 Days Later: My third foot unveiling

  This morning, I had my 4 week post-op.  I went with high hopes that I would receive the good news that I was healing on schedule.  This time, with decreased edema, I was more excited than nervous to see my foot.

  And the two week old cast comes off!  I exercised quite a bit with this cast on so surprisingly, there was no smell nor evidence of any significant water damage. (See Day 16: "Confessions of the Not So Perfect Patient.")

She's looking pretty good

Side view

  It's shocking how dry and scaly my feet were from being in a cast.  I gave it a good clean with alcohol solution before a the new cast went back on.

Underneath; cotton from the old cast stuck to the bottom 

Ankle trick - over pronation; a whole other issue

  The doctors and technicians were impressed with my healing.  "You must be keeping it elevated," said Dr. Brunet with certainty. "As much as I can", I responded, " and I've been exercising almost daily."  "Maybe that's helping the circulation to reduce the swelling," he said. "I'd like to keep you in a cast for two more weeks.  At that time, we will take some x-rays.  There is a 50% chance you'll move to an aircast or you could go into a stiff-soled shoe," he explained. 

  Hopefully, at 6 weeks post-op, I will be able to wear a stiff soled shoe, but either way, at least I will have the freedom to sleep without a cast on my leg. 

Notice the gap is closing between my big and second toe.

Confessions of the Not So Perfect Patient

Day 16

  I did something bad.  Something that I was warned about so many times.  I got my cast wet.
  At my one week post-op, Martin, the casting technician, gave me a high five because when he removed my plaster cast, there was no evidence of it being soiled with water.  "What did you do to keep you cast dry?" he asked.  "I bought a special shower bag", I responded with content.  "Well, you did a really good job at keeping it dry, but I would recommend you take a sponge bath instead.  You don't want to have to come back in to get it changed or be out of luck on a weekend with a wet cast," he responded.  A sponge bath?  Out off the question, I thought.  I'm a two shower a day type of girl.  No joke, I shower before and after I workout.  A sponge bath was not happening. "How can you tell if someone got their cast wet?" I asked.  "You can just tell by looking at it", he said, " and it would smell like decay."
  The following Sunday, I got my cast a touch wet.  The water pooled on the shower bag so when I took it off, the water ran onto my cast.  No big deal, I was getting a new cast in two days time and it dried up in about 4-6 hours.
  Today, only two days after my new cast change, it's soaked.  I'm not sure how deep the water penetrated.  I hope I can survive with this one on for 12 more days.  This time, the water actually got inside the shower bag past the rubber bands that were supposed to seal it.  My leg has been itchy and I've been cold all day.  I ran a blow dryer down my cast on the cool setting several times but it doesn't seem to be much help.

  I'm a bit worried I'll have to return to Ottawa tomorrow to get a new cast.  I feel a little embarrassed, after all, the incident did happen on my second shower of the day after my workout.  What will Martin think?  Am I that thick headed non-compliant patient?  I ask my patients to follow specific instructions all the time to ensure their best healing following laser eye surgery.  When they don't listen, it's frustrating.  I am that patient.  Two showers a day Michelle? Come on!

  I guess I'll go out and buy a sponge, darn-it!

Two Weeks Post-op: My second foot unveiling

Day 14

My second foot unveiling was this morning.  I had a dream last night that I was walking on my cast. In reality, I was hoping that I was a marvelous bionic healer and Dr. Brunet would put me in a walking cast today.  No such luck!  I'm healing well but there is still lots of edema that needs to subside.

I was instructed more than once, to keep my leg elevated as much as possible to prevent scarring and prolonged healing. Okay, so maybe my Costco run yesterday wasn't the best idea but it was nice to get out of the house with my Mom.  Besides, I bought a mountain of garbage bags and rode the electric wheelchair with authority. 

NB: I've transitioned from pyjama pants to jeans when out in public.

I thought was going to be late for my appointment this morning, so my Mom dropped me off at hospital's main entrance.  I opted not to take a wheelchair and stick to my crutches.  Boy, can I ever pick up speed with those things.  I was Sasha Fierce, there was no stopping me and people were sure to move out of the way.  I made up some time, got some cardio and presented myself to the reception desk slightly out of breath.  "Sorry, I'm late," I said.  "You're good, only two minutes over, no big deal," replied the receptionist.  Her response made me feel much better about my tardiness.

I was nervous to see my foot again.  At week one, I was so shocked to see how swollen my foot looked and today, I was afraid I wouldn't notice much change.

Removing the cast

Snipping the bandages

Removing the gauze

There she be!

I could tell the edema had decreased significantly.

Do you think I'm ready to be a foot model?

Toe exercise

Removing the ends of the stitches since they are dissolvable.

Applying the fiberglass cast. It's warm going on so it feels really good. 
 Fiberglass is sharp, so a tensor bandage is applied over top.

Dr. Brunet was happy with my progress.  He instructed me to practice toe exercises twice a day and cautioned that it should be uncomfortable.  My next post-op visit is at 4 weeks.  X-rays aren't taken until week 5.

Clearing the Air: Why I got Bunion Surgery

Bunion surgery is not an easy decision.  For most cases, it is 100% elective.  I've been putting it off for over 10 years. When I finally booked the surgery,  I almost instantly regretted my decision.   The thought of going from very active, to not being able to walk without crutches was mind boggling.  I couldn't picture myself alone, on the couch all day, watching TV and petting my cats.  I seriously considered cancelling it.

A great part of my profession involves discussing with people about elective laser refractive eye surgery. I've been doing this for almost 8 years; pros and cons, risks versus benefits.   There are people that I counsel that are great candidates and some not as much and I let them know this.  Laser refractive surgery has done great things for many people.  I couldn't work in this field if it wasn't a success. I think bunion surgery is similar.  I've shopped around, done my research and found my surgeon.  I've weighed out the risks versus benefits and today, the benefits outweigh the risks.  That's when you know you're a good candidate.

What if I lost feeling in my big toe?  What if I couldn't workout with as much intensity? What if I was in my more pain after than I was before?  Bottom line: any and every surgery has risks but so does giving birth or walking across the street or driving a car. You could get hurt or die at any time.  

I've been listening and watching other peoples stories for years.  This was not for cosmetic reasons.  I never thought my feet looked ugly.  I didn't even realize my bunions were unusual. In fact, I thought other peoples feet looked weird because their big toe was straight. I was never embarrassed and never hid my feet.

For my prom, I wore wedges with a half inch rise.  I was ok with that. They were silver and had sparkles.  Who cares?

I could never walk into a shoe store like Aldo, Spring or Payless.  They were out of the question.  I was lucky to find something at Naturalizer even with the wider width.  "We can stretch your shoe overnight," they would offer.  "Sure," I said with hopefulness. It never worked, the shoe never fit.

I bought my own shoe stretcher from the USA.  It's heavy and hardcore but didn't work for me.  "Your shoe should fit when you buy it," said my podiatrist, " you should never have to stretch it."

My shoe collection consists of many shoes that are barely worn. Most of them too big for me. They felt great at the store but in reality, way over compensated for my bunion.  The rest, too tight and not tolerable for more than five minutes.

I would prefer shopping for bathing suits or anything else for that matter. I hate shoe shopping!!!!!

I have a lot of running shoes.  But even they cause me trouble.  Two years ago, I discovered the Nike Pegasus.  This is a fabulous shoe.  Nice and soft, fits my orthotics and a beautiful mesh-like top that expands with my bunion.  Thank you Nike!

My last running shoe purchase was completely unsuccessful.  I returned two pairs and then another two pairs before giving up, four weeks before my surgery.  The Pegasus was not working for me; my feet didn't agree with it anymore.  I tried D width in another brand and my feet swam around in them. I don't have wide feet, I have bunions.

I'm always thinking about my future.  I have polycystic kidney disease (PKD).  I'm saving like crazy for my retirement because I know I won't be able to work until the ripe age of CPP.  My feet are part of this future.  I can't push this off any longer.  I want to be able to walk, run, cycle and stay fit for as long as physically possible.  This is the most important thing in the world to me.  Dr. Brunet wants to operate on me before I develop arthritis and while I can have an ideal recovery.  Now is the time, no more excuses. This is an investment in my future.

Pumpkin carving by Heather and Chris Buckley

The Misadventures of Michatan: the one-legged workout

Day 10

  When I googled "non weight bearing workouts" there wasn't a lot to choose from for people like me. I'm proof that you can have a good workout, even with a cast on your leg.  I'm not a fitness professional so my routine is not scientific. What I can say is that I sweat so much today that I needed to take a second shower.

  This is my comic strip character Michatan.  She was invented in 2004 by my best friend from college, Carolyn and drew this for me this morning.

By Carolyn Bott, 2014

  This was posted on my Facebook feed yesterday. It's motivating because I've worked very hard over the past 2.5 years to become fit and I don't want being in a cast to stop me from doing what I love to do.  

To view my work-out click here.  Love my eighties weights.

 This is my giant shower bag.  No sponge baths for this girl.  My favourite part of my day is breakfast in bed (thanks Tim for mastering the over-easy egg) and my shower(s).

Pity Party: 24 hours of self-commiseration

Day 9

  I was expecting this day to come right around now.  I had my pity-party; it's over now.  I was joking  with friends before my surgery how I picture myself after the surgery: in bed, barely moving with a bag of chips in one hand and drool coming out the corner of my mouth. Yesterday, I was that person.

  Everything I do takes much more effort and three times as long. I'm not that patient yet! Naturally, that made me a little sad.  Also, I drank way too much wine on Tuesday night in celebration of my return to Kingston and my one week post-op.  "Don't drink too much," said Tim. "I won't," I said thinking I have this totally under control.  That was not the case, I was way over my head.  Tim had to work the next day and I woke him up at 3am Wednesday morning to grab me a bucket and kept him up for the next two hours.

  I realize alcohol is a depressant and that I didn't make the best choice. I spent all of Wednesday feeling sorry for myself: crying, eating and staring off into space.  I didn't feel like doing anything and I was alone for the first time since the surgery. Tim bought some all-dressed and sour cream and onion chips the night before.  I found them in the same cupboard as our travel mugs on the top shelf hidden between the martini glasses. You can't hide anything in a woman's house.  She'll always find it!

  "MICHELLE, how are you?" texted Carolyn. "Hi," I responded,  "I'm that person I didn't want to be. Demotivated, bored and eating too many chips." "Watch documentaries on Netflix," she continued, "educate than scare the shit out of yourself."  Carolyn is my best friend from college.  She is the type of person that would say wildly inappropriate things at any time and is absolutely hysterical to be around. "Get Tim to draw dicks on your cast.  Big long skinny ones, short fat juicy ones, itsy bitsy teeny weeny peens." "It's fiberglass, can't really draw on it," I texted.  "Where there's a will, there's a way," she declared.  "Get a thick marker. Silver. Or you could decoupage some dicks on there." "No will here," I responded.  I ended up taking Carolyn's first suggestion and decided to watch a documentary on Katy Perry's 2011 tour. Even beautiful, successful, rich and talented people get depressed too.  I felt a bit better.

  I still have another 4-5 weeks to go with a cast that I can put absolutely no weight on before I get switched to a walking cast.  The good news is that pain is minimal in part to the fact that I've been keeping my leg elevated as much as I can above my heart to improve circulation and reduce swelling and discomfort.

  Anyways, I plan to do a little bit more with myself today.  I have a workout area set up in my bedroom.  In the back of my mind, I'm still going to become a one legged work-out YouTube sensation. But, probably not.

PG -13: Parents Strongly Cautioned

Day 7

My new foot was unveiled this morning when they removed my plaster cast.  Don't scroll down, if you don't want to see it; parental guidance is recommended. It was bruised and swollen and frankly looked like it didn't belong to me.  I couldn't look at it for more than a few seconds without feeling emotional.

I asked Dr. Brunet to draw me diagram of his work (see below).  He described the Lapidus procedure which is used to correct moderate to severe bunion deformity.  He cut the bone at the base of my toe, swung it over and put three screws in to hold it in place.  Then he shaved bone on the side of the bunion location (cresentic osteotomy) and shortened and lengthened ligaments (ligament balancing).

footEducation.com is a website by orthopedic surgeons and is a great source for more information.

I'm now in a fiberglass cast which is lighter and more durable.  My stitches will be removed next week.

Reclaiming My Independence

Day 6

"Does Paul miss Paul? It must be weird for him to know he's next...", texted my friend Carolyn.  "Lmao, you're hilarious," I responded. "No, the Pauls were," she said, "but you've killed one."

  I'm finally getting good at the showering routine.  My parents' water heater is adjusted to piping hot. Like when you point the shower knob to cold, it's still hot.  My Mom asked my Dad to turn up the water heat a billion degrees.  It took me a couple days of scolding hot water on my skin for me to remember this. I actually enjoyed my shower today despite having a giant bag wrapped around my leg.  I have discovered that the shower chair is not only a terrific tool for someone like me but could become an excellent help in the future for shaving my legs in the shower.  Why have I been standing in the shower all these years?  I highly recommend that you consider this for your own primping as well. 

  I made myself breakfast today although I had to sit while preparing it. I have also acquired a pink back pack to carry my iPad etc. around in.

  And yes, I have been going out in public in my pyjama pants. I am that person, but I have an excuse and I did put mascara on. All my normal pants are tapered and won't fit over my cast.  It's not my fault what's in style.  I went to Service Canada and acquired an accessible parking permit signed off by my surgeon for the next three months.  Perfect for the casino and the upcoming holidays.  So If you want to take me somewhere, I can promise you a good parking spot.

Paul Bunions

Intro

  My co-worker Karen calls them Paul Bunions.  "Poor Paul," she would say as I hobbled around in my scrubs.  Of course, both Pauls were aggravated as I just spent several hours standing on a hard floor.

  The pain wouldn't stop me though.  I would still exercise 2 hours/day 5-6 days week. I was used to it by now.  I would imaging myself at a spin class with only the discomfort of lactic acid to deal with rather than the Pauls screaming at me from below.

  I've hesitated for years to have bunion surgery.  I'm 33 years old and throughout my 20s, I've had multiple consultations with several surgeons. I've had bunions for as long as I could remember.  I've never been able to wear high heels due to the instant pain I get from the pressure on the balls of my feet or wear flip flops because my toes would crunch together over the plastic piece that went in between them.

  The last two and a half years of my life, I've become fairly active.  Although I lost over 30 lbs, my bunion pain became more intense and frequent.  It has become increasingly difficult to find any shoe that fit my feet.  To compensate for the Pauls, I would choose a half size bigger which would cause my heels to constantly slip out of my shoes. 

  My increased frustrations lead to a consultation with Dr. Jacques Brunet at the Ottawa General Hospital.  I asked my family physician in Kingston to refer me to him since I had recently talked to someone that had both bunions removed at the same time with him and was satisfied with the outcome.

  My boyfriend Tim, who has a medical background, attended the consultation with me and was not convinced bunion surgery was the best route for me.  I had already been wearing orthotics for years and I felt ready to explore the next step.  I was positive that I was ready to proceed this time and was very eager to hear what Dr. Brunet had to say. "Are you double jointed?" asked Dr. Brunet. "No," I said as he took my fingers and contorted them in funky directions. "Yes, you are. Look!" he said.  "Oh, that's weird," I said.  "You were destined for bunion surgery," he said, "I wouldn't wait any longer than two years to have them operated on."  I left the consultation pretty upset.  I guess was eager to hear what I thought Dr. Brunet would say and not what he actually did say. Only one foot could be operated on at a time since I would be non-weight bearing (NWB) for 5-6 weeks post-operatively and I shouldn't wait any longer than two years to have the surgery. You mean I have to go through this TWICE in two years!!! WTF!! Tim left the consultation confident that I should get surgery.  What a switch!

  I booked my surgery for my left foot for October 22, 2014 at the Kemptville District Hospital.  As this day approached, I tried to make the most of my active days.  I went for a manicure and pedicure two days before.  "Only polish on one foot please."  As for my fingers nails, I paid extra for shellac and then realized the nurses and doctors use your fingernails to monitor circulation. I scraped the shellac off off one fingernail the night before, hoping that one exposed nail would be enough.

  The staff at the Kemptville Hospital were extremely reassuring.  I thought I would be more nervous then I ended up being moments before the surgery.  They wrapped me in cozy warm blankets which made me unbelievably relaxed. The anesthesiologist told me that she would be my eyes and ears during the surgery as I was hesitant about being put asleep.  "We're bringing you to OR #2, the room with the view". "Perfect", I said, " that's what I asked for when I booked this."

  When I woke up from the anesthesia, I couldn't believe that I had been asleep.  Dr. Brunet was right there and I told me everything went fine. I felt really good. My foot was completely numb.  The nurse offered me ginger ale with ice chips which seemed like the best thing in the world.  

  Tim was in the waiting room to greet me after surgery and soon after my parents met me to take me to their house in Orleans.  My foot would be frozen for 18-36 hours post-op and I was feeling very relieved.

  If you are considering bunion surgery, I would highly recommend that you purchase crutches, a shower chair and a shower bag for your cast and rent a wheelchair.  Make sure you have someone who can help you for the first week.  I stayed with my parents who work from home and I enjoyed and sucked up every minute of it.  Also, I recommend the HBO series GIRLS to watch, but not with your Dad like I did.

Day 5

 Today is the day when I decided to write my blog; partly due to boredom and the desire to keep my brain somewhat active but also because I wasn't able to find or talk to someone who recently went through a similar experience.  Majority of people that I heard of or talked to all could get both feet operated on at the same time.  What if my first surgery was so awful that I would never want to do it again?  What if I could never return to the active person I once was?  Honestly, I haven't experienced anywhere near the amount of pain and discomfort that I prepared myself for. Granted, I've been faithfully taking my hydromorphone and acetaminophen and I'm certainly looking forward to having my plaster cast changed to fiberglass in less than 48 hours.

  My first legitimate wheelchair experience was today.  I watched a video on YouTube last night of Heather Dugan, who was in a cast and posted workout videos which included many many pull-ups.  She encouraged fellow cast-mates to make sure to continue to do things that are enjoyable and try to get out of the house.  Because I still need to keep my foot elevated, I had to sit in the back seat of the car with my leg spread over the seats.  The wheelchair wasn't so bad.  I managed to wheel myself away from Tim when he wasn't looking and because I'm only at hip height, I was pretty hard to find among the aisles of SAIL.  He bought me a water bottle. By the time I got back to my parents, my foot felt numb. I felt like I burnt the 1000 calories that I ate at lunch (Gabriel's Pizza).  My excursion was definitely one or two days premature.