12 months later

By 6 months after surgery my right foot had completely recovered, apart from a slight lack in sensation on the skin of my large toe. But my gait was normal and my foot was pain free, much better than before.

One year after the right foot had been repaired I decided it was time to complete the matching set. 

It is now the third day post operation and I'm relatively pain free. I use regular paracetamol and / or ibuprofen four times a day, but since the first post operative day no oxycodone. I am moving more than I did with the right foot and there's little swelling so far. Today I have used the exercise bike for 7 minutes. Last time I waited nearly two weeks.

The picture shows the foot just after I returned from hospital - only 6 hours after I left home. Again local anaesthesia with sedation. No after effects of this. 

Sleep and pain

Short answer

Sleep improves when pain improves

Exercise and good pain management seemed to help reduce pain.

My experience over second 2 weeks

Before I had bunion surgery I didn't sleep through the night, so I could hardly expect sleep to improve things.

The local anesthesia used in the operation lasted for 18 hours, so the first night's sleep was fine.

After a few days I had to get organised by day with pain management and hoped night time would take care of itself. It didn't. 

I'd wake up several times a night with some foot pain and a lot of lower back pain, from so much sitting with leg elevated and sleeping on my back with it elevated at night. The walk to the loo at the other end of the house often stirred up the foot. Then you wonder what to do to get back to sleep. If you rob from your daytime paracetamol rations, what are you going to do? It varied, sometimes the opiate, sometimes 1 paracetamol.

At my 2 week follow up appointment with the surgeon I complained about the back pain and he said, forget the leg elevation.  Well, I didn't, not totally. I moved around more, tried out the exercise bike I'd bought for this period and the back pain decreased and the sleep improved. Didn't elevate at night, laying in my normal side position with a pillow between my legs to take the pressure off the hips. More exercises - leg raises on the back and on the side. Spinal twists lying on the bed. professional massage and acupuncture helped too. Yey! Pain decreased. Sleep improved.

On day 29, my 4 week post-op appointment I'm expecting the surgeon to tell me to give up the post-op boot with the rigid sole. I've tried walking around the house in Crocs and it certainly improves your gait. Less limping. Walking more normalised. I'm ready for this.

I'm getting reading for those big toe stretches I've read about. Helps your walking return to normal.

Can now walk upstairs alternating on the steps, instead of leading with the good foot and bringing the other to the same step. Cannot do this downstairs yet.

Written on Day 26

What worked for me - and might help you

This is NOT medical advice

What the doctor says

Do follow the recommendations of your health care professionals, especially your surgeon

Motivation

I took those before and after photos as they keep me optimistic.

Help at home

Have someone to help you at home for the first week

Leg elevation

This is the thing that is supposed to prevent the dreaded inflammation. Set up places round the house where you might sit, including outdoors, with something to elevate your foot - an ottoman, a chair, a box and cushion. Take a cushion in the car that you can use there or take to an appointment.

Finding the right balance between elevation and moving around is tricky. Too much elevation and other problems develop. Too much activity and, well, we all know what happens. 

By day 13 I was getting up and moving for 5-10 minutes on the hour and half hour. 

Mobility

I try to walk as normally as possible.

My walking poles were helpful in the first week if I had to walk far to an appointment and to warn people to keep away from my PSF (Poor Sore Foot). I also hired a wheelchair with an elevating leg rest as I had to speak at a close friend's funeral on day 7. I didn't use it much but it was invaluable when I did. Of course you need a valet to push it.

In the car I tried sitting sideways across the back seat but that was most uncomfortable. What worked was sitting in the back behind the empty passenger seat, folding the front seat down as much as possible, and using the seat belt in the normal way. Time to be chauffeured around in an unaccustomed manner.

In the early days I had a shoulder bag containing my mobile phone, cordless phone, house keys and anything else important to reach quickly. Don't want to be trying to run for the phone.

Showering

To keep the dressing and wound dry, I used two bags, taped close to the ankle separately with masking tape. Got better at this after a few days. Didn't use the recyclable grocery bags or bin liners as they pierce easily. Used some thing more solid.

TIP: when taping up the bag to your ankle, do it reasonably tightly and end the tape in the centre front - easy to find after your shower.

Two chairs, one inside the shower recess, one just outside to rest your leg on with two towels resting on the back rest - one to dry yourself with, one to sit on. I bought mine at a large Swedish furniture warehouse for less than AUD10 each! Plastic garden chairs are OK but the arm rests get in your way.

Telephone shower head, hand held shower - really important.

Pain management

You'll probably be prescribed some opiate type pain killers in addition to being recommended to take paracetamol or non-steroidal antiinflammatories (like ibuprofen).  In the early days I found taking paracetamol at regular times as recommended and topping up with oxycodone when needed was fine. The maximum number of high dose paracetamol per day is only 6, whereas with the regular ones, 500mg each, you can take up to 8 a day. I found that better.

Some friends with much more pain management experience than I had dropped by and gave helpful advice. 

I started writing down what medication I took and when so I can keep track of it. Pain killers, antibiotics, heat packs and use of TENS machine. Daytime pain was manageable before night time pain. More next post on that.

If like me you have any other chronic pain it's likely to flare up with all that compulsory rest and your leg elevating posture. My lower back started up in 4-5 days. What worked for me was regular paracetamol, a borrowed TENS machine and hots packs on my back. In addition I made myself get up and move around every 30 minutes, rotated my hips, did exercises on the bed and with arm weights. No need to let yourself go totally! 

Water

Drink plenty of water - it's good for you, keeps the constipation under control and gives you regular reasons to get up and walk to the littlest room of the house.

Constipation

The pre-operative fasting, surgery and opiate drugs combined to give me a hard time (pun). That's despite a vegetarian diet and plenty of water. It didn't last long. I'm not on any other medication that causes constipation and don't often have that problem. 

Only tips I can give are just what your mother would have said. Extra fibre - psillium added to my muesli. Keep up the water. Move as much as you can. If desperate take something with lactulose in it. Don't take it for more than a couple of days until you get "movement at the station". And get off the opiates as soon as you can.

Sleeping

That will be my next post. Time to get up and move around.

Written on Day 13

Introduction to this blog

There are hundreds of bunion recovery blogs out there and this is not another recovery diary.  Not to say there's anything wrong with them. They're great! They really helped me in deciding to have surgery after 15 years of thinking about it. And they helped me get rid of a rude orthopaedic surgeon who said it was "inappropriate" for me to read such things.

This is a tip blog, a few of the ways I coped, mainly in the important recovery period. This is the time that health care providers don't cover in as much detail as you might like. 

Everyone's experience will be different. Depends on your exact foot problem, type of surgery, overall health and fitness beforehand and what advice you are given by your doctor about the post surgical recovery period.

Here's a before and Day 7 photo.

Just to put what follows into context, I had a Scarf and Akin procedure under local anaesthesia and intravenous sedation. It was a day surgery procedure. I could weight-bear in the special boot after 90 minutes. I am 60+ year old! female, reasonably fit, a little overweight, with chronic lung disease. I've had bunions since I was in my 30s, thanks to my grandmother, and both parents. So I never had a chance to damage my feet with poor fitting shoes.