Is surgery the best thing?

Foot care
1

These are my feet (You should have seen my grandmothers feet)

I am now 50 and they have got a little worse over the years but are broadly stable, however I get some knee pain and am worried this is connected.

As long as I can find shoes wide enough at the front (virtually impossible these days) they don't hurt much.

They do stop me doing certain sports but I am very active and just switch to something else if my feet become a problem.

So I couldn't do rock climbing because it involved tight shoes and balancing on my big toes which was beyond excruciating so I took up cycling instead.

I have just seen a surgeon on the NHS in London and he was very enthusiastic about booking me in for a Scarf Atkin osteotomy straight away. (Well, three to four months but that IS straight away on the NHS)

I was less keen and have said not right now, maybe later, so he has refered me back to my GP.

I can't find any research into success rates for this procedure to help me decide. Are there any published anywhere does anyone know? Can I ask to see a surgeons success rates? and given that no one has ever asked me how happy I was with any previous operation I've had to have, how do we know how representative these might be of the general population?

Also I have a long history of allegies and autoimmune problems and am not keen about having a large quantity of assorted metal hardware left in there afterwards that doesn't even seem to be titanium. I asked if he could take the screws and staples out when the bones had healed and he just said only if I had a problem at the time.

Allergies dont work that way, you don't start out with a problem -you end up with one.

Another consideration is that I live alone in a small house with a very steep staircase and upstairs toilet. I don't have anyone to look after me for the first two weeks as I have been advised is neccessary. I explained this was not possible and what were my options and was just told I had to sort that one out myself. How? I'm not rich and I don't see how I can take the several months off work required much less pay a home help as well.

On the one hand I am very tempted by the possibility of normal feet for the first time in my life, on the other I feel the potential for disaster outweighs the likelihood of success. Plus the process looks like a nightmare.

The surgeon was a jolly nice chap, but I am temped to abandon it and stick with the devil I know.

What do people think?

Thank you very much.

2

I am so sympathetic. Yourpicture showed rather flattish feet, mine look fine till I put weight on them then they flatten. Got mine from my Dad. I'm over 60 had 3 ops on one foot and 1st 2 weeks needed lots help. If I'd been on my own would have kept food packs by bed,v light backpak worked. Needed loo on same floor did stairs am and pm. Can't Comment on allergies. Very best of luck, can u get friends and online shopping. 

3

Thank you Pam.

I have high arches until I put my feet on the floor and put weight on them and then I have no arches at all.

Food deliveries are achievable, its the stairs I worry about. I can't even sleep in the living room for a couple of months with the loo upstairs.

Thanks for your reply, all best wishes and hope your feet stay well.

PS Do they look ok?

I'm worried they will be ugly looking post op which is a laugh to people I'm sure given how they look now but I'm used to the way they look at the moment.

4

They r much slimmer post op w bigger gap between big toe and rest which seems same as most pics I've seen. So fine, as it is 8 weeks post op can't comment on how they work as it seems along w most, to take 12 weeks min for full foot weight bearing +longer 4 say full exercise.  This Is biggest task Keeping fit, +keeping spirits up. in my 40s had 1 bunion trimmed, complete waste of time. like now took over 12 weeks till swelling went down wore 2 size bigger friends large sloppy shoe. Others agree time. My surgeon agrees will take till 1yr last 25 per cent of healing. Shd be much better by then. Best to tell u truth but only according 2 my experience.

5

Thank you.

It looked a year to normal function, if nothing went wrong, to me too.

Thank you

6

Your picture looks very like my feet pre-op.  I am 63 years old and had both bunions removed in January this year - had been getting ankle pain in my left foot for a few years, and the surgeon told me that it was likely this would get worse and spread to my knees, as I was unable to put my foot properly on the floor when walkig.  The other deciding factor for me was that

my mother's feet are so terrible (she's 92) that I could only imagine mine would get worse.

I was fortunate to be able to sleep downstairs and we have a downstairs toilet.  For "bathing" I bought a cheap plastic paddling pool which I used until I could manage the stairs again.   I think I possibly could have managed going up and downstairs on my bottom but was worried that I might fall over when no one else was around to help me get back up! 

For the first few weeks during the day I rested on the sofa with fruit, drinks, books, dvds close to hand and found I could cope a little better as the days went by.   After about 3 -4 weeks I was managing quite well on both the crutches to get around indoors.

Now 9 months later I can do everything that I could pre-op although driving long distances still makes my toes ache.   My feet are not perfectly straight - my surgeon told me they would still have a curve... BUT my big toes are not bent over and there are no horrible bunion lumps any more.  I don't get the ankle pain either, although I do find I need shoes which have some arch support.

Sorry, I can't comment on allergies but I have had no bother with the pins/screws.  My surgeon would have removed them if I had had pain from them.

Good luck.

 

7

Hi . I can also sympathise with your dilemma. I am 64 and  had both feet done 4 weeks ago after years of deliberation. The thing that swung it for me was that that the big toes were pushing the next toe to the extent that I had developed arthritis in the smaller toe joints and this was going to get worse. No pain in the bunion joint at all. I am a keen mountain walker and want to keep going as long into the future as possible so finally decided to go ahead. 

I asked my GP to refer me to a surgeon who specialised in foot surgery--ie not a general orthapaedic surgeon --this meant a long trip to a hospital further away but I felt more confident.  I'm afraid I couldn't get any info on success rates either.

Re coping with stairs --if you are normally an agile person I would say that you could get upstairs from day one but you wouldn't want to be going up and down every day to start with. You really do need someone to help even if they are not actually living with you. Is there anyone you could go and stay with?. Maybe you could get advise from the local authority community home care service. 

Can't comment allergies I'm afraid.

Anyhow good luck whatever you decide.

No experience of aller

8

Hi

From the look of your feet I would say you should have the op

I had one foot done 4 days ago under local anaesthetic virtually pain free

I have had very little and certainly manageable since 

I can't comment on your allergies etc 

I can say that with a little planning you could manage without anyone caring for you. Clean house and shop and freeze food to be easily reheated other stuff can be online delivery.

For example you can heel walk with crutches 5 mins each hour

Enough to get to kitchen or bathroom

Put a bag around your neck to carry things

Put drinks in a bottle

Keep wipes meds water books phone and anything else u need by your bed and chair

Strip wash or as I've done put a plastic garden chair in the shower and keep your legs outside covered by a towel

It is certainly not as bad as I was expecting

9

Dear Rr53391.

Oh dear. I have just read your message ad noted your concerns.

Firstly you enquire about infomation and succes rates.

Go to te website of the Royal Naional Orthopaedic Hospital and read its very helpful 'A Patient's Guide to Bunions ( Hallux Valgus) and Lesser Toe Deformities'. You may find this useful.

Like you I have cannot recall wen I last had straight feet and after many years of discomfort and dithering I took the plunge last year to ave surgery on my left bunon nd it's neighbouring hammer toe. I was vry apprehensive that I would end u witha ba outcome. How wrong was. The surgery went very well and apart from throbbing and swelling whchar perfectly normal after is surgery I had one of the severe pain I was warned I may experience afterwards.

My surgeon ( Mr C Mann at Bradford Royal Infirmary has been excellent throughout. I live in West Yorkshire) and not once have I been made to feel that I was a nuisance or indeed had to hurry the time I was allocated at appointments. I had my surgery on the NHS.

Unlike you, I am retired ( 64 years old) and very active  - walking, gardening etc.  -  and have a husband to help me.

I am so glad I have had the surgery after all these years and realise to have not done so would only have resulted in the condition deteriorating. I also live in a house with a steep staircase and only one bathroom and lavatory upstairs.My shower is also over the bath and that worried me and I made do with daily thorough washes until I had confidence enough to put on my 'Limbo' over my bandage and step into the shower. A 'Limbo' is a plastic stocking with a rubber cuff specially designed for people with plaster casts and bandages. They are easily available.

I have been amazed just how I have managed to get about once I got used to my bandaged foot and the special shoe one has to wear for the first few weeks and managed with the crutches. I have been quite surprised.

Now 10 months down the line I am almost back to pre-op. Also, please be assured that I have just had my other foot done on 1st October( this was just the bunion as there were no hammertoe deformities) and again I have been pleased to have done so as this foot seems to be recovering even better than my right foot  - which was actually the worse of the two. Both bunions were classed by my surgeon as substantial with the left foot bunion joint being bent at and angle of 37 degree. My right foot was bent at 32 degrees. Anything of 30 degrees is considered as 'substantial' by the orthopaedic profession.

As for your after care. Sadly, your surgeon is not the person to arrange this. However, I feel sure that if you have a good relationship with your GP the surgery may be able to point you in the right direction in getting a daily visit to help you in the first few weeks. Also, neighbours are usually very happy to feel able to help you out with shopping etc. Also, you may like to look at Wiltshire Farm Foods website with a view to getting some meals for your freezer. There are some lovely ones and not overly expensive and can be easily heated through.

After surgery you will have  to keep your foot/feet elevated above groing level for the first 2 weeks to help reduce the swelling and aid the healing process. Obviously you will be allowed to move around the house but, the recommendation is to limit this to 10 minutes out of each hour.

Take it from me, you will be happy to sit and rest and read and watch tv and listen to the radio.

The recovery time is long and I was filled with trepidation about this given I love to be outdoors and imagined I would go mad. However, the time did pass quicker than I thought and now, I am so glad to have had one success story and am in recovery with my other foot.

I am certainly convinced I have made the correct decision.

I hope my comments will be helpful.

Good Luck.

Gillian

10

Hi, I have had surgery on my 2nd Metatarsal because it kept going over my big toe.  I used to have a high arch on this foot but it seems to have gone.  Like someone else said my feet look normal until I stand.  The surgeon said for won't of a better word it was dislocated I am into my 6th week now, I had a slight infection in one of the stitch sites but other than a sausage toe not too bad.  I got up and down stairs on my bottom at first because I could only walk on my heel for the first week in the post op shoe.  Getting up at the top can be a bit difficult so I then went on my hands and knees to the bed and pulled myself up that way.  All very elegent I must admit.  I do have a downstairs toilet which did help tho.  Hope you make the right decision, the trouble is either way for me the toe got sore and would get blisters so I was having to wear plasters.  I now can get into trainers and I have bought a pair of crocs for indoors because they have a solid bottom and the hospital do not recommend slippers.  I cannot wait to get back to my exercise classes and swimming but it's taught me patience.  I had it done with a Foot Surgeon.  Good luck.

11

Thank you all very much for your help and support and taking the time to reply to me. It is a huge relief to have people who understand to talk to.

I think I will go and talk to my GP and ask the questions I should have asked at the hospital appointment:

1 -Do I have to have both feet done at once.

2 -Can I insist the hardware is removed once the bone is healed.

3 - Can I get any help the first few days after the op.

4 - What does he know of this surgeons success rates.

Thank you

 

12

Hi Gillian,  did you find that once you did start walking about the house more and first trips outside that you felt utterly exhausted afterwards. I feel so unfit with not doing my usual exercise and swimming even though it is 6 weeks on.  I am 67 though and perhaps I should take that into account. The Nurse who changed th dressings and took the stitches out said that you have build up the exercise you do gradually, so that is the answer.  

13

Hi,

I am 5 weeks postop after Scarf Atkin. I had no problems, no pain(when taking Ibuprofen and Paracetamol). I had to stay in the hospital for 1 day. I went home and could from that day on walk, weightbearing on the heel in special shoe. First 2 weeks keep your foot elevated and take just the time to go to the toilet and the kitchen for the most necessary things. I could go upstairs. Toilet for me was easy, one up and one downstairs, but it is managable to do the stairs when necessary. Important go for a real footsurgeon and ask. If you can walk from day 1 after surgery, it's not always like that. Sometimes it's no weightbearing for 2 weeks. That would be impossible for you. For the rest be prepared:use a backpack, thermos,plastic chair in the shower,books ,dvd, tablet or smartphone, some bandage for your foot(you have to change it a few times and you can do it yourself). After 2 weeks I was able to do everything in the house and even some shopping nearby, don't forget to rest a lot in between. When your alone do only one foot, and wait a few months for the second. For me the first surgery was19 sept and the second is 16 jan. For your work: when you have a not standing job, I think you can start from week 4 when you can drive a car( only possible for your left foot when automatic) or when you have public transport very nearby. 

When I see your feet, I think go for it. They will be really bad when you are older and you will have problems even for normal walking. I added some foto's. You can see how it is after 5 weeks.

Succes with your decision.

 

14

Hi there,

Lots of good useful suggestion have already been posted so apart from that I would say go for the surgery for the long term benefit you are only 50and by choosing the foot specialist/surgeon as already advised there is no reason why thing won't work out well I had booth feet done though there were not too bad, I had a very little discomfort . Best wishes and good luck

15

I might seem like I am stuck on one note on this forum, but having had both feet done by the very best feet surgeons in the Uk I can say that having a great surgeon do your foot by keyhole surgery will make it much more fesible to recover on your own, You will be able to weight bear from day one enough to get you up the stairs, be careful though! 

16

This definitely isn't keyhole surgery, he showed me a photo, this looks like major scars.

I asked about the Minimal keyhole thing but my feet are too bad he says which is what I expected to be honest.

Can you name any names as to good surgeons at all?

Thank you

17

where abouts do you live? 

18

London

19

OK I have looked  at your photos and they don't look too different from mine,keyhole surgery uses the same techniques as normal scarf and akin osetomy surgery, the same bone cutting and pins just using a live x ray. Dr David Redfern did my keyhole surgery and Dr Mark Davies did my traditioal surgey 14 years ago ( great long term result by the way). Both work from the London Foot and Ankle clinic in St John and St Elizabeths However, I had them done on my health insurance, I don't think they are NHS doctors, hope that helps...

20

That is the problem. I don't have insurance. Plus this would definitely be a pre-existing condition.

I think I was in contact with the London Foot Clinic to ask for prices and it is REALLY expensive. I contacted a couple of private clinics anyway.

Notwithstanding the loss of earnings while I'm off work.

Germany looked the best bet for keyhole and prices but I wasn't sure they could do mine as too great an angle off true for their procedure to work and anyway  I still don't have that sort of money.

But thank you for the info.

I am not sure if it's wise to proceed with this. I don't think I can do it by myself and I can walk ok as I am, even if people are rude about my defomed feet, so maybe shouldn't go looking for trouble.

Thank you for your help, I will check out those doctors to be sure though.