Fun with Foot Surgery After 50
We go to the doctor and they say, “At some point you might want to get that fixed.” Apparently, our 50s are that “some point."
Some of you may have read this on TueNight.com in December, but we’re reposting this here to share a few podiatric updates…
In our 20s, 30s and even 40s, we go to the doctor and they say, “At some point you might want to get that fixed.”
Apparently, our 50s are that “some point.” You’re not a senior citizen and the doctors still tell you things like “Well it’s good you’re doing this while you’re young…”
Eyes flutter: “Go on…”
Meet bunion. This thing on my foot. She’s been my little sidekick for a good 20 years: a pointy, red knob that juts out from my big toe joint alongside her curvy neighbor, hammertoe, a claw-like second toe.
Two of the least-pleasant sounding words in the English language, connoting decrepitude and busted dogs. That is, until you hear the more scientific word for bunion, “Halgus Vallux,” which sounds like you threw up in your mouth.
Really, the names alone make you want to rid them from your body.
Both were formed through a mix of genetics (mom has them), pointy fashionable shoes, a lifetime of city walking and, well, they just happened. In recent years, I’d been able to keep pain at bay by never ever wearing anything with a heel (if I did it would send me into a month of excruciating pain and a slate of physical therapy). My late uncle, an orthopedic surgeon, always told me to avoid surgery as much as possible, he said unless it hurts, don’t fix it: I could manage through shoe choice and stretching. Which I did, for a while.
Until this summer.
We’ve been trying to get my parents to use assistive walking devices to much grimacing; here I lunged at that thing like it was an old friend.
My niece was visiting NYC by herself for the first time and I wanted to take her everywhere. We covered massive Brooklyn territory, hoofing it to museums and restaurants and ice cream shops and my feet wanted to fall off, even wearing my bunion-knee saving sneaker of choice: Asics Gel 3000. I was noticeably limping. “Aunt Margit? Are you ok?”
It was time.
First, I made an appointment with a folksy podiatrist in Brooklyn who had a reputation as the local go-to for foot issues. Rolling my foot back and forth in her gloved hand while looking at an x-ray, she immediately assessed that, yup, I needed surgery. She suggested a relatively new surgery called lapiplasty which she could do at a nearby hospital, though she wasn’t affiliated there but they let her come in on off days. (Weird.) I’d be off my feet for months and couldn’t be weight-bearing. She handed me a lapiplasty pamphlet and said, I could do this next week if I wanted.
Part of me was oddly thrilled by acknowledgement that I had something that needed to be — and could be — fixed. But gah! Too soon! A I had some reservations. I always like to get a second opinion — that of a surgeon or M.D. versus a DPM. Also, to be real, I was a little put off by the fact that this doc took only cash and didn’t know how to share X-rays with another doctor for a second opinion. And she only took cash. Red Flag, as the kids say.
Amazingly, Doctor #2, an orthopedic surgeon at a top orthopedic hospital, wasn’t too keen on the invasive surgery the podiatrist had suggested. She noted the arthritis in my toe and how the hammertoe had curled around the fat pad on my foot and that these required a more nuanced, minimally invasive approach for both toes, where I’d have tiny incisions cut and the bones realigned with screws. “I’ll be honest with you, it might fix it temporarily and we’ll need to do more work in five years…or it could do the trick,” she said. While I really don’t want to anticipate more surgery, I appreciated her truthful assessment. The recovery time would be six weeks, as opposed to the four months the podiatrist suggested.
Tell someone you’re going to have bunion surgery and for every “Oh, my friend did that, changed her life,” two more people will tell you a horror story
By the way, tell someone you’re going to have bunion surgery and for every “Oh, my friend did that, changed her life,” two more people will tell you a horror story: It didn’t work, the bunion came back, the recovery got botched. In fact, during our last storytelling event someone told me they were suing their doctor because they wrecked her foot. “ Where are you having your surgery?“ “Hospital for Special Surgery?” “Oh, you’ll be fine.”
I scheduled bunion surgery (with the surgeon, not the podiatrist) two weeks before Thanksgiving which meant I wouldn’t be able to attend any festivities or travel during the pandemic. I’d just have to Netflix and recover. Gee darn. My biggest concern was how I would return from surgery, way uptown in Manhattan, in an Uber, and then, somehow, get up my steep two flights of stairs to my apartment — all after I’d been given a nerve block anesthetic behind my knee, which meant I couldn’t put weight on my foot for 24-48 hours. Would I hop up the stairs? How do people do this in New York City?? Anticipating this, and lucky enough to be able to afford this, I got an accessible hotel room for a few days near the hospital so I could be wheeled into a first-floor level and let the nerve block wear off before even attempting those stairs. Also, a friend had recommended Mobilegs, ergonomic crutches that create shock absorption and not so much underarm pain. That said, trying them before surgery, I could walk only about four steps on one leg with them. How the hell would this all work? I was trying to be as prepared as possible, but this was one giant unknown. “You’ve been through worse,” said several people, referencing my previous bout with cancer. True, I guess, but I’d never had someone put metal stuff in my foot? (Cancer does not make you some sort of superhero, people.)
A few hours before my scheduled surgery, a physical therapist showed me how to walk with crutches and go upstairs: “up with the good [foot], down with the bad.” And then he handed me a walker and said, “you should just use this.” “Oooo” I nearly squealed. Much easier. We’ve been trying to get my parents to use assistive walking devices to much grimacing; here I lunged at that thing like it was an old friend.
My surgery, scheduled for 3pm, was three hours late and now slated for 6pm — “The surgeon is backed up,” a nurse told me. “Everyone is trying to meet their deductible for the year and get stuff done before the holiday.” I told her, “Oof I can’t do anything complicated at 6pm.” The nurse smiled and I thought I caught a glimpse of “Right??” but then she assured me, “Well that’s why she’s the pro.”
The rest is a post-anesthetic blur, the doctor came in and seemed pleased, pointing out a small ball on the top of my hammertoe which looks like a little spy camera. “That will keep it straight.” She told me she had needed to do a little more than anticipated once she got in there. The rest of my foot was bulky and bandaged and they gave me a walking boot.
Somehow my husband, Mark — my tireless, supportive husband — got me into a car and over to the hotel. Did I say, THANK GOD I GOT A HOTEL? I did, but it should be noted that this hotel, being on a first floor, and a walk-in shower with a very large drain appealed to some small visitors. After a dramatic killing of a live roach nesting behind a coffee cup — I was too woozy to care — we settled in for a couple of days.
The first time I saw my new foot I had a mini panic. Where did my old foot go?
Then on Saturday, I headed home to navigate those stairs. Mark called a friend to co-spot me in case things got tricky. But I did it all by myself, I’m proud to say, and up-with-the-good footed all the way into my apartment. And I stayed there for two weeks, elevating my foot as prescribed, 80% of the day. Until the stitches came out — at which point the doctor’s assistant noted, “Looking good!”
So here I sit. Almost week four. Pillows propped strategically behind me and under my knee. Positions can last for only about 10 minutes until I start to feel an ache and then it’s shift, flip, adjust. Same for sleeping. My foot is elevated high, just above my heart to let the fluid and blood drain and reduce swelling. I’m now icing three times a day, micro-stretching my toe and wearing a splint at night. It’s clear that the hardest part of this is patience, but every day my foot looks a little less bruised.
The first time I saw my new foot I had a mini panic. Where did my old foot go? This new foot, albeit dotted with protective Steri-Strips, is slim and straight. Bunion has left the picture. Hammertoe is now just Toe, straight as a rod (it also still has said rod sticking in it, and out of my toe, until January). I almost miss my old friends, something I’d built up and fashioned for two decades from years of living, dancing, walking, and those chic, but dastardly shoes. Now they’re gone. And if I’m lucky, never to return.
I’d earned those sidekicks. And now I’m bidding adieu to a bit of my own history. Isn’t that just midlife? Shedding the shit we accumulate is both therapeutic — and quite hard. But I’ve traded in for a new model, better mobility, and maybe, perhaps, the chance to wear something with a little heel.
Welllllll…..I wrote that in December 2021. It’s now April 2022. Since then I’ve had about four months of physical therapy which has mostly fixed my toes, I can wiggle the big toe, I can mostly move the second toe, though as predicted it’s going to permanently float. It’s no longer hammertoe, it’s float toe. Fine. I can walk. Mostly.
Somehow, in February, while I was in physical therapy, while standing on one of those plastic bouncy half balls to work on my balance, I tweaked my ankle. Nothing broke, nothing fractured, but in trying to heal my toe I screwed up my ankle. The next day I was left with a swollen, painful red bump on the side of my ankle that, to this day, is still there. I’ve seen three doctors — my foot surgeon, primary care doc, and a rheumatologist — and none of them can figure out what it is. The foot surgeon prescribed some crazy strong anti-inflammatory (The label: “Can cause heart attack!” Great.) and suggested maybe laser treatment which I had once, and is basically someone shining a strong laser on your ankle for 10 minutes. “It kinda feels like sunshine,” said the technician. It maybe helped… a tiny bit.
When I asked the rheumatologist if he thought the laser treatment would help, he said, “I don’t know what that is.” He slid back on his wheelie chair, folded his arms and just glared at my ankle from a distance, thinking. “Just don’t bump it,” he said. “And be patient. It’s in a bad spot. I think whatever it is, it will go away, but just keep elevating it, ice it, don’t bump it.”
So here I am not bumping it. I think it might be getting better, through trial and error I’ve learned to that compression socks also help, anything to get the blood flow moving helps, and shoes that don’t rub my ankle — Dansko clogs FTW!
If I’ve learned anything in these decades of being in this body, it’s these three clichés:
1. Nothing is ever a quick fix.
2. Sometimes when you try to fix one thing you screw up another (maybe that bunion was serving another purpose and my ankle is trying to compensate??)
3. Patience is an absolute virtue.
So, until next time, I’ll be elevating.