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Surgery Chronicles: Start Here

I alluded in my last post to upcoming foot surgeries I'd soon be posting about. I'm now 19 days away from the first one, and my thoughts pretty constantly revolve around how my life will change after that when I wake up from my "twilight" sleep after the first operation. In my best frame of mind, the scenario is like this: I'll spend a few weeks out of commission, getting some forced rest, spend a few weeks in a boot, limited exercise, and my right foot will be recovered. Then I repeat on the left foot and by fall I'm back on my feet again. That's the Twitter version. But the version that most often plays out in my head is more like a volume of books, with the details of every day painstakingly planned, agonized over, and wondered about. How will I make food? Bathe? Focus on work? Get the mail, take out the trash, do laundry? Will I be in a lot of pain? Will I go crazy during my long days isolated at home? Will people forget about me? Will I get the results I want in the end? If the answer to the last question is yes, then the rest doesn't matter. It might in the moment, but I know it will all be survivable.

My 'Bony Prominence'

The procedure I'm having on each foot is a bunionectomy with osteotomy, which just technically means removing the bunions—what foot doctors like to refer to as a "bony prominence," which I think is adorable—from my feet and realigning the first metatarsal and hallux (big toe) to a more natural position. (I've learned so much medical and anatomical terminology that I have to use it somewhere.) Most people, particularly women, have some level of bunions. The women's fashion industry has made sure of that. But sometimes bunions are hereditary, as in my case (I'm pretty sure I came out of the womb with bunions), and they progress over the years until they someday cause problems, as in my case. I've almost never worn heels, or even fashionable shoes for that matter, but the progression happened anyway and is only likely to get worse.

One of few photos of me with all nieces, but I cringe at my feet in it (something others probably never would have noticed).

Another niece photo I super-duper love but am self-conscious of.

And another.

Another.

Although I'm emphasizing my displeasure with the appearance of my feet in these photos (at the gross neglect of the sweetness of them), I wouldn't undergo this surgery purely for aesthetic reasons. But you can probably see how the structure of my feet can cause poor mechanics and other issues that—not to worry—I will elaborate on.

Impediment to Running

While I have been able to enjoy an active lifestyle, swing-dancing feverishly in my young adult years and getting into long-distance running in my late twenties, I eventually started to sustain foot injury after foot injury, and it was suggested by more than one doctor that the underlying cause was likely my bunions, putting pressure on other areas of my foot and causing inflammation and pain. So I'd considered this surgery before but always decided in the end it wasn't truly necessary, and therefore I shouldn't do it.

Been here before. This was my second go-around in the boot (glad I didn't get rid of it!)

Beyond Running

But now it's more than just about running. I've been able to return to some level of running after each of my foot injuries, even if not to the level I'd hoped, and that was acceptable to me. I found other activities that I found satisfying. But recently I've experience newer problems that affect me on a daily basis. I can rarely find shoes that are wide enough not to squeeze my feet, and when they squeeze my feet they cut off circulation and cause numbness in various areas. And then a new nerve thing happened, and suddenly I had an area on the top of my right foot that became very sensitive to touch and triggered a sensation down to my big toe. And sometimes I get a cool, tingly sensation on the inside of my right lower leg. Well it turns out there's a nerve that runs along that whole area and is likely being compressed by my bunion. So now if I wear a shoe that touches that inside part of my foot—and most shoes do—I feel the irritation constantly, unless I cover it with a strip of KT Tape, a trick I discovered accidentally. I wouldn't call it pain, but it's nevertheless very unsettling. Also, I have a thing in the second-to-last toe on my left foot that is likely nerve irritation from my toes being squished from—you guessed it—pressure from my bunion. And I'm also developing arthritis at a fast rate in my left first metatarsal joint because of the diminishing cartilage that has resulted from the misalignment caused by ... my bunion!

Deciding on Surgery

So, while the idea of having surgery on my feet was, and often still is, terrifying, the idea of going through the rest of my life with these current issues, and what will likely become more, is worse. I could do things to manage the pain and irritation—tape my toes and feet daily in strategic and complicated ways that will ever so slightly minimize discomfort; I could stop running; I could wear custom orthotics every day (that would have been acceptable if it were the only modification I'd have to make), sleep in an a bunion splint every night, take my shoes to a cobbler to have them stretched, and then stretched again because they didn't do it enough the first time—these are all things I could do instead of surgery. And someone else might choose that direction. But I like to think I have a lot of years left to be active, hopefully even running, and if this surgery can give me those years and better quality of life overall, then it really isn't a choice for me; it's just what I need to do. I'll endure the difficulty short-term for the long-term health of my feet.

One of the simpler taping strategies.

The Surgery Itself

If you're squeamish, you might want to skip to the next section. It's pretty cool, actually, what can be done through medical technology to improve the human body. Personally, I'm not interested in body modification unless I feel it's truly necessary for better quality of life, and believe me I agonized over this decision and questioned my morals, ethics, values. But that's me. Anyway, for the procedure, the surgeon will first make an incision lengthwise on the inside edge of my foot roughly from the big toe base to the top of my arch. Then, he will use a tiny surgical saw (I can't help but picture a shrunken-down version of a chainsaw) to "shave" off the protruding bone, the bunion. Once he says adios to that sucker, he will use the same instrument to make a v-shaped cut near the top of my first metatarsal head, surgically breaking the bone so he can then straighten it out and secure it with tiny titanium screws that will, god willing, forever be a part of my body (one risk is that they could come out of place at some point in time and I'd need another surgery). So the recovery is largely to heal a broken bone. Sure, the incision will need to heal, but that shouldn't take long. The reason I need to be so careful in those initial weeks is because the re-placement of that first metatarsal needs to "take." That's my new foot. I can't mess it up.

My visual interpretation of the procedure, which could be off, but it's what makes sense to me.

What Happens Next

On May 17, my dear mother who just retired and moved to the east coast of Florida to enjoy some leisure will drive across the state to get me, take me to Lakeland (because that's where I think-hope-pray that I found the best surgeon) for the right-foot surgery, and stay with me until I think I can survive on my own. And by "on my own" I mean she'll transport me to my sister's place in Tampa where I'm hoping my two young nieces will think it will be fun to bring me food and drink and keep me entertained when I need it, because I won't be able to do a whole lot for myself that requires getting up from a sitting or lying down position. I'll have crutches, but I won't be able to bear weight on my foot, even in a boot, for a few weeks, from what I understand. I'll work from home, and I'm very grateful my employer will allow that. But I think I will go a little stir-crazy. I know I will. I have a hard time spending one whole day at home by myself. Even though I do a lot of things independently, I'm in public spaces doing those things. Coffee shops mostly. Once my family are all sick of taking care of me, I'll eventually be home by myself and will have no choice but to be immersed in my own thoughts, which is what I generally try to avoid by being in public spaces.

After a few weeks, I'll be able to walk around in a boot, but only as necessary. Then, after a mere six-to-eight weeks, I'll be out of the boot and can once again drive. This is a factor I did not take into consideration after scheduling everything; I'm going to have weekly follow-up appointments in LAKELAND and will need to depend on others to take me there. (I'm accepting volunteers, by the way. Will pay for gas and a meal of your choice, but you have to take me there, too.) But I am very lucky that I have such a supportive family and a couple great friends who will help me get through all of this. I literally don't think I could do it without them. So after nine weeks, just when I'm able to freely walk around sans boot, I'll do the whole thing over again on my left foot, but at least I'll be able to drive after a few weeks.

But for Now...

I've been planning for this surgery since my consultation in February. Not one day has gone by that I haven't thought about how I'll need to prepare. I've been keeping a list in my phone that I add to now and then. Stock up on necessities, rearrange furniture, plan meals that I can freeze, get an anti-inflammatory recipe book to help speed recovery (even if it only has a placebo effect), develop workouts I can do seated or on my back or stomach (should be interesting), look into UberEats, Shipt, and other services that will come to my door with things I need. The planning helps ease my anxiety so I'm not focusing only on my fears (which have been many). But also, I'm appreciating all that I'm able to do now. I'm still running, swimming, biking, not at a high capacity but doing it all nonetheless. I'm appreciating every moment as though it were the last. Maybe that's a little morbid drastic, but I know I'll have to be very patient to get through this with the best results, and I don't want to constantly think, when can I do this or that again, because that will just cause frustration and disappointment. Things I don't need.

What I do need: support. Mental, spiritual, physical—I'll take anything anyone can offer! And I need to maintain perspective and find the lessons and silver linings in each day so I don't just try to bypass these several months of my life. All of it matters; not just the days I have full physical ability. There's more to me, to life, than that. I might have to discover what some of those things are for the first time, but when I do, I will let you know what they are over the coming months.

Comments

May I ask which Dr in Lakeland? I'm also having surgery in a few months and a friend told me about your blog. I'm going to Dr. Werd. Thanks!

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