A Cheilectomy Story

[wdfifteen]

Over the past 15 years or so the hallux (big toe) on my left foot has gotten progressively more stiff due to arthritis. I had to stop running about 10 years ago because of it. For the past 3 years or so I’ve had to limit walking. I walked by rolling my foot off to the left because forcing my big toe to bend was so painful. The messed up gait was damaging my knee. I went from wearing size 10 ½ shoes to size 13, and tried a whole bunch of different orthotic insoles with some success, but the stiffness got worse. I could only bend my toe 15 or 20 degrees without pain. It got to the point where I was walking around like a penguin and not getting the exercise I should be getting.

Last summer my podiatrist said it was time for a cheilectomy – opening the toe up and scraping out the arthritic bone growth. I would be down for 4 weeks, so I scheduled the surgery for winter when I wasn’t so busy. I went under the knife last Tuesday, and I feel better already. I can already flex my toe through about 45 degrees without pain and it is expected to get better as the trauma from the surgery heals. I’m pretty optimistic about this, and actually looking forward to getting my right foot done next winter. It’ll be great to wear soft-soled shoes and I might even get into my old Fry boots again.

Don’t look at the next post if you don’t want to be grossed out.

[wdfifteen]

I was kind of shocked by the look of my foot when he unwrapped it yesterday. My foot was puffy and swollen. My nails were stained yellow from the antiseptic and all of the toes on my foot except the big toe were still bruised looking (they were black for a few days after the surgery). He had written “yes” and some other stuff on my foot. Awful as it looks, I haven’t had much in the way of pain.

This is my first experience with being cut open. The doc put me clear out for the surgery - I slept through the whole thing. He also did a nerve block that kept me completely pain-free for 2 days.

[WPOZZZ]

I hate nerve blocks. They kill all the pain, but you have no use of that limb as well. How did you move around if the nerve block lasted 2 days? I had the nerve block for my 2 shoulder surgeries and my whole arm was useless until it wore off. I had to move my arm with my other hand and there was no sensation of touch. I cold poke my arm with a fork and it was as if I was poking a bag of rice or something not attached to me.

[wdfifteen]

^^
It wasn't that severe for me. I could walk just fine and I had some control over motion of my foot.

[LWJ]

Sounds like a great success!

[masraum]

Wow, cool. I wonder why he put it off so long. It sounds like a year or two ago may have been a bit better.

[Nickshu]

Glad you are on the road to recovery WD. Here's to continued healing and a good outcome for you!

[pavulon]

Originally Posted by WPOZZZ

I hate nerve blocks. They kill all the pain, but you have no use of that limb as well. How did you move around if the nerve block lasted 2 days? I had the nerve block for my 2 shoulder surgeries and my whole arm was useless until it wore off. I had to move my arm with my other hand and there was no sensation of touch. I cold poke my arm with a fork and it was as if I was poking a bag of rice or something not attached to me.

You had an interscalene brachial plexus block (placed on the side of your neck as the nerves exit your spine). Your shoulder is proximal to the rest of your arm so the nerves feeding it are too. Blocking the conduction of signals takes out transmission (sensation and movement to varying degrees) of everything distal to that block.

If it were your hand needing surgery, a more distal block could spare the rest of your arm as it did his foot with what was most likely a block placed in his foot or ankle but possibly a little higher on his leg.

The advantages of blocks are numerous but not without risks or disadvantages.

[Evans, Marv]

Great you are going to be back to your old self - pretty much. Did they say anything about regrowth of the arthritic bone tissue? It must feel so good after so many years of pain.

[pwd72s]

May the healing be rapid...

[Cooper911SC]

Hear Hear to the healing!

Plus I learned a new word today! 😄

Cooper

[Tobra]

That is not gross. I sew better than your guy.

I would suggest you wear an insole with a cutout under the 1st metatarsal head henceforth.

[sammyg2]

Originally Posted by pavulon

You had an interscalene brachial plexus block (placed on the side of your neck as the nerves exit your spine). Your shoulder is proximal to the rest of your arm so the nerves feeding it are too. Blocking the conduction of signals takes out transmission (sensation and movement to varying degrees) of everything distal to that block.

If it were your hand needing surgery, a more distal block could spare the rest of your arm as it did his foot with what was most likely a block placed in his foot or ankle but possibly a little higher on his leg.

The advantages of blocks are numerous but not without risks or disadvantages.

Yeah, what he said.
I hate it when my arm falls asleep during the day, 'cause I know it's gonna be up all night.
Woudn't it be nice if we could take off our arms and hang them up while we're laying down so they wouldn't fall asleep?
Just take one off and hang it up, then grab the other one ..... no I guess that wouldn't work.

[wdfifteen]

Originally Posted by masraum

Wow, cool. I wonder why he put it off so long. It sounds like a year or two ago may have been a bit better.

I was the one who put it off. He told me I would need surgery right away, but it was summer and I didn't want to sit with my foot up for a month. He started giving me cortisone injections. He said, "This should keep you out of pain for two-three months, then I can give you another one. Three of these and you're done." We scheduled the surgery then.

Thank you all for the kind words. This may be a life changer for me.

My old GP, whom I changed from when he retired, never referred me to a podiatrist. Eleven years ago, after I finished the Paris marathon limping, I went to him and told him my knee would start to give out after about 18 miles. He put his elbows on his knees and looked up at me very seriously and said, "You're 57 years old and you need a doctor to tell you not to run 18 miles if it makes your knee hurt?" It was funny at the time, but I really needed more help than I knew. The knee was going wonky because of the way I was twisting my foot when I ran.

[Tobra]

You ought to get some orthotics from the guy and delay or obviate the need for a total knee replacement down the road.

[masraum]

Originally Posted by wdfifteen

I was the one who put it off. He told me I would need surgery right away, but it was summer and I didn't want to sit with my foot up for a month. He started giving me cortisone injections. He said, "This should keep you out of pain for two-three months, then I can give you another one. Three of these and you're done." We scheduled the surgery then.

Thank you all for the kind words. This may be a life changer for me.

My old GP, whom I changed from when he retired, never referred me to a podiatrist. Eleven years ago, after I finished the Paris marathon limping, I went to him and told him my knee would start to give out after about 18 miles. He put his elbows on his knees and looked up at me very seriously and said, "You're 57 years old and you need a doctor to tell you not to run 18 miles if it makes your knee hurt?" It was funny at the time, but I really needed more help than I knew. The knee was going wonky because of the way I was twisting my foot when I ran.

OK, this is fantastic news. It sounds like it's definitely going to be a life changer for you.

OK, the story is quite funny, but you're right, probably not what you needed. I'm sure he was pretty good, but also kind of like a coach that thinks that you should "walk it off" for everything.

[Bob Kontak]

Originally Posted by Tobra

You ought to get some orthotics from the guy and delay or obviate the need for a total knee replacement down the road.

Not only obviate but a delay in perpetuity.

[wdfifteen]

It's been 10 weeks since the surgery and the pain persists. The podiatrist gave me a cortisone shot three weeks ago and it did not good at all. I went back to see him yesterday and he says I'm going to have to have the joint replaced.
Looks like it will take about a month to recover and I can't take a month off now. Looks like I'll be hobbling around like a penguin for a couple of more months.

[Tobra]

It was always a matter of when you were going to get it fused or replaced. You don't get that problem and need that procedure if the joint is working as intended.

Did the changes to the shoes help at all?

[wdfifteen]

Originally Posted by Tobra

Did the changes to the shoes help at all?

Big time! I can't walk more than 5 minutes if I don't put the plates in my shoes. I made a second pair so I don't have to swap them in and out when I change shoes.