Thursday, September 29, 2011

8 Days Post-Surgery

So I went to the doctor yesterday. Things looked very well. The doctor took new x-rays of both feet. He said they both looked great and the incision was healing well. He gave me a compression sock for my left foot to help with the swelling that was still happening (even 4 weeks after surgery) and told me to take it off at night when I sleep. Also, I still had two sutures at the incision sticking out on the left foot. The nurse clipped the two sutures, which didn't hurt, and that foot was all done. For the right foot, I am still to wear the ACE bandage and boot to help compress the foot to keep swelling down. The doctor scheduled another check-up appointment for 4 weeks from now.

Here is a photo of my foot 1 week after surgery:

As you can see there is some bruising around the incision. What you can't see in these pictures is the additional bruising that has escaped away from the incision and is now along the outer side of the foot and on the toes. The bruising along the outer edges of my foot and toes does not hurt. The incision hurts, but is about a pain level 4 when pressed on and feels like a bad bruise...just sore.

I'm able to get my foot wet now. But during and after showering today, my foot was hurting because of the pressure from the swelling. I immediately wrapped my foot back up with the ACE bandage after the shower and it felt much better right away.

My next milestone is being able to drive. I need to be able to get my foot into a surgical shoe (instead of boot) to be able to drive. I have a surgical shoe, but the amount of swelling in my foot has prevented me from being able to Velcro the straps closed. I feel that in a day or two the swelling should be down enough. Otherwise, I'm getting around really well. I'm able to stay up on my feet all day at home without experiencing any pain.

I expect that before my next doctor appointment I will be back at work. I work as a waitress and need to be able to fit into my non-slip restaurant shoes before they will allow me to come back. My goal is to be able to begin working again two weeks from yesterday (3 weeks post-surgery).

I will continue to keep you posted!

Tuesday, September 27, 2011

6 Days Post-Surgery

So today is Monday, 6 days post-surgery. I have had trouble with my laptop and haven't been able to post much since Thursday. I'm doing great now. I believe I finished all the Demerol I had on Friday night and have been using regular over-the-counter Ibuprofen as needed since then. For the most part, I haven't needed to take the Ibuprofen around the clock. Each day I was able to get around more, but today was the first day that I was able to get up and stay up all day, with only a few minutes sitting. I was even able to stand for 2 hours to cook a nice dinner. The only pain I have now is from the incision. The incision feels tight and dry and has occasional shooting pains, but is definitely bearable. I just put ice on the foot when I feel the pain and take an Ibuprofen and I feel better.

I've been wearing my boot a little less everyday and by Saturday night, I was able to leave the boot off the entire night while I slept. (Although I wouldn't recommend this if you are not sleeping alone because of the chance of bumping your foot through the night). Of course, when I was up walking around, I always tried to wear my boot.  There have been a few occasions that I tested out my foot without the boot, but this isn't recommended.

Tomorrow I will be heading to the podiatrist for my 1 week check-up. I expect that I will get another X-ray. Then the doctor will come in and remove the ACE bandage and then the gauze (which has not been removed at all since the surgery), inspect the surgery site and re-wrap it with a new ACE bandage. And if everything looks good, he should also tell me that I can get my foot wet.

I'll be sure to let you know how the appointment goes tomorrow!!

Thursday, September 22, 2011

57 Hours Post-Surgery

So after 2 days with no shower, I decided to take one. I wrapped my leg directly on the skin, above the boot but below the knee, with duct tape. Then I covered the boot with a trash bag and then duct taped the trash bag to the duct tape on my leg. I put a stool in the bathroom with me in case I got dizzy and needed to sit down during my shower. I didn't get dizzy or need the stool. And thankfully, I was successful at keeping my boot and everything dry. I feel clean now, but I'm tired. I was able to stand the whole time on my foot without any pain. But the standing for so long for the first time in 2 days made me tired.

So, now I'm relaxing and eating some supper. I have been keeping up with alternating the 2 Demerol and 2 Ibuprofen every 2 hours, which has proved to be the most successful way of managing my pain. I am excited to say that my pain level is now at a 1. I couldn't be happier with the recovery process!!!

I'll keep you updated.


Before and After Photos from My First Bunionectomy

Three weeks ago, I had my first Austin Bunionectomy done on my left foot. I thought I would post a before and after picture to help you see what it looks like.

3 Weeks After
The incision is healing well as you can see on the after photo. I currently have NO pain in my left foot, 3 weeks after surgery. I'm able to keep my foot unwrapped at this point and make sure to wear my surgical shoe (not boot) when I'm walking on my foot. There is still a little swelling and redness on the after photo, but this is normal. The incision is still healing. There's still some scabbing left along the top and bottom of the incision, but most of the scabbing has come off. The incision does itch some, but is all part of the healing process. I'm able to bend my big toe, but have some limited mobility in it. I think that as the incision heals, I will be able to move my big toe more. The pin they placed below the big toe joint is permanent and I cannot feel it at all. Overall, I'm very pleased with the surgery and recovery and would highly recommend this to others. I have less pain now in my left foot after surgery, than I did before surgery with the bunion. Hooray!!

I will continue to post on my recovery from my right foot to let you know how that goes!


54 Hours Post-Surgery

Well, since my last post, I've had technical difficulty with my laptop. The keyboard decided to not work correctly, so I've now hooked up another keyboard to my laptop so that I can continue posting.

Yesterday after my last post, my pain level increased to an 8. But after taking the 2 Ibuprofen, the pain decreased to probably a 4. I have been alternating 2 Demerol and 2 Ibuprofen every 2 hours since then. Apparently the Ibuprofen is working wonders!! I have very little swelling, even without icing my foot. And my pain level now is probably a 2. I am able to walk on my foot with the boot without much pain at all. I would have to say that deciding to take the Ibuprofen between doses of Demerol has been the most helpful thing so far. This is something I did not know to try after my first bunionectomy 3 weeks ago and would have been extremely helpful to relieve the pain I was experiencing.

Since I have been able to get my pain level down so low, I've been able to sleep a lot during the last 24 hours. I feel rested and feel that the recovery is going very well.

I'll be checking in again soon to give you another update!


Wednesday, September 21, 2011

28 Hours Post-Surgery

Its now 2:30pm. I'm feeling more pain now and would rate my pain level at a 6. Its becoming uncomfortable. When I move my foot or boot, there is an ache and sometimes sharp pains just below the big toe joint. The numbing is almost completely wore off. I think my big toe itself is the only thing numb now. The joint is becoming not numb. So I decided to take 2 Ibuprofens at 2:00pm between my Demerol doses to try and alleviate some of the pain. I'm able to feel the swelling and pressure on my foot and the boot seems to feel tight. I took the boot off to see if I can loosen the ACE bandage some to try and relieve some of the pressure on my foot. I re-wrapped the ACE bandage as loosely as possible and that seemed to help. Having the boot off for a few minutes feels good too, but I need to make sure and not walk at all without my boot on. I think the swelling is what is causing most of the pain.

I had a cup of coffee earlier to alleviate any headaches. But now I'm feeling sleepy. I will try to take a nap now and see how I feel. My next dose of Demerol is not for another hour, and if I can sleep off that hour, I'll be glad! The pain level is now increasing to about a 7. I expect the rest of today and tonight will be the most difficult to get through, but I don't expect the pain to become excruciating...just really uncomfortable.

I'll check back in with an update later.

[Right Foot 28 Hours Post-Surgery. The ACE
Bandage is loosely wrapped.]


26 Hours Post-Surgery

So I got some good sleep! Its now 12:30pm on Wednesday, the day after my surgery. I was finally able to fall asleep at 4am! I set my alarm to wake up at 6am so I could get up and take more medication but I slept right through my alarm and didn't wake up until 11:30am. Even though I was 5 1/2 hours late for taking my pain medication, I was doing alright. Most of the numbing has wore off, except for about 1/3 of my foot where the big toe and joint are and also the incision where the surgery was performed. I could feel the swelling had increased to the point that my boot was fitting tight. I immediately took 2 Demerol at 11:30am and then ate a slice of pizza. I took the boot off and placed an ice pack on my foot. I would have to say my pain level is now at a 4. Still bearable, but getting a little uncomfortable. I'm also hoping that using the ice pack will help some.

The pain I am feeling is more of an ache, similar to a pulled muscle, right below my big toe. I am also getting a sensation of itchiness occasionally, probably where the incision is healing. I want to scratch it, but know that I can't. The feeling is definitely bearable, which comes and goes. Its very important not to uncover the incision area because we are trying to prevent infection. The doctor also puts an antibiotic gauze over the incision to help prevent infection. That's another reason why its important not to get the bandage wet. Infection would be the worst case scenario. It would cause extreme pain and swelling!

After removing the ice pack, I noticed that my foot didn't feel any better. I think the ice wasn't really getting close enough to my foot to make a difference. So I unwrapped the ACE bandage and put the ice pack directly over just the gauze covering my foot. I can feel the cold on my foot now and its making it feel better already! The best way to hold the ice pack on the foot is to just wrap it with an ACE bandage. And once the 15 minutes is up, I will remove the ice pack, put the ACE bandage back over the gauze, and then place my foot back in the surgical boot. I'm keeping my foot elevated at least 6 inches above my waist at all times to keep the swelling to a minimum. The more swelling there is, the more intense the pain gets.

One other thing I'd like to note is that I've had no trouble walking back and forth to the bathroom with my boot on. I have not needed crutches or assistance and putting my full weight on the recovering foot doesn't hurt. Its amazing how much support the surgical boot gives me!

I'm going to check back in for an update in a little while.


16 Hours Post-Surgery

It is now 3:30am and I have to say I haven't slept. I'm having difficulty getting sleepy and it is not related to pain or the surgery. While I must admit that drinking the "small" cup of coffee earlier took my headache away, and even though it was a small amount, the coffee left my mind going. My mind seems to still be on, while my body is tired. I would have opted for the caffeine from sweet tea earlier, but I'm not sure that would have made a difference in how my body handled the caffeine. At least my headache is gone. And other good news is that my pain level is still at a 2 and there is no less numbness and no more swelling than in my previous update. And thankfully, I am still not experiencing any nausea.

At 2am, I finally took my next dose of Demerol. (This time I went ahead and took 2 Demerol at once, knowing I will need to sleep some between doses, and may not wake up at exactly 4 hours.) I made sure to eat some cheese and crackers this time with my dose and have so far not had any indigestion. I also took my nighttime prescription medications that I am prescribed for another medical problem I have (unrelated to my feet) and expect that the side effects from the nighttime medication will make me drowsy soon. I can only hope!! [And I also make a note to self: Drink coffee earlier in the day tomorrow to ward off any headache and prevent myself from being awake so late into the night...]

I will check back soon and give you an update!


Tuesday, September 20, 2011

12 Hours Post-Surgery

Its now 10:30pm, 12 hours after my bunionectomy. Since my last update I have noticed some of the numbing wearing off on the right (outer) side of my foot. I can feel my last two toes and their joints, which feel swollen and difficult to move. My pain level is now at a 1, meaning I am beginning to feel discomfort and very little pain. (On a scale of 1-10, 1 would be very little pain and 10 would be extreme pain). I did unwrap the ACE bandage on the foot and re-wrap it loosely, which seemed to help relieve some of the pressure on the toes I can feel. And taking off the boot for just a few minutes to re-wrap the ACE bandage also helped me to feel a little bit more comfortable.

At 8pm, I took another Demerol (which would be 3 hours after my last dose). And then again at 9pm, I took another one. I have no nausea from the Demerol or from anything else, so I have not taken any of the Phenergan since I got the script filled. After I took the two doses of Demerol at 8pm and 9pm, I realized I hadn't ate anything and soon after noticed some indigestion. I took two Tums and they seemed to help right away. So now, I am eating some leftovers to help curb my appetite through the night and have something on my stomach. I seem to have a slight headache (maybe from caffeine withdrawal - I usually drink a couple cups of coffee or glasses of sweet tea a day and have missed having them today). I am a little surprised that the Demerol is not taking my headache away...hmm. So I decided to have someone fix me a small cup of coffee to see if that will alleviate my headache. I definitely don't want to drink too much caffeine with the medication I am taking. The last thing I need is to get nauseous at this point! I also have only iced my foot once today, which was shortly after I arrived home. I plan to try that next to help with the swelling. (The suggestion of putting an ice pack on the foot for 15 minutes out of an hour was optional, depending on the swelling and pain/discomfort level. This is not something they ask you to do EVERY hour, but it is a guide for the MAXIMUM amount of time to leave ice on your foot.)

The only other discomfort I am noticing is I can't seem to get comfortable sitting up.  My leg is also getting tired from being in the elevated position for so many hours. Laying down will be my best option to relieve that. I will still be able to elevate my foot, but just turning on my side to elevate it that way will help. I think I will be ready to sleep again soon. By staying awake most of the day (except for a short 30-minute nap I took) I am hoping that I can sleep through the night tonight. I am planning to get to sleep by 11pm and basically sleep until my next dose of Demerol, which will be at 1am. And hopefully, I will be able to sleep for another 4 hours after that.

During the next 24 hours from now, it will be imperative for me to take my pain medication as often as prescribed (a maximum of 2 Demerol at a minimum of every 4 hours). Once the numbing wears off, which is usually 12-24 hours after surgery, the only thing that will help the pain will be the Demerol, elevating the foot to keep swelling down and also icing it as the swelling becomes uncomfortable. If I miss a dose or am late taking the Demerol, the pain level will continue rising and will be very difficult to get back down to a tolerable level. I expect that tomorrow (Wednesday) will be more painful for me, so I am determined to keep it under control.

I'll check back in for an update later. Buenas noches! (Good night!)


9 Hours Post-Surgery

So its now 7:30pm. I have to say my foot is still almost fully numb. I can feel my pinkie toe (barely). Otherwise I still have no feeling in my foot from the ankle down. I took another dose of Demerol at 5pm and had supper. My pain level is still a 0 but I'm feeling a little bit of pressure, mainly from swelling. The nurse told me if I think the ACE bandage is getting too tight with the swelling in my foot that I can loosen it some. Also, she told me if the pain gets bad later on that I can alternate taking the Demerol and Ibuprofen every two hours.

Okay, I'll check back in later.

The Day of Surgery

Right foot before surgery.
[Note: The bunion is the bone protruding from the left inside part of my right foot,
just below the big toe. Notice how the big toe leans to the right.
The pain I was experiencing was coming from inside the joint
where the bunion is.]

Two weeks ago, I saw my podiatrist and he suggested I have a surgical procedure done, which is called an Austin Bunionectomy, to correct the bunion on my right foot. For me, this meant outpatient surgery where they would shave the side of the bunion off, shorten the bone below the big toe joint and re-set it, placing a pin inside the bone to hold it in place. I was told that unless there were complications, this pin would be permanent. This would create an alignment of the big toe bones which could possibly alleviate my pain if everything went well through recovery. I agreed to have the surgery done and it was scheduled for today, Tuesday, September 20, 2011.

I was told to arrive for my surgery today at 9:15am and that surgery would start at 10:15am. I was not to eat or drink anything besides water or soda after 2:00am today and not to drink anything after 7:00am this morning. I made sure to eat my supper around 11:00pm last night so that I wouldn't be very hungry this morning. Because of other medications that I take in the mornings, I was told I could have water (or in my case, I was allowed to drink Crystal Light-flavored water) to take my medications, but to only have a small amount just to wash down the pills. I was asked to remove the nail polish on my right foot and not to wear any jewelry, cosmetics or perfumes. If I wore cotton underwear, I would be allowed to keep them on.

I arrived at the outpatient surgical center at 9:00am. I went inside, filled out some paperwork and waited to be called back to be prepped for surgery. At around 9:30am, they called me back and I was asked to completely undress except for my underwear and put on a gown. They checked my blood pressure, heart rate and we discussed my medical history and allergies. Then a nurse started an IV line in my left arm, just above the wrist. I was hooked to a bag of fluids and waited for the doctor to come in and go over what would be done today. The doctor came in and marked an X on my right foot and verified the procedure being done. I waited a few more minutes and then the anesthesiologist came in to talk to me and get permission to have a general anesthesia done (which means I would be put to sleep for the procedure). 

Next, they wheeled me into the operating room at 10:20am. Right away they put me on the operating table and placed straps around me to keep me from falling off the table. They injected my IV line with a round of antibiotics, and a small amount of sedative. As I watched them prepare the room and my foot for the surgery, around 10:30am, I was given the rest of the general anesthesia and was immediately asleep for the procedure.

Shortly after the surgery, I was wheeled into the recovery room and woke up around 11:30am. A nurse got me a cup of coffee and I came out of the sedation pretty quickly. I felt no nausea or pain. With a little help, I was able to dress myself. They had already wrapped my right foot with gauze and a layer of ACE bandage and a nurse placed a surgical boot on my right leg. The surgical boot also has an inflation device inside, but I was told not to inflate it yet because of the swelling that was occurring in my foot. I felt no pain whatsoever. I could tell that my foot from the ankle down was numb. It felt just like it does when I sit on my foot for too long and it falls asleep. I could wiggle my toes, but felt no pain. Within 15 minutes I was helped out to my car and my waiting family member. I was immediately able to put my full weight on the right foot and walk with a little assistance (since I was still recovering from the sedation).

Upon leaving the surgical center, the doctor gave my family member a prescription for Demerol 50mg (1 or 2 tablets every 4-6 hours) and Phenergan (for nausea). I was also told to keep my boot, bandages and foot completely dry and to wear my boot at all times. I am allowed to loosen the boot to put ice on it when needed. My family member drove me to the pharmacy to get my prescriptions filled and then we went directly home.

We arrived at home around 12:30pm and immediately I ate a sandwich and took my first dose of Demerol. I was told it was important for me to take the Demerol with food, and as soon as I got home. They didn't want the numbing to wear off before I took my first pain medication. They said the pain would come as the numbing wore off.

Its now 2:40pm and I'm having no pain or pressure. My foot is still completely numb. I have been able to walk by myself to the bathroom and back with no problem (and no crutches).

Since I had already had one Austin Bunionectomy 3 weeks ago on my left foot, I kinda knew how to prepare myself ahead of time for the long hours in bed with my foot elevated. I had made sure to fill a pillowcase with several thick blankets to use to prop my foot up to keep it elevated. This is much more comfortable than using a stool, and pillows seemed to fall off each other when I tried that last time. They recommend that you keep your foot elevated at least 6 inches above your waist, when sitting, to keep the swelling to a minimum. I also purchased an inflatable donut in the pharmacy section of the local Walmart to take pressure off my tailbone when sitting for such a long time (which really helps). I also prepared a cooler to put by my bedside with drinks and sandwiches and ice packs. They recommend that you ice your foot (over the ACE bandage but inside the boot) for 15 minutes out of each hour. I found that the freezable, reusable gel packs worked the best. I also made sure to have my phones by my bedside along with a trash can (in case I were to get nausea and vomiting), some books, my laptop and of course, the remote to the TV!!

After my previous surgery on the other foot 3 weeks ago, I came home very tired. I rested for the first few hours after the surgery. But this time, I am not tired or sedated. So I have been just passing time with my foot elevated and keeping a check on my foot for any feeling of pain (by wiggling my toes). Its important to take more pain medication BEFORE you feel a lot of pain. Its my understanding that if you allow the pain to get severe, it is hard to get the medication to catch up and take away the pain that has already begun. Therefore, taking the pain medication at the first sign of pain can help alleviate the pain level from growing to a level of discomfort. Usually doctors measure pain on a scale of 1-10 (1 being the lowest, 10 being the highest level of pain). So in my blog, I will note my pain levels based on this score.

It is now 3:00pm and my pain level is a 0 and I have no nausea. I plan to take a nap now and I will check back in later to let you know how things are going!


My Austin Bunionectomy - Pre-op, Surgery and Recovery

  Hello, my name is Laura. I'm 34 years old and have suffered from bunion pain for the last 6+ years. In Merriam-Webster's medical dictionary, a bunion is described as an inflamed swelling of the small fluid-filled sac on the first joint of the big toe accompanied by enlargement and protrusion of the joint. I have bunions on both of my feet which at different times has caused me great pain. After seeing my podiatrist, he suggested I would need surgery to correct the bunions and relieve the pain I was feeling.

I am creating this blog to help others who may be considering surgery for their bunions. I have no medical training and I highly recommend consulting several knowledgeable professionals before you make a decison about surgery. Though surgery was the option I chose, there are other options to help bunion pain and contacting a podiatrist would be your first step.

I have already had surgery to correct the bunion on my left foot, 3 weeks prior to this blog. The surgery was successful and has healed well up until this point. I am now going to have surgery on my right foot. This blog will give you an idea of what the surgery (pre-op, during surgery and post-op) and recovery was like for me.