3 Months Post Surgery

No news is always good news.  I haven't posted here, because my recovery has gone very well, and I am happy with the results of my surgery.  Goes to show that those most motivated to write about their stories online are those who have not had good results.

By 2 months post surgery, I was walking long distances.  Barely any pain and swelling in my 1st MTP joints.  Now at 3 months, I hardly think about my feet anymore.  I am happy that I moved forward with my surgery.

In the larger studies I have read, most patients who are good candidates for a cheilectomy have positive results.  Good candidate = still have a decent amount of cartilage in the joint.  This is a well studied surgical procedure with a proven track record.  If you are a good candidate for the procedure and suffering from a fair amount of pain, I think that this surgery is a no-brainer.  Just make sure to vet and chose and a good surgeon.

On the question of doing a bilateral surgery:  I am also happy that I did both feet and got it all over with at once.  My doc said that he would make a rare exception for me, since my case was very clear-cut and I was obviously a good candidate for the procedure.  If there are any doubts about whether or not this is a good procedure for you, probably best to do one foot first and let several months pass before you decide to move forward with the other.

Conclusion:  Cheilectomy of MTP joints worked great for me.

My final words are very specific to my case and thus probably not relevant to most who would come across this blog.  I had debridement done on the IP (interphalangeal) joints of my big toes as well (where I actually had the greatest amount of pain).  According to my surgeon, this is much rarer, and I could not find any academic research on this procedure.  Often when this joint presents problems, the bones are simply fused.  These joints have been more problematic and slower to recover, quicker to swell up post surgery.  They also lost quite a bit of mobility post surgery.  Still, the pain and swelling in these joints is slowly disappearing, and I hope that in a few more months, I will no longer notice them, as I no longer notice the MTP joints where I had the cheilectomy.

Good luck to all those with upcoming surgeries!  Michael

Days 11-13: Dwindling Patience with Pain

I've concluded that I practically have had a unilateral cheilectomy.  So few problems in my R foot, but my L foot, which received greater surgical intervention, is the source of a lot of pain.

Once the bandages are removed (in my case, at 10 days), it allows your feet much great flexibility and range of motion, and thus more potential for moving the joints in ways that cause pain.  At day 10, my doc sent me home with wrapped in only Ace bandages, and said that it was OK to not wear them around the house; not wearing the Ace bandage would encourage the joints to start moving again.  Still have to keep the feet dry until stitches are removed at 3 weeks.

Bathing without bandages:  I have figured out a way to clean my feet and other toes (I seriously cannot go 3 weeks without washing my feet!) without getting water on the wound.  While sitting in a dry tub, I carefully wash with soap and rinse using a cup, without the soap or water getting into the wounds.

Days 11-12:  I started to get bold, trying to live more normally.  Running around car shopping, going to picnics, walking a fair distance, standing in the garden for an hour watering plants.  Still putting a lot of weight on my heels and the outside of my L foot to avoid putting pressure on the big toe joints, which makes the entire foot hurt.  By the end of day 12, my L foot was in serious pain, the wounds so swollen that little drops of fluid were escaping through the stitches.  I had to take another painkiller to get to sleep and my left foot still hurt in the morning.  Today, Day 13, I stayed in all day and gave the foot some rest. Pretty discouraged that I'm still somewhat housebound, but I also know that I have to be patient and give it some time.

Day10: Pics & Doc Visit

Doctor visit today. Stitches won't come out till 3 weeks after surgery, so I have a while to go till I'm out of the "cast covers" for bathing.

Driving again:  Drove for the first time today. No problem at all to drive an automatic since my right foot is in much better shape.

Exercises:  Doc said to start exercises today; simply bending joints up and and down with a finger (pulling toe toward me and away from me). Five minutes every hour. Is there a degree I should aim to achieve?  "As far as possible."

Pain:  Left foot in considerable pain if I try to move joints. This will not be an issue for most people reading this (who most likely are just getting the standard cheilectomy of MPT joint), but what is especially painful for me is the interphalangeal (IP) joint of left foot (which also underwent debridement in my case). I'm generally optimistic, but a little worried about this joint since I have read that it is more difficult to fix with surgery than the MPT joint.

In the pic below, you see two different surgical wounds on each foot.  The lower incisions are for the "cheilectomy" on the MTP joints.  The upper incisions are for arthritis in the interphalangeal (IP) joint (which is probably irrelevant to most readers here).

One Week Post Cheilectomy Surgery

"Daddy, you're walking a little faster every day," my 5-year-old observed this morning.

Exactly seven days ago, I was under the scalpel.  The gradual improvements are noticeable.  The same day of the surgery, I was scooting around the floor on my butt.  By the next day, I could take tiny paces on my heels.  Now, I'm no longer just walking on my heels, but putting a little weight on the metatarsal heads.  The change is pretty unconscious; I just walk as my feet allow me to without feeling pain.

Big difference between my two feet.  My left foot was more adversely affected by the arthritis and bone spurring than my right, and required more surgical intervention (removing loose bone fragments, drilling into the bone).  Now when I walk, I can already slightly bend the MTP joint on my right foot without pain.  On the left foot, by contrast, I'm still mostly avoiding placing pressure on the metatarsal heads (balls of the foot), walking more on the outside of the foot.

The difference between my two feet tells me this:  Every case is different.  If somebody else's anecdotal story boasts of an easy surgery and quick recovery, her case was not as severe as yours.

The good thing about my right foot being in better shape is that I feel that I COULD NOW DRIVE if I had to!  Still haven't tried, but I think it would be no problem.  This is a good feeling, because for me, mobility = liberation.  Although, once I'm driving, it also means the end of my reading "vacation."

Days 5 & 6: Out of Bed

A little better each day.  Now sitting at a desk for most of the day; don't feel the need to have my feet perpetually elevated.  Still slow shuffling around, but no longer feeling exhausted after minimal exertion.  Will visit the orthopedic surgeon on Day 10; I'm guessing/hoping that is when the stitches come out and I can start driving again.

Day 4: Bilateral vs. Unilateral Cheilectomy?

Little change since yesterday.  Still mostly in bed.  When I do get up, still shuffling around on heels, which is slow and tiresome.  After about 15-20 minutes of feet not being elevated, the pain and swelling increases.

Went out to dinner with family to get out of the house.  Exhausted by the time we returned.  My body is telling me that it needs rest, and for the most part I'm listening.

Beginning to see the advantages of operating on one foot at a time (I opted for bilateral surgery).  If I had done only one foot, it would be much easier to get around, making the non-surgery foot bear the weight and do the work.  I imagine that I would be driving already.  Having done both feet, the recovery is going to be much slower.  Maybe in a year, when I hope that this is all behind me, I will be glad that I did it all at once and don't have to go through it again.  Right now, I wish I had at least one good foot.

Preparing for your cheilectomy surgery

If you don't want to send your loved ones on multiple trips to the pharmacy post surgery, here is a list of things to have ready pre-surgery:

• Pillows or devices to prop legs (practice in advance).
• "Cast covers" that envelop and seal your foot/feet for bathing.**
• Shower chair for bathing (optional; I just took baths).
• Crutches or walker (optional; will help in first week).
• Ice packs that wrap around with velcro.
• Aspirin (take daily post surgery to avoid blood clots).
• Stool softeners and/or laxatives (painkillers cause constipation).
• Laptop and e-reader/books (you'll spend a lot of time in bed).

**  The "adult" cast covers come up over the knee and the rubber only seals at your thigh (they will not seal around calfs, which are too narrow).  I would check out "child" covers; I guess that they would fit better for just covering the feet.

Also, check out this great list of ways to prepare psychologically and emotionally for the surgery.

Have I forgot anything?  Please add to the comments.