Day 1 - surgery
Arrived for a midday appointment. It's important to make sure you have someone who can take you to (and more importantly) collect you from your appointment. You CANNOT (nor will you want to) drive after the surgery. And trust me, you ain't gonna be taking public transport either.
I was advised that because I was having a local anaesthetic, I could eat and drink normally, to bring something to eat and drink and a pair of shorts to wear under the hospital gown and a dressing-gown to wear over the top.
I changed and ate my lunch and drank my flask of tea and discussed the pain meds that I'll be taking for the first three days after surgery (my worse fear - way worse than the surgical procedure - and the point of all my questions).
I do not get on with painkillers - namely, my stomach doesn't. I took ONE co-codamol tab for the knee when I did it in. OMG! The cramp in my stomach was abysmal. I took FOUR ibuprofens the following day, and by day three my insides were in such a mess and I was in so much pain, that I decided it was better to put up with the knee pain than continue the meds.
The first guy said I could make do with ibuprofen if I didn't get on with co-codamol (did he even hear me?!). Luckily the second guy (who I'd seen initially in May and who was going to do the surgery) thought that was an 'evil' suggestion and we agreed on naproxen and omeprazole to help settle the stomach.
NB it's really worth considering your tolerance to certain pain meds and doing your research (which I did) and suggesting what might work for you.
The nurse did a round of tests - namely blood pressure and pulse - asked me if I had any allergies.
The specialist doctor arrived and asked me what I thought was going to happen today. I said I was going to have a cheilectomy, that this involved making an incision on top of my toe joint, that they'd remove the bony spurs, clean out the joint and possibly put a screw in. He concurred, wrote up the notes, marked my leg and foot with a black marker pen and put a stripe over the toe joint and got me to read and sign the consent form.
The anaesthetist came round and asked me to lay on my back (and said it's not gonna be pleasant) and then gave me a heads up just before he stuck with with a couple of needles. I'm not gonna lie, it wasn't pleasant, but it was ok. Then I had to lie on my side and he did something that made me yelp and my leg kicked out involuntarily. This was the nerve test (they test where your nerve is so that 1. they get the anesthetic pumped into the right place and 2. so they don't injure the nerve). Then there was another needle (I had to practise some sturdy yoga breathing for this one) and then it was all done.
'That's the worse bit over, trust me,' he said and I didn't doubt him for a minute. He covered the foot and left me alone for the numbness to kick in, telling me that if I felt faint or sick I was to call the nurse immediately.
I did feel nausea and was glad I had taken a little lunch. My breathing quickened and I didn't feel great for a few minutes. Not bad enough to call the nurse. Then my breathing squared and I felt fine. I rested back and waited.
A nurse arrived and I got in a wheelchair and they wheeled me to theatre. It was pretty cool in there, so when I got up on the table, I had a blanket over me. They put a pillow under my knee (as it doesn't straiten) I had pointed this out when I arrived because I wanted to make sure no one inadvertently pulled or straightened that knee and compound the meniscus problems I have on that side.
The foot was put into a kind of soft clamp and the surgical team throughly washed and disinfected it. The surgeon stuck all round the foot with a pin to test that the anesthetic had kicked in (it hadn't and they had to pump some more). He tested again and I said I thought I could feel more than pressure. (When I go to the dentist, I always need more than one injection for any work, sometimes even three, so that's a good indicator of how much you'll need to make sure the foot is fully numb). After waiting a while the surgeon went to make the incision and I must have given him a wide-eyed look.
'I can feel that,' I said, 'That's really unpleasant.'
He stopped immediately. Waited a bit. Then looked at me quizzically. 'Can you feel that?'
'Feel what?'
I think he smiled.
'Ok, we're ready to start.'
Now, I've never been in an operating theatre, I've never been under the knife, I've only had injections for fillings and crowns, and I've only had one stitch (in my finger when I cut it with glass). So all this was quite new for me.
The surgical team comprised 5 people who were all friendly and introduced themselves by name. One of them kept close to my head and kept me talking - we discussed my (visible) tattoo, the music that was coming from a radio somewhere, our yoga practices, the weather (unusually hot for the UK). and so on. Then the 'saw' started up to cut away the bony spurs restricting the toe movement and I'll be honest with you, the vibration was really off-putting. I adopted my own method of self-soothing (rocking my head side to side and tapping three fingers in rhythm on my breastbone) and did some deep breathing which developed into a loud humming in time to the sound of the saw. My companion thought I was rocking and singing to the music. I didn't correct her!
The surgeon called for a 20mm screw - so I was getting some metalwork (rose coloured titanium he later informed me - I didn't know you could get rose-coloured)
I looked at the clock. I had got up onto the table at 14:00, the procedure started around 14:14 and at 14:35 the surgeon called 'Done!' and they stopped the clock.
I looked at him over the curtain dividing me from my leg and said, 'It's not a race!' But even so, I was pretty impressed and a bit relieved it was all over.
They sewed me up, dressed the incision, and wrapped and bandaged the foot, all the while he was explaining what he had done and that I had dissolving sutures and that I would need to keep the foot elevated for the best part of the next two weeks (most of their post-op calls are from worried patients who are experiencing pain due to swelling because they don't elevate the leg enough) and that the dressing should stay on during this time until my follow-up appointment.
I was wheeled back to my bed area to rest and have some (more) lunch.
I ate a sandwich and drank some tea and the nurse came round with surgical stockings (these are for the OTHER leg, because the surgery leg is in tubigrip and both legs are at risk of developing DVT (deep vein thrombrosis - more on bed exercises to help circulation later). I had my blood pressure and pulse taken again, a surgical shoe fitted and told I could go.
I was wheeled out with my leg elevated and got my ride home. The foot remained pretty much numb for the rest of the day so didn't need any pain meds. I had a little supper, made sure I was hydrated and headed off to bed with the foot raised on a pillow.
Top Tip
At this point the foot was completely numb from the anesthetic, and meds, so I was blissfully unaware of it. Which meant I was scooting around a lot on the foot and weight-bearing on it. That is NOT advisable. Rest it from the get-go, and keep it UP UP UP!
The surgical technique (minus the osteotomy)
Here are a couple of links to animation/video of the technique:
Animation (not graphic) https://www.youtube.com/watch?app=desktop&v=zDsPAIy3K84&feature=youtu.be
Video of actual cheilectomy (WARNING: GRAPHIC) https://www.youtube.com/watch?v=gIcn548xcNY
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