cheilectomy-diary

 As each month milestone approaches, it feels like the toe is worst than the month before, but when I read back, I can see that's a fallacy. I guess, as it gets better, I just measure its progress day by day, so some days it feels worse and some days it feels better. And that's kinda the lesson learned in this post.  For example, the last couple of weeks we've had a cold snap in the UK (temperatures down to -2 in the daytime), so I've had to swap the trainers to more suitable walking boots (something I couldn't wear last month). I've been in the walking boots every day now for a couple of weeks. It feels roomier than when I tried the boots last month, so that indicates the swelling (from Covid probably) has gone down. It's more comfortable to wear the boots now, so clearly that's progress. I've been doing around five miles in them, but do find that it's a matter of one day on, one day off. So if I do a five mile walk one day, I'm not up for a...

 Gosh, four month mark already. Well, here's the update: the toe seems worse than it was at 3 months. Though in a way I think it's hard to tell whether it's just worse, or just different. The obvious clanger has been Covid-19 which I caught at the start of November and which had me off my feet (and pretty much in bed) for the best part of a week. After that it was a further week or so before I started to feel fit enough to resume the daily walks. Right away the toe was niggly. In fact, during the peak infection time with Covid and while I was laid up, I had stabbing pains in the toe joint where I had surgery. I also had similar in odd joints around the body - left shoulder, right knee, left wrist - which cleared up after a few days once I started to recover. I've read that this can be a symptom of the Omicron variant of the disease, so I'm guessing Covid is the chief suspect in all of this. Maybe also, being suddenly laid up and off my feet for almost two weeks at a...

As I go into week 8 from the date of the cheilectomy and osteotomy to treat hallux rigidus stage 2, I'm mindful that this is supposed to be a big turning point. In my notes that I was discharged with it states,     "You should return to your normal daily activities (and stop the PT exercises) after 8 weeks, although exercising the joint from time to time may still help." Now I'm a bit literal, so I'm tempted to follow the guidance to the letter. But I actually think my PT has really only just begun. Maybe that's because I had the osteotomy, maybe the guidance is pretty good for cheilectomies on their own. And as for getting back to 'normal' activity, well, given that normal activity was much reduced due to the condition of hallux rigidus in the first place, this could be a little difficult to measure (and since I'm not a runner, and I'm in my mid fifties, it puts me a little at odds with the experiences of many in blog posts and discussions I...

Progress, progress, progress! Vacation week and I loaded the bike on the car ready for a week of driving, cycling, camping, kayaking and hopefully, walking. Well, let's just say, I'm glad I packed the bike!  The good news is, I was pretty much able to enjoy my vacations (hols for the UK audience) without hinderance. The only bit I didn't manage was a walking trip. I can walk around all day pretty much without issue, but to actually go for a walk is - not ready for that yet.  It's been hot again, and I've been doing the exercises and icing a fair amount. I used the bike to do shops and get around. Kayaking was fine - before the op, I'd get burning pain from the spurs if I used my toes to anchor myself in the kayak, but there was also the pain of turning the toes downwards to accommodate the feet - remember, I have knee problems the same side as the foot, which prevents me being able to comfortably turn the leg outwards to allow the toes to sit sideways. But now w...

Have come away on holiday - a three hour drive in a manual car with plenty of motorway queuing, which went fine, though the under part of the MTP joint was a bit achy by the end. I'm hoping to be able to do a little walking next week, but for this week I'm happy pootling around on the bike.  At home I'm in a cheap pair of flip-flops. I couldn't bear flip-flops before the op - the bit between the toes drove me mad. But I reckon the numbness I've still got on that toe, or the op itself, is making it fine wearing them now. I actually think they provide some good PT as well, as the toe performs a little dorsal flexion - sort of gripping the sole - as I walk in them.  I was able to be pretty much back to normal at the weekend, with plenty of time on my feet, swimming and kayaking. I'm using the bike mainly rather than walking, which I would have done before the op. Otherwise, I did a lot with very little pain or discomfort. The beach here is very stony and there'...

I've started swimming again - yay! - and the salt water has helped move the incision wound into a better place. No scabs now, just a fresh pink line of new skin. Been walking more in a pair of new trainer/walking shoes a half size up from what I normally wear with a thick sole.  Walked to the park and around a small circle for the first time since the operation. Did the walk in 40 mins - usually takes me 20 - and I just concentrated on trying to make the gait as normal as possible. Hobbling around over the weekend took it out of the knee and made the foot pretty fatigued.  Getting around on the cycle now - shopping, visiting folk, getting to the beach.  The biggest thing at the moment is the sensation I get underneath the MTP joint. It feels like I'm stepping on a big wadge of something. I'm guessing this will be swelling. It probably takes around 6 weeks for bones to start to be healed. I had an osteotomy and a screw in there, so it's probably this not settled yet, and...

It's the 3 week mark and it's been a busy weekend - well, it's all relative. I've been able to get on a bike - lowering the saddle so I can easily put my foot down. It's been more a case of rolling along at walking pace than actually 'cycling' - the foot feels too fragile to go straight off out of the traps onto the road in case of any sudden mishaps that could mean mucking up the osteotomy before it's healed.  On healing, the incision wound is finally sealing up and looking less angry. Still haven't gone swimming - still looks like it needs a little more time to scar properly before risking the water (submerging the skin, risk of tearing, and infection from sea water). Hope that changes this coming week. I can't feel the top of the toe near the incision at all - it's numb. Hoping that changes.  Doing the exercises as directed - push and pull until it's uncomfortable twice a day for 5 minutes. I was able to walk the dog to the park and ba...

Finally, it's the day of the post-op hospital visit. Because of the Covid-19 pandemic (and other stuff), all these types of procedures are being done in a suite at a small private hospital near the airport, so it's a 70 mile round trip from where I live (even though usually I'd go a few minutes down the road to the County hospital in my town). So needed have someone drive me. Meanwhile I tested out what shoes I'd take to replace the surgical shoe. Once at the hospital I had a couple of x-rays (which required me to weightbear on the foot). The screw I had inserted is clearly visible on the pics, still not quite sure what its purpose is! The one above shows the diminished space between the MTP joint where the cartilage is missing. All looks good according to my podiatry surgeon (Dr James Alvey). The incision wound is still a bit weepy - it's been in the compression bandage a couple of very hot weeks - so it really needs exposure to air now to finish off healing. So no...

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 inside...

In May 2022 I saw a specialist who confirmed my diagnosis of arthritis of the big toe, hallux rigidus (stage 2). X-rays showed I had diminished joint space and osteophytes peri-articular, with a range of movement 20 degrees dorsiflexion (normally 50 degrees for a walking gait - 65 running) and 10 degrees plantar (sole) flexion. Usually for people in my age group (over 50's) the recommended course of treatment is destructive surgery, whereby the toe is fused rigid with plate and screws to stop it bending and creating more arthritis. The primary objective is pain elimination.  A quick word on pain:- since the accident with the axle grinder two and half years earlier, I have experienced pain or discomfort in the foot at the big toe around 90% of the time (and that includes while in bed or at rest). The pain can be classified as between 0-10 on a scale (0 - no pain/ 10 - excruciating) in the following: 1. At rest/asleep - 5 - often I would be woken up by it in the middle of the night, ...