Bunion Surgery - Preparation Tips, Surgery and Post-Surgery
I had bunion surgery December 12/18. This is my journey in case it helps to better prepare others for same/similar surgery. I googled as much information as I could prior to surgery as well including reading other blogs. I have included in my blog info that I found missing from other readings.
Preparation
My doctor (very nice gentleman) in my one and only post-op/assessment appointment (really, how many appointments do you need anyway? You’ve got pain and your shoe shopping has shrunk to anything soft and squishy and you want it gone so let’s go!) looked at my xrays I had brought and decided they were too old (you know it can take 2-3 months to get an appointment with a specialist right?) so I had to go and get new ones right there. Once he checked them out and assessed my foot and I said I wanted surgery, we settled on a date and the assistant filled out all my paperwork. He said I should stop all my vitamins (I don’t have daily medication to stop) one week prior to surgery.
* I am very sorry but I forgot to take a picture of my foot before operation but you will see pics of my right foot on this blog and my bunion was a little worse than the right foot (next one to get surgery).
I did some research on the internet because I was not thrilled to stop all my vitamins. Some of them, i.e. vitamin d3, are needed in our Canadian winters and my mood really suffers without it. I realized some doctors make a blanket statement like that because they don’t want to go through with you what you can and can’t take, especially if you take medication and they have to look up interactions with surgery meds. I was particularly taken with this website:
This is a very good website that explains how taking the wrong meds can interfere with clotting after surgery. Dr. Sinatra is a cardiologist so I felt that he should be very knowledgeable. Eating lots of garlic, vitamin e and fish oil (omega) can all do that. Ginkgo biloba and aspirin, Tylenol, St. John’s wort, ephedra (also called ma hang), feverfew, goldenseal, ginseng, ginger, licorice and valerian also no no’s. If you take medication then for sure let your doctor know what you are taking prior to surgery. Check out this website for full details but for the most part he says you can re-start vitamins 3 days after surgery.
This is another one I looked at that was interesting:
This is another good website that goes into more detail about pre-surgery supplements. Personally it was a bit too much for me. I already have a bunch of vitamins I take every day so I don’t want to add a whole lot more unless I feel it is really beneficial.
Using Dr. Sinatra website and from other websites I decided to ignore the doctor's instructions to stop all vitamins and decided to take the following vitamins one week prior to surgery:
B100, vitamin d3 (I take 5000 mg daily), probiotic (I take 50 billion daily) - all these are part of my daily intake
vitamin c (1000 mg), zinc picolinate (30-50 mg), COQ10 (50 mg) - pre-surgery additions
I made sure to stop all the supplements and vitamins Dr Sinatra's website indicated would complicate surgery. I felt pretty confident with what I decided to do as I take no prescribed medication that would complicate things.
After surgery I took the following:
Omega (2000-3000 mg) (as this was one of the no no’s I waited until the second morning after surgery to start taking this) - doctor says to take this for two weeks (I normally take 1000mg per day anyway so I just had to double it)
Bromelain on an empty stomach for two weeks
COQ10 (200 mg) for 14 weeks
Vitamin C (1000 mg) three times per day for two weeks
Milk thistle for four weeks
Zinc picolinate (50 mg) for two weeks
I also re-started my serrapeptase once daily on an empty stomach (also waited a couple days before re-starting)
These are the bottles of vitamins I took specifically for the surgery that were different from my normal ones.
Day of Surgery
Had to be at hospital for 7am. Checked in. Changed into gown and grudgingly made friends with my IV companion. Soon taken into the secondary waiting room. The doctor himself came to take me into the surgery wing. He kindly waited for me as I wanted to use the restroom before going in. He actually rightly assigned blame to my IV buddy. Surgery was scheduled for 9:15 but we didn’t really get in until about 9:45am.
Got into the room and the anesthesiologist said, I will just give you something to relax you through the IV. Take that to mean, I am knocking you out now. Lol.
Woke up could not open my eyes. Was desperately trying to wake up as my son was told to come at noon and I was worried I would not be ready. Took me a long time to come awake enough to function. The nurse told me I would need a surgery shoe. My son had to go pay for it first. It was only $25 so beware of the need to purchase. I did not think about that at all.
I don’t know how but I seemed to have not noticed the big casts people were using in my internet searches. Anyway, I was surprised I had a big cast to deal with. Doctor told me to walk on my heel when walking. Nurse told me to wiggle my toes periodically every day to keep the blood flowing.
I took these pics of my cast when I was lying in bed at home that first day.
Post-surgery
My son wheeled me out to hospital entrance and I sat in the back with my foot up in between the front seats. Got home around 3pm. Settled into my bed with firm pillows under my foot. Keep it elevated above heart for as much as possible week one. Same for week two if you can. When you put your foot down all the blood rushes down and you feel like your foot will swell and pop. The faster you get it back up the happier you will be.
Hospital wheelchair to get me to entrance. Looks like a shopping cart doesn't it?
Had a lot of numbness in my toes. Apparently the doctors do that to help with the pain. Takes a long time to wear off.
*At this point I need to mention that I have a high tolerance for surgery pain. I have had some shaved along my gum line and Lasik/PRK eye surgery and both surgeries I handled without meds. So what I am saying is everyone has a different pain threshold and you can’t gauge things by how someone else handles pain.
I did take an excedrin (not on purpose as I thought it was Tylenol) at 4am just cause I thought it might help me sleep better and not have to think of the throbbing. Yes, the surgery site throbs and pulses. As I didn’t end up having any Tylenol I took an Advil in the afternoon cause I thought, why not? And that’s it for pain meds for me. I didn’t even bother to fill the prescription the nurse gave me. I did meet a lady when I went for my post-op appointment who had her surgery the same day as me. She said she had read that you should gauge your pain, meaning see how the pain level went as the anesthetic wore off. Doing that she found she only needed to take regular Tylenol for a few days. She doesn’t like the spacey feeling you get on the heavy meds. If your pain tolerance is low, fill your medication prescription while your leg is still numb and dose up on it for a few days. Think of all those days you feel you need more sleep and then enjoy.
I never realized the learning curve needed to use crutches. I borrowed them from a good friend ahead of time. I was so unsteady using them. I fell onto walls and near fell often. The second night following surgery I put the crutches against a wall, took a step and the cast slid out and I fell. NOW I know they want you to use the surgery shoe in the house to prevent that! Thought it was just for outside until then so now I have to wash it every time I go outside and come back in. Anyway, after that I grabbed my son’s old wheelchair and wheeled around in the house using that for safety. (Yes it is sad my child has had a few of these but there are lots worse ailments people deal with.). My children didn’t trust my stability so was actually funny that at times my son in his walker was pushing me in his wheelchair in the house!
You can’t take a bath/shower for the first 2-3 days so was very happy to finally try to have a bath. I bought a leg shower cover off of Amazon a few days prior to surgery. Was about $20 for a child’s large. It is huge. I was going to get one from Shoppers Drug Mart Health Store but when I called they were selling one for about $45 plus I would have to drive and go get it. I was scared of leakage but the thing seals well. It feels really tight on your leg around the gasket but that is to stop water right? I was nervous to try to stand with it and let water rain down on the bag but after using it for over five and a half weeks I can say you need not worry. It does not leak. Anyway, back then I sat in the tub and put the shower had on the floor so I would soap up and then use the wand to rinse off. I needed help the first couple times to put on/take off the bag over the cast until I got the hand of it myself.
Over the first 10 days throbbing on and off as expected and swelling when foot was down. Definitely nicer having the foot up.
Surgery shoe to be worn inside and outside. So I have to wash the bottom of the shoe every time I come back inside. A pain but worth keeping my house clean of outside germs.
First Post-Op Appointment
This is another one I looked at that was interesting:
Using Dr. Sinatra website and from other websites I decided to ignore the doctor's instructions to stop all vitamins and decided to take the following vitamins one week prior to surgery:
B100, vitamin d3 (I take 5000 mg daily), probiotic (I take 50 billion daily) - all these are part of my daily intake
I made sure to stop all the supplements and vitamins Dr Sinatra's website indicated would complicate surgery. I felt pretty confident with what I decided to do as I take no prescribed medication that would complicate things.
After surgery I took the following:
Omega (2000-3000 mg) (as this was one of the no no’s I waited until the second morning after surgery to start taking this) - doctor says to take this for two weeks (I normally take 1000mg per day anyway so I just had to double it)
These are the bottles of vitamins I took specifically for the surgery that were different from my normal ones.
Had to be at hospital for 7am. Checked in. Changed into gown and grudgingly made friends with my IV companion. Soon taken into the secondary waiting room. The doctor himself came to take me into the surgery wing. He kindly waited for me as I wanted to use the restroom before going in. He actually rightly assigned blame to my IV buddy. Surgery was scheduled for 9:15 but we didn’t really get in until about 9:45am.
Got into the room and the anesthesiologist said, I will just give you something to relax you through the IV. Take that to mean, I am knocking you out now. Lol.
Woke up could not open my eyes. Was desperately trying to wake up as my son was told to come at noon and I was worried I would not be ready. Took me a long time to come awake enough to function. The nurse told me I would need a surgery shoe. My son had to go pay for it first. It was only $25 so beware of the need to purchase. I did not think about that at all.
I don’t know how but I seemed to have not noticed the big casts people were using in my internet searches. Anyway, I was surprised I had a big cast to deal with. Doctor told me to walk on my heel when walking. Nurse told me to wiggle my toes periodically every day to keep the blood flowing.
Post-surgery
Had a lot of numbness in my toes. Apparently the doctors do that to help with the pain. Takes a long time to wear off.
You can’t take a bath/shower for the first 2-3 days so was very happy to finally try to have a bath. I bought a leg shower cover off of Amazon a few days prior to surgery. Was about $20 for a child’s large. It is huge. I was going to get one from Shoppers Drug Mart Health Store but when I called they were selling one for about $45 plus I would have to drive and go get it. I was scared of leakage but the thing seals well. It feels really tight on your leg around the gasket but that is to stop water right? I was nervous to try to stand with it and let water rain down on the bag but after using it for over five and a half weeks I can say you need not worry. It does not leak. Anyway, back then I sat in the tub and put the shower had on the floor so I would soap up and then use the wand to rinse off. I needed help the first couple times to put on/take off the bag over the cast until I got the hand of it myself.
Surgery shoe to be worn inside and outside. So I have to wash the bottom of the shoe every time I come back inside. A pain but worth keeping my house clean of outside germs.
First Post-Op Appointment
Decided to use the crutches to go into the hospital. My son dropped me off at the front. As I said previously, I sat in the waiting room next to the other lady also recovering from bunion surgery. Interestingly she actually had taken a walk around her block during the last 10 days, with her cast! I don't know how the swelling in her leg allowed her to do that but again, everyone's swelling is different too.
Nurse cut off the cast.
This is what my foot looked like upon cast removal. I was surprised there was no swelling, bruising or blood everywhere. (Swelling is actually under bandages and also my foot is up.) Very impressed by how straight my foot is.
Doctor came and assessed the foot. Keep walking on my heel. Keep wearing the surgery shoe. Can now start to get used to having my foot down so don't have to elevate so much any more. Next visit four weeks. (Nurse thought I might have been able to go home in a running shoe but no. She said all the doctors do different things. I guess mine prefers to keep the surgery shoe for better healing. If it ensures a good result for sure I will comply.)
After the doctor left the nurse put the thin sock on my foot over the bandages, wrapped gauze around it and put bindings on top of that. I had the choice of lime green, red or bright pink. Cannot get it wet for the four weeks.
Felt so much nicer walking back out with no cast!
11th Day to Four Weeks Later
If I concentrate on my foot I can feel the throbbing. So I occupy my thoughts elsewhere. Swelling still there but slowly train my foot to be down longer and longer. I still sit with my foot up on the sofa alot. Found when I got home that I could walk around with the surgery shoe and my slipper on the other foot fine without crutches so yay! I just switch to an outdoor shoe on the right foot to go out.
Bindings Off Finally
Bindings cut off after the four weeks. Doctor told me to bring a to spacer with me. I am to wear that even to bed for six weeks. Still must wear my surgery shoe until the next appointment in six weeks.
I can definitely see the swelling in my foot and ankle.
While I was waiting for the doctor I was trying desperately to scrub off all the dry skin that had not been cleaned for 5.5 weeks. Doctor said I could now wash my foot. They did not take off the bandages.
I went home and slowly and gingerly peeled off the bandages. I stupidly tried to peel it off horizontally to my foot instead of either pulling down toward my toes or up toward me. Quickly found out that horizonal is wrong as you are opening the wound. Tear off up or down the line of surgery so everything stays in tact.
While I was waiting for the doctor I was trying desperately to scrub off all the dry skin that had not been cleaned for 5.5 weeks. Doctor said I could now wash my foot. They did not take off the bandages.
I went home and slowly and gingerly peeled off the bandages. I stupidly tried to peel it off horizontally to my foot instead of either pulling down toward my toes or up toward me. Quickly found out that horizonal is wrong as you are opening the wound. Tear off up or down the line of surgery so everything stays in tact.
Then I soaked my foot in Epsom salt bath and scrubbed and scrubbed to take off all the dead skin. The nurse told me that some people after they take a cast off put oil all over their skin and that helps it all come off in the water. Anyway, that soak took off quite a bit of dead skin. Will take a few days to get it all I imagine. And of course I had to be careful around the scabs which are tender.
Pics right after I peel off the bandages.
Good Epsom salt foot soak. (No reason for this other than I thought it would be good for it.)
After the soak.
Now I can finally see the difference in the two feet! Here you will see my right bunion. My left one was slightly worse. Left one is so nice a straight now. Haven't seen my foot like that since I was young. Notice the swelling and also notice the toe spacer.
Exciting to be able to wear my own socks again and give hubby back his and also to wear regular pants again instead of baggy sweats.
On the advice of the nice lady at the health store, I immediately started applying arnica gel to the wounds. Apply as often as I could as it dries after a few minutes. Interestingly what it seems to do is dry the scab so it falls off.
Notice how much scab came off by the end of the day. This was an afternoon and evening of applying the arnica gel.
This is taken four days later. Quite a lot of scab gone. Notice the scar is also no longer raised. I realized a day after the bandages were off that massaging is necessary to get the blood flow going and get the stuff pooled up gone. Lightly tap the scar like you are playing the piano as it will tingle and feel weird. As you get more used to having the scar touched you can start to try to massage it. I used pain rub and used my whole hand to massage. Was painful at first to massage where the scab is so I didn't do there until it felt comfortable.
Doctor also told me to manually start bending my toes to get the flexion back. Been working on that as often as I can and working on bending the toes on their own.
I also wear a thin sock to bed to hold the toe spacer.
This pic above is taken two weeks after bindings were removed. A lot of the scabbing has fallen off with the daily arnica gel application. I put it on a few times in the evenings. The scar is still swollen closest to my heel as that is where the suture tie-off is and my skin is not liking the lump there. Same thing where the tie-off is on top of my foot. Definitely more irritated on the side here. Been doing my massaging daily and working on pressing down my toe for flexibility. Throbbing as usual from the site.
These two pics are taken seven weeks after surgery (5 days after the last pics). All the big scabbing has fallen off. Notice the tie-off area is still swollen and irritated. The incision is healing nicely.
I realized I have not been working on pushing my toe up. Have started to work on that as my ability to flex on that toe is very limited.
These three pics are taken eight weeks after surgery. You can see by the colour foot is still swollen to some degree. Healing coming along. Still throbs (nothing horrible but it is there).
I found this website shown above that shows exercises for the toe after surgery. Am going to work on these to improve flexibility. Hard though when foot is still swollen.
I will update as I progress in recovery. I hope this helps someone.
