Tuesday 9 March 2010

Best Foot Forward?

You may recall one of my previous posts - Give A Girl..... - where I share my journey of seeing a podiatrist....


Well the shoes are off being made as I type but in the meantime I was also referred to a foot surgeon as my big toe is doing its own thing and being a right pain in the ass!



When I was 12, I had surgery on my left foot... There was a bunion on my big toe and my middle toes were clawing... For those of you not familiar with the terminology.  A claw toe is a toe that is contracted at the middle and end joints. Ligaments and tendons that have tightened pull down, causing the toe to curl downwards.  It is called a claw toe because of its similarity to the claw of an eagle....




I was told that the bunion would be removed and it was decided that the only way to treat my 'claw toes' was to remove the bottom joint (each toe has 3 joints), therefore 'shortening' the toes...


The operation was a success, apart from the little shock I had after I got home... Turns out that an ingrowing toenail had gone septic in my middle toe so the tip had to be amputated.  Was a definite shock while I was having a nose under the dressing... screamed my head off!


Anyway I digress...... 


Coming back to now... Even though I had a bunion removed from my big toe, I was now getting what you call 'hammer toe'  This is where the 1 or 2 joints bends downwards, making it resemble a hammer.  This makes it extremely painful when wearing shoes as the bent part rubs against the shoe, plus I've been getting a dull ache at the base of my big toe.






My consultant decided to refer me to the podiatrist for specialist shoes as well as the surgeon.  This was because it transpires that when I had the bunion done, my big toe was also fused at the bottom 2 joints (something I didn't even know until that moment) and it was now the top joint that was 'hammering'


The waiting list to see a surgeon at my local hospital was extensive, so I was offered an appointment in Loughborough.


Arriving there fairly early, I grabbed myself a cuppa and chatted with the lovely WRVS ladies for a bit.  Walking into clinic, I was greeted with a smile, booked in and I think I'd only been sat down for 5 minutes when I was called in.


My surgeon was a definite friendly face... Dressed in a smart suit with bow tie, he reminded me of the 'old school' surgeons I used to have.  We chatted about my usual history and he asked to see my feet...


Wiggling my toes, he could see where I'd had my previous surgery.  He seemed a little surprised at how young I was to have the surgery, especially the fusion (glad I wasn't the only one)


It was then that I was given the options..... 


Stick with the orthotic shoes as these would give me the protection with the toes, and insoles would provide comfortable positioning for the big toe....


Have surgery to fuse the remaining joint in the big toe, which would then allow me to wear 'everyday' shoes without the rubbing etc.... Because of the fusion, the shoes would need to be flat, possibly 1 inch heel maximum.


The surgeon was totally understanding about the orthotic shoes.  He agreed that they were not exactly a sort after design for young women, and he felt sad that with all the research there is, why a better design could not be found.


I felt the same.  I will always try and avoid surgery if I can.  Its a drastic measure and given my age, its something surgeons will try and avoid if they can.  However in this case, there really is no other option.


The other drawback of the fusion is because my other toes are kind of bunched together... you know how your toes squish together when you wear pointed shoes.. thats how mine are anyway, and by fusing the big toe, this will straighten it completely meaning there will be a gap between the big toe and 2nd toe.... 


However, the surgeon offered a slight solution..... He could fuse with a slight bend so it didn't look as apparent.  I told him it didn't matter because its not as though I wear open toed shoes, or would ever walk barefoot on a beach... While I've accepted my arthritis and the impact its had on my body, I still haven't built that 'friendship' with my feet...


So it was on to the next stage... to have x-rays and make sure my bone hadn't gone like cottage cheese...  I'd never heard it be called that before but I knew what he meant... Its when the bone goes soft, so much that there is very little that can be done.  I had something similar when I had a hip revision 17mths ago.  The old joint taken out, but the centre of my femur collapsed due to the bone being very soft... I needed bone grafts and 'scaffolding' put in to secure the hip.  When this happens, you end up being non-weight bearing for at least 6wks.


The x-ray was over and done with and I nervously walked back to clinic.  Luckily I didn't have long to wait and the surgeon was greeting me with the news that the bone was healthy and surgery could go ahead :)


Now the waiting begins... approx 3mths... sooner if I get a cancellation.  I do have mixed feelings.  It will seem strange having a straight big toe, it will look much bigger than all the rest but it means I can go on wearing 'feminine' shoes and be in less pain.  If I leave the toe as it is, eventually it will try to turn onto its side, which will be very painful, and will continue to rub on shoes.  This will lead to sores and possible infection...


Even though I wish I didn't have to go down this path, I know I've made the right choice..... 

2 comments:

  1. As much as most of us would rather not have surgery on our joints, I'm grateful that we live at a time when such things are not only possible, but are done. Hard to imagine what it was like (and still is, in many parts of the world) when things like this happened to people and there was no option but to bear it and eventually become crippled (or worse).

    It sounds like you're making the best decision for yourself, looking at the long run. In the meantime, maybe they'll start making nicer-looking shoes ... ;o)
    -Wren

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  2. Good luck with your toe! Hope it turns out the way you want! :) Laurie

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