The Osteotomy Operation & The Post-Op Days
Written on Day 5
13th August came and the OH took me to Care UK at Goodmayes for the bunion and toe osteotomies (Weil, Akin and Scarf procedures). I’m not saying I’m superstitious about the number 13 but, on this occasion, I carried a silver, four-leaved clover and wore lucky pants. I needn’t have bothered with the latter.
We were swiftly taken into a small day-surgery ward full of wincing, teary-eyed, post-op women, who either bore crutches or some kind of walking-aid, lay in bed or hobbled about awkwardly. Pilgrims who’d gone before me and wearing the badges to prove it. One very tall, young girl who looked like Agyness Deyn wore a shocked and sad expression, and was lying in bed coming round from her op. I noticed the bandaged foot and the Velcro shoe lying on her bed-table. This could affect people of all ages.
There was a pre-op visit from the anaesthetist and from Mr. Fabulous, my surgeon, who again asked if I had any further questions. Once again, he would have had no idea I was too stunned by his looks and charm to think of anything useful to ask, even with my lovely OH sitting there. He could do what he damn well liked, as far as I was concerned. And he did. He drew a very fierce but unmistakeable arrow on my right leg, chatted with us a while, then disappeared. I wouldn’t be seeing him for six weeks. Gutted.
After a long delay because I’d forgotten not to have skimmed milk in my morning coffee and during which I was issued with crutches and given instructions on their use (especially on stairs) by the Physio as well as watching all the other patients gradually leave the building, my turn came.
For the delayed three hours, I’d been sitting on the bed with my phone in my hand Googling a few last bits of information. As mentioned in Stage One, it’s been useful to Google: bunions, osteotomy, Scarf Akin and Weil’s procedures, metatarsalgia, bunion blogs, etc. And I took these pictures. Pity I didn’t get a decent ‘before’ picture of my horrible bunion.
By the time they came to tell me to change, I was as well informed about this bunion business as I was going to be. It was my big moment to wear nothing else but the unfetching gown and polythene-wrapped paper knickers that had been placed on my bed.
My OH and I assured each other we were loved and next thing I was wheeled off to a theatre ante-room having a canula placed by the Anaesthetist who told me she’d be giving me an ankle-block, too. There was a tiny glimpse of Mr. Fabulous as someone opened the Operating Theatre door. Oh my. Then another woman placed an oxygen mask over my face and that was that.
I woke in Recovery with a male nurse fussing about, taking temperature, blood pressure, and administering i/v Tramadol and Co-Codamol. Even with a giant bandage dressing in place, I could tell my foot was finally straight in the area where the gross bunion lump used to be. And, despite the initial intense pain, I still had a foot!
Wheeled back to the ward, being greeted by a relieved OH (who’d waited for an hour-and-a-half) and given tea and toast, I was sitting in bed when ‘they’ came round to ask me what level of pain between 0-10 I was having. I said 8-9. I should have said 10 or 11.
So I was sent on my way with a packet of Co-Codamol (30/500 – quite strong), a hideous ‘Darco’ Velcro-fastening, reverse-wedge shoe – to put weight on heel, if at all – and crutches. That was my first practical crutch-using session, awkwardly loping towards the entrance where my OH was waiting with the car. I knew now why those women had been raw, tearful and wincing earlier on in the day. Day surgery does not necessarily mean painless surgery.
That night and the next day, the pain actually did become unbearable. I shall always remember that first night, awake and in pain, seeking solace in some talk radio phone-in, anything to distract me. I’d love this to be a totally good-humoured piece about those funny old things, bunions, a my-how-we-laughed affair, but that was serious and nothing, not even a repeat showing of Karl Pilkington’s adventures in Egypt (‘you don’t see that in the brochure’ as a nappy flies past him at the Pyramids) could make me mirthful in the midst of agony. I couldn’t be distracted from the pain by anything, not even my OH’s stupid dance he does when I need cheering up.
Painkillers were only slightly taking the edge off the pain for roughly 40 minutes to an hour. So the routine appeared to be. Take meds, wait an hour for them to work, achieve slight relief for an hour if lucky, then wait 2 more hours for the next pain relief. And then it seemed I’d just get to the ‘taking the edge off’ bit when the loo might be needed, so then I’d get up, take the stairs gingerly and agonisingly, only to come back down again to worse stabbing pains than ever. I was not amused.
It’s hard for your loved ones to do anything for pain, other than make you take the meds and try to distract/amuse/soothe you. And I so tried to be brave. But I am no heroine and wasn’t out to win a medal. So I put in a tearful call to the emergency doctor who then arranged for OH to be able to collect Tramadol from a Boots in Romford. This was a trial and error thing. One tablet wasn’t enough to take the pain away. Two made me feel sick. Finally, I came to a one during the day, two at night (oh, those painful, awake between 1-4 a.m., nights) arrangement.
I still had no idea what was actually causing all this pain, only a bit of knowledge about the kind of operation I’d had. What lay beneath the bandages was still a mystery. It was one of the questions I could have asked if I hadn’t been so mesmerised. But I was going to be enlightened upon this point very soon.
On the 15th, the Wednesday, we had to return to the hospital for a post-op X-ray and then go back to the Care UK Treatment Centre for a dressing change. I’ve found Care UK (@careuk on Twitter) to be friendly and efficient. Having had private hospital treatment in the past, they compare very well – and yet my treatment has been free through the NHS.
So OH dropped me at the main King George’s hospital entrance before parking. Within seconds of trying to stand like a crutch adept to wait for OH to return, the pain was excrutiating. Luckily we were able to borrow a wheelchair for the long march to the X-Ray department and back again. They X-rayed my still bandaged foot from a couple of angles and then it was back to the Care UK Treatment Centre.
The nurse wasn’t at all surprised by what lay beneath the bandage. I was horrified. It was pretty grisly. I’d been surmising (assumptions again) there would be maybe a two-inch (5cm) scar. But the scar looked maybe double that length, halfway from my toe to my heel. And there was another scar to the right of it.
I honestly thought there’d be the one scar and they would have done all procedures through it. But I was forgetting the operation on the metatarsal bone of the lesser 2nd toe. The stitches were as tight as the knots round a lamb joint and the largest scarring I’ve ever received. Considering the foot is such a small area, that’s quite a shock. It’s like seeing yourself laid out in a butcher’s shop window. Anyway, they dressed and rebandaged the foot again and I was told to rest up now until I came back on Day 12 for the stitch removal.
It’s been an ever-changing learning process in the 5 days since then. There’s been learning to navigate the stairs, wincing and oohffing, with a crutch or two and the giant shoe. That’s one thing when the Physio shows you how to do it before the operation, and with two relatively good feet. Quite another thing afterwards. We have a tight little turn at the top of the stairs on which it’s difficult to get the whole shoe and, first of all, I had visions of hurtling downstairs, crushing all the good work on the foot and knocking myself out on the hallway wall to boot.
There’s the elevating the foot above heart level for at least 22 hours a day. That’s great fun, ahem, especially in bed at night. OH is sleeping in the spare bedroom. I stack four pillows. But this is all in order to help with healing and blood flow and I’m determined not to do anything to louse this up, certainly not having gone through more pain than I’d imagined with it.
The pain wakes me at least once in the night but, after the first, three days, it has become more bearable. Or is it just that I’m getting used to it? There’ve been a few lonely nights up with pain, listening to even more painful radio phone-ins to pass the time till the Tramadol works. Yes, it’s come to that.
And there’s learning to have patience with myself, with my OH (who has made my meals, cleaned, provided me with a flask of coffee before he goes to work in the mornings, amused me and, crucially, washed my hair) and with the healing process.
The foot has to stay elevated, non-weight-bearing and dry for at least two weeks and it’s easier to stay in bed, near the bathroom, than to get up and have to keep painfully navigating the stairs.
I have an appointment for stitches removal tomorrow; and another appointment with Mr. Fabulous, the handsome Hungarian surgeon, in five weeks. It can’t come a moment too soon for me.
That’s my experience of the Bunion Pilgrimage to date. The only way is up now.
Stage Three coming soon.
So far, the chief instructions have been:
- Keep foot elevated and dry, to reduce swelling and help healing, at least until 12 days appointment for stitch removal.
- Take meds as necessary (in my case Tramadol and Co-Codamol) and tell doctor if they’re not adequate pain relief.
- Elevation of foot at least 90% of the day, therefore only getting up for the loo (pressure on foot as little as possible).
- Use crutches, whether on the flat or up and down stairs; for any walking, use the Darco Boot which means pressure is only put on the heel.
- Showering/washing. The idea is to get a plastic stool or chair for the shower (as standing/pressure on foot not allowed) and tie a binbag round the foot to keep dry. I am simply being patient over this and have strip-washed. My OH has washed my hair, with me on a stool leaning backwards.
- Enlist as much help as possible, especially in the first couple of weeks.
Some Very Useful Blogs:
I found the personal stories and practical information in these blogs very useful, especially while feeling painfully isolated and yet needing to know more about this bunion business, during these days at home. They are in no particular order – take what you can from them:-
Best Feet Forwards (added 20/04/13) Recent blog about operations on both feet, simultaneously.
Lucky Knickers: http://www.blogs.mspmags.com
All others taken by Yours Truly (From the CanYouTellWhatItIsYet School of Photography)