Hi. I have an appointment for the pre-op for the Great Toe Fusion on Friday, February 18th. I'm hoping at that time that I can get a surgery date for February 28th or March 1st (he does surgery on Monday's and Tuesday's) as I want to get this surgery done as soon as possible. I know that I have about a 3 month recovery time so I want to get this done so that I can be walking again - FINALLY WITHOUT PAIN, by the Summer and also not having to wear the Cam Walker when the weather gets hot. The dr will put me in the Cam Walker as long as I am complient witht he instructions on how to wear it and it will allow me to takl it off to shower!!
When I initially saw the dr, he said I'd have about the same level of pain that I did with the chilectomy, but I can't imagine it will the same as this surgery with the removal of the joint and inserting a screw. I think that drs are somewhat nonchalant about how the pain might actually be and the level and tolerance of pain is different from patient to patient and I understand that. What has been your experience with the pain level of the fusion surgery to the chielectomy? He said that he will give me enough pain medicine during the surgery that should last several hrs after I get home and will prescribe pain medicine so I will have it if needed.
One BIG question I had too was about deciding about anesthesia. When I have the pre-op testing I will meet with a Anesthesiologist and discuss this, but I am trying to determine some things about this particular surgery and what I might experience under conscious sedation and nerve block or an epadurial. I understand with conscious sedation that one generally falls asleep, but I don't want to be able to hear ANYTHING the dr is saying or feel or hear any of the drilling, etc.!!!
When I saw the PT last year and I voiced my concerns about the problems I had last time with the crutches, she suggested a walker might be more stable for me. I have already mentioned that I would like to do this and because I had problems last time the health plan will authorize a PT to help me with the walker and crutches as I will need them when I leave my apartment as I have stairs.
I KNOW these are a lot of questions, but I would appreciate if you could answer them BEFORE I see the dr. This would be extremely helpful.
Thanks so much in advance!!

Dear Great toe pain,
I think the best person to ask regarding anesthesia is your anesthesiologist, I am sure that if you voice your concerns he/she will accommadate you and try to make you as comfortable as possible during the surgery.

It's really difficult for me to gauge how much pain you will experience post-operatively. There are a lot of factors that may affect you level of pain for example:1) your pain threshold 2) amount of swelling to the affected area 3) activity level 4) pain medication and so on....

The best advice I could give you is 1) to stay off your foot as much as possible during the first 72hrs post-operatively, 2)Ice the affected area and 3)use the prescribed medication as directed. Keep in contact with your surgeon in case of emergency.

Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM
foot.com expert

Hi SBarlizo,

Thanks for your answer to my psot regarding the Fusion Surgery. I will be seeing the dr tomorow for the Pre-Op appointemnt and have a listi of questions to ask him. If he can't answer them I will bring them to the Pre-Op testing that they do where I se the anesthiealogist.
What is your experience with pain redction once the fusion is healed. i can't wait to be able to walk pain free!!! I can be fine oneminute and do something like snag my foot while dressing, stub it, catch it on a hole in the sidewalk and OWWW!!

Andrea

Hi SBarlizo,
I saw the doctor on Friday and will await a call either this week or next for a surgery date. I just want to get the surgery and recovery behind me and know that this time I will be able to walk pain free. What's that ? LOL It has been over 5 years now since I have had pain free walking. IT WILL BE SO NICE!!!
The dr prescribed a aircast and they fitted for me after the appointment. I've been trying it out so I can get used to how it feels and how to put it on and take it off. The doctor said I will be able to walk on my heels and I suppose the whole time the toe is fusing I will also be using the crutches along with wearing the aircast. The people in the cast room inflated the aircells and she said once she did it it wouldn't have to be done again. I noticed that on the website for the Aircast, the foam at the top of the aircast is level to the shell of the boot. Should they have cut it? On the aircasts that go to just below the knee, they have a piece of foam that goes over the toe which would keep my toe warm when I am outside, but I don't see how this one would. I was wondering though when I do take it off (I suppose I wouldn't at all in the first 2 weeks, wouldn't my toe be unsupported and valuenerable to getting bumped and affect the surgery. I guess I will have to be extremely careful when taking it off and one thing the PT can help me with is figuring out a safe way to get in and out and shower without knockling my foot. I did buy a grab bar for the bath tub, but am not sure of the correct and best place to put it to have it be efective.
I will let you know when I get a sugery date. If you would respond to some of my questions in this post I would appreciate ti.

Andrea

Dear Andrea,
Is it an aircast or a cam walker???

SBarlizo,DPM
foot.comexpert

hi SBarlizo,
When the doctor originally told me what he would use he called it an Cam Walker. What he prescribed is an Aircast- SP Walker. He said I could walk on my heel, but unlike the post op shoe, it doesn't have a slanted heal so it puts a lot of strain on the shin area. Oh well, you can't win.
I'd appreciate if you'd answer the other questions I had in my last post.

Thanks.

Andreea

Dear Andrea,
There are actually quite a number of Aircasts on the market. I would recommend asking your Doctor any questions you may have regarding the device that he prescribes. Don't be shy, just ask him questions, he is after all your doctor.

Thank-you for contacting foot.com,
SBarlizo, DPM
foot.com expert

Dear SBalizo,
I HOPE after this surgery and rrecovery I wouldn't need to use the name "Great toepain!! I FINALLY got a surgery date of Monday, March 21st. I am looking forward to geting it done, but of course with any surgery there is some anxiety as to whether it will turn out ok, how much pain and I have a lot of wondering how I am going to take care of myself for the 3 months.
The aircast is an "Aircast" (brand) SP Walker. The doctor said it should be fitted before surgery as the foot will be swollen ( or he said something like that). When I saw the doctor for the pre-op visit he brought up that I was calling to much which I don't think I was and that he wondered why I had a nurse case manager from my health plan involved, Doctor's don't like the health plans getting involved as I think they feel scrutinized. I fielded a LOT of my concerns with her and the questions I was going to ask him. My friend is taking the day off to go with me for the surgery so I will give her a list so she hopefully can remind one of us to ask the doctor about the air cast and any other questions before I go home.
I'll keep you updated. Thanks for your assistance!!

Andrea

Good-luck Andrea!

SBarlizo,DPM

SBarlizo
Hi! Yesterday I saw the surgeon and had the pre-op testing in preperation for my surgery on Monday to fuse my Right Great Toe. I am NOT looking foward to the sugery and recovery, but will be so happy when I can walk as much as I ant PAIN-Free. It has been so long since i have been pain free.
I will let you know how I'm doing after the surgery.

Andrea

Hi Sblaizo.
It is 2 days post - op. It is going to be a LONG recovery being on crutches!! Last time I didnb't hve practially ANY pain and this time it is really bad! I have been taking the meds, but it doesn't always seem to help. I am taking it more like every 4 hrs as it takes about an hour to work. he directions say every n6 but the d told my friend I could take it every 4 hrs. The dr wrapped my leg in a splint and ace bandages up to my knee. I am not suppose to put any weight on the foot for the first 2 weeks, but last night twice - both times when I started to lose my balance. The first time harder than the 2nd ime when I slid on something with the crutches(. Boy did that hurt!!!!!!!!!!!
I have an appointment next Wed wtih the dr for post op appointment. Does sound par for the course post op? Please answer ASAP. Thanks.

Andrea

Dear Andrea,
Try to be very careful on your crutches. It will take some getting use to, so be patient. Unfortunatey, it is not unusual to have pain after surgery. Follow your doctor's post-op instructions. If you have any questions, ask your doctor.

Good-luck,
SBarlzio, DPM
foot.com expert

Hi Sabarlizo,
I went to the dr today for my first post-op appointment. He said the incision looked good and he took x-rays which were fine. I was a little worried when I had put my foot down and/or slid but everything was ok. He put the foot in a cast and I see him again Aprill 14th. I thought he'd take out the stitches today, but he didn't. By the time I go on the 14th it will be 3 weeks. I also thought the inscion would be were the other one was for the Chilectomy, but this one is on the side of the toe. Oh well!! Once it fades it wouldn't show and as long as I can walk again without pain I wouldn't care!!!! (and can't wait!! )
Thanks for your answers and support.

Andrea

Dear Andrea,
Hope you are doing well.

sbarlizo, dpm
foot.com expert

Hi SBlaizo,
I saw your reply today to the post I made over a month and a half ago. It's been almost 4 weeks post-op now and I am in my 2nd fiberglas cast. Yesterday I had my 2nd post-op appointment where I brought the Aircast. but requested a fiberglass one instead as I found out when trying on the Aircast before surgery the foam layer in the Aircast made the foot quite hot. I really haven't felt overheated in the fiberglass cast, just very flaky skin around the top edge which I put moisterizers on. I know not to put anything under the cast!! With the skin cream tub and the Aircast win my basckpack when I went to get up in the doctor's waiting room I fell completely forward, but my hands went out. Everyone rushed over to help me up. Not good. This seems to happen from time to time but it's better than I try to be really pay attention on the cruthces especially getting up and down from sitting down It falling and losing balance is better than it was at first. The doctor hadn't taken the sticthes out yet which he did yesterday. i had heard from many people over the years that it doesn't hurt. WRONG, boy did it ever!! It almost brought me to tears. He pulled the stitch from one end and I could feel it as it moved, oww. Since I fell he did another x-ray and I had the cast put on. I see him again on April 28th were I will go to the Aircast and start putting weight on it leading to not needing the crutches and being able to walk on the Aircast. By then it will be 7 1/2 weeks. even if I had the Aircast now, he still doesn't want me to put any weight on the foot. 2
I'll post another updated after the next appointment.

Andrea