A PATIENT'S STORY (Unedited)
Read Donna's story about her decision to proceed with foot surgery and whether it was a good choice or not.
I finally decided to deal with a progressing bunion after watching a video about Scarf Osteotomy by Consultant Podiatric Surgeon, Mr. Stuart Metcalfe.
After discovering how much quicker it was to recover compared to more severe ops I was intrigued, especially reading about the high success rates too. Although I wasn’t suffering with a lot of pain, I hated the sight of my foot and how my shoes were starting to change shape because of the bunion. This had got suddenly worse in the last year.
After a consultation and X-ray and learning that I was on the cusp of needing the more severe operation, I bit the bullet to have it done just 2 weeks later.
I chose to have a local anaesthetic despite being terrified about being ‘present’ during the operation because it was closest to travel to and cheaper than having a general.
I laid down and started to receive injections in the foot and ankle to numb it, however it took longer than expected and I required a double dose of injections and then a ‘machine’ that finally numbed me! It was uncomfortable but not unbearable. The surgeons took complete care in making sure I was 100% ready for the operation.
I was wheeled into the room, couldn’t see a thing except a sheet draping down from the ceiling in which was laid across my upper legs so that I cou see beyond them. As I had no visibility from the moment I entered the surgical room I stayed fairly calm yet I was shaking a little. I came prepared with a Michael MacIntyre show to watch on an iPad with headphones, which I must admit I wouldn’t have wanted to be without!
I could hear the surgeons discussing the operation and general chit chat whenever I took my headphones off to have a listen. They’re relaxed voices gave me confidence so I continued watching my show. In no time at all, I started to hear the machine to cut the bone, a much softer sound than I expected. Other than being aware that my leg was moving around a little, I felt nothing. The surgeons kept me updated throughout, checking I was ok and before I knew it, it was over (about 40mins).
I got to see my foot before the bandages went on and the excitement of seeing my toe straight with no bunion was terrific!
After being wrapped up, I was wheeled back into the original room, provided crutches and a boot and given clear instructions for rest, ice and elevation.
That night, I had no problems sleeping and still had the benefits of the local anaesthetic numbing the foot.
Following all instructions and taking my first round of 2 paracetamol with 2 ibuprofen about 5am, it worked a treat in remaining pain free all day.
Day 1 Evening
By the evening at 4pm I had had my full allowance of medicine and the pain begun to arrive. So I decided to take more! But by 9pm the throbbing was painful. I contacted the surgeons PA, but before she had a chance to respond, I read online that the pain was being driven by the swelling pressing against the bandage, so I started to loosen the bandage and restuck it down, thankfully the throbbing subsided. I was offered an appointment the next day to check it but by loosening the bandage I had solved the problem.
A small amount of pain continued but nothing unbearable that tablets didn’t fix, plus I didn’t need to overdose on them this time! I knew it was on its way to healing.
Remarkably I didn’t take any medication from here on in, I continued to rest and ice practically all day every day as I was instructed whilst admiring my straight toes!
The bandage was replaced during an appointment, stitches were checked and swelling wasn’t as bad as I had imagined it might be. All was well. See below
I continued to rest, ice and elevate all week, I didn’t need any medication for pain at all. From the amount of sitting and elevation, the hamstring of my elevated leg was starting to hurt and I got a little sciatic pain through my glute. I decided to start exercising from a seated or laying position with weights and resistance bands to keep my cardiovascular system healthy and my strength up followed with stretching. This helped reduce the hamstring ache and sciatic nerve pinching.
Appointment 2, the bandage was removed and Mr Metcalfe checked how it was healing. The swelling had gone down some more, the scabs had further reduced and the skin had started to even out. He provided me with my next set of clear instructions and the reasoning behind them. I had to start stretching the toe joint in a specific way and exercising my toe to strengthen the tendon. So, like a good patient, I did exactly that! I could also now get in the shower again. Hurray! This was nerve wracking at first, but realised I could stand on my bare foot only on the outer edge with absolutely no contact between the ground and the first 3 toes. So in the shower I went!
My skin started to peel all around my foot like a snake losing its layer! The exercises were nerve wracking to do at first, scared to move the toe for breaking it, but I persevered and my flexibility really improved and my toe got strong that I could grab things and lift them up between my big toe and second one like I used to. The exercises really built my confidence in my toe in readiness for the next stage. I continued exercising on the floor and I believe by keeping a strong circulation I healed well.
1 month: X-ray day. It was confirmed that I can now remove the boot and start weight bearing through normal walking. I was instructed to continue my toe exercises and stretching and gradually increase the activity on my foot. Putting my trainer on was a squeeze at first and I used the crutches at first whilst walking to get used to having my foot flat on the floor. But by the end of the day I didn’t need them.
I would do this operation all over again, only with Surgeon Stuart Metcalfe and would only have the local anaesthetic as it was no where near as scary as I thought it would be, I was in and out in no time! Having a partner to help me remain with my leg mostly elevated for the first week was key. By the second week I moved around a lot more by doing light cleaning, but still elevated, rested and iced a lot too.
After 2 weeks, up to the X-ray in week 4 I was more active again but still made time for some leg elevation but didn’t feel the need to ice anywhere near as much.
I am absolutely delighted with the results and just so pleased I didn’t put it off anymore. All I would say to anyone is- don’t leave it so late you have to get the major operation like Lapidus, the NHS advised me to leave it until it was terrible. I’m so relieved I didn’t follow this advice and discovered what a Scarf Osteotomy could do.
REPLY FROM MR METCALFE
"A big thank you for your feedback. The feedback about my overzealous bandaging is noted! I am sure patients will find your story valuable in helping them understanding what to expect after bunion surgery. I am delighted you are progressing so well and wish you well for the future. "