Question from Diane: I will have bunion surgery on Friday on my left foot. It’s had problems of blisters and pain. The right is not as bad. So I planned on just repairing the left first. Please give me some tips on preventing the next surgery or should I just have it done at the same time?

Smiling Walker: I wish I had all the answers for you. Here’s my experience and what I learned:

Both my surgeon and 2nd opinion doctor advised against both feet at the same time. Both have done surgeries on people who had both feet done. I have spoken to four women who had both feet done at the same time.

Woman #1, a good friend, said it wasn’t a problem physically. She just shuffled on crutches at her job (she’s a teacher) for several weeks. She was married at the time with two preteens and said she got little help from the family, which made it difficult. She also only had problems with the big toe bunions.

Woman #2 said she was a busy, active woman with two teenage children and a husband and couldn’t waste the time off her feet doing one foot at a time. She demanded her doctor do both or she’d find another doctor. He did it. She said she slid on her butt in the house for a month and crawled with her feet up for a few weeks after that, but then it was over and she was back on her feet running (literally – she is a runner). She said it helped that her children waited on her or she would have been left to the dogs. It’s been two years and she says her feet are not “big boob” pretty, but they work.

Woman #3 (#2’s sister) is also a busy woman, but single. Her experience was very painful and difficult. She attributes this to not having the support system to help her while she was recovering. She recommends one foot at time to anyone who asks.

Woman #4 is a mom of three boys now, but was single at the time she had her bunions removed. She said her fiancĂ© did everything for her for a month. She didn’t walk on her feet the entire time except to go the bathroom, and like #2, she crawled with feet up. She said it was really hard to follow instructions, but she did. It’s been 20 years and she has had no problems. She, like Woman #2, is very active – a fitness trainer.
She also said that she did weekly physical therapy recommended by her doctor (mine didn’t recommend this, which I found odd) and felt that helped her tremendously.

I considered doing both feet because of the time factor, but talked myself out of double foot surgery for several reasons and only did my right foot, which was causing a lot of pain.

  1. I am single and a self-employed professional speaker who is on my feet for hours at a time, I didn’t have the financial or social support to be off my feet for 4-6 weeks or the extra downtime if I had complications.
  2. Because both docs were so against double foot surgery, I decided there must be something to that. They both said I needed the other foot for balance and walking and without it if there were problems, I’d have more complications. After the cynic in me thought they might just want more business, I decided I’d rather have a happy surgeon cutting on my foot than someone who was energetically stressing because I might not follow post-recovery protocol and end up with complications that could affect their business.
  3. I didn’t have pain in my left foot and the docs had said to use surgery as a last resort. This made sense to me because technology is changing so quickly so who knows what new techniques they could have in the next decade.
  4. I met several alternative healers who said that with exercise and focused visualization I could at the very least prevent the left foot from getting worse and at best, perhaps even reverse the bunion. (That fell in the miracle category for me, but I’m open. <smiling>

In retrospect, post surgery, I made the right decision for me to do one foot at a time. I should also mention that I had two “procedures” on my right foot – bunion surgery and hammertoe surgery on the 2nd toe, because I let things go too long (I didn’t know I should have seen a podiatrist in my teens. I’ve had complications with my right foot that I’ve addressed on my blog.

Regarding preventing the next surgery, what I’ve learned is that podiatrist-fitted orthotics (range $250-$600) can, in some cases, prevent bunions from getting worse, so that could be a good option. I’m guessing your doctor will recommend them. I have them now and while I’m noticing slightly less pain on the pad of my right foot, there is still pain. Also, I’m flat footed and do notice arch support and that my ankles are not caving inside (called pronating) as much when I walk.

I’m not sure what you should do, nor would I tell you since I’m not a doctor, however, I do believe you already know the answer for yourself.

One of the ideas I’m working with when I don’t know what to do is to choose conscious non-action and ask for a clear answer in my meditations, which eventually comes, sometimes only at the moment when I’m forced to make a choice. I also ask my foot (or whatever body part is in pain) what it wants. May sound crazy, but that dialogue has connected me more with my body and healing.

Best wishes on a successful surgery!

I just got next week’s issue of U.S. News and World Report. There’s a great article on “50 Ways to Improve Your Life.” I couldn’t help but notice #3: Lose the shoes.

Everywhere I go now that I’ve come out of the shoe closet about my bunion and hammertoe surgery, I meet women who share their bunion stories, and are still wearing shoes “to die for.”

Cameron Diaz was on “Ellen” and came out wearing heels that were were as tall as the ten story buildings she jumped over in Charlie’s Angels. Six-inch heels! It doesn’t look like Cameron has bunions, and I’m not sure if Ellen does, but I can tell you that no matter how cute those shoes were, there is no way anyone who has had bunion surgery (at least my kind of bunion surgery) would ever get near those shoes for more than a minute.

Ellen asked to try the shoes on, shuffled precariously a few inches and said, “Um, tell me why you want to wear these again?” Cameron laughed and said, “Because they’re fun.” “Yeah, right,” Ellen said, “Fun for who?”

Oprah shared one of her most painful secrets (I posted on this November 1, 2006) — she wears her beautifully stylish high heeled shoes only on the set because they hurt so much. She takes the elevator down to the studio in bare feet, put on the shoes just before she walks out, and then takes them off again immediately after.

I’ve “been there, done that,” but now after B.S. (bunion surgery), my body actually begins to shudder, my teeth clench, and my eyes wince when I even think about wearing anything other than my athletic shoes. I accidentally left my dress shoes at a Christmas party last Saturday night. Fifteen minutes into the party I switched from the Donald Pliner stretchy-fabric, low-heeled pumps, which are as comfortable as they come, at least pre-surgery, into my sturdy leather J. Crew sandals I brought along “just in case.”

Ahhhhh. How do you spell relief? “Lose the shoes.”

“The good news” Dr. Robin Ross, a podiatrist in NY is quoted as saying, “is that the pointy shoe is heading more toward the rounded toe box.”For a list of bunion shoe brands and styles, check out:

Bunion Survivor’s Ebook Guide to
Successful Bunion Surgery & Recovery

Day 63 Post Surgery Update: Read this day’s post only if you are willing to see beyond my challenges (okay, whining to some) and detailed personal update to discover several tips to make your recovery easier. If you’d rather pass by the personal details, go directly to the bottom of this post for lessons and tips.

My foot is still swollen. The orthotics I picked up from the doctor last week do not fit properly and need to be adjusted.

I had my second Feldenkreis session and discovered that my calf bones on my right leg that I had the bunion surgery are bowed out, exacerbated by the improper fitting of the orthotic, causing my hip to swing my leg outward before landing my foot on the ground. This is causing my leg to put all its weight on my right outside foot and cause occasion loss of balance.

The two inches of scar tissue on the top foot below my 2nd toe is still pulling my 2nd toe upward and causing it to rest 1/4 inch above the ground.

My big toe is now looking like it has a bunion again and is still moving east when I’m not wearing the night splint. It is still swollen and stiff, even after using orthotics, doing daily exercises and walking 1 mile a day, which the doctor recommended. It is also very tender on the underside when I walk on it. The surgeon says that it is still more swollen than it should be by this time, but to wait until the 12 week point to see if the swelling has gone down before making any new recommendations. Supposedly swelling can last up to to a year in some people.

The pain underneath my third toe is still there. I’m told it “should” recede as the swelling on my big toe goes down, but that may not happen until the screws are removed. I’m also told that the screw may be causing swelling and inflammation, which is causing the bone not to heal as quickly, which means the screw can’t be removed because it will make the bone unstable. It seems like a catch-22. My concern is that by waiting until 12 weeks the bone will have healed curved and need more surgery to correct (which the doctor has alluded to).

The most frustrating thing is that the very reason I had the surgery was to relieve the pain on the underside of my foot beneath my 2nd toe. Now the pain has shifted to my third toe, and is more intense, along with the pain beneath the big toe, which the surgeon’s assistant who fitted the orthotics said may be because the foot hasn’t walked on that area and it has to build new callouses. Great. Seems like I’m just moving the callouses on my foot from one place to another.

But the good news is that there is no pain on the side of foot where the bunion was. Of course I haven’t worn normal shoes yet, so who knows about that, but I’m looking for the bright side.

I can still walk. My left foot even with bunion isn’t hurting me. I’m healthy. I just had my colonoscopy and I have a happy healthy colon.

So what have I learned to help you?

1. Be VERY clear in asking your doctor pre-surgery what the best AND WORST outcomes could be specific to your foot.

2. Do your homework ahead of time and ask for a splint right away to keep your big toe straight and keep it from healing back into the old curved position.

3. Consider working with a Feldenkreis Practioner to help your feet realign themselves naturally. This has been a blessing. If you’re in San Diego, contact Feldenkreis Goddess, Sharon Moyano at sstarmoyano@yahoo.com.

4. If you have any gut feelings that your post-surgery healing isn’t going as you think it should, get a second opinion one week following your surgery.

5. Just because a surgeon does a good job doesn’t mean that he has good follow-up care. Be assertive and ask for the attention you deserve. If you’re not getting answers that make sense, push for clarity.

6. Practice visualization before and after your surgery, seeing your foot healthy and happy and you walking normally and with great ease. This will help build a better image in your mind and counteract your worry. Until your mind can see your foot healthy and happy, it can’t create it. Nature will take its course. Help it along.

Bunion Survivor’s Ebook
Guide toSuccessful Bunion Surgery & Recovery

Sorry to be so focused on what isn’t working. After rereading this post, it’s clear I’ve got to up my positive visualization. I’ve been talking to my foot and my mind, asking for help in staying positive. It’s not my nature to complain so this is also a real test for me to acknowledge what isn’t working clearly yet briefly and move into solution, visualization, and action as quickly as possible.

Step into your future and keep moving your feet,

Smiling Walker

Back walking at the beach! Yay! And what a different view from the top. No golf ball hidden in the right “Great Toe Joint.” For comparison, revisit the before bunion surgery photo from July 18, 2006.

Foot after Bunion Surgery & RecoveryBunion Surgery Recovery Update: Well, I wasn’t prepared to find out that my foot is more swollen than most at six weeks following surgery and that it could be several things: 1) the screw holding the bones together is irritating the skin, 2) my circulation is poor, 3) I’m doing too much activity, 4) it’s my body’s healing process.

I also wasn’t prepared to learn that I may have to have more surgery to straighten the 2nd toe that he shortened, which is now still laying a 1/4 inch above the rest due to the scar adhesions pulling it up. As well, the 3rd toe bone is now (and probably always was) digging into the pad on the bottom of my foot and may need the same surgery as the 2nd toe to correct it.

And, the pain I’m feeling on the side of my foot at the Taylor’s bunion spot (just below the little toe) may or may not go away and will also potentially require surgery if the pain persists after the swelling of the big toe goes down.

Suggested action: watch it all for another six weeks and then come back and we’ll see where things are. In the meantime, don’t walk when it hurts, be fitted for orthotics in my exercise shoes and don’t go barefoot – which is the major reason I came in for the surgery in the first place! Grrr!

What I’ve learned:

  • I did ask for a prescription for physical therapy to make sure I’m walking properly as I heal and did get that after asking for it three times.
  • I did ask for orthotics, and was fitted. They’ll be ready in three weeks, when I’ll return for a final fitting.
  • I acknowledged to my surgeon how much I appreciated his attention on this visit to my foot and what was going on and what my options are, because it helped me feel confident in his care and that helped my healing.
  • I will get a 2nd opinion on this.

What I’m grateful for:

It’s hard to feel grateful right now given my expectation that I’d have the surgery and that would be the end of all pain. I know it’s really important to get into a grateful state of mind for easier healing, less stress, and good relationship building.

So I will remind myself that I have options, I’m not in a wheelchair, I’m healthy, and I can still walk in the canyons and along the ocean and smile.

And I can write and share this with you so that you know to take great care of your feet and don’t wait like I did until the pain gets so bad that you have no other options. Take care of yourself NOW.

Mary/Smiling Walker

Bunion Survivor’s Ebook Guide to Successful Bunion Surgery & Recovery