By: Dr. Mindi Dayton
Happy to be back to report on my Lapiplasty Big Toe Joint Fusion weeks 4-7. I am sorry I haven’t blogged for a while as it has back to business and life and usual…which has been very busy! I kept telling myself I needed to get this done, but then…well, I’m sure you know how that goes.
So, here is my last few weeks in a nutshell. I have my first plane flight post-op on December 15th, just shy of four weeks after surgery. I wore my boot and had very little trouble navigating the airport. Thank goodness for TSA precheck so I did not have to take my boot off, and surprisingly, (I had no idea prior) our boots do not make the metal detector go off! (Great new info learned to share with patients.) I walked around the Mall of America with my boot, and it was slow, but my foot felt great; my left hip and thigh was a different story, however. I took lots of breaks and didn’t push myself at all and was able to finish the Christmas shopping I had put off.
At about 4 weeks I transitioned to my post op shoe for clinic, as I do very little walking during a regular clinic day, but still used my boot when I went out to go shopping until just shy of 5 weeks. Quite frankly, the boot is easier to walk any distance in comfortably than the post op shoe from a gait standpoint. Around 5 weeks I transitioned into my tennis shoe. I had to start with my Altra Paradigm without any insert or liner in it in order to fit my foot, Incrediwear compression sleeve and sock. They were perfect as they are very wide in the toe box and also have a decent amount of height in the forefoot. The first few times I was very hesitant to “shove” my foot in and it felt like it wouldn’t/couldn’t go; however, I realized it was more fear and just “weird” feeling, so after a deep breath and pushing forward, literally, and figuratively, it worked fine. Our mind is a powerful tool and often holds us back due to fear! I know I couldn’t “hurt” my fusion site, but even I was still nervous.
Christmas was wonderful. We had all of our family at our house, and we had a terrific meal and a great time with our family. Unlike Thanksgiving, where I let Paul and our son take care of it, Paul and I conquered the Christmas meal as a great team!
We felt we needed a little getaway after the busy holiday season, so treated ourselves to a trip to Las Vegas for slightly warmer weather, some great food, and a little Three Card Poker as a late birthday trip for me. (No, we were not winners- but if you haven’t played Three Card Poker it is fun, and you need to know nothing… and can play for a long time on just a little money *most* times.) I wore my Altra’s the entire trip; yes, even with my cute dress clothes for dinner and we had a fantastic time. We walked the strip a fair amount at a slower pace than usual and again, we took several breaks to…well, let’s just say enjoy Vegas! I did find myself feeling limping quite a bit. I didn’t feel like I wanted or needed to due to how my foot felt, I just couldn’t stop myself! It was rather annoying and frustrating, I must admit; and it led to quite a bit of discomfort and muscle pain in my left (non-surgical leg) outer thigh.
What I learned:
- I could walk more normal with less limp when I took longer, more normal strides. The shorter “protective” strides I had been doing to walk flat-footed led to more limp.
- The 5th toe (where I had a hammertoe correction) really is the worst! Patients state that seems to bother them the most and now I understand- it really does!
- I really need a pedicure!
Early the first week of this month (January) I was able to get back into my New Balance 860’s (which are a little narrower in the forefoot than my Altra’s) without an insert without any issue. I am still only wearing my tennis shoes out and about, and walking barefoot or in my Hoka slides in the house. I feel like I could comfortably wear other shoes and my snow boots if it wasn’t for my darn 5th toe!
We had the opportunity to travel to St. Thomas in the Virgin Islands for a meeting last week/weekend. I continued to wear my tennis shoes and felt really good walking around. I did take a pair or reasonable sandals that I tried on at home prior to leaving and they felt comfortable then, but by the end of the day when I tried to wear them to dinner my foot was too swollen to fit into them as I had not worn my compression sleeve that day, so back into the tennis shoes it was.
When we had a little downtime, we took the opportunity to walk along the beach barefoot. This was wonderful, given we were getting pummeled with snow back in Iowa at the same time. Paul got some good video of me walking which I will post on YouTube. I also have found that now, at just shy of 8 weeks stairs are easy both up and down with a pretty normal cadence. At this time, I have just a little bit of a limp I notice if I don’t pay attention to how I am walking. I don’t feel the “need” to limp” it is just a habit now to some extent, so I am working hard on doing what I tell patients to do: focus on heel toe and a normal gait and not let myself put more pressure to the outside of my foot or limp. I think each day I am doing it less and less and having to think about what I am doing less and less.
7 weeks Post Op
Loved walking on the beach and sand in the toes!
Current foot status broken down at 7.5 weeks:
- No “pain” at all no matter how active I am at the Lapiplasty Big Toe fusion site
- My 5th toe is a little tender sometimes- the darn thing! But it looks so much better than it did before surgery!
- Still some swelling of my foot and ankle depending on the day, activity, and if I am wearing my compression sleeve. Some days the cankle is real!
- Still a little mild numb “y” feeling between my big toe and my second toe, but this has improved significantly. I notice this most when I am a little more swollen.
- Feels a little “weird” pushing off of my big toe, but not uncomfortable or painful by any means.
What is up next? I am going to start doing some early lower extremity exercise next week during week 8 on the treadmill and in the home gym so I will let you know how that goes and share any new lessons learned.