This week I turned 39. I will have a cheilectomy on my right foot (the foot I use to drive) in one month.
In the years during college, and more than a decade afterward, I lived in Chicago. I love fashion and wore a lot of high heeled footwear. Given that I lived in a large city, I walked almost everywhere I went - a block to the grocery, several blocks to the train station, a couple miles during a day of shopping and fun with friends. I loved city life and I loved walking. I realized quickly, upon moving to a big city where my walking would total miles each day, that high quality footwear was important, so I did not skimp on inexpensive, poorly made shoes. I invested in well-made shoes. I say this for no other reason than to dispute one idea put forth as a cause of foot problems - that poorly made or ill-fitting shoes are to blame. That was not the cause in my case.
Following the birth of my first child at age 31, I started to notice that I was not able to walk comfortably in high heeled footwear. During pregnancy, my feet also grew (permanently) by half a size. I resigned myself to new shoes - more practical shoes, with lower (or no) heel height. I also found myself walking less. These modifications did the trick.
A couple years after that, I found that I really couldn't wear high heels at all. The most I could do was a 1.5 inch wedge. I still suffered through 2 inch heels for weddings or formal occasions, but this really made my feet hurt. Not just your typical aching feet from a long day of standing or walking, but real pain that lingered.
Following the birth of my second child at age 37, I was experiencing foot pain even with my practical wedges and flats. Even in comfortable running shoes. My feet experienced hot, burning pain. Also, it was clear to the naked eye that I had some sort of malformation of bones or something. From a quick glance, it appeared I had a bunion. I started asking around and found that bunions were not unusual among women in their 50s or 60s.
At age 37 (6 years after my earliest symptoms), I decided to see an orthopaedic surgeon specialized in foot and ankle. When the surgeon showed me the images of my bones, it was clear even to me - with my limited, Google-centric medical "knowledge" - that bunions were not my problem. He easily diagnosed me with hallux rigidus, more commonly known as arthritis of the big toe. With a diagnosis like this, I felt kind of silly. But as I sat with the knowledge, I realized that this was not that different from the millions of baby boomers living with arthritis in their knees, hips, or hands. The big toe may be a physically tiny joint in ones body, but it's a critical part of how we get around every day.The surgeon said my treatment options included (1) orthotic inserts to stiffen my shoes and increase my comfort when walking, (2) a cheilectomy, (3) a fusion, or (4) a joint replacement or implant. He did not necessarily recommend 2, 3, or 4 to me but he wanted to give me a sense of what treatments would be available to me over my lifetime - since arthritis is of course a progressive disease that will only get worse over my lifetime and can never be "cured." He noted that he'd seen some interesting research regarding option 4, but that joint replacements were so new that he wouldn't recommend one at this time. But maybe during my lifetime at some point? (I like having hope!) Option 3 was downright depressing to an active woman in her 30s - a fusion means you will no longer have any bending abilities in your big toe... decreasing your ability to be active or wear high heels (yes I'm vain, but I like my high heels).
I like knowing as much as I possibly can (I'm a "more info is better" type of person when it comes to medical issues) so I set out to learn as much as I could. But I was busy as a stay at home parent to a school-aged child and a toddler, so it was easy to become distracted. My foot didn't hesitate to remind me about my problem, though. In the spring and summer of my 38th year, I began to have constant pain, even when resting my foot or laying down to sleep. I began to realize that for a few years I'd been "babying" my right foot by relying more on my left foot when squatting down, doing planks at the gym, or walking. My pain was primarily of the hot, burning sort - a classic description of arthritic pain. In casual conversation I heard a referral to a well-liked podiatrist and decided to get a second opinion.
At age 38, the podiatrist gave me the same diagnosis and set of treatment options. Having already researched these options one year prior after seeing the orthopaedic surgeon, and discussing them further with the podiatrist, I decided right then and there to proceed with a cheilectomy. I am a bit of a medical snob, having worked in the administrative side of the healthcare industry for more than two decades. All along I intended to have a surgeon do my cheilectomy, but the warmth and understanding I felt from the podiatrist, as well as her confidence, training/professional background, and the frequency with which she performs cheilectomies, made me decide to move forward with her. I spoke to a few trusted friends (who are doctors) about the podiatrist vs. surgeon matter, and each of them said that it depends on the podiatrist - that they wouldn't hesitate to use a podiatrist IF that person was appropriately trained and credentialed. I might be unusual, but this was a bit of a concern for me.
So - why am I writing this blog? I may be vain about my shoes but I do not like being the center of attention in a more general sense. Also, I highly value privacy online. However, my decision to have a cheilectomy was made much easier by having reviewed online forums where others suffering arthritis had discussed details of their cheilectomies and recovery. (This one in particular. Thank you, anonymous friend, for writing such great information!) I want to contribute to this body of information and hopefully my experience will offer a resource for others.
More particularly, I found virtually nothing online about highly active people under the age of 40 with hallux rigidus who decided to pursue a cheilectomy. (Yes, Shaq had one... but, a Midwestern stay at home mom is a little different than a pro basketball superstar.) Being young and active, I am trying to plan ahead so my feet will enjoy many more years of moving, walking, dancing, and fashionable footwear-wearing. Given that a cheilectomy isn't a procedure that should be repeated every few years, I did not enter lightly into this decision. This is my shot to buy one or two decades of more comfortable walking. I do not want to have a fusion for a long, long time - if ever. I hope yet don't know if an implant will ever be the best option.
My questions now:
In the years during college, and more than a decade afterward, I lived in Chicago. I love fashion and wore a lot of high heeled footwear. Given that I lived in a large city, I walked almost everywhere I went - a block to the grocery, several blocks to the train station, a couple miles during a day of shopping and fun with friends. I loved city life and I loved walking. I realized quickly, upon moving to a big city where my walking would total miles each day, that high quality footwear was important, so I did not skimp on inexpensive, poorly made shoes. I invested in well-made shoes. I say this for no other reason than to dispute one idea put forth as a cause of foot problems - that poorly made or ill-fitting shoes are to blame. That was not the cause in my case.
Following the birth of my first child at age 31, I started to notice that I was not able to walk comfortably in high heeled footwear. During pregnancy, my feet also grew (permanently) by half a size. I resigned myself to new shoes - more practical shoes, with lower (or no) heel height. I also found myself walking less. These modifications did the trick.
A couple years after that, I found that I really couldn't wear high heels at all. The most I could do was a 1.5 inch wedge. I still suffered through 2 inch heels for weddings or formal occasions, but this really made my feet hurt. Not just your typical aching feet from a long day of standing or walking, but real pain that lingered.
Following the birth of my second child at age 37, I was experiencing foot pain even with my practical wedges and flats. Even in comfortable running shoes. My feet experienced hot, burning pain. Also, it was clear to the naked eye that I had some sort of malformation of bones or something. From a quick glance, it appeared I had a bunion. I started asking around and found that bunions were not unusual among women in their 50s or 60s.
 |
| My arthritic foot at the pool |
At age 37 (6 years after my earliest symptoms), I decided to see an orthopaedic surgeon specialized in foot and ankle. When the surgeon showed me the images of my bones, it was clear even to me - with my limited, Google-centric medical "knowledge" - that bunions were not my problem. He easily diagnosed me with hallux rigidus, more commonly known as arthritis of the big toe. With a diagnosis like this, I felt kind of silly. But as I sat with the knowledge, I realized that this was not that different from the millions of baby boomers living with arthritis in their knees, hips, or hands. The big toe may be a physically tiny joint in ones body, but it's a critical part of how we get around every day.The surgeon said my treatment options included (1) orthotic inserts to stiffen my shoes and increase my comfort when walking, (2) a cheilectomy, (3) a fusion, or (4) a joint replacement or implant. He did not necessarily recommend 2, 3, or 4 to me but he wanted to give me a sense of what treatments would be available to me over my lifetime - since arthritis is of course a progressive disease that will only get worse over my lifetime and can never be "cured." He noted that he'd seen some interesting research regarding option 4, but that joint replacements were so new that he wouldn't recommend one at this time. But maybe during my lifetime at some point? (I like having hope!) Option 3 was downright depressing to an active woman in her 30s - a fusion means you will no longer have any bending abilities in your big toe... decreasing your ability to be active or wear high heels (yes I'm vain, but I like my high heels).
I like knowing as much as I possibly can (I'm a "more info is better" type of person when it comes to medical issues) so I set out to learn as much as I could. But I was busy as a stay at home parent to a school-aged child and a toddler, so it was easy to become distracted. My foot didn't hesitate to remind me about my problem, though. In the spring and summer of my 38th year, I began to have constant pain, even when resting my foot or laying down to sleep. I began to realize that for a few years I'd been "babying" my right foot by relying more on my left foot when squatting down, doing planks at the gym, or walking. My pain was primarily of the hot, burning sort - a classic description of arthritic pain. In casual conversation I heard a referral to a well-liked podiatrist and decided to get a second opinion.
At age 38, the podiatrist gave me the same diagnosis and set of treatment options. Having already researched these options one year prior after seeing the orthopaedic surgeon, and discussing them further with the podiatrist, I decided right then and there to proceed with a cheilectomy. I am a bit of a medical snob, having worked in the administrative side of the healthcare industry for more than two decades. All along I intended to have a surgeon do my cheilectomy, but the warmth and understanding I felt from the podiatrist, as well as her confidence, training/professional background, and the frequency with which she performs cheilectomies, made me decide to move forward with her. I spoke to a few trusted friends (who are doctors) about the podiatrist vs. surgeon matter, and each of them said that it depends on the podiatrist - that they wouldn't hesitate to use a podiatrist IF that person was appropriately trained and credentialed. I might be unusual, but this was a bit of a concern for me.
So - why am I writing this blog? I may be vain about my shoes but I do not like being the center of attention in a more general sense. Also, I highly value privacy online. However, my decision to have a cheilectomy was made much easier by having reviewed online forums where others suffering arthritis had discussed details of their cheilectomies and recovery. (This one in particular. Thank you, anonymous friend, for writing such great information!) I want to contribute to this body of information and hopefully my experience will offer a resource for others.
More particularly, I found virtually nothing online about highly active people under the age of 40 with hallux rigidus who decided to pursue a cheilectomy. (Yes, Shaq had one... but, a Midwestern stay at home mom is a little different than a pro basketball superstar.) Being young and active, I am trying to plan ahead so my feet will enjoy many more years of moving, walking, dancing, and fashionable footwear-wearing. Given that a cheilectomy isn't a procedure that should be repeated every few years, I did not enter lightly into this decision. This is my shot to buy one or two decades of more comfortable walking. I do not want to have a fusion for a long, long time - if ever. I hope yet don't know if an implant will ever be the best option.
My questions now:
- How hard will it be to do my job (taking care of a 7 year old and a 2 year old) in the weeks and months following my cheilectomy?
- When will I be able to drive?!?!
- When will I be able to return to my beloved Pilates reformer workouts?
- How many medical aids will I have to purchase to make it through the first couple weeks of recovery?
- What will my cartilage look like when the podiatrist opens up my toe? (Fingers crossed!)
Comments
Post a Comment