Bunions & the 10-year difference

The Right Foot Starts It Off

About a decade ago, in 2013, I started having pain in my right foot. I liked being active but, with my foot hurting the way it was, I wasn’t even trying to walk in sneakers with a very roomy toe box. My podiatrist told me that the bunion on my right toe was the source of my pain. Bunions are genetic on both sides of my family; therefore, I knew I had them, but I had never had any pain before. A bunion hurts like a mug once it decides to bother you.

Left foot bunion x-ray photo (June 2023)

According to the Mayo Clinic, a bunion is a bony bump that forms on the joint at the base of the big toe and occurs when some of the bones in the front part of the foot move out of alignment. The tip of the big toe shifts towards the smaller toes in the foot, forcing the joint on that toe to stick out. Essentially, your toes end up with a noticeable side lean. Although bunions can be caused by shoes, wearing pointy toed, high heels was not my style. I love comfy shoes, and was definitely a victim of genetics!

My podiatrist recommended surgery and I decided to do it. I had my right foot corrected in the summer of 2013, healed beautifully, and moved on. My left foot was absolutely fine at the time. I never even considered the possibility of future pain, but ten years later, at the beginning of 2023, the bunion on my left foot started acting up! I knew all of the signs, but was hoping the pain would disappear and I could avoid surgery. A miracle did not happen. Instead, I started having auxiliary pain in my knees and shins to overcompensate for the bunion. By June, I couldn’t ignore the pain any longer. The bunion was affecting my life, and it was time to get it fixed.

My feet in 2021 . Right foot bunion corrected in 2013.

It is never a convenient time to be down a foot. I knew I would be in a surgical boot for at least a month, so scheduling was going to be a hurdle. My doctor only did surgery two days a month, so between his surgery schedule and my work and personal obligations, the soonest I could undergo a hallux valgus correction with osteotomy, the official name of my bunion surgery, was the end of September 2023.

I tend to be an over doer, earnestly believing I have the capacity to do much more than is realistic. Therefore, true to form, the only days I took off from work were Wednesday, the day of surgery, Thursday, and Friday. This surgery involved having my foot bone shaven down, strategically broken and reset. Although I have been trying to embrace rest as resistance and leaning into the soft life, clearly, I still struggle. My rationale was that I worked from home, so I was going to be alright. I even worked a few hours the day after my surgery to figure out an issue. Sigh.

Contributing to my fallacy in thinking was my experience from ten years ago. I don’t remember how long I took off from work but, knowing me, it was no more than a week. In 2013, I was commuting to work EVERY DAY, driving into the office on the foot the surgery was performed, and hobbling from my car to the office and anywhere else I needed to hobble. Back then, I lived in a building with no elevator. In addition to commuting, I was walking up and down three flights of stairs every day.

The Left Foot Finishes It

I assumed my recovery in 2023 was going to be a cake walk because I was working from home. I was so incredibly wrong. There was no part of me that planned for a rough recovery period. None. I didn’t even go grocery shopping and I really should have. A friend of mine came to visit and was like, ‘Nekose, didn’t you do any meal prep knowing you were having this surgery?’ No ma’am, I did not. Clearly, I entered into an unrealistic decision-making process with myself that took hindsight for me to regret.

The first two days were fine. I was slowly dragging that foot behind me at home, but all hell broke loose on Friday night. Apparently, the pain had been manageable because I still had the IV drugs in my system and the local anesthetic in my foot had not worn off. By Friday night, everything had worn off and my foot was on fire. I had already taken the recommended dose of the acetaminophen-codeine #3 300 pain meds I received and was still in pain after two pills.

Another friend of mine brought me food and advised me to take an additional pill. I couldn’t keep my eyes open after the third pill. Instead of actual pain relief, the meds just put me to sleep. The weekend was a mixed bag between feeling okay and my foot being like, “WHAT DID YOU DO??!!” I started using crutches I already had at the house. My foot could not take the pressure of my body weight. In 2013, I never needed crutches and didn’t even get a precautionary set. The point of surgery is to ultimately be able to weight bear comfortably; therefore, walking on the foot as soon as possible is preferable.

The Soft Boot

By Monday, I thought I had rounded the corner but definitely wasn’t ready to drive. I went to my follow-up doctor’s appointment using a rideshare service. I was x-rayed and examined, and everything appeared to be in order. It went downhill after I accepted the offer of a hard boot, and one of the office ladies tried to get me in one. I already had a soft boot, but my doctor said if I was going to be walking around, the hard boot would make it easier. It did not. The pain I felt when that hard boot went on and was tightened was excruciating. After that ordeal, I had to rest in the office, then went back home in my soft boot.

I knew I was in real trouble that same day when I couldn’t make it to the trash and recycle areas in my community. I had to flag down a nice man to take the items from me. It took me forever to hobble back to my unit. Putting any pressure on my foot was extremely painful, the crutches were cumbersome, and the Tylenol with codeine still wasn’t helping. I did not want to be asleep from exceeding the recommended dosage so I was suffering. By Tuesday night, the foot pain woke me up out of my sleep. By Wednesday morning, exactly one week after the surgery, I was in even more pain.

The blister forms

There was a vein near the incision site that was bulging and throbbing. A hard knot was forming at what felt like the end of that vein. By 9:00 a.m. I had diagnosed myself with either a seroma or a hematoma and had done a ton of research on if a throbbing vein needed medical attention. Dr. Google and I had been rolling deep because my doctor’s emergency line was not working. I reached out to my nurse and doctor friends and decided to call my podiatrist’s office to get an emergency appointment.

One of my sisters came to pick me up, no more rideshares to the doctor for me. By then my self-diagnosis was firmly in the seroma camp. Turns out a huge blister was forming under the surgical tape on my foot. I could see it by the time I got to the doctor, but it was not visible in the morning when I first felt the knot. My podiatrist lanced the blister, which was filled with clear fluid, assured me I didn’t have a seroma or a hematoma, and sent me on my way. Once again, I thought I had rounded the corner and decided to treat my sister to lunch.

Instead of having her drop me off in front of the restaurant, like a reasonable person with a foot injury, I decided to walk with her from the parking structure, without my crutches, to practice my weight bearing. Once again, I was doing too much. I couldn’t make it to the restaurant and my sister was not strong enough to carry me. A friend of mine who owns an exercise studio close to the restaurant in Downtown Silver Spring came to help and decided it was actually faster to just carry me. I was no longer self-sufficient and was carried into the restaurant like a big, heavy baby. It was a sad, sad day for me. Then I ate lunch, had a cocktail, and forgave myself. I did not hobble back to the car and had my sister come to the restaurant instead!

For a period of time, I was legitimately concerned that my foot wasn’t going to heal correctly. Here I was trying to fix a problem, and now I was wondering if I was permanently injured. Showering required the use of a stool, walking with the crutches took forever and wasn’t comfortable, and putting weight on my foot hurt. At home, I had taken to crawling around my house. That was easier than hopping on my right foot or using crutches, but my knees didn’t appreciate the crawling. They are soft and sensitive. In 2013, when I had surgery on the right foot, my left foot was a rockstar! I could hop on that foot for as long as necessary, with no problem. In 2023, my right foot said no. It was like, “We not about that hopping life, your body has changed.” My foot was shading my behind.

My Peg Leg

I bought a peg leg thinking that would help me get around hands free, but it was heavy and cumbersome. Then I bought one of those 4-wheeled knee scooters. In hindsight, my foot was terrible for about a 5-day window where it felt like all hope was lost. I started missing all the activities I could do seamlessly, like easily putting on my clothes and walking. By the beginning of the following week, the foot was feeling better. Then another blister started to form the day after my third doctor’s follow-up (in a 2-week time frame). I lanced it myself then went down a rabbit hole on fracture blisters, which I was convinced was the cause of the blistering and potentially irritation from the surgical tape.

The Ten-Year Difference

I got asked a ton of questions about what happened to my foot and ended up talking to lots of folks about my bunion surgery. It took these conversations for me to truly sit with how big of a difference being 10-years older and heavier made in my healing process, and how my body responds to trauma. At 35, I did not blister at all. I took a pillow to work with me and kept my foot elevated on my desk. I did have a very considerate roommate who made sure I didn’t have to hobble around the house. She also put the garbage and recycling out and got us food, so I hardly did anything when I was home. Thanks Marisa!!

One of the many bunion conversations I had was with my dad, who told me his bunion hurt FOR YEARS then “just stopped hurting.” I could not even imagine. The level of crankiness that would live in my soul if my bunion hurt for years. Two of Daddy’s toes are now crossed, but at least his bunion doesn’t hurt anymore. At his age, he is not interested in getting something fixed that’s no longer hurting. My aunt in Guyana told me my Auntie Malva, who passed away a few years ago, never wore closed toe shoes because of her bunions. The pain was too much so she only wore sandals (Guyana is a tropical country). A number of older Black people I chatted with had painful bunions they never addressed. We are very fortunate to have better options than our elders.

The consensus from everyone who saw my foot was that I had a really good scar and folks asked for my podiatrist info! Although the surgery scar itself is minimal, the scar from that blister looks terrible and that’s what I see when I look at my foot!! I didn’t even pick at the blister, and I still ended up with a scar. Despite the scar, I am very glad I had the procedure done. I will never have to worry about a bunion again because the type of surgery I had mitigates a recurrence. I truly have had no problems with my right foot all of these years later, which was the catalyst for me to get the left foot done.

A decade ago, I gained weight during my bunion recovery period. My activity level was much lower than before surgery, but I was still eating good! This time around, I lost weight. My lack of preparation meant I had to order most of my meals. What I wasn’t going to do was spend $50 a day on Door Dash. Walking around the grocery store was not an option either, although I did use those electrified carts on two occasions. It was not the same as shopping with my legs. Navigating those carts in the aisles, and around people, gets tricky plus I needed help returning the cart! Driving it back into the store meant I had to walk back to my car and I didn’t have the energy for all that. Some nice man in the parking lot drove it back for me.

I spent so much time in pain, or generally not feeling well, that I honestly didn’t have much of an appetite, which is typical for me when I am upset. I ended up ordering one solid meal a day that I would split into two portions. My caloric intake was greatly reduced and I lost about eight pounds. This is the most unsustainable way to lose weight! Once my appetite came back, and I stopped stressing over the future of my foot, those eight pounds showed up like, ‘hello old friend.’ My activity level picked back up and I was feeling like myself. Age makes a huge difference in how the body handles things. I had the same doctor perform the same surgery, a decade later, with vastly different recovery experiences.

The Business of Healthcare

The medical billing for my bunion surgery was ridiculous! The surgery center collected their money up front, taking more than $1,000 before doing the procedure. I got phone calls for a week prior to surgery saying that I needed to pre-pay. On the day of the procedure, I asked to pay half “just in case.” Y’all shouldn’t get no money if you kill me. They still took the whole amount, then I got a bill from the doctor’s office for about $845. I was confused because I knew my podiatrist had a financial stake in the surgery center so wasn’t I paying him at the same time?

I was told that there will always be three bills associated with surgery—the surgery center (which pays the staff), the doctor’s bill, and the anesthesiologists bill. Healthcare in America is a continuous failure. Part of the reason for my ridiculously high medical costs was that my employer failed to notify us that our plan year began on September 1. This meant a plan year deductible of $1,000 was applicable to the colonoscopy I just had in August, and then again for the bunion surgery in September because it was a new plan year. It’s super important to know when your plan year begins. Our insurance “open enrollment” occurred after the start of the plan year.

When I received my explanation of benefits from the health insurance company, it said I owed the surgery center about $300 instead of more than $1,000. Always check your explanation of benefits. After the dust settled, the surgery center refunded my overpayment and I even ended up being credited on the doctor’s bill. I took that as a pain and suffering credit for the numerous times I tried to call the after hours emergency line and it wasn’t working!! I hope they fixed that ‘cause you know I mentioned it.

March 2024 Feet

Back on the Good Foot

It’s been six months since having my bunion surgery and my foot is doing well. My doctor said that it’s not uncommon to have soft tissue swelling for up to a year. I was definitely experiencing that, and residual tenderness on the top of my foot. However, I was able to go back to Pilates 6-weeks after surgery! I definitely had to take it slowly and did not have the same range of motion as before. I’m back in the full swing of Pilates now, but my balance is not completely back to normal yet and my toes are still working on their full range of motion. The foot stretching, flexion, and extensions have been super helpful. I definitely credit Pilates with an assist on my healing.

I have even been able to take kickboxing classes. I experienced more swelling after kickboxing so went back to wrapping that foot up to better kick the bag. I probably should have checked in with the podiatrist before going to kickboxing, but the goal for my surgery was always normal, pain-free activity. I know my foot appreciates being used in all capacities. The blister scar needs to fade so I’m not constantly reminded of the trauma. Outside of that, with each day, I am closer to optimal foot health and am even back wearing my little high heeled boots with a roomy toe box!