Five Tips To Help You Through Bunion Surgery

Foot surgery can be a real relief; in fact, most of us are in enough discomfort, long enough, that surgery to relieve a painful bunion is the only choice after putting off the decision as long as it was tolerable.

Now that you have decided to rid yourself of your foot problem, learn the top 5 things that will help you know what to expect during your bunion removal experience, and how to be back on your feet as quickly as possible.

Surgery Dressing Protector

Following is what you may likely expect to happen prior to, during, and shortly after your foot surgery. This is from someone  who has both had bunion surgery, and who has worked in surgery.

1.  Scheduling Your Surgery

The procedure is usually done on an outpatient basis , meaning you check in and out the same day, often into an outpatient (ambulatory) surgery center. Typically you are required to have nothing to eat or drink for several hours prior to your procedure. (This is a "just-in-case" requirement; in case you need more anesthesia than anticipated.  Follow the instructions though; it is for your protection and your procedure could be canceled if you do not comply.)

Depending on other factors (age, general health, etc.) you may be required to have some lab tests (which is scheduled and have done at least the day before your surgery) to screen for anything out of the ordinary.  Depending on procedural policies at your particular surgery center, you may receive a call from your anesthesiologist, the doctor who will deliver sedation for your surgery. Doctor

He or she will ask some routine questions in order to best meet your needs.

The scheduling staff , either from your Doctor's office, the surgery center, or both, as well as the nursing staff will all contact you.  Schedulers are determining insurance coverage, consent forms and, of course, scheduling; the nursing staff will further screen your basic health back ground, as well as initiate teaching.

You will need to know what to expect on arrival, during your procedure, and what you need after you get home. This usually means pain medication, having your remote control and phone nearby, a nest where you are close to the bathroom and able to elevate your foot, laptop, iPod, books, etc. Make a plan now.

Tip: Please do not be upset if your surgery schedule is changed; sometimes it can be changed several times.  No one is trying to inconvenience YOU; they are accommodating people with urgent problems.

2. The Day of Surgery:

You arrive, usually with someone who has driven you in for your procedure (You will NOT be driving home after any sedation; please do not ignore this directive).  You have not had anything to eat or drink for several hours; you check in with the front desk staff; there are more consents and privacy policies to sign, insurance cards to provide.  You may sit and wait a bit.

waiting room

Next, you are invited back to the surgical unit. Now it seems more real.  Usually there is an area to change into your backless gown, meaning you totally disrobe (some centers let you keep your underwear on, but not all do); you will have a place to store your belongings.  Give anything valuable to the dear person who drove you.

Tip: Be sure to empty your bladder!

At this time you may be asked to remove glasses, contact lenses, all pierced jewelry, etc.  This is as much for your protection as anything.  For example, sometimes an electro-cautery device may be needed during your procedure to coagulate a bleeding vessel (sounds a lot more serious than it is); the current could be attracted to metal on your skin, leading to a burn. At some centers you are allowed to keep dentures in place, hearing aids, glasses, etc., until or unless you need to remove them.

before surgery

3.  Immediately Before Surgery

Next you start your pre-operative care: a checklist to ensure you haven't eaten or drank, checking consents, possibly more consents, paper work blah blah blah.  You may be fitted for a post-op "shoe" which is a rigid-soled, velcro-tabbed support that will be your best friend for the next several weeks, if you are not having a procedure that requires wearing a cast.

The "post-op shoe" is not attractive, but it does the job to protect you post-procedural foot.  You can always decorate it with rhinestones!

You may also be fitted for crutches , depending on your particular circumstances.  You will asked to confirm what type of syrgery you are having, and on which foot it is being done.  Your foot will probably be scrubbed or painted with a betadine solution to kill germs (cold, wet, brown, but good for your foot).

You will be given a flimsy cap to cover your hair (to prevent infection; hair is a huge bacteria-harboring place).

So now you are looking pretty good ; your foot is brown from the betadine, you are thirsty, you are wearing a stupid cap, no make-up, you hope no one is really noticing you (actually they're not, this is just another day).

Either a nurse or the anesthesiologist will place an intravenous line in your hand, wrist, or the inner crook of your elbow; you may or may not have a little numbing agent to the site prior to insertion.  It is uncomfortable but only for a moment.

There is no needle in your vein after this, just an extremely flexible, sterile plastic tube-let, as flexible as cooked spaghetti.  We are so fortunate in this day and age!

You may hear conversations that do not make sense,

confusion such as talk of "vital signs" (simply checking the basic temperature, heart rate, breathing rate and blood pressure), "pulse-ox" (the little finger clip that measures the percentage of oxygen in your bloodstream, actually called a pulse oximeter), "leads" (the wires connected to the sticky electrode pads you likely had placed after you got dressed in your surgery attire), and lots of other lingo.

Eventually, your surgeon shows up and greets you.  Your operative foot may be checked, and marked (either again or for the first time, depending on policy where you are).

Now things are happening; the flurry of check, re-checks, signing consents (the surgeon rechecks everything), and you now meet your operating room nurse, and darned if he/she doesn't go through another checklist.

You may be feeling frustrated by this point but you should feel good; these measures are in place to protect you. (WHICH foot is it?  Right; left?) It's kind of like the clerk at the department store who asks for additional ID; everyone is watching out for you.

4. Surgery

Now, your bed on wheels takes you into the operating room; this is it. You will be greeted by your OR scrub tech, or perhaps it is an RN, and perhaps you met them before surgery (if you didn't it's only because they were in surgery already and couldn't leave to introduce themselves).

Everyone in the room will be in gown, masks, and odd headwear, maybe like your own fun head-cover.  You will see a LOT of strange equipment and an array of rather large and intimidating silver tools laid out over a blue paper-covered table. Good. All is correct. operating room

You will move onto the operating "table", which is hard, cold (fresh sheets!) and narrow (so surgeons can reach anywhere easily).  You will have the aforementioned electrodes attached to your torso and arm, a blood pressure cuff applied to your arm (hopefully the one without the IV), and usually a cold gel-based pad in case you have the cautery to coagulate blood vessels.

Next, your anesthesiologist, who will be behind your head, will begin instructing you on what is coming next.

Then, you will either:

Be completely inducted into general anesthesia, awakening after the procedure is finished,

Be given local anesthesia, which means numbing medication is injected into your foot for the procedure, OR (Most likely)

You will be given, through your IV, a short-acting sleep agent, and your surgeon injects the numbing medication while you are sedated.   When you wake up, the procedure will be underway and you won't feel any discomfort.  You may feel strange sensations as your doctor is operating and may notice strange odors.

operating staff

The atmosphere in the operating room can be anything from extreme quiet, except for the sounds of instruments, machines, and shuffling papers, to general conversation, and all the way to music and joviality; it just depends on individual personalities in the operating room.  So do not worry if it is quiet, but if things seem too loud you are free to request more quiet.

5.  After Surgery

Once the surgery is finished you will either slide over or be placed back on your guerney (the bed on wheels) and taken back to the PACU (Post-Anesthesia Care Unit).  Your foot will be elevated, cold packs applied, fluids offered for you to drink when you are fully awake.  Your foot will be numb and feel strange, and heavy.

Usually your foot is encased in a soft dressing of gauze wrapped with coban, which is like an ace bandage that clings, like saran wrap can.  Depending on the procedure, you may have a cast.  Either way, you have a dressing that absolutely needs to not get wet.  Ever (germs thrive in damp conditions).

Even though this leg protector may seem like more than you need, it is not expensive and it does the job. Plus, it overwhelmingly had the most positive reviews on Amazon.com.

Surgery Dressing Protector

Besides that, there will be a lot of instructions both verbal and written for you and your caregiver to follow.  Your significant other hopefully will be by your side. Your post-operative "shoe" will be applied if appropriate, crutches if ordered, you will be asked to empty your bladder once, just to check that you can, and your surgeon will stop by if there is time (if your surgeon doesn't have to go do another case).post op boot

 

This whole routine usually happens within an hour. Your instructions for home usually are

RICE:

Rest

Ice  usually 20 minutes on forty minutes off while awake for at least 2 days

Compression (your dressing will already be doing this), and

Elevation above heart level, about 30 degrees

You will have had a good local block of numbing anesthesia (like at the dentist's office but much longer lasting).  You should start taking your pain medication starting that evening, however, to have it in your system and working before the numbing effects are gone.  Be sure to  have a few bites of food with your medication, and take it during the night as well on the first night, unless you are positive you do not need it. doc calling patient

Your surgeon will likely call and check on you the same day; the surgery center usually within 24 hours. Your foot will be "asleep" from the numbing medication for several hours; just follow your Doctor's orders on medications post-operatively; the surgery center will also re-inforce the instructions.

The main thing to remember is your body will help you know how you are doing; if your foot is throbbing, elevate it. Relief is immediate.  Do ice it the first few days. As an aside, the first night you may feel that the dressing is uncomfortably tight.  Your surgeon will often advise you to snip into the dressing a bit; you had some swelling after surgery, which is normal.

after foot surgery

Call your doctor if the area is extremely painful, swollen, or red and hot to the touch. Swelling will last for weeks in most cases ; be patient.  You will have several visits to see your doctor depending on your particular foot surgery. You will be dancing soon. Don't dance?  You should think about it.

dancing penguis