Monday 27 May 2013

25 weeks - toenail drama

This post might seem a bit out of the blue, because having looked back over the blog it seems I haven't really talked about this very much, but I think that is because previously it didn't seem a big deal.

Way back when my casts came off at seven weeks, I talked about how my left middle toe was very very painful, red and swollen in this post. I thought it had been crushed by the cast a bit and so wasn't overly concerned.

I did raise it with my surgeon in my email to him, and his reply, which I posted here .

Basically he said: "I am sorry to hear that your left middle toe is very red and if it is clear that the plaster has been rubbing then I am sure this will settle quickly. If, however, it continues to be uncomfortable I might suggest you ask your GP to see it."

Now, I feel rather let down by this. I think that if he or one of his colleagues did not feel they wanted to look at it, they should have told me to make an appointment with my GP.

As it was phrased, I felt the subtext was: "Hey, silly patient, it's fine, stop worrying about nothing. But if you are a total hypochondriac, go and pester your GP and waste his precious time."

I certainly didn't feel encouraged to go and see my GP to get it checked out, and so when I continued to have problems with it, I didn't even talk about it on here, so convinced was I that it was nothing.

Well, more fool me.

It did start to become clear that the toenail had been damaged, but after reading up on runners' forums about toenail loss it seemed to be a minor cosmetic issue that would eventually resolve when the broken nail grew out and a new one appeared beneath.

So when, in the bath one day, the old one came off, and I could see a small new one below, I thought it was all sorted.

Then, when that new one became discoloured, I wasn't overly bothered as I had read that sometimes bad damage to the nail bed took a nail or two to resolve.

Well, a few weeks ago I was concerned enough to try and get an appointment with my GP. The nail was white and thick, and obviously lifting off the nail bed *boke*. My appointment is tomorrow but I have now self-dagnosed with the help of Dr Google, and it is clear that the original damage and infection have resulted in a fungal nail infection which is now very well established.

Of course, had I not been made to feel that I were being a hypochondriac, then I would have gone to the GP earlier, and got treatment earlier. Fungal nail infections are notoriously difficult to treat, and to make matters worse, most treatments can't be carried out while breastfeeding or when pregnant or trying to conceive.

I currently tick one of those boxes, will soon be ticking two, and hope that shortly I'll be ticking a different two.

Does that make sense? Basically I breastfeed the Little Lady and we are going to TTC (try to conceive) as of next month (I know, I know, TMI!) and hopefully will soon be pregnant.

So I can't treat it!

Well, there are some home remedies I might try but I'll see what my GP says when I finally get to see them tomorrow (yes it took about two weeks to get a simple appointment).

I am really upset and cross and feel so let down. If Mr Nugent had just said "go and see your GP about your toe" then I could have had help so much earlier, before it got this bad. And now, my feet are still ugly and horrid, because while the toes are straight, my toenail is grimsville.

In fact, today I pulled the second dead toenail off and underneath is just soft nail bed and white stuff, which I assume is the fungus *double boke*.

The strong of heart may enjoy the following pictures. EVeryone else should scroll to the bold part quickly.

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off you go, squeamish ones

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Ok, here we go then. Here is my bokey toenail before I pulled it off.



You can see that it looks white and a bit fringed around the edges. And I can tell you that it was just held on by virtue of being tucked under the skin at the edges. It was so easy to just prise it off gently.

This picture shows what it looks like now, sans nail.



My poor toe! It looks all gammy and grim. The white stuff does scrape off a bit but I'm worried about transferring the fungus to my fingernails, so only did that a bit before realising it was a bad idea. I think I should probably try and remove it if I can, but the skin is tender.


The next two are shots of the toenail that came off. It's really just a nail remnant, and it is very white.

Top:



And underneath:



I chucked it in the bin before thinking I should have taken it with me to the GP so they can test it, but I bet they wouldn't have anyway.

Squeamish people return here.

My Googling has found that a lot of people swear by the following home remedies for fungal nail:

1 - vinegar

2 - gentian violet

3 - Vicks Vaporub

4 - tea tree oil

Those are in no particular order. Now, as gentian violet is often touted as a remedy for nipple thrush (the things you learn as a breastfeeding supporter!) I can see that it might work on toe fungus too.

Vinegar is very popular, and as I have white vinegar in the cupboard, I may well have a go at that. I'm very intrigued by Vicks Vaporub and would love to know if anyone has tried it.

The only good thing about my nail having come off is that it is easier to get at the fungus which would otherwise have been covered by it, so I'm hopeful that perhaps in the month I've got available before we TTC, I can at least get the fungus on the retreat, and then I can stop using any prescribed treatment (as the Little Lady is nearly four and feeds about once a day, I won't bother telling the GP I'm breastfeeding and I know they won't ask as they won't expect it at this age) and get going with the vinegar (or Vicks).

I'm still really fed up about this unexpected side effect of the surgery though.

21 weeks - approaching normality

HUGE APOLOGIES! I thought I'd published this but it was still in my drafts. Sorry! I think I was going to add some pictures, but instead I'll just get this posted and do pictures for you another time. I do have videos I've been doing but I have so much trouble getting them uploaded to YouTube I may give up on them. Anyway, hope this is still useful/interesting and I'll get writing more I promise.

*should have been published a month ago, whoops*

It's been three weeks since my last update, and I'm now 21 weeks post-surgery.

Last week I picked up my new, custom, orthotics from the hospital. That marked the end of my hospital appointments at the Royal Berks, apart from when I need the orthotics replacing in about two years' time.

The orthotics are as slim as they can make them. You can see from the picture that they are really thin, but the curve of them where they support my arch and heel means that they push my foot up, which means I need to be careful what kind of shoes I wear.

I am working on a post looking at shoes, but basically my orthotist would like me to wear big, clunky shoes with very rounded toes, either completely closed or with a wide strap, and generally pretty ugly.

So far I've found I can wear my orthotics in my flat ballerinas, which have a rounded toe, because although they have no strap they grip the back of my heel and my heel doesn't slip out of shoe when I walk, which is often a problem with very open shoes.

I also wear a pair of sporty styled shoes with two velcro straps over the foot.

As the weather warms up, I probably won't wear the orthotics as often as I should, because you cannot wear them in sandals, but I do make sure that I am conscious of my foot positioning and pronation, and I hope that will be enough to make up for it. I'll definitely wear them all winter.

Right now, I can't wear them the whole time anyway. The orthotist told me I had to build it up by wearing them for half an hour the first day, then an hour the next day, and two hours the next, and so on.

I find they do make my feet and legs ache, because the muscles are adjusting to the new positioning, so I'm still working on increasing the time. I can't wear them in the house unless I wear shoes inside, and I usually wear slippers, so it's taking me longer to build the time up, but I think that's OK.

I also saw my physiotherapist again. I know Ed has been reading the blog, so "Hello Ed!" *waves*

I had to admit I've not been doing my exercises as much as I should have been, because they make me hurt, so I have promised that over the next month I will do them regularly, and wear my orthotics, and hopefully when I go again he will discharge me.

I did go back to yoga and have done two sessions now. Surprisingly, it wasn't as hard as I expected.

During my recovery I have been making sure I did foot exercises, and calf stretches, and I found I was no where near as stiff as I thought I'd be. My teacher, Minna (who also reads this so "Hi Minna!" *waves again*) does try to tell me to take it easy but I like to push myself and I never do anything that is painful.

As expected, it was a challenge to roll over my toes to go from all fours into downward dog, for example, but I either do it one foot at a time, or I do both together but put a lot of my weight onto my hands and arms.

Over time, it will definitely get back to normal, I'm sure.

I am actually really pleased with my recovery; with my range of motion and with my lack of pain. I know I've worked hard on my recovery but I also feel very lucky and blessed.

I do still have the problem with my toenail on my left foot, but I can now see that there is a new nail growing under the old one, and the old one is growing out, so in six months that is going to be back to normal. It's irritating, but a temporary annoyance.

So there we are! I'm still doing my exercises, building up my general stamina for walking and standing, and sometimes overdoing it a bit! Some days I'm fine, some days my legs and feet really ache, but the progress is in the right direction and soon, in terms of medical appointments, I'll be flying solo!

As usual, please ask any questions or make any comments below.

Sunday 7 April 2013

Exercises

I thought it might be helpful to have a post with all the exercises I have to do.

Currently, I do a mixture of things my physio has given me, and some that I have found/invented myself.

1 - the elastic band
Take an elastic band, a reaonably thick one, and hook it round the big toe from below. allow the band to pull the toe up, then use muscles to pull toe back down next to the others. Repeat 20 times.
Move band so it is hooked from above. Use other foot to hold it on ground then lift foot so big toe is pointing down and other toes are not. Use muscles to pull the toe up, next to the others. Repeat 20 times.

Do 2-3 sets of these twice a day.

2 - the resistance band
Hook resistance band around something heavy, like a table leg. Place foot inside band loop, with band on big toe side of foot. Move foot till it is swung out to the side by the resistance. Then scoop the foot against the resistance even more, as though you wanted to look at the sole of your foot. Repeat 10-20 times.

Do 2 sets 2 times a day, building up to 3-4 sets once a day.

I found some pictures of this. The first one shows how I've been doing it, using the kitchen table leg to hold the band out to the side. I used to sit on a chair but it makes my knee hurt so now I sit on the floor like this guy is:



Picture courtesy of www.physioadvisor.com.au.

And then I found this picture:



Picture courtesy of https://healthy.kaiserpermanente.org

Which shows using the other foot to hold the band so you can hold it with your hand, meaning you can do it anywhere. Revelation! I'll be doing it like that from now on.

3 - toe curls
Various things to help the toes curl up and back, like tiptoeing but not while standing.

a) Lie in bed on your front. Curl toes under and use mattress resistance to help you bend them until it begins to feel uncomfortable. Stop and breathe through discomfort, then increase the stretch.

b) Face a wall, a little way away, and place palms on wall, leaning forward, as though to do a calf stretch, but then go on toes to curl them back. Do both at once if possible, one at a time if not. Increase stretch by moving further away from the wall.

Personally, I find this one scary and painful, and so I do it one at a time, but Ed says I should do it both together ideally.

c) Stand facing a stair (or wall). Position yourself so your toes are up the stair and your sole on the floor. The closer you are to the stair, the bigger the stretch.

4 - tiptoe exercise
Go up on tiptoe, either using your hand to support yourself on a table or sofa, or freestanding, and allow your weight to go through the toes. Go as high as you can.

5 - toe bends
These are to help your toes bend down, and to counteract all that tiptoeing.

a) Sit down and use your hand to bend all the toes over and down, stretchng as much as possible. Then do each toe one at a time.

b) Stand up, and tuck the toes of one foot under so the nails are on the floor. Put some body weight through until the stretch is uncomfortable, then hold.

6 - toe V-bends
Using your hands, pull the big toe out, away from the other toes, to create a V shape. Hold at your maximum stretch for a while, then release.

Currently, these are all the things I am doing, as well as massaging my feet generally, and my plantar fascia muscle (the arch of the foot) specifically, as that gets quite achy.

It's a lot, and that's why they don't all get done every day, but they do all get done over a week, usually. It is hard work, but that's the only way that the mobility can be regained - it won't come back on its own, you do need to work at it.


18 weeks - progress and an update

We are so overdue a post, and I have not told you about quite a few appointments, that I almost don't know where to start with this. Which is partly why I've not posted, because I'm one of those people who becomes overcome with procrastination when I am behind with things. Even though that just makes it worse! I know, I'm weird.

Anyway, it's been six weeks since I last updated. Then, I was finding driving challenging, limping on the foot the orthotist had yanked the toe of, getting more mobile, and due to go back to the hospital.

Now, I have been discharged from the hospital, I've been back to the orthotist (who was nice this time!) and had my feet cast for custom orthotics, and had two physio sessions.

At my discharge appointment I was very disappointed that, once again, I did not get to see my surgeon! So I haven't seen Mr Nugent since he changed my casts at 2 weeks, and won't get to see him ever again!

Is it just me, or is that weird? I really wanted to hear how HE felt it had all gone, but that's not going to happen. I did consider phoning his office and arranging to see him, but I never got around to it (see, it's that procrastination again) and now I guess I can't see the point. But it would have been nice.

Going back to the orthotist was interesting. Mainly because I spent hours beforehand trying to buy some shoes that would fit my standard orthotics, only to be told by her that I should wait till I got my custom ones. Just as well I didn't buy anything!

She had a really good look at my feet, and commented that I have good control over my tendency to overpronate (roll my feet in). I do work hard to remember to hold them straight, and it's starting to become a subconscious thing now, so that's good, as I believe that will also help my knee problems a bit.

I'm waiting for my custom orthotics to be made. They cast your feet using oasis - the stuff florists use - in a shoe box. They just just push each foot into it and then make a cast from that, then use that cast to make the orthotics.

It hurt a bit doing the oasis, because she pushed my foot down first and my toes bent up a bit, so on the next foot I asked her to push the toes down at the same time, which was much better.

I go back to get them on April 22 and then I will have to try and find some vaguely attractive shoes that will accommodate them! I've been researching already, and will do another post on that.

As for physio, Ed is very patient with the fact that I don't do my exercises as much or as often as I should! He actually is a really great physio and listens to my silly worries and then works with me to see what we can do about them, which is fantastic.

I really need to video and photograph all of them, but I already told you about the one with the elastic band in this post, and now I also have a resistance band that I have to use to work the muscles that lie along the sole of my foot and around my ankle.

I hook it around a leg of the kitchen table, then put my foot in it with the band around the big toe side, and kind of scoop my foot. The instructions say "as if to look at the sole of your foot". I'm supposed to do this 10-20 times, two times, and twice a day, building up to three to four sets of 20, once a day.

It is extremely hard work. More so than you'd imagine. And so I'm a bit lax about it which is bad, but I do try and keep up with all my exercises as much as possible. There just seem so many now!

I do have a video of me doing it, which I made a few weeks ago, and I'll upload it to YouTube and get it posted soon.

Last time I went to see Ed, we talked about how scary it is for me to do things like sit back on my heels with my toes tucked under. Like this:




So we talked about some things I can do to improve my ability to do that without the frankly frightening levels of pain it currently causes.

He also measured my progress in terms of being able to go on tiptoe. Previously, I was achieving 35 degrees, but now I have improved to 45 degrees. I'm really pleased with that, and hope to improve it further.

Last time I posted about physio, I said that 35 degrees was two third of what Ed can do, which means he can manage about 53 degrees, by my rudimentary maths. So that's something to aim for, and maybe I could even improve on it?! (competitive, me?)

Finally, in this quick round-up of the past six weeks, I'll end with the letter I received from Mr Sikranth Kodali, the doctor I saw at my discharge appointment at the Royal Berks.

He was writing to my GP, and summed up my progress as: "She is having mild discomfort in her big toes otherwise she is doing fine. I can see her excellent range of motion in the first MTP joint and the osteotomy site is solid. All the X-rays done before are satisfactory. She is not 100 per cent happy as the correction of the big toe is not 100 per cent straight. I explained to her that there is always five to seven degrees of distal interphalangeeal joint angle, but otherwise the overall alignment is absolutely fine.

"She can slowly build up her activities over the next six weeks and I am pleased to discharge her."

That last bit was something of a surprise. I didn't remember him saying that to me, and so I'd pretty much gone back to normal, but from the aching and pain that followed it's obvious I should have eased myself back in a bit more. Although how I'd have done that I don't know - after a while people expect you to be back to normal and the help and support dries up, understandably.

Anyway, as of tomorrow I'm past that magical six weeks and so I'm hoping to see improvements in my stamina. Currently, my feet and knees ache almost constantly again, but more of that in my next post, which will be about all the things I am able to do now. It's a long list, hurrah!

Tuesday 2 April 2013

An apology and a promise

Hello lovely readers

This is just a quick apology that I haven't updated in a while. I keep meaning to write a post about how I've been discharged from hospital, and how my physio is going, and I even made a video for you the other week, but finding enough time to sit down and write it is proving hard right now.

Thank you for still reading - nearly ten thousand views now! - and I promise I will write a post soon with details of my physio exercises, and how it's going.

There isn't so much to say now as there was at the beginning, because progress gets slower as the feet get better, but I do intend to continue posting at least for the first year of recovery, so please bear with me!

Monday 25 February 2013

12 weeks! Moans and milestones.

Wow! Today is a special day. It is the 12-week "anniversary" of my operation. Is it me or has that three months gone slooooooowwwwwwwly?

I'll start with some positives.

I'm still able to drive and finding it gets easier, although sometimes if I have to use the clutch too much it makes my foot hurt. But it is so nice to have the freedom that driving brings.

Other than that, there's been nothing major. I'm still doing my exercises, which I still need to photograph/video for you, and still hobbling around.

That's my moan - that my left foot is still very painful following being yanked by Emma of orthotics, and I've decided to put in an official complaint about her as I feel she's set my recovery right back.

I limp on that foot and it is still extremely painful along the top of the foot, in a line down the centre of the toe and along the foot itself.

I've noticed that whereas a few weeks ago I was thinking about how to move or do things, I am now doing things without thinking.

While that is definitely progress, it does mean that sometimes I do something my feet don't like - and they really let me know!

I'm continuing to massage my scars every day, and they still look much as they did a few weeks ago.

In fact, I can see now why so many bunions blogs start to peter out around this stage of recovery.

There just isn't much to say!

That, and life begins to get busy again as you get back to normal and there's less time for blogging.

But I really do want this to continue to be a resource for people, so I'm determined to carry on blogging and updating you.

Tomorrow I go back to the hospital and I'm hoping to see Mr Nugent. If I don't get to see him I plan to ask for another appointment so that I can.

As I have very little to say, I thought I'd leave you with some pictures of my feet in socks, with the spacers in and without, so you can see the difference the spacers make, and the shape of my feet with no orthotics or spacers.

They're not quite as straight as I hoped, but I still think they're pretty good!

Here they are with the spacers (taken in daylight):




And without (using flash):




Remember, if there's anything you want to ask me, or ask me to write about, you can message me via the comments section below each blog post. I love to hear from my readers so feel free to write me a comment. I try and reply to all comments, although it may take me a few days.

Sunday 17 February 2013

Progress at 10 weeks 6 days

Despite today's blogfest, which has no doubt overwhelmed you with posts to read, I thought it was time for a specific progress update.

Incredibly, it's been two weeks and four days since I posted my video updates, and three weeks and a day since the last non-video progress report, so it's definitely overdue.

However, I think it's important to remember that the casts came off at seven weeks and one day, so it's not been that long since then.

If you want to catch up then click on the "progress" tab in the labels cloud to the right and they will come up, or find them in the archive, also to the right.

At seven weeks I was able to walk but only slowly, and I could go up on tiptoe between 2.5 and 3 inches

At eight weeks I was walking on stairs using alternate feet, and had slightly improved tiptoe-motion.

Now, I don't even think about what I'm doing on the stairs, and I have started going up on tiptoe to do things like reach into cupboards and get out of the bath, without even thinking about it, which is great.

Walking is getting a bit quicker, although I've been set back a bit by the orthotics lady who has made my left foot really painful with her yanking of my big toe.

The biggest bit of progress has been getting back behind the wheel.

As I live in the UK, I drive a manual car (aka a stick shift, as it is hilariously called in the US) so I have to be able to use the clutch safely.

Yesterday, I had a go at driving home from Tesco and I managed it! I did need the seat a bit closer to the wheel than usual, to avoid overstretching my toes, but I managed it.

I don't think I could cope with too much clutch control, like in heavy traffic, as they did ache, but I can definitely do short trips that don;t have too much stopping and starting.

However, I managed to crock myself a bit with the Tesco trip. What was supposed to be a half-hour shop turned into an hour and 90 minutes with hubby and the Little Lady and it was just too long to be on my feet, especially on my new orthotics.

My legs, especially my knees, really ache today and I've had to elevate them all day and try and rest.

Half an hour would have been fine I think, though, and it's all progress.

So there we are. I'll do some pictures of the tiptoes test and my exercises this week.

Wobbles and worries

Something I know from previous times I've had surgery that alters my appearance, is that at various points along the road to recovery I end up having moments of severe anxiety.

I'm sure this is just a normal part of the process. Having surgery is a major thing in itself, but add in the fact that you want certain results from it, both functional and aesthetic, and there is huge potential for worry.

My main aim with having my bunions done was to end the pain, but I also wanted to get rid of the unsightly bumps on the sides of my feet, and have pretty feet that I wasn't ashamed of people seeing.

I've had a couple of moments of worry, one of which is happening now, and they are both about the same thing - are my big toes really fixed or are they bending back over?

Now, you've seen the pictures, so you know that in reality the toes are much straighter than before. But I have times when I think they are shifting back over again. And there are times when it really does look like that, but then I wonder what other people's feet look like, and I reckon mine, now, probably look like most people's.

Or at least, most people who habitually wear shoes. It wouldn't be helpful to compare my feet to unshod peoples', which look very different (and presumably much more like all feet should naturally look).




As you can see, the shod foot looks like what we would call a 'normal'foot, whereas the shoe that hasn't worn shoes (quite possibly, ever) has more spread-out toes. I'm going to revisit this in a blog post at some point; I find the whole barefoot movement facinating and very appealing.

Anyway, what's been happening is that occasionally I look at my feet (first thing in the morning and in the bath are particular flashpoints) and think "oh my goodness! Look at my toes!! the big toes have gone back to where they were before! They're touching my second toes! It's all gone wrong!" and I feel like crying.

I'm sharing this only so other people who have this surgery will know that this reaction is normal and to be expected. It is also not rooted in reality.

Here's some pictures to show you what I mean.

When my feet have been resting for a while without the spacers, such as overnight, or in the bath, they tend to look like this.




Which does look horribly like the big toes have moved back toward the other toes. However, this picture is of the feet in mid air, not on the ground, plus some of what is happening is that the other toes have moved into a straighter position now the big toe is not constantly shoving them over to the side, so filling the space I've grown accustomed to seeing next to my big toe, especially when I have the spacers in.

Here is the foot placed on the ground.




I don't think the actual toe placement is any different, although the right one may have moved slightly, but being on the ground somehow makes the big toe look straighter, so my theory is that the pressure from the floor alters the shape of the rest of the foot. (And yes, I do seem to be holding my left foot at a funny angle, it's probably because it hurts, thanks to Emma of orthotics.)


And here are my feet after I walked (well, limped) around the living room, then stood still.




It's a subtle difference between this picture and the first one, but the toes have spread out slightly from the weight on them and the action of walking, and they look much more how I would want them to look (although never as straight as with the spacers, sadly).

So, I hope this shows how wobbles and worries are just that, and shouldn't be taken too seriously.

And if all else fails, I just have another look at my before picture.




Yep. Surgery definitely worked!


The osteopath gets her hands on my feet

The last time I went to see my osteopath, Jane Kaushal of Hands On Health, she seemed rather keen to get her hands on my feet!

I felt too nervous last time, but in the last fortnight my feet seem to have improved a lot so I thought that yesterday I'd allow her to have a go at them.

Because the orthotics woman had really hurt my left foot (see this post for details) Jane decided just to look at my right foot.

She massaged the arch of the foot, or more specifically, the plantar fascia muscle that runs under the foot. I know that muscle is really tight as just pressing on it with my finger is painful, so it was good to have her expert hands on it.

She spent a few minutes on it at the end of my usual session, so it was only a quick massage, but it made a big difference - my feet felt really different afterwards.

Encouragingly, Jane said she felt that my midfoot was much more flexible than she had expected. I'm hoping this is because I've been doing my exercises and looking after my feet, but it may simply be because I am highly flexible.

The midfoot is the blue section in this picture. The grey section is the bit of the foot up to where the toes start, which I guess is called the forefoot, and the white bit is is the toes. I assume medical people also call those toes, lol. (You can read about foot anatomy here.)




I have borrowed this picture from this website. If you click on the link, you may notice, as I did, that the foot used in the video on the page has a bunion! They are EVERYWHERE and I plan to do a post on that at some point as the more I look at feet in magazines and images, the more I see bunions.

But I digress.

So, Jane was generally happy with how my feet are recovering, which is great to hear as I really respect and value her opinion. I also plan to let her loose on my feet again, and hopefully both of them, as it made a big difference to my right foot and I think will help speed my recovery.

So far, my recommendations for good recovery are:

Decent trainers (*sad face*)

Toe spacers

Exercises (see here and here)

Physiotherapy

Osteopathy

Plenty of rest for the first weeks/months

Gentle mobilisation when you are ready

And most important - LISTEN TO YOUR BODY and do what it tells you. Don't push it too far.

One final point. Jane felt it was important for me to spend some time without the spacers in. I do already take them out at night (keep meaning to post about that) but now I'm going to incorporate some spacer-free time in the day too, and walk around without them. Jane said it would help with the muscle mobility, which may be hindered by using the spacers all day. (Jane, if you're reading and I've not explained that very well, feel free to email me a better explanation I can post on here.)

Saturday 16 February 2013

Two hospitals, one day, and three orthotics.

Thursday was a busy day, and not just because it was Valentine's Day and I was sorting through my large pile of cards from admirers for the best part of the morning.

Lol.

Actually, I did end up with three cards - one from the hubby and two from the Little Lady, bless her - but I was busy because I had two hospital visits.

The first was at the Royal Berks to the orthotics department. You may remember I'd asked to be referred when I had my casts off, and the appointment came through very fast.

It turns out that it came through too fast, and I have to go back in a month, but I did have a full appointment anyway.

I saw someone called Emma. I'm not sure what her title was because I didn't catch it (does anyone ever? They just rush their name and title at you as soon as you walk in and I'm lucky if I remember their name) and she isn't listed on the department's web page so I can't look her up.

What can I say about her? She was young, probably mid to late 20s, she was Scottish...oh yes, she nearly crippled me.

Obviously she needed to examine my feet, but she took hold of my left big toe, grabbed it and then YANKED it up towards the ceiling!

I nearly hit her!

It was so painful, but she didn't feel the need to apologise. She just carried on.

I did ask her to be more gentle, and we managed the rest of the examination without incident, although afterwards she said "I thought you were going to assault me". If I had, I'd only have been returning the favour!

I wasn't very impressed with Scottish Emma, which is a shame as we share both a name and a heritage, but she told me all about how bunions are not caused by anything at all, and are not only purely genetic (that bit's true) but "just happen". Hmmm. Not what almost every other medical professional will say, but she certainly seemed to believe it.

Another medic to add to my "do not believe" list I guess.

I came away with some insoles for my shoes, with added-on bits supposedly making them a bit more tailored to my feet.

When I go back they will see whether I need custom-made ones, which was what they were going to make for me this time but can't. The ones I was given cost £50 while the custom ones cost £150, so I imagine they'll try to avoid making some for me if possible.

This is what they look like.




The coloured bits are the added-on sections.

And this is the box, in case you're interested. Emma told me that it is cheaper to buy them direct from Talar so if you want to get some then this is the box to look for. I had a look on their website and am not sure which ones are mine exactly, but they definitely are cheaper direct.







Emma told me to wear them for short periods and build up to a full day because the foot has to get used to a new position. I figured that I am a) not walking much and b) getting used to new foot function anyway, so I'd just wear them whenever I wear my trainers.

That appointment done with, and a new one booked for next month (at which I hope I get someone else), I went to my local hospital in the afternoon for a physio assessment.

Townlands Hospital is a cute community hospital which has been saved from closure numerous times, although much of it has been shut down, including the maternity unit. These days if you want your child to be born in the town then you have to have a home birth (which is exactly what I did, although not for that reason).

We still have one building left, which houses the minor injuries unit (like a mini A&E, very useful) and the physio department, plus X-ray facilities, and other things such as clinics. My first appointment with Mr Nugent was at Townlands; it's an excellent facility to have.

Enough eulogising!

My appointment was with Ed. Unlike the RBH physio bit I went to while on Hunter ward, which was like a storecupboard, Townlands has a large room filled with equipment, although there was only Ed and me there.

We chatted about my history and operation, and Ed had a look and tested my mobility.

Sadly, because nobody measured my mobility before my op, we don't really know how much I have lost. Ed says there's no 'normal' so it's impossible to say, which is a shame really.

But what I do have is the ability to bend my toe 35 degrees, which is about two-thirds of what Ed can achieve, so I'm not doing too badly. I am pretty hypermobile, so I probably had much more than that, but average will suit me fine.

Apparently my toes are weak and stiff, but that's only to be expected really. Thankfully, Ed approves of all my exercises (see here and here) and just added in one more, which uses an elastic band (very high-tech!) as a resistance band for my big toes.

Basically I have to use the band to pull my toe in one direction, like towards me, then use my toe to push against that the other way, then swap and do it in the other direction. This will build up my strength in my toes.

Ed also had a look at my orthotics, and devised me a different one, for my most painful foot. It's a short-term fix for my pain when walking. The idea is that my other toes are lifted up so that when I propel off from my toes the big toe doesn't have so far to travel.

In the short-term this will help me learn a new gait or way of walking that is correct, as at the moment I'm tending to either walk stiffly, or to propel off the side of my foot.

This orthotic looks like this:




It's basically made from thin foam board (probably not the proper name for it) like the stuff you can get for crafts, and some cut up pieces of that padded sticky stuff (also not the proper name) that you can get from Boots, like this.

All very Blue Peter, but it does work.

One thing you might notice is that it has been cut to my actual foot shape. Yes, that is my actual foot shape! Amazing. I'm so pleased.

I see Ed again in a couple of weeks. Our goals are to maximise mobility and minimise pain, so we shall see if we can manage it.

Ed did say he might read the blog, so if you are reading Ed, then hello!

Sunday 10 February 2013

A letter from my surgeon

You may remember the rather unsatisfactory dicsussion I had with a doctor the last time I went to hospital, to have my casts removed.

If you don't, then you can read about it here, but basically he told me I could wear any shoes I wanted from that point on, I could drive within a few days, and didn't need to do any exercises or have physiotherapy.

I was deeply unhappy with that advice because I felt that it was, not to put too fine a point on it, wrong.

So I called my surgeon's secretary, who was lovely and agreed to print out an email from me and give it to Mr Nugent.

So I did that on the Wednesday after my Tuesday appointment. On Friday afternoon I realised I'd had a bounceback to my spam folder (doh!) so I resent it. And then I waited.

It took a long time, due mainly I think to the actual time it took for the letter to be posted, but last week I received a letter with some responses to my questions.

I had asked:

Should I be wearing trainers?

Can I walk barefoot in the house? Or should I wear the velcro shoes?

Should I be doing some exercises? The doctor yesterday said no but I have heard of just gently moving the toe up and down, and raising the foot on the toes, to increase the range of motion, and if appropriate I would like to do that - is it OK?

The doctor also said I could drive next week but I don't feel I'll be ready. When is normal to go back to driving?

My middle left toe is very red, swollen and feels bruised, and kept me awake with agonising pain last night despite me taking two codeine tablets. I think the cast has been pressing on it and has bruised it. Is this likely and should I be doing anything?

The doctor told me I could rub Bio Oil on my incisions to help the scars, so I am doing that. Is there anything else I should be doing for scar management?

How much walking should I try to do? I feel very unstable and sore, and not sure how much would be too much?

Also, the skin on my foot where the cast was is very tender, feels gritty and is a speckled red, is that OK? I rubbed all the dead skin off by hand in the bath last night so maybe I was bit enthusiastic?

Can I take the spacers out when I have a bath or do they need to be in 24/7?

My right spacer is very uncomfortable under the adjacent toe when I walk - can I cut it to make it less lumpy or is it possible to get a new one made?


So many questions! But in my opinion they should all have been answered at the appointment, without me having to ask. I'd say they are fairly basic.

Mr Nugent was comprehensive in his reply, which I've photographed removing my identifying information. I hope you can read it. I think that if you click on each picture it will open up an enlarged version for you.



He has said everything I expected to hear, really.

Yes, I need to wear trainers.

Yes, I need physiotherapy.

No, I can't drive immediately.

Yes, I can trim the spacers. Although I didn't expect to be told I could stop wearing them at nine weeks. I'm choosing to continue to wear them.

Yes I need to exercise although walking should be sufficient. I'm choosing to do some specific exercises as detailed in these posts, though, because I think they are useful.

So that's good to know. But I think that such basic information should be in a printed sheet and handed out at follow-up appointments so people don't have to ask, be misinformed, and chase.

Imagine if I'd followed the other doctor's advice? I could easily have ruined my feet. That's not good for anyone; me, or the NHS. I really do think it's time the follow-up care matched the quality of the surgery.

Frustrated and achy at 9 weeks 6 days

Sorry for being a bit AWOL recently. I usually aim to write something every four days max, but I've been a bit busy and a bit miserable and so after posting my videos over a week ago I've been MIA.

I'm feeling quite down about my feet right now. Some of it is not really to do with my feet. Partly it's because it's winter and I get a bit of Seasonal Affective Disorder (SAD) which you can read about here. I have had depression on and off since I was 13, and although I've been free of its worst ravages for a few years now, I do find winter a VERY hard time.

It's also partly because had I not lost my last pregnancy, I would have been a new mum with a two-week-old right now, and that is obviously a really difficult milestone to face. Especially as I have lost five babies in pregnancy, to first-trimester miscarriages caused by my Factor V Leiden, which you can read about in older posts here.

So it's been a tough time.

Add to that the fact that my feet ache all the time, and I often get some sharp throbbing along the incision sites, and you can see why posting hasn't been my top priority.

But I have promised this would be a no-holds-barred account, and so it's only right that I explain my absence.

Over the last week and a bit, my feet have definitely entered a new phase of recovery. Sadly, it's a really difficult and frustrating stage that brings with it new aches and pains.

I've gone from my feet being mostly OK, to them hurting pretty much all the time. In the main it's a dull ache in the big toes, and under the foot in the arch, as well as generally in the soles.

If you have a read of what makes up the arches of the feet, it's easy to see why this is happening.

My feet have been totally reshaped by the bunion removal. Bone has been cut, shaved and moved, tendons have been moved and adjusted, and now my entire leg needs to work in a new way, which puts strains on pretty much all the muscles in the legs and feet.

So my hips ache, my knees ache and click (because they always have clicked at times, it probably wont happen to you!), and my feet hurt as well.

Seriously, I'm trying to be upbeat but I am struggling because I feel so miserable!

I have managed to see my osteopath. Last weekend I had my first appointment with her since the surgery, and it was great!

She was amazed at the new shape of my feet, and also at how tight my entire body is! Clearly, all this inactivity and new ways of using my body have taken their toll - my back was so tight she couldn't finish it off in the session, and my head and jaw muscles (the reason I go to her in the first place) were so bad I need another session really soon.

But she was quite keen to get her hands on my feet! I said no because the thought of it made me go cold, but since then I've been thinking how nice a good massage that properly remvoes the tension in my feet would be, so next time I think I'll let her.

I definitely wouldn't let someone without her level of knowledge do it though - no massage therapists for sure. My osteopath is Jane Kaushal (see her website here) and she has good knowledge of anatomy and is highly skilled.

The main frustration is that I expected to be much more mobile by now. I thought I'd be able to walk about almost normally, so that a short trip into town or on the preschool run would be feasible, and while I thought I'd need to rest still I didn't expect a short baking session with the Little Lady to completely wipe me out.

But I'm nothing if not adaptable. So I've arranged for my lovely mum to come and stay next week (half-term!) to help out with the Little Lady, maybe do a little bit of cleaning for us, and generally ensure I'm not trying to do too much, which I definitely have been this last week and I'm suffering as a result.

And I'll probably be leaning a bit more on my fabulous friends again, to do school runs and help me entertain the Little Lady. I know I owe so many favours right now, but I'll happily pay them back because everyone has been so amazing.

This week I have a hospital appointment to get fitted for some orthotics, which are shaped insoles for my shoes. I had asked about those at my last appointment and the date came through really quickly, so hopefully they'll be made in the next few weeks.

My plan for the future is to wear orthotics and spacers as much as possible, to help maintain my foot shape and hold off recurral of the bunions.

So that's me at the moment. Little Miss Miserable! Let's hope I'm Little Miss Sunshine again soon.

Thursday 31 January 2013

Progress report 8 weeks 2 days, VIDEOS!

I was walking down the stairs yesterday when I had a bit of a revelation - that I was WALKING DOWN THE STAIRS!

Sounds dullsville but it was the first time I have managed the stairs without having to put my heel down first, and without needing to put one foot down, then put the next foot on the same stair, like a child does.

This was so exciting I felt that pictures just wouldn't cut it. No still picture could possibly convey the amazingness (yes, it's a word) of me walking down the stairs. So I did a video.

And then I got carried away and did a few videos for you, of my exercises and walking, and just a general look at my feet and scars.

So...all the words today are in the videos, here for your viewing pleasure. Enjoy!

(By the way, don't my toes look fantabulously straight in that opening still!)








I'll tell you what, though, it takes at least half an hour for each one to upload to YouTube, so it's definitely not an option for a quick update. The third one took over 90 minutes to upload!

Let me know if you like them - leave me a comment here on the blog. If videos are popular, then I can do more. No weird requests please!

Sunday 27 January 2013

Toe spacers and pedicures

I noticed yesterday that the pink toe spacers that my surgeon made from putty for me, when he changed my casts in week 2, were feeling a little loose.

I especially felt that when I was standing my toes were spacing out wider than the spacer, leaving it floating between them.

My guess is that now I am putting weight on my feet, my toes are moving further apart due to that pressure, which is obviously a good thing, but it's making the gap between my toes bigger than the spacers.

So I wondered how useful they were really being?

My desire is to have toes that are as straight as possible, and while I don't know anything about the mechanics of the recovery, I assume that although the bones themselves are surely set in place now, the tendons and muscles are still learning their new positions and movements, so this might be a window of opportunity to continue to improve the positioning.

I could be completely wrong, in which case any medical people reading, please let me know!

Anyway, I wanted to replace the pink spacers with wider ones to help encourage my toes into the best possible position.

I had a Google to see if I could get some of the putty, as making my own custom spacers felt like the best option, but I couldn't find a source and I wasn't entirely sure what I was looking for.

So then I searched for "toe spacers" but soon found that some places call them "toe separators" which to me sounds more like those things you use when you paint your toenails, like these (note the slight bunion bump on the side of the foot and the tight spacing of the big and second toes! Even models have bunions!):





What I wanted was these:


Credit: Amazon

They come in different sizes, although they don't specify how wide they are so it's not easy to compare. Those ones are pretty good value, but I wanted some new ones asap, so I sent the hubby to Boots and he got me these:



Sorry, I took the spacers out before I took the picture. You can see them on the Boots website here.

They are more expensive than the ones on Amazon, but then Amazon doesn't pay for a retail unit, or even the right amount of tax, plus I wanted them today rather than having to wait. And hey, we get Advantage card points too!

So, hubby got them after church today, and I wasted no time in testing them out.


I think they are wider than the pink ones. They definitely feel it. I could handle them being wider, but I think I can probably wrap some lambswool or cotton wool around them to add a bit of width and customise them to suit me.

The observant among you will notice I did my pedicure last night - bubblegum pink base with a gold and dark pink dotted flower on each big toenail. I love nail art but am still a complete amateur so all I can manage are dots or tips.

Anyway, one thing I have noticed today with all this in-out-in-out-shake-it-all-about of spacers is that when I don't have them in, my big toes are noticeably closer to my second toe than when the spacers are there.

I'm not entirely happy about this, and am hoping I will be able to ask my surgeon about it when he comes back to me on my other questions.

Although I do remember reading an American surgeon's site where he said he never does women's toes totally straight as they then find it hard to wear fashionable shoes afterwards, because most shoes (men's or ladies' in my opinion) have an angled toe box.

So maybe that's applicable to me?

Anyway, I took some pictures to show the difference:




The top two pictures I did without moving my feet on the pouffe, so you can use how much paattern is visible as a guide to how much the toes have moved. I'm afraid the last one was a standalone picture but you can still see that they are definitely not as straight as when the spacers are there.

You can click on the pictures to see larger versions, and underneath you should get a tickertape of all the pictures in the post, so you can click on them to run through the sequence, and if you flick between the first two you should see the toe move!

In case you just want the pictures bigger, then here they are again, larger.





Right. In the interests of being thorough, I also took some while standing with my weight through my forefoot. I thought that might make a difference. Again, I kept my feet in the same position so you can use the pattern as a guide.




Standing didn't seem to make a difference. There is definitely movement once the spacers are taken out.

I've got to admit, I'm a bit disappointed. I thought the idea was to make my toes straight, and I'm concerned about the bunions coming back if my toes bend in a bit. It's definitely something I want to ask Mr Nugent about.

In case all this staring at my feet has made you forget what normal feet are supposed to look like, here is the Little Lady's adorable foot.



As you can see, her big toes almost tilt the opposite way to mine - her feet haven't yet been put under undue pressure by shoes (I always get her brand new shoes that have been fitted properly by a trained fitter).

I intend to write about natural foot shape another time, but as this post is all about spacers, I'll leave you with pictures of a couple of products that some people swear will help keep your toes in proper alignment.

I haven't any experience of them myself, nor do I know anyone who uses them, but I plan to investigate further once I'm fully recovered.

We have the toe stretchers (aka Yoga Toes TM):


Credit: Amazon


And these are the separator socks:


Credit: Amazon


And finally, the bunion splint:


Credit: Amazon

Ok, so those look a little like an instrument of torture, but I have read that some people think they are brilliant. Obviously, nothing can correct an existing bunion except surgery, but I think this splint and the other separator devices could probably help negate the pressures of shoes, if worn regularly and over a period of time.

Worth thinking about, anyway.

Progress at 7 weeks 5 days and some other updates

One of the reasons for writing this blog is so that people considering the surgery, or booked in for it, or who had their surgery after mine, can see my progress and get an idea of how they will progress.

Obviously, everyone is different, and as a result we will not only all have different experiences of the surgery but also of the progress afterwards.

But I hope that this will give at least some idea of how the pain and mobility might be at certain points along the journey.

I realised that I forgot to mention a few things in my previous report because there was so much else to say.

Importantly, I wanted to mention that it took about 48 hours (two days) after the casts were removed before I could put my foot and toes totally flat on the floor without any pain.

I was surprised at how even that simple action was sore and difficult, but by two days afterwards, I was able to place the whole foot flat on the floor without difficulty, and put my weight through the whole foot too.

The first day I could, with effort, put my toes down, but there was no way I was going to put my weight on them! But the day after, I could do that too.

Now, at five days after the casts came off - I'll call it C-Day - I'm able to put all my weight on them happily, but I'm still wary of bending them as I walk, so I have a tenative way of walking that is slow and laboured.

But it's all progress, which is great.

I've labelled this post 7 weeks 5 days, which is actually yesterday, because I wanted to share yesterday's exercise pictures.



This one shows me pushing up on my toes on both feet. I have tried to hold a ruler so you can see how high I can get currently, but it's my black Filofax one and doesn't really show up well. I think I'll make a clearer one from cardboard for future pictures.

It's also not very accurate because the measurement doesn;t start at the edge of the ruler, but taking that into account you can see my heel comes up about 2.5inches.



This is just the left foot. I'm not sure if this one has more range of motion or if it's easier to push up on one foot at a time, but you might be able to see that this heel is around the 3-inch mark.

I promise I'll make a better ruler for next time!



Friday 25 January 2013

I like to move it, move it

One of the main concerns in my recovery is getting full range of motion back in my big toes, so that I can walk, run, do yoga and, ahem, wear heels.

I did ask the doctor (not my surgeon) at the hospital when the casts were removed about exercises, but he said I didn't need to do them.

However, I know from reading other people's experiences that in America especially, people get given exercises to do, and it makes sense to me that it would be beneficial to do some, even if the NHS doesn't deem them necessary.

The main exercises I can find online pretty much all seem to be the same as these ones here.

The timings on the sheet are different, because it seems that in America people get their casts off really soon, after a couple of weeks. I'm not sure why that is as the standard bone healing time here in the UK is six weeks - if you break a bone, you get a cast for six weeks - so it seems odd to me that they'd take them off sooner than that.

I'm glad I had mine on for seven weeks as I feel it gave my bones a really good chance to heal in the right place.

Anyway, ignoring the timings, I am now trying to do the same exercises every day.

So I hold my big toe near the operated-on joint and move it up as much as I can without crying, then hold for ten seconds, then do the same thing moving it down and hold for ten seconds.

Then I put my toes on the floor and lift up as though going on tiptoe, putting weight through the toes, as much as I can without weeping in pain, and hold for ten seconds.

It really hurts.

I am careful not to push beyond discomfort into agony as that would be counterproductive, but I have learned from yoga that it's important to breathe through mild pain and listen to your body so that you challenge it, but at the same time don't push it too far.

Yesterday I took some pictures so that a) you lot could see how little I can move and b) I can chart my progress over the coming months.


This picture shoes how far I can currently lift my feet from the floor. It's not so bad - I could definitely get some low heels on lol.


The same exercise with just the left foot. Probably I should do this with a ruler for future pictures, but it looks about three inches?


This is me pointing my toes. I feel like they don't move at all when I do this!


Applying pressure to the toe to move it as far down as possible. Which is probably about one millimetre!

Overall I think that the progress is OK. Even in the last few days I've gone from it being painful to get my feet into the trainers, to being able to do it without pain, albeit gently and slowly.

You just don't realise how much you bend your toes in daily life until you can't do it easily. I have a new respect for elderly people now, I can tell you.

Recovery without casts - the first few days

Well, the first night after the casts came off was agony. Not in my big toes, but in my left middle toe.

When the casts were removed, I noticed that toe was very red. It seemed like it had been crushed by the cast over the previous five weeks and when I touched it, it felt bruised, so I decided in my wisdom that what it needed was a massage.

Bad idea.

Massaging it sparked off agonising pain that continued for hours. I took two codeine at 2.15am but they didn't seem to do anything, and by 3.15am I was nearly crying, and wanting to bang my head against the wall to distract myself from my toe.

I must have fallen asleep eventually because I woke up in the morning and thankfully it had stopped hurting, but I haven't dared touch that toe since! I have asked Mr Nugent on email about it, in case I should see someone.

In fact, today (Friday) is three days after the casts were removed and the toe has a purple spot on it in the middle of the red, so I think my bruising/crushing theory is probably right. I guess it's just going to take time to heal.

Here's what it looked like yesterday (Thursday) two days after the casts came off.



You can see how sore and inflamed it is.

The day after the removal, the Little Lady went to preschool so I spent the day rubbing cream into my feet, especially on the scars, and trying to manage to put my weight fully through the forefoot.

It felt really sore and tight, especially around the incisions, and I was amazed at how little flexibility I have right now.

Yesterday, I put my trainers on (no pictures, I can't bear it!) and walked the Little Lady to and from preschool at both ends of the day.

What is a mere 0.4 miles, and takes five minutes at adult pace or around 15 minutes at child pace, took me TWENTY-FIVE MINUTES.

And I had to go back again as well. So it was just under an hour for drop-off, then I rested until it was time to fetch her, and did just under an hour of shuffling again.

Big mistake.

My feet swelled up, were very sore, and today my legs and hips are aching like I ran a marathon! Crazy.

It doesn't help that my right toe spacer feels lumpy under the next toe, and when I walk (shuffle) it is painful as it digs in. I've emailed Mr Nugent to ask if it's OK if I cut it down a bit to try and stop that happening as I need to be able to put my weight through my foot.

I have some pictures I took yesterday of my scars. All the dead skin has come off now, and although they are still very dry and need a lot of cream, they're pretty much back to normal skin-wise.

Here they are looking great.



Look at those straight toes! *big grin*

And have a look at my scars! I am beyond delighted with how they are looking.



I am so pleased. Obviously they are still pinky red right now, but they are so thin and neat! Mr Nugent has done a fantastic job and I can tell that when they do go silver they will be hardly visible.

I know that's a bit of a vain concern, but it is important to me tthat my feet look as normal as possible in future.

The only thing I'm disappointed about right now is how little range of motion I have in my toes, but that's for the next post.

The big reveal. Part 3. A bath at last!

For me, the big moment was always going to be when I could at long last get my feet into warm water and begin to get to know them again.

That might sound odd, but I haven't been able to see, let alone touch, them for nearly two months, and now here they are all puffy and with sore red incisions, feeling tender and achy.

I really want to massage them and make them feel better, but I'm also scared to touch them in case it hurts too much!

Anyway, you're all just here for the pictures, so let's start with what they look like in the velcro shoes, while standing.



Sorry it's dark, we have ceiling spots in the bathroom and the multiple shadows they create, coupled with my amateur photography skills, make it difficult for me to get a good picture.

But I think you can see what my feet will look like in shoes once they're healed, and obviously once I no longer have to wear the spacers the other toes will move over into a more natural position, and I won't have a massive gap.

The next lot of pictures are close-ups of my dry scaly skin, and the incisions, steri strips and dried blood. If that's a problem for you, scroll down to the bottom, then scroll up slowly till you reach the point where I tell you it's safe!

Grimometer rating: 3/10

Off you go squeamish people!








Everyone else, here we go!






Nice huh? I was really interested in the pattern of the cracking on the balls of my feet. It wasn't what I'd expected, not that I'd thought about it much!







OK, squeamish people! You can come back in at this point. No more close-ups of grim stuff, I promise.




Next are some pictures just of my feet.




And just one more (well, you are reading a blog about feet!) showing my feet on the floor with a bit of weight on them, to try and see how they will look when I'm standing (but at this point I was too scared to stand on them!).



Again, apologies for the shadows. But you can see how the shape of my feet are very much more Roman now, than Greek. If that is all Greek to you (see what I did there?!) then have a read of this post, but basically this picture will show you what I mean.



Before I had the surgery, my feet looked like this:



And now they look like this.


If you can manage to get both pictures on your screen at once, you can see how amazing a job Mr Nugent has done.

At long last, it was time to get in the bath.



That was taken after I'd sorted out all the dead skin and cut my toenails. You'll be glad to hear that I didn't take any pictures of the dead skin, but suffice to say it was really quite disgusting.

There was so much on my feet, more than was obviously visible, that rubbing it off with my hands felt like I was degloving my foot.

Be very grateful I did the Googling for you - it also brings up pictures, and if I thought it was bad enough imagining it, I was right. DO NOT Google 'degloving' unless you are very strong of stomach. (There's no pictures on the link.)

Basically, it felt like I had a lot of very thick creamy stuff on my foot, which just slid off as I rubbed. Ugh. It really was vile.

And there was so much!

Eventually, it started to feel gritty when I rubbed, so I decided I'd reached virgin new skin that was very tender, and stopped. My feet were quite spottily red afterwards, and needed lots of cream rubbing in. But I will be doing that regularly from now on anyway to help them heal and to massage my scars.

I also peeled off my steri strips, which came off easily and without me feeling weird, once they were soaked through.

I gently dabbed at my feet with a towel to dry them, and gingerly applied loads of cream. The scars felt quite tender still, but I'm sure they will harden up with time.

To finish I put on some very thin socks to keep the cream from rubbing off. I used a pair I got from the soft play centre that are meant for one use only. They actually hold up quite well in the wash, and I like them as lightweight socks to put on after I've put cream on my feet at bedtime.

You can't buy them in the shops, as they are only sold in bulk from Blue Box Socks and I can't imagine having a use for 200 pairs! But they only cost £1 from play centres and my two pairs have survived a 40 degree wash quite happily.

So there you have it! The full and final reveal! Now it's on to relearning to walk, looking after my scars, and the final leg of the recovery.