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Hi, I'm a 37 year old female and am scheduled to have my Austin Bunionectomy on 8-7-09 at 8am. The nurse at my doc's office has given me information but I hate to keep calling with questions so I have come here seeking answers. I have had this huge bunion for as long as I can remember, in fact all the women in my family have them. Doc tells me I have Hallux Abducto Valgus (right foot) and he will be performing the Austin Bunionectomy he said Austin means the type of cut which will be a zig zag cut at a 60 degree angle, he needs to break, realign and put a screw in my toe, he says I can't drive for two weeks and will be off work for a minimum of 3 weeks. ( I have a sit down job) and the plan is to get me back into a regular shoe sometime between week's 3 and 4.
So does the zig zig 60 degree angle cut refer to the incision or to the way he will cut the bone?, will I need crutches?, will I be able to go upstairs to my bedroom or should I plan on camping out downstairs for a while?, whats the best way to keep the bandages dry when I shower? and I guess my biggest question is ....since I will be under "twilight sedation" will I hear what's goning on. (I think that's the part that's bothering me the most about this procedure)

Any answers and/or advice you could offer would be great.

Thanks in advance
Trish

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No need to worry - Five years ago I had it done to my right foot and just got it done to my left a week ago. Recovery shouldn't take that long. I was in surgery at 7am Tuesday, home by 11am and at work Thursday morning. I too have a sit down job but need to keep my leg elevated. So to answer your questions:

So does the zig zig 60 degree angle cut refer to the incision or to the way he will cut the bone? the way he will cut the bone

will I need crutches? nope

will I be able to go upstairs to my bedroom or should I plan on camping out downstairs for a while? um if you want to hop on one leg all the way up and risk tripping and hurting your cut I prefer you grab your favorite blankie and bring it downstairs. . . you must not put any pressure on your foot for the first couple of days.

whats the best way to keep the bandages dry when I shower? honestly? wrap your foot up in a plastic bag and keep it out from the shower. You can still wash your leg and shave them if you'd like but definitely try not to get much water on it because it will somehow find its way through the bag and on to your bandages. . .

and I guess my biggest question is ....since I will be under "twilight sedation" will I hear what's goning on. (I think that's the part that's bothering me the most about this procedure) - YIKES!!!!! I was totally knocked out for both of mine so I couldn't tell you!! I'm sure you'll be able to hear what's going on but maybe far away as if you're dreaming it?! SCARY!!! I much rather pass out and snore my life away while they'r drilling screws in to my bone thank you very much!! OUCH!!!!!


You're definitely going to feel some discomfort the first few days and your leg may even swell up to your calf, its perfectly okay just be sure to take your medication and keep an ice pack handy at all times. Wiggle your toes if you can, it'll feel tight but at least you know you still have control of your toes. Wear comfortable clothing because you'll probably end up coming home and sleeping allllll day. During your post op visit you will be able to see the cut and its going to look crazy and your foot is going to look like it got run over by a truck but that's normal believe it or not. It had just been traumatized so its going to look banged up. REST REST REST is my biggest advice. Don't push yourself !!! Good luck!!!!!!!!!!!!!!!!!!!
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I had my right bunionectomy 2 weeks ago yesterday. I'm still not driving at all because I'm in a large walking boot. No way would I drive and jeopardize my life or the life of anyone else.

yes, you'll need crutches as you will be non-weight bearing for 5-6 days post-op. I used my crutches for about one week and simply went from bed to bathroom.
NO showers for one week, did sponge baths from wheelchair.

You will need to sleep downstairs unless your husband can carry you up the stairs.

I had twilight sleep...believe me it's amazing. I was frightened prior to surgery and up until they wheeled me into the OR (and I'm a nurse) but it was fine. Yes, I was partially awake but amazingly I never thought about what they were doing to my foot (they had a drape up across my knees so I could not see them nor what they were doing). I never felt anything...not one thing.
In fact, it was 2 days later that the anesthesia wore off in my foot and I started to feel anything at all in my foot.

I was not in much pain...took 1/2 pain pill to sleep at night mostly out of fear of waking in pain.

It's 2 weeks post op and I'm still not walking on the foot (it's tight and swollen if it's not elevated and iced) without my big compression boot.
I keep it up and iced most of the time...yes, still.
I use my DynaSplint 3 times a day to keep the toe mobile and increase the range of motion and avoid any scar tissue.

I follow the Doctor's Orders to the letter. I've researched this surgery for years and I've learned that :

you must not rush the rehab,
you must follow the orders to stay OFF of the foot
you must keep it elevated
you must keep it iced several times a day
you must do your stretching exercises of the toe 2-3 times a day
you should consider dynamic splinting (keeps it stretched for 20-50 min 3 times a day)
you need to get reccomendations of 2-3 sucessful patients before you select a surgeon
there are many doctors doing bunion surgery and only a small select few that have great outcomes: TAKE YOUR TIME SELECTING

I'm working from my home office and accomplishing more than when I was driving back and forth to a corp office.

Best of luck!!! Let me know how you are doing....I'm available to help answer any questions.
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Thank you both for the advice. Surgery is 5 days away and I'm starting to spaz a bit.....I tend to be one of those perfectionist everyone loves to hate and I'm trying to make sure things are in order before I'm stuck on the couch. It's the little stuff like laundry, getting the house clean, grocery shopping, making sure there are healthy snacks, comfort food, stuff for my husbands (Tom) lunch, ect ,ect. I have also prepared a few meals and put them in the freezer so all Tom or Meloney (my daughter) has to do is put them in the oven. I also plan on making extra for dinner every night this week so I can freeze the leftovers as well....Basicaly I'm trying to make life easier for them while I'm laid up.
I am feeling so overwhelmed by all that needs to be done and the fact that I have a teenage daughter that acts like I'm asking her to move Mt. Rushmore if I ask for help, and a husband that feels inside work is a womans job is not helping my stress at all. Don't get me wrong my daughter will help me after surgery as far as bringing me what I need but they will both whine and complain about doing any chores like cooking or cleaning.
I feel like I'm forgetting something though. I have put several book's,some magazines, a puzzle book, and some writing paper and ink pens in a tote bag to leave by the couch (or recliner). I have a small cooler for water and snacks (so no one has to wait on me to much)Since I only have one flexible ice pack I have bought bags of frozen veggies to use as ice packs. I have made arrangements with my friend so she will be with me at the hospital and will stay with me until either Tom or Mel get home. I have Ibuprofen. I'm going tomorrow for my pre surgery work up with my family doc, and will go get blood work done when I leave her office.

What am I forgetting???? I'm off on Mondays so I want to tie up as many loose ends as I can. If I have left anything out please let me know.
Thanks again for your help and support
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My fiancee took a week off to stay at home with me and he literally did everything. I was non weight bearing on the operative foot for 5 days post op and had to use crutches only for the bathroom and then back to bed with my foot elevated.

You'll want to buy a wedge cushion to keep your foot elevated as pillows can slip and squish down. My wedge cushion was purchased at a medical supply pharmacy and was a life saver. It cost $25. It was shaped like a triangle and at the highest point was about 18 inches high.

I was unsteady on the crutches so it was great to have someone guiding me when I got up the first few days.
My fiancee brough me my meds, my food, my ice packs, etc.

I'm now 2 weeks post op and doing very good so all of the icing and elevation and non weight bearing really helped. One of the most important aspects of the surgery, other than finding an excellent surgeons with many satisfied and sucessful former patients, is the after-care and rehab. Many try to ignore the post op care and do everything themselves and they suffer for it.

Good luck and I'm happy to answer any questions. I'm a Rehab Nurse as well as a post op patient.
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Just a couple questions for ya CaliforniaDreamin......I have a Hyatial (sp?) Hernia and I had my gallbladder removed about 2 years ago, therefore I get heartburn at the drop of a dime. I'm not talking minor either I'm talking "trip to the ER thinking I could be having a heart atack" kind of heartburn. I take Aciphex twice daily to help keep it under control, but I'm not sure if I should take it the morning of surgery. I KNOW the IV meds will give me heartburn and my hope is that when I mention this they will give me Protonix or something similar, but on the off chance they don't give me enough I would really like to take my own meds as long as it won't put me in any danger.

Also (and this is a silly question) how big will the bandage on my foot be, will they wrap my whole foot, or just the toe area? I ask because I'm wondering what to wear. I really don't want to have to change clothes when I get home so I was thinking jammy pants, or shorts as long as it's not to chilly that morning (I have to be there at 6am and surgery at 8am)

I was unable to locate a wedge pillow in my price range at our local home healthcare store, all the one's in the $20-$30 range are on back order. I read another post somewhere where a woman used a bean bag chair and loved it, so now I'm on the hunt for one of those with the thought that since my daughter has been asking for one she can have it when I no longer need it. And if all else fails I will just use pillows.

We are actually going to rearange the furniature tonight so I will be able to have things at arms length. I only wish I had a lap top, I'm going to miss my computer if I'm unable sit at my desk.

Have I forgotten anything? The clock is ticking and the closer it gets the more nervous (sp?) I become.....I am no longer afraid of the surgery itself, it's the pain after the ankle block wears off the scares me. I have NO pain tolerance and everyone says to take the meds before the pain starts to get a jump on it, but I hate the idea of taking pain meds if I don't feel pain, it's a catch 22......LOL I am such a sissy.

One last thing I waned to ask that I will talk to doc about do you think he will recomend PT. My hope it that I can just do my own rehab here at home.......If I haven't mentioned before I have a great surgeon with glowing reconmendations, I know several people who have went to him and I also googled him to find out his education backround. His name is Danian Dieter, DPM. But let me get through surgery and recovery before I gloat to much about him.

Thanks again, this site has been a real God send
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Hi there, I think these are some great dips that you've posted here! I don't think I'd thought about using a wedge pillow. My dad had this surgery a few years back and I don't think that we bought this for him and he was not doing so hot... Does the wedge pillow actually help with recovry time?
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Okay 12 hours till surgery and I have searched this town high & low for a wedge pillow and have come up empty!! It's also a negative on the bean bag chair, so it looks like pillows for me. No biggie I'll make do.

I wanted to thank you all for the advice and support, I will post again when I am able to sit at the computer desk.

In the mean time Happy Healing to all, your in my prayers.

Trish
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Trish,
I hope your surgery went well. I too, found this message board to be useful. I researched the "medical" side but wanted to hear from actual people who have gone through it. You are probably in pain right now. I had my bunionectomy 3 weeks ago. My block was so strong, it lasted for the entire day of my surgery AND the following day. So I thought this was going to be a piece of cake. I was sadly mistaken and had to take Percocet the next few days. But don't worry. It WILL improve as each day passes.
I hope your husband was able to take some time off of work to help. I have two teenage sons and actually rang a small bell to get their attention when I needed help.
For the past couple of weeks, I've been using my supermarket's delivery program which was only $10.00 plus whatever groceries you order online. However, I couldn't have done it without using my son's laptop.
Not being able to take a shower with running water (especially in hot summer days), was a problem. Spongebaths/faceclothes didn't seem to provide the same cleanliness that I would have liked. My husband had to rig a patio chair in the shower (on a non slip mat), so I could run the shower. My foot/lower leg was wrapped in a large hefty bag and electrical tape was used to keep it wrapped snuggly around my calf. I then wrapped a towel above that area & rested the leg on the edge of the tub. This system was used around day 7 or 8. I still cannot stand when taking a shower but use a stepping stool to sit on.
Hang in there. Just take one day at a time.
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Hi Ruby, You hit the nail on the head when saying I was probably in pain right now, it hit me at about 4am this morning. I am having a hard time keeping up on the pain meds for some reason. Doc gave me a very low dose vicodin and said I could take 1 every 4 hours...(at this point I would kill for a percocet) I am adding Ibuprofen with the vicodin and it barley seems to take the edge off. I'm finding ice packs to be my new best friend.

My hubby has been AMAZING he actualy slept downstairs with me last night and plans on doing the same this evening. He's not ging to take any time off, but our daughter will be with me so no worries there. Everyone has been great so far, I have had people helping me right and left and I'm letting them do it. I especially liked it earlier today when a friend of ours called from the store today to see what kind of ice cream I would like for him to bring me.

The swelling is really something else....also there is a huge black & blue lump on my second toe. The weather is really hot here with a very high humidity (thank God for air conditioning) which is making me want a shower more than anything.....It's so funny that I'm looking forward to the small things like tomorrow hubby says I can double up on my pain meds and he will carry me up to the tub. The plan is to rest my foot on the side of the tub while he washes me and my hair and rinses me with a cup. I have to call Monday to schedule a post op appt for next week so he can take the bandages off, look it over and rewrap it (stitches will come out at week 2)

I need to be getting back to the couch as sitting here in this hard chair with my foot propped up on a stool is killing my tailbone.

Once again THANKS to all and I am always open to advice.
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Glad to hear you are doing OK. The pain will subside in a day or two, in fact every day gets better.... I'm at 3 weeks post-op (I'm sure that sounds like an eternity away) and today was a great day. I went out to the movies and propped my foot up on the seat in front of me. Wearing the boot takes all pressure off my toe and joint and makes walking a pleasure.

I can see the light at the end of the tunnel...finally. Still swollen but not as much. I sat in a resturant with my foot down for about 20 mins at a time and then put it up on the booth for 20 mins and I was fine.

The cellulitis frightened me this week...but its fine now on antibiotics. The risk factors for cellulitis are surgery, swollen skin, and feet are particularly at risk due to the proximity from the heart of the circulatory system. I think in retrospect I was not cleaning my ice bag every time and once or twice I put it on the floor and stepped on it and then put it back on my foot near the incision. I should have been more careful as I think back about it.

I am doing 50-75 theraband exercises morning and night flexing and dorsiflexing my toe joint....
I'm wearing a soft splint at night that holds the toe in proper alignment.

And, oh yes...I'm wearing a compression stocking all day.....which decreases swelling and increases circulation to the foot.

Hope you are doing better each day Trish....be sure to take your anti-inflammatories and your Protonix or Acidiphex. I, too, have a hiatus hernia and a duodenal ulcer history and take protonix each day. My stomach started to hurt because of the anti-inflammatories and the antibiotics that I took for 10 days post-op so I took some pepto bismol a few times a day.

then I got constipated....so be sure to watch out for that and increase your fiber and perhaps try some Ducolox tablets if you need them. I was miserable on the 5th day after surgery because i had not gone to the bathroom for 5 days....that was awful. So watch out for the Vicodan...very constipating.

Take good care,

California Dreamin
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I have a few more tidbits to share after reading these recent posts...The biggest mistake I've ever made was to schedule surgery on a Friday. It's very hard to reach your doctor with any questions/concerns over the weekend and the "on-call" doctor doesn't know your history. 10 years ago, I had a portion of my intestine removed (I have Crohn's disease), on a Friday. I was in terrible, terrible pain and the nurse was the absolute worst! I had to wait until Monday to get stronger pain killers. Trish, Vicodin doesn't help (at least with me), for moderate to severe pain. You can always contact the on-call doctor, over the weekend to ask for something stronger to help take the edge off. I have to be really careful of what meds I take due to the Crohns. To help with constipation, try drinking apricot juice instead of taking a stool softener. It worked for me and it's much healthier than taking another pill. Calif. Dreamer, if my math is correct, it sounds like you and I had our right foot bunionectomies done around the same time. (I went July 15th). I was glad to read you are seeing light at the end of the tunnel. I don't think I'm able to keep my foot down long enough to see a movie yet. I can stand/walk with the compression boot for about 2 hours before needing to elevate & ice once again. Do you always wear the splint and ace bandage? I asked my doctor if I could take it off and he said to wear it all the time (aside from showering). At 3 weeks post-op, I got permission to swim as long as I don't push off the walls of the pool with my foot. I'm heading to my gym tomorrow to see if I can actually accomplish getting in/out of the pool. I can "heel" walk from the locker room to the pool but think the boot will have to be utilized. If I'm not ready, I will see if I can spend a little time on a recumbant bike. Has anyone out there tried this yet? The only excercises I've been able to do are band stretches and ankle weights. I don't need the boot for those because there's no weight bearing on the feet. One last question for anyone who can answer...During the night, when I am sleeping, I'll get sudden quick sharp stabs of pain in my toe. The entire foot is protected and wrapped so it's not due to movement. I'm thinking the toe joint may be stiffening. Any thoughts out there??
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Ruby,

My surgery was on Friday, July 17th so yes we are about the same time for sure.

I wear the soft spint at night only and a compression stocking that covers my foot and ankle and half way up my calf at all times during the day.

I actually did not need the pain pills. My doctor promised it would be pain free and he was right. It was uncomfortable but not painful. I took it to sleep 'just in case'. In my opinion the entire thing is an 'ordeal'....can't walk, drive, etc.....foot burns and swells....gets all hot and uncomfortable...but I would not call it pain. I got a little 'down' after 3 weeks and had myself a little cry and felt better.

My cellulitis was scary but luckily I caught it in time and it's almost completely gone....that set me back.

I still do the heel walking but I actually can put full weight on my foot but it's tender and it burns....when I'm not in my boot.

As far as the gym, I've done upper body weights and the theraband workouts and sit ups, etc. My incision is still not 100% closed (probably due to all of the swelling of the foot) so I'm not going into a public pool but if you're all healed then go for it. Water is a great non stressful form of exercise.
I need to get into my office as my boss has been great about letting me work from home the past 3 weeks but I need to show my face tommorrow. So I'll just do my floor exercises for now.

As far as the movie theatre, I sat with my foot up on the seat in front of me and people were kind enough not to sit near my foot. I think the big boot scares people away...they're so glad it's me and not them!

Not sure what you mean about the ace? I wear a compression stocking which is made of tight elastic material and the spint is a soft brown material with velcro strips around the toe that anchors my toe out to the left so it stays in alignment. splint is only at night when I sleep. It looks soft and harmless BUT that sucker pulls my toe into alignment and it hurts a bit....throbs more than anything.

yuck...can you even THINK about doing the left foot??

What about wearing a normal shoe on the right? When will THAT happen????????

Oh well, I won't go there....gotta go ice it....

All the best,
CaliforniaDreamin
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Okay three days post op and I can't stress enough how greatful I am that it's Monday. The MAJOR pain started in about 10:30 Saturday night. I called the hospital where my surgery was done because there is no after hours number for my doc (wish I knew that going in) I have been in so much pain it has actualy brought me to tears, my poor hubby just sat and rubbed my back not knowing what to do. The nurse I spoke with had a pager number for my surgeon but said she couldn't give it out, however if I were to come in to the ER they could page him for me. After talking with this VERY nice nurse (who just happend to have had the same surgery a year ago) she said it would be okay to take 2 of the vicodin (5mg/500mg) every 6hrs instead of 1 every 4hrs. She said to try that and if it didn't work to come in and they could give me a shot.......Well not wanting to be vertical any more than absoultly necessary I have just suffered through it.

Sure taking the 2 pills instead of 1 (with the ibuprofen in between) has given me just a bit more relief and has allowed me some sleep (until I move my foot that is) but my foot is still trobbing and the burning is almost unbearable. It feels like there is open fire on my foot (I'm guessing the burning is where the incision is).

I did leave a message on docs machine yesterday and plan on calling when they open this morning. My sister has the same doc and says that he is one that does not like to give pain meds so I hope he has some trick up his sleeve, if not I am at the point where I will go to the ER and get that shot.

I just keep telling myself it will get better, I don't have "the boot" I have a square base shoe with velcro over the top of the foot and ankle. However it hurts to have anything pressing on the top of my foot. I only have to wear it when I get up....One question for ya, Should I be iceing the boottom of my toes too?

I need to get back on the couch now, I will get back on when I can....Thanks again

Trish
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25 days after surgery (right foot Austin bunionectomy) and the light is finally shining at the end of my tunnel!! I can stand while taking a shower, get chores done around the house, garden, drive AND can now ride a recumbant bike for some cardio workout! There really isn't any pain, just some discomfort due to swelling if I'm on my feet too long. Yesterday was the best day every. I spent an hour and a half at the gym, went to physical therapy for my knees. Came home, raked leaves and watered the flowers. I am really looking forward to getting back to my active lifestyle.
I know it takes 2-3 months after surgery to get "I may not be able to do step class or aerobics anytime soon BUT the bike is a start and I'm already padding the foot pegs in my ocean kayak to head out to get some "water time" on Cape Cod by the end of this month!
BTW, I am planning to have the same procedure done on my left foot next summer!! Since I teach...summers are the only time I can use to get these procedures done. But, even if I had more options of times to get it done, I would still choose the summer or even late spring.
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