Appointments

After my initial referral from Rheumatology, I waited a while for my appointment to come through. I was first given an appointment with a general surgeon, who I think was classed as 'Sports Medicine'. In the waiting room I noticed people who had obviously had surgery on knees and elbows. I went in to speak to the surgeon and he asked for my general history and what the problem was. He also asked to look at my feet. When I got my feet out and especially when I stood up on them and walked barefoot for him, he looked a little scared and did say that he would not be able to help me with my problems but that he would refer me to a foot specialist. He also sent me for X-rays so that hopefully all the data would be ready for next time.

When I got my appointment through to see the foot specialist, I was feeling quite apprehensive. It seemed that my feet were very bad and the previous surgeon's lack of confidence had knocked my confidence too. I had come to the conclusion that maybe my feet were too bad to be fixed through surgery. However, when I went in to meet with the foot specialist surgeon, I was pleasantly surprised. She was extremely friendly and confident and also did not seemed at all perturbed by the sight of my feet! It seemed as though this was normal for her and almost run-of-the-mill. She explained that it was operable and described the procedure to my husband and I. She had some concerns about my ankles, but when I explained that I only wanted my forefoot fixing, she was much happier.

She explained that in cases such as mine, the technique involved straightening my big toes and fixing them with pins that would stay in permanently. The rest of my toes would be straightened and put into the correct position on the balls of my feet. Each toe would have an incision each to allow access from the top of my foot. Each toe would have a small amount of bone removed to allow the toe to be straightened. She explained that, due to the way the toes had curled up, my nerves and blood vessels and things were tight and, if my toes were straightened without removing some bone, the nerves and blood vessels may not reach properly and this would obviously be very bad for my toes. By removing the bone and shortening the length of the toe, the nerves and blood vessels should be able to reach and my toes would be OK. Each of my toes would have a K-wire inserted for six weeks to help with the healing process. The foot would also be in plaster for those six weeks.

The surgeon explained that I could now decide whether to have both feet done together or have each foot done separately. She explained that having both feet done together would require a general anaesthetic but if I had them done separately I could have local anaesthetic only. My husband expressed some concerns about general anaesthetic and she did say that another option would be an epidural. I also asked questions about waiting times and getting around after the operation. She explained that waiting times were usually around three months and that following the operation I would be able to hobble around with my weight on my heels, sufficiently to allow me to get to the toilet and back for example.

My husband asked whether the procedure would need to be repeated later in life but she said that it was considered to be a permanent solution. We were especially concerned about this as I am quite a bit younger than other people having the procedure might be, so we were relieved that she felt it would be permanent. She also explained that the operation has around a 95% success rate and that known issues would be that some of my toes may possibly be a bit floppy after the procedure. She also explained that I would be in hospital for five days to closely monitor my toes and the blood flow to them. If there were problems with this, she explained that the wire would be removed early and that would mean that the toe would be quite floppy. As an extreme result of blood flow problems, a toe may have to be amputated but she said this was very rare.

At this point, I explained that I was slightly overwhelmed by all the information and asked whether I could go away and think about it. She said that was fine and gave me her secretary's phone number to ring when I had made a decision.