Yep, I’m back to wearing two shoes again!
I went to see Dr. Herbst on Friday, January 21, and he said my x-rays look great. He’s confident that I will not re-develop the bunions in either foot because of the excellent position of the metatarsals. When looking at the x-ray of my right foot (and I’m sorry, I forgot to get a copy to show you), I actually thought the bone looked a little crooked, but he said, “You have to ignore this part,” as he covered up the screws with his thumb. “The realignment had to happen somewhere in the bone. What you look at is the total angle of the bone, from the center of the top to the center of the bottom, and how that lines up with the bone next to it.” And when he drew those lines on the x-ray, I could see that the first two metatarsals, which once had formed a V shape, are now parallel. “Also,” he said, “you can tell by the sesamoid bones” — those two little bones that are supposed to be directly under the metatarsal. That’s where they are now, but before, you could see them way off to the side. Or rather, the metatarsal was way off to the side, leaving those poor sesamoids all alone. (To try to see what I’m talking about, look at the first x-ray on this post. The little shadowy, kind of roundish bone to the inside of the angled metatarsal is one of the two sesmoid bones in each foot. It’s not a great image, but maybe it will help you understand.)
Dr. Herbst also said the scars look good and will continue to fade.
I asked him about my right foot. “I was looking at it, and I realized I don’t know what a normal foot is supposed to look like. But it seems like that big toe is starting to angle back in again.”
“Yeah,” Dr. Herbst said. “That’s because the smaller toes were angled out for so long that they’ve grown that way. You’re not going to have a big space between the big toe and the smaller toes, because all the toes want to come together. Since the smaller toes have learned to angle, the big toe is going to migrate toward them.”
“But that doesn’t mean the bunion’s coming back?” I asked.
“No,” he assured me. “Definitely not. Sometimes I do another tendon release to adjust the toes back, but that’s only in the case of severe deformity. I wouldn’t do that for you because it isn’t severe. Plus, you’d end up with a lot of inflexibility and you wouldn’t be happy with the result.”
So my toes will probably always be a little crooked. I’m okay with that.
We talked about increasing my activity. He said cycling, swimming, and the elliptical are the best ways to start. Then a treadmill, slow and with no incline, gradually increasing speed before increasing incline.
I told him I had a dream that I asked him if I could run a half marathon this weekend. He laughed. “Really? This weekend, at six weeks? That would be a first.”
“Apparently you told me it was okay, because the next thing I knew I was finishing the race.”
Yep, in my dreams I’m a medical marvel.
In reality, though, I’m pretty average. Dr. Herbst said that the type of surgery he performed for me is what he does for about 70 percent of patients with bunions. For some elderly patients with severe bunions plus arthritis, he’ll do some fusing of joints, and for a few patients who don’t have the angle in the metatarsal but have the bone bump bothering them, he’ll just shave that off. Also, he said the average age of his patients for this procedure is about my age. He said he thinks it’s because in their 30’s and 40’s, people get settled and in a routine and have good insurance. Another popular age is right when the patients get Medicare; they have a secondary insurance and no deductible, so they come in the day after the Medicare card comes in the mail.
So… I’m regular. But I can dream about being amazing.
My next appointment is scheduled eight weeks from now.