Bunions! 🦶🏻🦶🏻

[Moomin8]

Morning Peeps 🙂

I hope this post finds you rested and as well as you can be today 🥰

I have bunions on both of my big toes. Over a year ago, my rheumatologist agreed that she would put me forward to having them seen to. After second letter being sent, I have now an initial appointment in a couple of weeks.

I wanted to ask you lovely people - if it is agreed that I can have my bunions operated on, I'm assuming that (at a minimum) Tocilizumab would have to be stopped for a while? I have Sulfasalazine, mtx (Metoject) and Tocilizumab, as my main RA meds. My worry is that my Tocilizumab might stop working if I have a break, as one of my other meds did when I had to have a break from it. I have been told that Tocilizumab is my last biologic as I have had 6!! I can't even begin to imagine not have a biologic med in my arsenal😭

Also, I would like them done at the same time. I work in a school, so I'm wondering how long would I be off my feet? Schools are so understaffed, at least they are in my area, and I don't want to be away any longer than absolutely necessary. I am not sure about staying awake during the operation...I'm a big wuss! 😄

Regarding travel insurance, did your travel insurance go up because you have had surgery due to your RA?

I know I'll ask these questions at my appointment, but I'd like to hear your stories, if that's ok 😊

[AgedCrone]

From personal experience..,having had bunion surgery on both feet - separately. Unless you have someone to push you around in a wheelchair having them done together is probably not on.

I had mine done separately- about 9 months apart. …under a General Anaesthetic….but speak to the surgeon who will do the operations.

I was using crutches for I think about 6 weeks for each foot …driving is out until you can brake safely.

I don’t remember having to stop Mtx ..but it was about 10 years ago…so things may have changed.

My travel insurance didn’t go up…..but I’d had bunions for years before I had RA…so it didn’t cause them.

Despite the inconvenience…the surgeries were well worth having ….being able to wear nice shoes & not having painful feet really is worth taking the time to get it done……but there is no fast track….weight bearing too soon can mess up the result…but again your surgeon will advise you on time scales.

Good Luck!

[Moomin8 in reply to AgedCrone]

Thank you so much for your reply 😊 You have shared some sensible advice. I'm pleased it worked out for you.

[Esmereld]

I had one bunion done about 8 years ago.

I can’t advise you about drugs. Sorry.

Two at the same time would be an option but you would need a lot of support. Feet up for two weeks!. No popping the washing machine on!.

I wouldn’t even mention surgery to holiday insurance. It’s not life threatening or putting you at risk of needing treatment unless you plan to go before being discharged.

I was able to choose my operation date. Consultation was August and I wanted it done just before Christmas to save being off work for too long. You might get the same chance.

[Moomin8 in reply to Esmereld]

Thanks for your reply. How did you find the surgery. And how was your recovery? Were you puy right out for the surgery?

[Esmereld in reply to Moomin8]

I had day surgery at the Birmingham Orthopaedic Hospital by choice. It was a very slick outfit with about 20 women in a modern dormitory type room. The surgery went well and I woke up with a massive bandage around my foot. Went in at about 8 a.m. and left at around 5. I had no pain for about 12 hours due to the block at operation time and pain controlled well with paracetamol and brufen for a day and a half after that. Then discomfort for a day and a half. Again, took pain killers. A bit of tenderness after that but not for long.

I recovered very well. My scar is a very fine silver line like a stretch mark. I have no pain. Ever!. I know people that went against the advice to elevate legs and rest. They still suffer pain years later.

They knocked me out. Reluctantly. It’s better for everyone to have a local but I’m a wus like you!. 😆

Having both done together has pros and cons. It will be tough on you and your family. Believe me, when you start walking with the (one) special shoe they give you, it’s hard work. It’s quite an effort. Only have to do it once though. You need to discuss it with whoever will take care of you afterwards.

You need a stool for the shower and one of those plastic waterproof leg thingy bobs!. Like a long loose plastic boot. They’re elastic at the top.

Clean the house to within an inch of its life before going in. Those cobwebs will drive you mad when you’re lying staring at them, unable to do anything about it. 😁.

It’s a life changing op. Well worth having. Good luck.

[aliplayspiano]

Can’t comment on the bunion surgery as though I do have bunions, so far surgery not been mentioned. I am also on tocilizumab. About three years ago I had pneumonia and ended up in hospital. I was told I couldn’t restart the toc until I had spoked to the consultant so in the end I was off it for about 9 or 10 weeks. I was ok for about the first five weeks but then I really struggled with a big flare. I was really concerned that either I wouldn’t be allowed back on the toc or it would no longer work. Thankfully the consultant told me I could restart it and thought it took a while to start working again it did work and I am still on it today.

[Moomin8 in reply to aliplayspiano]

Thank you. I'm glad you recovered from pneumonia - it sounds like you had a rubbish time of it though. It's such a balance with out meds though, isn't it?

[aliplayspiano in reply to Moomin8]

Yes it certainly is a balancing act! The toc has been great and enabled me to do much more but it does send my neutrophils down low so I only inject fortnightly. And I guess it makes me more prone to infection. Thankfully I’ve not had a repeat of the pneumonia!

[cyberbarn]

I had two bunion surgeries in my teens, and they lasted until I was in my 50s when I had to have one redone and some remodelling work on the other.

I agree with the others, two at once will need a lot of help. It is important to elevate your feet. When I was a teen I was very bendy and after a couple of weeks I could sit at my school desk with my foot up on the desk beside me, not so easy as an adult. Luckily this time around I was a phd student working from home so I was able to have my foot elevated while I reclined on the sofa with my laptop.

I had the last two done under a local with podiatric surgeons. First time with sedation but I hated that so I had two more surgeries with nerve blocks and no sedation. It was great because it meant I really could give informed consent when they opened up the joints and saw how bad they were (I refused a fusion!).

Things are so different now compared to when I was a teen. Back then I was in a plaster cast for 12 weeks, no weight bearing, but now it for me it was one of those special 'sexy sandals' as the surgeons called them, no weight bearing for two weeks, then gentle walking but still keeping the foot up.

You should be given all this information when you go for a pre op appointment.

I can't comment on the medication, I wasn't on any at the time.