I’ve been having some problems with my right great toe for several years. The joint at the base of the toe is swollen and tender, it hurts with every step, and has very limited extension.
Had an appt with an orthopedic surgeon the other day and he recommended a couple of surgeries. The cartilage in the joint is completely gone, and there is considerable arthritis on the bones. Said the most straightforward procedure would be to fuse it, which would relieve the pain and reduce some of the size, but of course, would leave me with no motion of the joint. As an alternative, he said he could try to clean out the joint and stretch/manipulate the tendons and such, with the hopes of restoring some movement. He said the second alternative was not guaranteed, but if it failed, we could always do fusion later.
One downside is that he said after either procedure, I really shouldn’t do any running - my main form of exercise.
I guess I’m not completely sure how much I want to go through this surgery. As much as my foot hurts, I’ve been living with it for several years. And I really enjoy running along the lakefront with my buddies over lunch. Not thrilled with the prospect of just going to a gym and getting on an elliptical or something. And I like to eat too much to not get some kind of regular exercise.
I was hoping folks with experience with similar surgery could check in with their experiences - how much of an improvement they received from various procedures.
I think this is a perfect example of a need for a second opinion, or at least more information. Or maybe you’ve gotten one…it’s not in your OP.
IANAD, but I know a bunch from my career in the insurance industry. It seems like your doctor is following what is a good rule of thumb in Orthopedics; “fusion as a last resort”. Most of the time, fusion is reserved as a last case scenario in back problems, but I’ve heard of it otherwise (in toes like yours, for example).
My recommendation would be to try any alternative therapy (remember to pre-certify it with your insurance company…meaning make sure they’ll pay!) before getting a fusion. Fusion is a last resort, especially for an active, athletic person (I seem to remember that, in addition to being a runner, you’re a martial artist as well). I’m sure you’ve been thinking of it, and that you’ve realized that your toes play a huge part in your stride for running (pushing off as the last contact with the ground), especially if you’re running on pavement. I’m not a martial artist (“IANAMA”?), but I would think that footwork and power are at a premium in any serious martial art.
I would suggest the second opinion, specifically from an Orthopedist from Illinois Bone and Joint Institute (disclaimer: they’ve been a shared client of mine in the past, but they’re well-known and respected in the area…I believe you’re in Chicago, Dinsdale. They’re in a lot of the Advocate facilities, I think). Try anything short of fusion, and cross your fingers.
I’m not trying to scare you, so my apologies in that respect.
-Cem
Sorry, just thought of some other stuff to add. I think I’ve seen something about replacement cartilage from cadavers (similar to the ligament/tendon stuff). IBJI folks would probably know. I’m a firm believer that second opinions are an absolute necessity if it’s going to impact your standard of life. Plus, 2nd opinions are likely covered at 100% by your insurance (check to be certain).
Should have known a poster named Cemetary Savior would come up with cadaver cartilage!
Couple things - I used to do martial arts. Quit about 5-6 years ago after I screwed up my foot (as well as shattering my L wrist. Been thinking about having surgery on that joint one of these days as well.) The big toe is HUGE in grappling - in fact I’d contend that two of the most important things about fighting on the ground are to keep your hips low and push off your big toe. That’s how I screwed up the toe - I hyperextended the joint, and then just kept taping it up and wrassling. What a maroon!
I took up running after I stopped fighting, and ran a marathon a couple of years back. The doctor couldn’t believe I run on a joint as bad as mine - including 5 miles just before I saw him. From martial arts I developed a pretty incredible tolerance for pain, as well as an incredibly stupid refusal to listen to my body.
My best golf buddy had the same joint fused a couple of years age. He gave me his doctor’s name for a 2d opinion. Maybe I’ll check it out - or at least go back to this guy with more questions. I want to get going with it, tho, so I’ll be recovered by the time we start seeing the occasional nice golf weather come March.
Hell, I’m a short hop down 290/355 in Glen Ellyn. Never been to Bittersweet, but if you’re in AH, we can certainly find someplace closer to both of us than Gurnee. Why don’t you send me an e-mail?
Actually, Palatine’s muni was on the short list of cheap local courses I’ve never played and meant to try out last year. Couldn’t you pretty much hand us drinks over your back fence?
Actually, I’ve been considering a DoperFest/DoperGolf outing for a few years now (I’ve ben lurking since pre-pay). There have to be a ton of Dopers around Chicago…right? Odds woudl have a few of them hitting the dimple-ball!
I’ve played Glendale Heights a few times down your way.
But if there’s a free drink to be had…Palatine it is!
Since we’ve hijacked the crap out of Dinsdale’s OP already (and he helped!)…do you have the perfect job-combo…teacher during the school year, and golf-course worker during the summer?
Actually, I’m not a teacher or a golf course worker - I’m a secretary who just goofs off a lot and happen to live in a townhouse community that’s on the back 9 of Palatine Hills GC.