I first got a Morton's Neuroma (MN from hereon!) in my left foot, between toes two and three, back in 2010. (Read my last blog posts about it here and here.) Initially I had a cortisone injection to zap it. That lasted for about a year, but a second injection lasted only a few months and also caused one of my toes to become deformed. I could have had surgery to correct the toe, but it sounded pretty unpleasant, had a long recovery time and anyway, the pain I have been experiencing has all been from the MN. So yesterday I had day surgery at the Nuffield Orthopaedic Centre (NOC) in Oxford to excise it – basically to cut out the section of nerve that has become inflamed. Here are my thoughts on the surgery. I'll be updating this blog with my progress regularly in the hope that it will be of interest to anyone else thinking of having MN surgery!
Having surgery is never an easy decision, and having elective surgery even less so, but the MN has been causing me a lot of pain for months now, not just when I walk but also through giving me shooting pains in my foot when I'm at rest. I could have continued with cortisone injections but frankly the effects of the last one lasted less than six months and I couldn't contemplate having to have them for the rest of my life, so despite the risks of any operation I decided surgery was the best option.
I arrived at the day surgery unit at the NOC at 7am yesterday, accompanied by Steve. Nothing much happened till about 9am when an assistant to my consultant asked me a few screening questions – did I have asthma, did I smoke, how much did I drink, that kind of thing. A while later my consultant Mr Lavis came to see me, accompanied by a junior doctor, who was very interested to examine my poor deformed foot! Mr Lavis talked me through the procedure, marked up my foot to ensure he operated on the correct one, and answered my questions, mainly around how soon I could be walking properly (2 weeks) and driving (2-4 weeks or thereabouts, possibly as many as 6) again, how long complete recovery would be (perhaps as long as two months) and what side effects there could be (definitely numbness between the two toes, because of the nerve removal; a possibility that the remaining part of the nerve could form another neuroma, which would need treatment; a rare but unpleasant sounding condition where the entire nervous system in the foot goes haywire; plus the usual risks and side effects of having a general anaesthetic). Surgery would involve going in through the top of my foot, moving the toe bones apart and cutting out the affected bit of nerve. He would also inject plenty of local anaesthetic in there to relieve the pain immediately after surgery.
Then an hour or so later a nurse came to do a pre-op assessment, which included taking my whole medical history, weighing me, measuring me, and taking my temperature and blood pressure. She also gave me a pressure stocking which I needed to wear on the opposite leg when I went into theatre, and then all the time till I'm back to full mobility (2 weeks). Felt like we were getting somewhere now! But typically I was the last person on the ward to go down to surgery. The anaesthetist came to visit me at about 12.30 to introduce herself, and it wasn't till 1.30 that I was finally taken down to theatre. By then I was very hungry, having not eaten since 8pm the previous night!
Once I was down in theatre I got onto a trolley and the team hooked me up with all sorts of monitors on my chest, to measure heart rate and oxygen levels, and also put a cannula into the back of my hand, which was a bit uncomfortable but not too bad. They then told me they were going to give me something that would be like having a G&T. “More like half a dozen!” I giggled as my head went all woozy. And that was the last thing I remembered …
… Until I woke up in recovery just before 3pm, freezing cold, wearing some sort of woolly hat and convinced I was in my friend Andrea's caravan in Portugal and the rain was beating down on the roof. Very weird! The HDU nurse was lovely and got me some extra blankets, and folded one and put it over my head. (Strange, I was convinced I had a woolly hat on … But maybe I was imagining that as well as the rain!) She also got me some water, which was very welcome as my throat felt quite dry and sore; I think I probably had an oxygen tube down there while I was in theatre. My foot felt sore, very stingy, and the cannula hurt too, especially when the blood pressure cuff I appeared to be wearing kept tightening up, so she gave me a couple of codeine tablets, which helped. I was very drowsy and kept closing my eyes, but eventually I managed to come back down to earth. I had a look at my foot and was surprised that it was only my foot that was bandaged – I've done a lot of research into MN surgery and have seen people with bandages up to their knees, so mine looks quite minimalistic!
After about half an hour I was taken back to the ward and there, waiting for me, was a cup of tea, an egg and cress sandwich and some biscuits, as well as my lovely Steve, who had waited there the whole time and had had nothing to eat but a couple of custard creams! The tea was especially welcome. My foot felt pretty good, considering, and I was able to hop into a wheelchair to go to the loo. A student nurse did a few tests – blood pressure, temperature, checke I had blood flow to my foot – and I was told I'd be able to go home at 5:15, but by the time I'd been given my discharge instructions and meds it was nearly 6pm, meaning we'd been there for eleven hours!
So the discharge instructions are that I have to elevate my foot as much as possible – preferably above my hips – for the next five days or so, standing only to get to and from bed and to go to the loo. Good excuse to put my feet up, relax and let everyone pamper me! When I do walk I need to wear an incredibly stylish black orthopaedic shoe, and put my weight entirely on my heel for the first few days, and then gradually increase the pressure on the front of my foot as it begins to feel more comfortable. Hopefully next week I should be able to walk fairly normally, but I need to keep the shoe on for a good few weeks. Actually I'm slightly confused as to how long. The discharge nurse said I needed to wear it for six weeks, but my consultant suggested I could start driving in 2-4 weeks when it feels comfortable – but I don't think I could drive in the shoe! I might have to phone and ask in a few weeks time. I was also given a fun bag of medications – codeine and paracetomol to take four times a day, and diclofenac to have three times. It's not been feeling too sore this evening, but I've taken the meds anyway; the diclofenac is especially important as it's an anti inflammatory, and I need to keep any swelling to a minimum (which is what the elevation is all about). I 've made an appointment with the practice nurse at my doctor's surgery (which just happens to be literally over the road from me) to have the stitches out in a couple of weeks, and I have a follow up appointment at the NOC for the end of May. And the biggest problem is I have to keep the bandage clean and dry, which means no proper showers for a few weeks … Aargh!
Despite spending far too long at the hospital, it's not been a bad experience overall, the pain is definitely manageable and I'm looking forward to a few days of bed rest and a fast recovery!