Pace Setter : March 2023

Footnotes: A Medical Journal

by Stephanie Mumford Brown

Part 3: The Big Reveal

I am Stephanie’s left foot. I am a perfect 10.

Perfectly awful.

That score emerged as we looked at my before/after lapiplasty X-rays projected on a medical-office screen. How bad was the old Lefty bunion, Stephanie asked the pros, on the usual scale of?

Top of the pops, the Bo Derek of deformities. My big toe had taken a sharp left turn away from the metatarsal bone that connected it to the rest of me, and was heading down the road to nowhere.

Surgery has since ushered my status well down the aisle toward 1 or 2 or less. Not there yet, but eight weeks after lapiplasty adjusted my joints and tacked them into place with titanium, normal life seems entirely achievable. Boring, conventional, and exactly what Stephanie wants.

The Big Reveal arrived after I spent three post-surgical weeks bound and gagged (and the microphone got highjacked by Righty for Part 2 of this series). The scene was not for the faint of stomach, as several feet of dried-blood encrusted bandage got snipped and unwound. One observer likened my emergence to a Philly cheesesteak.

Scarring, scabbing and swelling made me look like a sandwich and feel like a balloon for about 10 days. More dispiriting, Stephanie found new levels of exhaustion just when she thought we’d beaten the post-surgical fatigue. Her energy sine wave alternated between bustling highs and plunges into lassitude.

Still, progress happened swiftly. During Weeks 4 through 6, we returned to a simulacrum of normal life, including showering and hair-washing, cooking in and dining out, and socks.

Here are a few of the tools I’ve counted on since the Big Reveal:

Cane. More graceful and chic than the initial walker. (Didn’t do crutches.) Had we needed a cane for more than two weeks, Stephanie would’ve looked into the numerous style options. Maybe society should bring back this accessory as proper street dress for everyone, along with hats and gloves. Meanwhile, hiking poles will have to do.

Ortho boot and oversize shoes. I hobbled out of the Reveal in a black strap-on, ankle-high ortho boot with a modest platform. More style-setting potential here? Three weeks later, at follow-up #2, I got cleared for a shoe. Not so stylish—I’m wearing Stephanie’s fella’s two sizes larger tennis shoe to accommodate my swollen self, but it’s great to hit the sidewalks again.

Cryo-cuff and Epsom salts. Another loan from the fella, who learned about it from coach colleagues during his days in academia. Jocks like the Cryo-cuff for circulating icy water around stressed body parts for relief and shrinkage. I like soothing soaks in a hot bath of dissolved Epson salts, though I’m not sure Epsom salts do anything scientific besides stimulating tomato plant growth.

YMCA. This is my favorite hangout. Stephanie thinks it’s because I can do a half-hour of aerobic fun on the rowing machine without bending uncomfortably. It’s actually because the whirlpool bath and sauna feel fabulous while making me think I’ll be able to bend again someday. Also, the Y denizens include plenty of people with imperfect body parts. This makes me feel at home and corrects any recovery impatience with gratitude that my situation is temporary.

Eight weeks after my major rearrangement, Stephanie is walking pseudo-normally. She moves like a stereotypical stiff-legged old lady, which she is not, at about half her usual ground-eating pace. Running? Not even close—not so much because a need to avoid the impact, but because I can’t bend.

The swelling acts as a natural splint, after the fiberglass one comes off, as my adjusted metatarsal joints complete their fusion. Although I’ve diminished somewhat (she measures me daily), I still have all the pudgy charm of a cute toddler foot—but size 10.

Righty is waiting. Will Stephanie do it again? Should you do it at all? I now hand her the microphone.

Stephanie’s testimony, so far

Bunions are a funny phenomenon for medical decision-making. They cause misery but they don’t kill you—at least, not directly. Yet impairment from body-part failure can be lethal insofar as it reduces your cardio health and muscle strength.

We all know the potential gradual destinations of insufficient fitness over time. Then there’s surprise fitness failures like falling down the stairs, which has killed several people in my life.

So, the medical precept, first do no harm, gets blurry here. Not to forget, this is major surgery followed by significant, if elective, disability.

When I got an initial pre-problem evaluation a few years ago from a podiatrist, he advised me not to mess with my success in adapting to my bunions without pain. His practice did traditional bunion surgery, which basically just saws off the extra bone and reportedly involves more pain, slower recovery, and a lower long-term success rate than lapiplasty. Thus his conservatism.

Then came my first attempt at a half-marathon in 2021. Lefty had finally had enough, leading to my search for surgical relief. If I’d held off longer, my deformity might have exceeded the bounds of relatively uncomplicated correction. It goes to 11, so to speak.

Today I look forward with confidence to a fully functional left foot. Now I’m curious to see whether I get any more than that. Will this be like my cataract experience?

Granted, a bionic eye lens provides medical instant gratification: within 24 hours I saw birds in the trees, bricks in the walls, and brightness in the sky that I didn’t even realize I was missing. The next weekend, I shot my lowest 18-hole golf score in five years.

Over time, will I find comparable athletic lagniappe from lapiplasty? Will my 5K and 10K times return to my 2019 personal bests? Will my next attempt at a half marathon yield a significantly faster time as well as a less excruciating final 3 miles? Or are those outcomes entirely dependent on heart and lung, not foot, fitness?

It’ll take a couple more months before I can run again at all, let alone with any speed. I’ll need a bendable foot before I can undertake a healthy dose of remedial training. But I’ll check in with one more report when there’s a spring in my step again.

Coming in May: Footloose.

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Stephanie Mumford Brown is Chief Wiseacre at Wiseacre Press, where she’s trying to compile the missing assembly instructions for the second half of life. She's a former journalist and marketer, now focusing on essays and fiction.

Click here for her other articles

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