(At some point, I’ll head back and fill in days 1-240, but for now, here’s the entry for day 241 in my cheilectomy diary.)

241 days ago, I went into hospital for a cheilectomy, a relatively straightforward procedure (or so my surgeon assured me) to remove a bone spur on the top of big toe joint on my right foot. This post isn’t aimed at anything other than, should some nervous or hesitant potential operatee stumble across it via a Google search, to attest to the efficacy of the procedure¹.

I’d had problems with my big toe for some five years prior to my operation, the usual fare for someone suitable for this procedure: stiffness of the toe, pain when walking any distance, inflammation, altered gait, shoes abnormally worn down etc. I’d previously been referred to a podiatrist who had run me through the usual list of increasingly-invasive treatments: orthotic shoe inserts, steroid injections, bone spur removal, joint fusion, and finally joint replacement. I opted for the easiest, least painful choice on the list, and had some orthotic inserts made for my shoes. They were quite uncomfortable to begin with and, to be honest, I’m not sure they did much for me. Nevertheless, I stuck with them for a number of years, getting them replaced as and when my odd gait wore them down, all the while not really noticing any less pain or discomfort.

Finally, I decided I’d had enough. Or, more accurately, Kath decided she’d had enough of me hobbling around like a decrepit old 90-year-old. Back to see the doctor I went, and was referred once again, but this time to an orthopaedic surgeon, the quite awesome Mr. Harris. He decided that I was an ideal candidate for a cheilectomy, the third entry on the aforementioned List Of Painful Procedures™. He didn’t think my case warranted fusing the toe joint (good), and there was no real talk of joint replacement (really good), so all that was left was  ‘chipping bits off until it moves better’. Sounds… delightful.

The operation itself was a day-case, so admission at 7.00 in the morning, nothing to eat for a few hours before, and in for the op just before lunch. A spot of general anaesthetic and 45 minutes later,  and I found myself in the recovery room with a large bandage on my foot, and no real pain, which was nice. A quick episode of vasovagal syncope, and consequently a not-so-quick extra hour in the recovery room, followed, before I found myself back in my room eating an incredibly dry ham baguette and drinking litres of water. The physiotherapist came round around mid-afternoon to show me how to walk in my special new idiot shoe, and to show me the best way to climb the stairs (spoiler alert: as little as possible), before the nurse gave me my drug cocktail for the next fortnight (two types of painkillers,  anti-constipation drugs to undo the bunging effect of all those painkillers, and a daily anti-DVT injection to stop me pooling and dying) and sent me on my way. Kath managed to get me to the car and home in one piece, where I promptly flopped on the couch, and stayed there for two weeks.

The surgeon and physiotherapist weren’t joking with their instructions to stay off my feet for two weeks and keep my foot elevated. The time it took to walk to the kitchen to get a drink and walk back was all that was needed to start my foot throbbing, and require a dose of painkillers. The only time I was on my feet during that two weeks for any longer period than that was climbing down and up the stairs every morning and evening, and having a shower. This latter task proved to be… interesting. Under (further) strict instructions to not get the bandage on my foot wet, it was recommended to me to wrap my lower leg up in two bin bags² and tape up the bags using parcel tape. Needless to say, this procedure became both an awkward and an expensive daily affair. A solution was needed, and my friend James had a solution from his days of a broken ankle-leg thing – the LimbO Waterproof Protector. Oh what a piece of technology! Akin to pulling on a thick, leg-length condom with a neoprene rim, this bad boy laughed in the face of any water than got even vaguely close. A modern day wonderment, the LimbO is. Once I was equipped with this marvel, my showering became much more confident, and far quicker, which helped my poorly foot no end.

Over the course of the two weeks, sporadic swelling and throbbing due to too much hobbling about aside, the pain was minimal. The biggest discomfort occurred around 17.30 each day when Kath administered an injection in my gut to minimise the risk of thrombosis due to being sat down all day (that fucker stung quite a bit). I was far too much of a wuss to be able to administer my own injection…

After my two weeks internment was through, I was called back to the dressing clinic to have my bandage removed. Initially nervous at what may be uncovered, and being unsure as to whether it would need re-bandaging, I put on a brave face as the nurse chopped through the strapping and bandaging, and gave my stinky, manky foot a clean. Lo and behold, it was still in once piece, with a neat 8-10cm scar that was as straight as a die and healing nicely. The surgeon took a look, gave it a bit of a wiggle and deemed me fit to remain unbandaged and newly en-shoed. Joy.

The fun, however, wasn’t over. Whilst I was now allowed to walk a little more (although keeping my foot elevated when sat was still recommended) and to start driving again, I suspect the only reason for this was to aid my transit to the cruel, sadistic physio every week or so. Boy, did that hurt. Whilst she was doing nothing more than merely bending my toe up and down (with some force; the aim was to overcome the stiffness produced by everything knitting tightly back together again), the pain, at least for the first few sessions, was sufficient for me to become light-headed, and to need a bit of a lie down³. The physio worked on my toe for the next couple of months or so, giving me exercises to do at home, such as prancing around on tip-toes, and working my toe’s flexibility during our sessions.

Finally, I was called back to see the surgeon for, hopefully, my 6-month sign-off. He was reasonably happy with my progress, and consequently gave me a clean bill of toe-based health. Which was nice.

So here I am, 241 days after the operation. How’s my body holding up?

• Movement – I’ve got substantially more flex in my big toe now. Prior to the operation, there was literally (not even figuratively — literally) zero degrees flex upwards in my big toe. Now, there’s probably 30-40 degrees. A normal toe may have anything up to 90 degrees. Clearly, I’m nowhere near where I should be, but my expectations for this were set appropriately by Mr. Harris before the operation. I’m happy with this improvement – my gait is far more normal now, and doesn’t require a strange roll to the side of my foot, which was the thing that was making my ankle, knee and hip sore before.
• Toe pain – The pain is substantially reduced. I can walk five miles nowadays without any significant discomfort, whereas previously I’d’ve been popping the ibuprofen and moaning for a couple of days subsequent. I do get some discomfort when the weather is cold and damp, but I suspect that’s more to do with the arthritis in the big toe joint that anything else, and that’s something about which I can do nothing.
• Other pain – The pain and discomfort I used to experience in my hip and posterior due to my wonky gait is as good as gone. This is amazing. I’ve had discomfort all about the lower right of my body for a number of years, and having this operation has seemingly revealed it was all to do with my bloody non-bending big toe. Quite the pleasant revelation.
• Shoes – An unexpected bonus, but previously I wore the outside of the heel on my right shoe far more than any other part of either shoe, necessitating new shoes far more often than expected. Post op, my shoe wear is back to normal. Take that, shoe companies.

So that’s about it. Once again, your mileage may vary, and check with your doctor yadda yadda yadda, but a cheilectomy seems to have righted most of the wrongs I was experiencing, and I wouldn’t hesitate to repeat the operation if I was in the same situation again. Unless, alternatively, I was offered some sort of bionic robot toe, which I’d take without thinking, obvs.