Thursday, January 20, 2011

Fibular Sesamoidectomy - Relax.

Ok, so here is the HUGE news about sesamoid excision:

1) Get yourself an orthopedic surgeon that you trust, preferably at a highly regarded teaching hospital in your area - this is your foot you are talking about for the rest of your life. I am sure that there are some good DPM's out there that do a fine job, but I have had personal wonderful experience with ortho's and I would hands down recommend one - that is good, confident in his/her work and has done it successfully before - many times.

2) Do the appropriate waiting period that your doctor will force upon you whether you like it or not (will likely involve walking cast - make sure they give you a big one that goes up to your shin, none of that foot-only bs). This will last 3-6 months depending on your doc.

3) Stay active even while in the waiting period when you are testing whether it will heal on its own without surgery - I recommend push-ups and situps (done hard) at least once a day, or at a minimum once every two days. This may be way less exercise than you are used to, but will ward off unpredictable emotional breakdowns.

4) If you must have surgery, just do it. You've done the waiting, you trust your doc (your orthopedic surgeon! - make sure s/he has done many before and they have been successful), so do it (if it's the right time for you - only you can determine what amount of pain you are willing to live with).

5) Be good to yourself after surgery. Don't cheat. NO WEIGHT on the foot for the prescribed period of time. Sleep in the boot (wear it for 24 hrs/day until you feel comfortable sleeping in it.) Don't shower until you are supposed to - learn to appreciate baths again if you have one.

6) Be patient and give yourself time. Expect to build strength and confidence at a relaxed pace. Accept that you should not even attempt running for 6 months to a year after surgery. Sure, be frustrated by that, feel limited; but then move on. Breathe again, and maybe even enjoy the extra time you have now, time that you might otherwise have spent running excessively. Maybe read more. This is one time in your life when you have to rest. So do it. Enjoy it, and learn all you can about the balance between healthy eating and exercise. Learn that eating normally without intense exercise is a viable way to live and still feel good about yourself. Dealing with the same problem 5 years from now will not be worth trying to "get the endorphins" back while struggling through a painful run at 3 or 4 months. Just chill. You'll be walking comfortably at 10-12 weeks if you rest well, and biking soon thereafter.

7) Most of all: trust your doctor. My doctor's confidence in his work is what has kept me sane throughout this. I was unfortunate to have had a bad experience with a DPM before seeing my doc at Georgetown, and my emotional and physical health suffered because of it. Start with a good doc, and end with him/her - whether that is DPM/Ortho surgeon/someone else.

Good luck. It's ok to lean on people for support! (physically and emotionally.)