Is Bunion Surgery Pain Preventable?

Does bunion surgery have to be painful? In this video excerpt from an interview from Chattanooga's Award Winning Foot Surgeon, your will lean about bunion surgery and concerns about post-op pain. Bunions are a correctable problem. You don't have to live with painful (treatable) bunions.



Dr. Christopher Segler is an author, inventor and award winning foot surgeon with a surgical podiatry practice in Chattanooga. He invented and a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He publishes articles teaching other foot doctors about his methods to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.

Do Shoes Cause Bunions?

New video excerpt from an interview with Dr. Christopher Segler of the Ankle & Foot Center of Chattanooga explains the relationship between bunions, shoes, and foot pain. Don't toss out all those Jimmy Choo shoes just yet!




Dr. Christopher Segler is an award winning foot and ankle surgeon with a podiatry practice in Chattanooga. He is the inventor of a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He publishes articles teaching other surgeons about his techniques and how to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.

Fearing Pins with Bunion and Hammertoe Surgery

Today I got a question from a patient who is thinking about surgery for bunions and hammertoes. She explained that a friend of hers had a similar surgery. She said that her doctor pinned the hammertoes. In addition, he put a plaster cast around the front half of the foot. Her friend was wearing a surgical shoe, but that the pins and cast would have to stay in place for at least 5 weeks!

So the question is… is it necessary to have pans sticking out of the end of the toes after you have hammertoe surgery. The other question is how long does it take for someone to really recover.

There are many ways to fix hammertoes. In the cases described here, the patients also had bunions and decided to have surgery to fix both of those problems at the same time. Many times as a bunion forms, the big toe will move over against the second toe and push the toe out of alignment. This causes the hammertoe deformity.

If this is the case, fixing the hammertoe alone is not a good idea. Without fixing the bunion that is pushing into the second toe, the hammertoe deformity is likely to develop again.

When the hammertoe is straightened, something has to be done to keep the toe in alignment while it heals. One way to do this is to drive a pin in the end of the toe through all of the bones in shish kebab fashion. I personally don’t like this method. Although it is simple and inexpensive, it does have additional risks.

A pin sticking out of the end of the toe is a portal for bacteria and can lead to an infection. Whenever you walk or move the foot, the skin moves back-and-forth across the pin. Over time, the bacteria that normally grows on the skin can work its way down the pin as it pistons relative to the skin.

Because the pin is driven into the bone, this can lead to bone infection. Bone infections, also known as osteomyelitis, are very difficult to treat and often lead to amputations. This is a very serious complication.

A better way to correct a hammertoe is to put an implant in the joint that is corrected when the foot surgeon out the toe. This implant is completely contained within the toe. There is no exposed tendon and no additional risk of contracting an infection. There are both absorbable and nonabsorbable implants available to surgical podiatrists for this procedure. The nonabsorbable implants are typically made of titanium or surgical stainless steel.

These implants do cost more than the pin that’s typically left sticking out of the end of the toe. Medicare will not pay for these types of implants. For my patients, this is no longer a problem is I have decided to opt out of Medicare. I believe it’s important to make sure the patient has the best treatment available, not just the cheapest treatment.

Regardless of which method you and your foot doctor choose, it does take about six weeks for the corrected hammertoe to heal. It is necessary to wear either a surgical shoe or a fracture walking boot while you recover. Most people can walk while they are recovering. It’s not always necessary to use crutches.

If the pin is sticking out of the end of the toe, it is typically necessary to leave in place anywhere from four to six weeks. Much of this depends on the patient’s age, how well the person is recovering, and whether or not an infection develops.

Although this can be an inconvenience, there are other methods. It’s important to discuss your expectations and desired activities with your foot surgeon before you have any foot surgery. Making sure that you understand what will be required for you to recover, to make sure that you can get back to activities you enjoy as quickly as possible.

Dr. Christopher Segler is an author, inventor and award winning foot doctor with a surgical podiatry practice in Chattanooga. He invented the patented surgical instrument that simplifies flatfoot surgery and bunion surgery. He publishes articles and teaches other surgeons about his unique methods to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.

Can I Drive After Bunion Surgery?

When anybody starts thinking about foot surgery, they start to realize her to have limitations after the procedure. Aside from having some limitations of walking, people next start to realize that they might not be able to drive a car.

For any kind of surgery, anesthesia can impair your ability to think and drive. That is why all hospitals and surgery centers require someone to come with you on your date of surgery to make sure that you can get home safely. He should never drive within 24 hours of having surgery under any circumstances.

In terms of foot surgery, many people feel confident enough to drive immediately after the procedure. However, what is a wise choice. If you have an immobilizing device such as a fracture walking boot, cam walker, cast, or posterior splint he should never drive an automobile. All of these immobilization devices make it very difficult for you to feel the pedals in the car. It is very easy for a fracture boot to become lodged between the gas pedal and the brake.

While I was in residency, I had one patient who had had bunion surgery and decided to drive her car. One morning when getting ready to come into the office to see me for her postoperative follow-up appointment, she got in her car, and proceeded to lose control and drive it straight through her garage. So be very difficult to explain to an insurance agent.

About a year ago, at another patient here in my office in Chattanooga, who had an ankle fracture. He was wearing a fracture walking boot in order to provide stability to the injured area. Although he had been instructed not to drive a car while wearing the boot, he thought he could handle it. Unfortunately, he lost control of his car and drove into the Hardees restaurant. Fortunately no one was injured.

One of my instructors and residency used to always tell patient that driving a car while wearing a fracture walker was a “personal legal decision.” The reality is that if you get into an automobile accident while wearing one of these immobilization devices, the investigating officers will almost always consider the accident to be your fault.

Even if you are only wearing a surgical shoe to provide stability after bunion surgery, a 2008 study published in the Journal of Bone and Joint Surgery investigated the motor skill ability of patients who had had bunion surgery.

In that study, the investigators took 28 patients who had undergone bunion surgery on the right foot and evaluated them. They used a custom-made driving simulator in order to compare the bunion surgery patient’s abilities regarding total brake response time, reaction time, and actual brake time. The bunion surgery patients were compared to a group of 28 subjects who had not had surgery. These two groups were matched for age, driving status, and sex.

What the investigation found was that two weeks after bunion surgery on the right foot, 75% of patients were unable to complete the test. This showed that two weeks after bunion surgery, most patients will be unable to safely operate a car. Interestingly, however. Six weeks after bunion surgery the patients' reaction, brake, and total brake response times were even better than they had been before the bunion was surgically corrected.

The study concluded that it is safe to operate a car six weeks after bunion surgery, but not before. It’s always important to use common sense. Although it may be a minor inconvenience, if you can make arrangements to have a family member help you with transportation while he recovered from your bunion surgery, it will be much safer. He will also likely to recover faster because you won’t have pressure applied to surgical repair while the area is healing.

It typically takes about six weeks for the bone to heal after bunion surgery. If you were forced to apply the brakes, or if you are involved in a collision, there would be a substantial risk that the bunion correction could be damaged. If you have had bunion surgery, it is always important to discuss your plans with your foot surgeon, before you drive a car, just to make sure that you won’t have any problems.


Dr. Christopher Segler is an author, inventor and award winning foot doctor with a surgical podiatry practice in Chattanooga. He invented the patented surgical instrument that simplifies flatfoot surgery and bunion surgery. He publishes articles and teaches other surgeons about his unique methods to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.

Secrets to Finding a Qualified Bunion Surgeon

Anyone who is considering surgery, whether bunion surgery or brain surgery, has a potentially stressful and serious decision to make. It is important that you, as a patient considering surgery, make the right decision. By asking the right questions, and with a little footwork (no pun intended) you should be able to find a well qualified bunion surgeon who can help you, correct the bunion, relieve your pain, and get you back to all the activities that help you enjoy life on your feet.

   
Before I begin, I’ll start  with a qualification that I myself am a bunion surgeon. I have been awarded a United States Patent for an instrument and technique which I invented to to simplify complicated bunion surgery and I have also published original research in medical journals teaching other foot surgeons how to reduce or eliminate pain after bunion surgery.  I’ve also been invited to lecture and present my research on the new advances that I developed at multiple medical conferences in the United States, Canada, and New Zealand.

  
Having said that, there are many doctors like me in virtually every area of the United States who are well qualified to perform your bunion surgery.  The goal is to help you discern the real qualifications from deceptive ones.  This way, you will be able to determine for yourself, whether or not your surgeon is likely to provide you the outcome you want...no bunions and enjoyment of life.

 
Board Qualification 

This is actually the area where most of the deception lies. The foot surgeons held to the highest standard with the most hours of training and most extensive board qualification testing are affiliated with the American Board of Podiatric Surgery. There are other “board certifications” such as the American Board of Foot Surgery and the American Board of Multiple Specialties in Podiatry.  While the other boards “sound official,” they are rarely accepted as proof of competence by hospital committees.

Training 

Your surgeon should have three years of foot and ankle surgical training in residency after medical school. The more training, the more experience with a wide range of surgical techniques. There is a reason they say doctors are “in practice,” and the more practice the better.

 
Research 

Making certain your surgeon has experience with medical research, (particular in the areas of your particular problem) will ensure that he/she is interested in finding ways to perform better.  A history “in practice” alone is not enough to indicate your surgeon has the skill you are looking for. Research is what separates leaders from followers.  The leaders are always out in front and aware of the latest advances in technique. 

Awards 

Less than 1% of all surgeons will have won awards for advancing the field of surgery.  If you find one, you likely have a winner for sure. Check their website or search the internet for evidence that they are at the top of their field. 

 
Creativity 

Surgery is a science and an art. Creatively looking at new ways to solve problems is always a useful trait in a surgeon. If you can, find a surgeon who has demonstrated innovative thinking such as patenting a surgical instrument or has patented techniques that improve surgical outcomes. 

 
Authority 

It is no coincidence that the word “authority” starts with “author.”  Those that write books, publish articles in medical journals and use their writing skills to educate other surgeons always stay on top of their game.  All you need to do is search the surgeon’s name on Google.  If they are a winner, you will have many hits.  
Surgery should be a great experience because it will be the start of your recovery, and the start of a new more active, more enjoyable life. The time you spend researching your surgeon will be time well spent. 

Dr. Christopher Segler is a nationally recognized award winning foot and ankle surgeon practicing in Chattanooga Tennessee. He is the inventor of a patented surgical instrument designed to simplify bunion surgery. He has published articles teaching other surgeons about his techniques about how to decrease pain after bunion surgery. You can request a FREE copy of his new book about common causes of foot pain at http:www.anklecenter.com.

Why Bunions Hurt More in When its Cold

As the seasons change and cold weather arrives, sandals and flip flops get tossed aside. Women start digging around in the back of their closets trying to find some suitable cold weather shoes. Many of them will venture out in search of those perfect new fall shoes to match their new wardrobe. Many are switching from open toed sandals to boots and shoes. Shoe stores get an influx of women with bunions shopping for fashionable yet healthy shoes at this time of year. 

As a foot and ankle surgeon, I notice more women seeking relief for painful bunions every autumn. Many women experience a sudden increase in pain from bunions and hammertoes, that haven't been painful in quite some time. This has much more to do with shoes than weather. The reason for this is simple. Warmer weather typically lends itself to open toe, nonrestrictive shoes and flip flops. As soon as the mercury drops, people start stuffing those feet into tight shoes.  This is often compounded by the desire to be fashion concious. Buying new shoes to match a Fall wardrobe adds the pain associated with break-in to the equation. New shoes never feel as good as ones. Any area of pressure has to be worn in to the shoes. 

As a result, I see an increase of women in my podiatry office this time of year. Many of my female bunion patients are in agony and describe a constant, throbbing or burning pain in the feet. For most it is worse with activity, but some even continue to experience pain after they take their shoes off in the evening.

A combination of factors cause them to seek treatment. For many, the changing weather seems to aggravate the foot pain. More women inquire about bunion and hammertoe surgery in the fall because they are also less busy than in summer months. Many also realize that they are closer to meeting their insurance deductibles. That means that the surgery will be at a much lower out of pocket expense than after the first of the year.

Even though many people start to realize that surgery does make more financial sense toward the end of the year, I always explain that surgery should be a last resort treatment, even for women with painful bunions. Often times, other treatments will help. For many women, something as simple as wearing shoes with wide toe box can drastically reduce bunion pain. For those withbunions complicated by flat feet or instability, custom shoe inserts can help keep the problem from getting worse. There are also gel and foam pads as well as anti-inflammatory medications that might provide pain relief.

Only when when the pain from the bunion interferes with a woman's daily activities, it's time to seriously consider surgical correction. Not only is this my opinion, but also the recommendation of the guidelines set forth by the American College of Foot and Ankle Surgeons. If the bunion becomes inflamed, ice it, wear sensible shoes and try to avoid shoes with seems or stitching over the bump. 

Dr. Christopher Segler is an author, inventor and nationally recognized award winning foot and ankle surgeon. He is the inventor of the patented Tarsal Joint Distractor, which is a surgical instrument designed to simplify bunion surgery. He has also conducted peer-reviewed research and published articles teaching other surgeons about his techniques about how todecrease pain after bunion surgery. You can request a FREE copy of his new book about common causes of foot pain athttp:www.anklecenter.com.

Can Bunion Surgery Be Pain Free?

When anyone has suffered from painful bunions and starts to think about bunion surgery, they always ask me...is bunion surgery painful? Bunion surgery does not have to be painful. With the obvious disclaimer that any surgery certainly can be painful, it does not have to be. There are many techniques the properly trained and skilled foot surgeon can use to ensure that you have as little discomfort as possible related to your bunion correction surgery.

First, make sure your bunion surgeon will provide local anesthesia before your surgery starts. This is important because making the foot completely numb before the procedure starts will help to ensure that you do not experience the “anesthesia awareness” that has recently been reported on it the news. This is the situation where someone might be unconscious for the surgery, but still actually feel pain. If your foot is numb because it has been made numb with local anesthetics before the procedure begins, this can prevent that otherwise rare occurrence. In addition, make sure that your surgeon utilizes (so you will benefit from) all of the latest developments in post-operative pain reduction.

For example, while in Surgical Residency, I worked on research related to a simple, effective, low-cost method of reducing pain following bunion surgery. In that study, 95.92% of bunion surgery patients reported taking less pain medicine and believed that there pain much less than had the “pain pump” not been placed in the surgical site and used in their foot surgery cases. I published the secrets on this technique in a medical journal called Ambulatory Surgery in order to teach other foot surgeons how to make bunion surgery a better experience for their patients.

You should also make sure that you have access to other postoperative pain reducing techniques such as cryotherapy. This is a very simple device that circulates temperature controlled cooling through a special pad incorporated into the dressings applied at the time of surgery. By continually icing and cooling the surgical site for first couple of days after surgery, patients have less pain, less swelling, and recover faster.

Post-operative pain is not just an unpleasant annoyance, but it is also generally unhealthy. Pain can actually impede wound healing and stall your recovery. For these reasons, your foot surgeon should use every single available effective method to make sure that your bunion surgery goes smoothly and with as little discomfort as possible.

Your feet are critically important to your ability to enjoy everything from walks on the beach to dancing at the charity ball. You should only expect the very best performance from your surgeon when considering corrective foot surgery. It is important to not only imagine what your life would be like without the pain from bunions, but also to think about how simple bunion surgery could be if you chose a surgeon who would help ensure the fastest most comfortable surgery possible.

Dr. Christopher Segler is an award winning foot and ankle surgeon with a podiatry practice in Chattanooga. He is the inventor of a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He publishes articles teaching other surgeons about his techniques and how to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.