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Amputation as treatment option

Discussion in 'Ask your questions here' started by Unregistered, Apr 8, 2014.

  1. Unregistered

    Unregistered Guest

    Hi everyone,

    I have a question regarding whether amputating my big toe is a viable treatment option and I've received different opinions from several doctors so I'm a little confused!

    Ten years ago, at the age of 30, I had bunion surgery on my right foot, and developed several post-op infections, including osteomyelitis that occurred five times in the three years following the initial surgery. Five years ago, I had surgery to help improve function and decrease pain - my big toe was fused at the base of the toe and my lateral sesamoid was removed due to chronic stress fractures. That surgery was not as helpful as hoped, and the bone infections came back again. This past October I made the decision to try one more salvage procedure (by that point I had had 7 surgeries, 5 of which were to deal with infection).

    The eight surgery occurred in October; my big toe was re-fused (it had been set too high) and my remaining sesamoid was removed. Unfortunately, the wound did not heal and I was hospitalized for 5 days with cellulitis, and the infection went into the bone again. I had surgery #9 in November for skin debridement, removal of hardware, and a skin graft. One week after that surgery, I went into septic shock and was hospitalized for 29 days.

    Unfortunately, the pain in my big toe and functioning is now worse than it was prior to October. My remaining joint is extremely arthritic and doesn't move at all. I have permanent nerve and bone damage due to all the surgeries and infections. Walking with a normal gait is almost impossible due to extreme pain in the remaining joint. I am on medication for the neuropathy, take the maximum dose of Motrin daily, and take one Percocet a night. I also use a prescription topical ointment. Additionally, I usually ice my toe each night to help with swelling, and meditate daily.

    My quality of life has been negatively effected as I am unable to do the things I love doing (e.g., jogging, hiking, etc...). I am still relatively young and would like to be able to be active again, or at least walk without wanting to whimper. I am a college professor and spend 6 or 7 hours on my feet five days a week. I am not willing to try any more salvage procedures but have researched whether amputation is an option. My understanding is that I will be able to walk normally, and with a prosthetic I could run and do similar activities. I understand there is a minimal risk of phantom pain, but have been told it would be no worse than what I am currently experiencing. As far as I can see, the only real negative would be slight balance issues (currently, my balance is not great since I have no movable joints in the toe). I am 40-years-old, do not have diabetes, and am in relatively good health.

    Has anyone chosen amputation or been faced with a similar problem? I would appreciate any help in making this decision. It is possible that I am not seeing all the negatives and would welcome any feedback!

    Thank you very much,

    RM
     
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