Bunion Advice Please

I'm very impressed by the no nonsense and understandable answers you give here on your board and am hoping that I could pick your brain on something that concerns me. I have what I think are bunions that are very painful when my shoes rub on the bumps. I've been told by others that surgery is the only thing that can be done but I worry from what I've heard on a lot on other web sites about pain after the operation and the bunion coming back. I am a 135 pound 35 year old woman in good health. I work in retail sales so I'm on my feet most of the day. Can you give me an idea of how long most people are off of work and the chances that bunion surgery will be permanent? If I haven't told you enough let me know and I'll add whatever I can. I read in your other posts that you cannot give answers to individual's problems and I understand that. I just would like to know in general what the chances of a successful bunion operation are and what I can probably expect after the surgery. I would like to say that you seem to be the kind of person that is what a doctor should be. Thanks for your service and your patience.

[FootDoc]

First . . Thanks for your kind words. The specific answers to your questions would have to be based on factors which you probably do not know and cannot offer. But essentially they revolve around the type of procedure(s) needed to be performed, base on a professional evaluation of your bunion deformity. Such an evaluation will determine mainly whether you need an osteotomy procedure to bring the first metatarsal into good alignment or just a "bumpectomy" and soft-tissue corrections. That bears on the need for a cast or other immobilization techniques which may then be a determining a factor as to whether both bunions can be done at one time or whether they must be staged. But the general answer to your question is that without complicating factors, most patients who work on their feet will generally be wise to consider something in the area of 2-3 months off of full time work. Sure, there are those who get back much soon and even some who do not get back in that time. But a lot depends upon the patient, his/her tolerance for discomfort and propensity to swell. I would rather predict a more lengthy time off of work than will actually be the case, even if the patient declines surgery than to under-predicted the healing time and have them possibly have their job at risk. As far as the success of bunion surgery goes, although I don't have absolute statistics and sometimes I consider the surgery a success or failure and the patient does not, and vice-versa, in my hands, I believe that I have at least 85% success, depending on the goals of the patient. Recurrences, when they occur are generally those procedures which were either flawed from the get-go or did not adequately address all of the factors of the deformity. Pain is always variable, and other than for complications, has probably more to do with the patient than anything else. But with a few exceptions, my patients have told me that they found the procedure to be less painful than they had anticipated and certainly less than they were led to believe by others. Keep in mind that patients who have had more pain than anticipated or a worse result are far more likely to speak about it for much longer of a time than those who were pleased. I hope this answers the questions which you indicated concern you. Pick your doctor wisely and for good medical reasons, and then obtain all of your information from him/her. If you cannot trust your doctor to give you correct information both prior to and after surgery, you should not or should have not let him/her operate.