A New Journey

Wow. It’s been a long time. I haven’t stopped running, I just stopped writing about it. As a matter of fact, just this past October, I was able to PR at the Chicago Marathon with a time of 2:35:05. The race was one of those races you hope for, where things just clicked right from the beginning. The kind of day you dream of when you’re out there pounding the pavement every day wondering if it’s all worth it.

However, while I was out there “pounding the pavement” this summer, things became very difficult for me. What started out as stiffness in my big toe nearly 4 years ago(as described here), slowly evolved into constant pain, causing me to question if I would even make it to the starting line at Chicago. Somewhere in June, I made a promise to myself that if I was able to make it through this training cycle, I would get the foot taken care of over the winter months. So just a few days before the Chicago marathon, I made my way to the Midwest Orthopedics at Rush to get their diagnosis and opinion of the toe.

The diagnosis wasn’t all that surprising: Hallux Limitus/Rigidus in the big toe, which basically is arthritis. They gave me several options for treatment. I could go conservative with some orthotics and maybe a turf toe strap or plate. I could try a cortisone injection in the joint to see if that relieved some of the symptoms or I could opt for surgery. To be honest, I went into that office with a single goal in mind and that was to leave with an appointment for surgery, and that’s what I got.

So the surgery is set for 11/6/2009. They are going to do a hallux dorsal cheilectomy, with a possible akins osteotomy. What’s that? Well, basically the cheilectomy is just shaving off a lot of the debridement that has formed over the joint at the base of my toe. Right now that is quite a lump there, which shows up as the definitive shark fin on the xray) and wearing anything but the widest of shoes causes me lots of pain. Getting that taken care of should provide quite a bit of relief, along with a lot better flexibility in the toe joint as well. At this point, I’m not able to bend my toe upwards at all.

The second procedure that may or may not need to be done is the osteotomy. What this basically entails is cutting out a wedge from the big toe bone and then pinning it back together so the toe straightens out. The hope is by straightening the toe, it will relieve some of the pressure on the joint, to slow the arithitis that is present in the joint down a little. There is a possibility, I guess, that when they do the first procedure, the toe will straighten out naturally which would make the second procedure unnecessary.

That’s my hack understanding of all of it anyway. I’m sure I got some of the technical stuff wrong, but I think I’m at least on the right track. The cheilectomy doesn’t scare me a whole lot. I know there will be associated swelling and some pain with it, but since no bones are really be modified, the recovery shouldn’t be too bad. The osteotomy is a little scarier. Basically, it’s breaking a bone and pinning it back together. Now I’ve have a few broken bones in my toes before and have actually been able to run through it for the most part, but that was a minor fracture. This is an actual break and then having a pin (or staple) taking up permanent residence in my toe. The research I’ve done on the procedure have been scary with people complaining about residual pain and swelling for months and months following the procedure. Foot surgery just seems to be a very tough type of surgery to predict. While I do want to get this taken care of, there is a temptation to opt out of the osteotomy unless there is no other option.

Which is why I started back up this blog. From a runners perspective, getting your foot operated on is a pretty scary proposition. What makes it even scarier is that it’s hard to find a lot of information about the recovery process, especially for someone who’s main goal is to get back to running as soon as possible. I’m starting this back up to document the journey, from 1 week pre-surgery (today) all the way through the recovery process. I’ll take some pictures of the toe as warranted (along with proper warning as I’d imagine the pictures could be somewhat nasty).

The good news is that once I get the all clear from the doctor, which could come as soon as 2 weeks post-surgery, although 4-6 is probably more realistic, I can pretty much do whatever I can tolerate from a pain perspective. I’ve always considered myself to have a pretty high pain tolerance so I’m hoping by the beginning of 2010, I’ll be ready to start training in earnest again for a spring marathon.

A long shot? Maybe. But I’ve always had a thing for long shots. And for those wondering what exactly a cheilectomy entails…here ya go. Hope you weren’t eating anything.