Laser Treatment of Toe nail Fungus

I seem to be getting the best results when I combine topical prescription anti-fungal medication with Laser Treatment.

Laser treatment is always needed more than once.

I usually suggest 3 sessions that are done 2 month apart.

Recurrence is the biggest problem with nail fungus. Doing the laser more than once significantly decreases recurrence rates.

Between the sessions, the topical medication is used.

Our office is located in Irvine and Huntington Beach - Orange County, CA.

Feel free to visit my website for more information on herbal treatments and cost for laser. 

Podiatrist in Huntington Beach

Podiatrist in Huntington Beach

Dr. Kolodenker of OCPodiatry has opened up a second location in Huntington Beach, CA on September 2016.

Due to increasing demand for a Podiatrist in Huntington Beach, we have added another office location.

We want to thank all of the patients and physicians that made this move possible. Without you, we would not be here.

The community has been very welcoming and we've been thrilled being here.

Our Huntington Beach office will be able to do most of the same things that can be done at the Irvine location.

Our HB address is 19582 Beach Blvd Suite 270

By Beach and Yorktown

For a full list of things that we treat, please take a look at our website. 

Feel free to call our office for a consultation with Dr. Kolodenker (949) 651-1202

Podiatrist in HB

Dr. Kolodenker

Consult us before having your toe, foot or leg amputated!

Limb salvage is a very difficult and tricky thing to achieve.

We have had wonderful success in saving feet and healing wounds.

There have been plenty of situations where the patient was advised to have an amputation and we have been able to save them from that or at least minimize the loss.

It takes a full team and we have that available here at Hoag hospital in Orange County California.

Salvage is more time consuming and more expensive than an amputation. In the long run it is more worth it to keep your foot/leg. Your life expectancy decreases with a below knee amputation. Getting fitted for a prosthesis is not cheap either.

If there is a chance that something can be done, I will do it.

I've used lots of modalities and technology to heal wounds and prevent amputation.

I'll show some of the worst cases and the results we can get. There are more pictures on my website.


Case 1 is a young male with history of Diabetes. Necrotizing Fasciitis. Multiple surgeries were done. During the healing process patient ended up needing his 3rd toe amputated due to gangrene. Once complete gangrene sets in, there is nothing that we can do other than amputate.





After multiple surgeries and the use of Wound VAC



A very healthy granular bed that is ready for a skin graft.



A few days after skin graft placement. The graft has taken.






All wounds are almost fully closed. The last part is closing and we expect it to be fully closed in a few weeks.

Case 2. Large necrotic wound on the bottom of the foot. The top picture is after the first surgical debridement. Skin grafting and wound vac therapy allowed this to heal.

Feel free to contact Dr. Kolodenker for a consultation. 

(949) 651-1202

Orange County - Irvine, California

Congratulations to Dr. Gennady Kolodenker on winning the 2015 Patients' Choice Awards for Podiatrist in Irvine, CA

Congratulations to Dr. Gennady Kolodenker on winning the 2015 Patients' Choice Awards for Podiatrist in Irvine, CA
Verified by Opencare.com

Marketing Yourself in a Medical Private Practice

They don't teach you in residency the business of running a medical practice. They especially don't teach you on how to get new patients.

Most doctors think that they will start working on this when they are out of residency. BIG MISTAKE.

Start now!!!

The main way patients will find you or at least find out about you is online. Even if their primary doctor recommends you, they will google you.

Google yourself, see what comes up.

Create a website that is pertinent to your specialty. Do not worry so much about the SEO of it at this point. If you know where you will plan on practicing build the site tailored to that.

Have a professional facebook page.

Have a LinkedIn account.

Have a HealthGrades Page.

Have a YouTube Page. This is extremely helpful.

All these things will make you even more marketable.

For the doctors that want the freedom of a solo practice or small practice setting, you need these skills. If you don't have them, pay someone to do it for you or at least advise you.

All the negative posts about foot surgery

The most common thing I hear from patients after surgery is their amazement of the negative, horror stories that are written online about various foot surgeries.

My belief is that most people have great results after foot surgery. The things that are written online are rare case scenarios. Majority of patients that have great and good outcomes from surgery will not take the time to write their hearts out in a blog. People that do well move on with their lives.

The negative blogs are a way for people to share their feeling, find some answers and in a way try and help other people. I think it's great to second guess having surgery. Though the results are usually very good, they are not 100%.

You don't know what the underlying medical condition is present with the patient that writes a negative blog. Perhaps they can not take any pain medication or their pain threshold is much lower than yours.

Do your research and find a doctor you are comfortable with and will go over the common complications that can occur with whatever surgery you might be having.

If it is something foot or ankle related, feel free to ask on this blog and I'll do my best to get you an answer.

Contact Dr. Kolodenker

How to provide and take a great history so that a more accurate diagnosis is reached

I usually follow the NLDOCATS routine when talking to a patient Nature Location Duration Onset Course Aggravating factors Treatments Special/Other Always start by writing the Age and Gender.

Example: Joe is a 34 year old male who complains of...

Nature: What is the problem? Example: ankle fracture, foot pain, leg pain, toe pain, nerve pain....

Location: Be as precise as possible: Medial/Lateral, Left/Right, Dorsal/Plantar, name of tendon

Duration: How long has this been going on?

Onset: Was there any recent trauma? Did you just wake up with it? Was there a history of prior injuries or pains?

Course: Getting worse, better, same? 

Aggravating factors: What makes it worse? What makes it better?

Treatments: Has anything at all been tried? Medication, splints, braces, therapy, other doctors? 

Special/Other: Change in activities? Shoes? Run more? Run faster? Really anything else to fill in the gaps of the story.

This is a great way to obtain a detailed history.

Joe is a 34 y/o male who presents c/o pain in the left foot at the 3rd interspace. Feels like a sharp pain that radiates to his 4th and 3rd toes. Sometimes he notes a clicking. The pain has been present for about 6 months. Denies any history of injury. It has been getting worse the last few weeks. Pain is relieved with rest. Notes that he has increased running lately. Has been doing more business meeting in a dress shoe. Has tried Motrin with no relief of symptoms. Has not seen a doctor in the past. Diagnosis? Most likely a neuroma.

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Place Sanitizers in shoes. Place shoes & Sanitizers in UV-proof safety bags. Power 'On'. Device turns off automatically after 15-minute treatment.  

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Bunion Splints and Sleeves as a conservative treatment for Bunion Pain

There are a variety of bunion splints on the market.

The goal of a bunion splint is to pad the painful areas. Some patients will try and wear them to correct the bunion deformity before considering bunion surgery.

If you take the concept of braces for your teeth, a bunion splint works the same way. The main problem with bunion splints is the amount of time they are worn.

If you spend more time outside of the splint than in it, the product will not work.


Darco Bunion Splint

Helps to keep your toe straight after bunion surgery!

The soft but sturdy construction of this splint allows for maximum comfort, while splinting the big toe in a straight position. Gently stretching the soft tissues around the big toe joint helps prevent the bunion from returning after surgery. We have found that this splint may help to provide added insurance for a good post-surgical result. Wearing this splint after surgery may also help to control swelling

Dr. Jill's Gel Bunion Sleeve

Features of Dr. Jill’s Gel Bunion Sleeve:

• Soft tan satin fabric.
• Cushions and protects the painful bunion.
• It's large soft gel pad protects the bunion from shoe pressure.
• The cushion conforms to your foot and does not create bulk in your shoe.
• Universal – provides a comfortable fit on either foot.

PediFix Soft Bunion Splint (Hallux Valgus SoftSplint)

Features:

• Designed so that this splint can be worn comfortably, whether you are weight-bearing or resting.

When used after bunion surgery, this Bunion SoftSplint: 

• Helps to maintain ideal positioning of the big toe.
• Constant metatarsal-phalangeal joint alignment.
• Helps control swelling.
• Offers post-operative security to the surgical site.
• It is constructed of thin, light-weight, comfortable, and durable materials. 
• The SoftSplint is washable.
• Velcro fasteners makes adjustment and application of the splint simple and easy.

PediFix GelSmart Toe Spacer -- Bunion Guard Combo

Bunion cushion and toe separator in one!

• The contoured gel bunion shield (pad) helps minimize friction, pressure, and bunion pain when in shoes, while the soft toe spreader gently provides proper toe alignment to help prevent the 1^st and 2^nd toes from rubbing. 
• Made of Visco-Gel that stretches to fit your foot and slowly releases medical grade mineral oil (USP) and vitamin E which soothes, softens, and moisturizes skin. 
• Washable and reusable.

How It Works:

Soft Gel Spacer separates and aligns first and second toes that rub, while the contoured Gel Guard cushions and protects the bunion. Original Visco-GEL® slowly releases medical grade mineral oil (USP) and vitamin E which soothes, softens, and moisturizes skin.

Features:

• Eases buinion pain - cushions, protects, and soothes, painful bunions.
• Absorbs pressure and friction.
• Separates 1st and 2nd Toes.
• Washable and reusable.
• One size fits all.
• Fits right or left foot

Ball and Ring Shoe Stretcher

This easy to use bunion stretcher allows you to stretch the specific part of your shoe causing pain rather than stretching the entire shoe. This device can stretch problem areas without stretching the entire footbox.

Directions: 

• Determine the area needed to be relieved.  
• Place a Zip Lock bag over the shoe to protect the exterior finish. 
• Place the ball inside the shoe with the ring on the outside. 
• Press the arms of the Stretch together over this problem area of the shoe. 
• You should see immediate results, with your shoe fitting more comfortably.  
• Can be clamped on overnight for especially difficult areas

Please feel free to post any questions.

Advice for Podiatry Third Year Residents - Senior Residents

Yes, it is true that this is when you have the most amount of academic knowledge. What you don't have is real patient experience.

You are probably thinking about looking for a job or doing a fellowship.

I did both when I finished my third year at UMDNJ. I ended up doing a fellowship in Sports Medicine and Surgery of the Foot and Ankle in Irvine, CA.

The main reason I did a fellowship was because I wanted to obtain the highest level of education possible for my field. I am now in solo practice. I started out as an associate and am now a partner in the process of purchasing out the practice.

I'll try and go over the main things to look for when considering both.

Let's start with a job. The most important thing to ask is where will this job lead? Do you have the ability to become a partner? How much will it cost you to become a partner? How long will you be an associate? There are of course lots of other questions, but the ones I stated should be the main focus.

Maybe you don't want to have your own practice and would like to work for someone. The main things to consider there is can you live in the area? Will your spouse agree? Is the patient flow what you want? What are the benefits? Salary, vacation, sick time, 401k, car, bonus...

What should a first year associate make?
This all depends on the volume of patients you see. Your salary can range from $70,000 to $160,000 first year out. There should be a bonus clause in there. Let's say you agree on a $100,000 salary. The bonus can kick in once you collect a revenue of $250,000 at a percentage. The percentage is between 5%-50%. So, let's say for the year you collected $300,000 and your bonus percentage is 20%. You will make $110,000 for the year. Keep track of your patients and the EOB's

Taxes?
Are you an independent contractor or employee?

Starting your own practice?
This is very doable for the entrepreneur physician. I have lot's of experience with that if you have questions. My knowledge is in California, but it applies to most states.



Fellowship

When considering a fellowship, you must think about the step after. Do you want to do the above or work for an academic center? If you want to do the above I would highly advise on doing a fellowship in an area you are interested in settling down in. This will make your job search later on much simpler.

If you want to teach at an academic center then you should do a very specialized fellowship. Diabetic Limb salvage is usually the top choice.


Please feel free to post questions on my Google+ or FB page.

I've been through this and will be glad to offer advice.


 - Dr. Gennady Kolodenker

Types of Bunion Procedures and Terminology

You might hear different terms used to describe a bunion surgery. Depending on the severity of the bunion, a more complicated procedure might be needed.

A Cheilectomy is a term used to describe just shaving the bump. It can also involve shaving around the joint to make things more rounded. In this procedure no hardware is need and it allows for the quickest healing time.

If the bunion is more severe, a cheilectomy alone is not appropriate because it has a high chance of recurrence. With most bunion surgeries a cheilectomy will be done on top of the described procedure.

The next common bunion procedure done is a Chevron osteotomy, also known and an Austin or and Kalish. This is a "V" type of cut in the 1st metatarsal to slide it over. Once the bone is slid over screws are used as fixation. The screws stay in forever usually. They do not set off any alarms at the airport. Rarely the screws need to come out.

An Akin procedure is an osteotomy of the big toe, hallux. Sometimes in order to make everything sit straight the big toe must also be corrected.

When closing the surgical site repair of the capsule and ligaments is done to help hold things in alignment.

Moving further back there is a Scarf type of bunionectomy also known as a "Z" type osteotomy. This will also be held with screws.

A closing or open base wedge osteotomy is done even closer to the base of the metatarsal for more of the severe bunions. This procedure is held with a plate and screw or just screws.

Finally there is the Lapidus bunionectomy that involves fusion of the 1st metatarsal-cuneiform joint. This is done for patients with severe bunions and those patients who have ligamentous laxity. This procedure usually requires screw and plate fixation. It is one of the more complicated bunion procedures due to technical components. It will usually require limited walking along with a period of possible non weight bearing.

For a surgical consult on bunions please feel free to contact Dr. Gennady Kolodenker (949) 651-1202.

Bunion Surgery Specialist in Orange County - Southern California - Irvine - Newport Beach

Laser Treatment for Toe Nail Fungus in Orange County - Laser Nail Fungus Treatment Orange County

Help from your successful Laser for Toe Nail Fungal Removal Clinic in Orange County 

We offer laser fungal toe nail treatment at a greatly reduced cost

The treatment will be offered on scheduled days. Schedule your appointment soon, we tend to fill up.

visit site for price details

Contact our office in Orange County for an appointment.

(949) 651-1202

How can we offer toe nail laser fungus treatment for such a low price?

We will be doing the treatment only one weekend per month. We are able to rent the device for a competative cost and pass on the savings to our patients

What is Toe Nail Fungus?

The medical term for toe nail fungus is Onychomycosis. When fungus gets under the toe nail it feeds off the keratin. As the fungus grows the nail will become yellowed, thickened, discolored, dystrophic and possibly ingrown. Frequently the fungal toe nail will feel painful due to the thickness.

Where does nail fungus come from?

There is fungus all around us. There is no good medical explanation of why some people develop toe nail fungus, Onychomycosis. There is usually a traumatic incident that causes the nail to lift up slightly. Once the nail is elevated off of the bed the fungus begins to colonize.

What are the treatment options for Nail Fungus?

The treatment options for nail fungus range from topical medication, oral medication and Laser Therapy. Topical medications need to be used for the growth cycle of the nail. The nail typically takes anywhere from 6-10 months to fully grow out.

Various topical medication to treat and kill toe nail fungus can be purchased online.

Another option for treatment is oral medication. Prior to starting oral medication treatment a blood test should be perform to evaluate the function of Liver. Medication is taken for a total of 12 weeks, one pill per day. At about 6 weeks the blood test should be repeated to evaluate the Liver function. There is a very small chance of Liver damage. Success of oral fungal nail treatment is around 70%-80%.

Finally, Laser Nail Treatment is a revolutionary toe nail fungus treatment that is safe and successful. Success rate for laser nail treatment range from 70%-80%.

Does the Laser Fungus Nail Treatment Work?

Yes. The Cutera Genesis Plus Laser is safe and effective in the treatment of onychomycosis.

Will I see instant results after Laser Fungus Nail Treatment?

No. It takes the toe nail an average of 6-10 months to grow out. While the nail is growing you should start to see a clearing at the base. Sometimes multiple treatments are needed.

Does the Laser Fungus Nail Treatment Hurt?

No. The treatment takes about 5 minutes per toe. The nail starts to feel warm. There is a temperature monitor on the laser.

What is the Cost of Treatment?

Cost depends on the numer of toes and feet done.

Does Insurance Cover the Laser Treatment?

No. Unfortunately most insurance plans will not pay for laser nail fungus treatment.

What Should I do After Treatment?

Use an Ultraviolet Light to eradicate and kill toe nail fungus in your shoes or it will re-infect your feet and toes nails.

Some patients require a second laser therapy treatment 6 months after the first. There is no extra laser cost if a second laser therapy procedure needs to be done.

Call your Laser Toe Nail Specialist in Orange County for an exam.

Finding a Bunion Surgeon in Southern California

It is sometimes difficulty to figure out if you are picking the correct surgeon in Southern California.

How do you start the search process for a Bunion Surgeon?

There are lots of websites that can help guide you.

Yelp has lots of reviews of Doctors.

Go online to the Podiatry Medical Board and look to see if your doctor has any sanctions or is on probation.

In the end you need to feel comfortable with your doctor.

For any further questions feel free to contact me. Dr. Gennady Kolodenker, DPM

Bunion Surgery Specialist in Southern California.

(949) 651-1202

Ingrown Toe Nail Treatment - Common Mistake

Very frequently I will see patients that come in to the office because they have an ingrown toe nail and the pain has been present for several days or weeks.

The patient may have been seen at an urgent care center, primary care office or pediatrician. The treatment rendered was a course of antibiotics. Possibly soaking.

The patient presents with continued pain, swelling, redness and draining fluid (pus).

So what is the mistake?

Treating an ingrown nail with antibiotic alone is a poor choice.

Removing the ingrown nail border will correct the problem. In 99% of patients an antibiotic is not even needed.

With growing antibiotic resistance save the the medication for a time that is really needed.

For an Ingrown Toe nail procedure contact Dr. Kolodenker in Orange County California.

4950 Barranca Pkwy
Suite 308
Irvine, CA 92604
(949) 651-1202
(949) 552-9493 - fax

How to create a bi-lobed flap in the foot

How to create a bi-lobed flap in the foot


A bi lobed flap is very useful when surgically removing a large soft tissue mass, a tumor or a wart.

The following images are for surgical education purposes and training only.

The first image is of a large soft tissue mass that turned out to be a plantar verrucae. The lesion was taken out by another doctor and returned to grow much larger when the patient presented in my foot and ankle clinic. The advantage of placing a flap is primary closure of the surgical site.

The first part of creating a bi lobed flap is surgical planning. It is vital to know anatomy and skin tension lines. 

Pearl: I would advise not to place any local medication under the surgical site. An ankle block or general anesthesia is best. Local anesthetic will place too much tension on the skin and make it difficult to rotate the flap. 

Second Pearl: The width of flap B should be about the same as the soft tissue mass (C). The width of flap A should be about 40% smaller than flap B

In the above picture the relationship of the bi-lobed flap is 90 degrees (Black Lines). I would advise to make the flap relation around 80-65 degrees. 

Index:

A: Used to close flap defect

B: Used to close the soft tissue defect

C: Soft tissue mass

Step 1: Draw a circle around the soft tissue mass and make sure to take a clear margin.

Step 2: From the opposite corners of the circle create a cone. In the above picture the cone is made of one red line and one black line.The point of the cone is pointed up in the above picture. 

Step 3: Draw a 90 degree line from the red line- two lines should be about the same length

Step 4: Draw a 80-65 degree line from the black line - two lines should be about the same length

Make a full thickness incision. Undermine the entire flap. Undermine the skin around the other side of the incision. Be careful when handling the soft tissue. Be very delicate.

Rotate the entire flap and suture it down.  

Suture the flap down. 

Some areas might look slightly white. As long as the patient has good blood flow the skin color should return to pink. 

Finally, remain off the foot for 3 weeks.

For more information contact Dr. Kolodenker, Foot and Ankle Surgical Podiatrist in Orange County

Bunionectomy

 

What is a bunion?

A bunion is a bump on the big toe side of the foot and is actually bone. It may be red and painful whether you are walking or resting. The first metatarsal, the large bone located where the toe meets the foot, rotates outward and pushes your big toe inward toward your other toes. This can sometimes cause your toes to overlap, which causes pain.

What causes bunions?

Bunion formation runs in families, so if a parent or other relative has a bunion, you have a higher risk of also developing a bunion. Bunions can be irritated by friction from ill-fitting shoes. Wearing high-heeled shoes puts unwanted pressure on the joints of the forefoot, which can result in painful bunions. Bunions may be caused by a congenital anatomical deformity, flat feet, a tight Achilles tendon, polio, or rheumatoid arthritis. Even if you develop a bunion, it may not progress to the point where it needs surgical correction. Non symptomatic bunions can be managed by appropriate shoe wear.

When choosing shoes, follow these tips:

• Judge the shoe by how it fits and feels on your foot, not by the size marked on the shoe or the box.
• Measure your feet regularly as you grow older. Foot size changes with age.
• Try on shoes late in the day when your feet are at their largest.
• Do not wear shoes that feel too tight. Do not expect them to stretch.
• Make sure your heel fits comfortably in the shoe with minimum slippage.
• Walk around in the shoe to make sure it fits well.

Diagnosing bunions

Diagnosis of bunions is based on physical examination, a complete history of your symptoms, and diagnostic studies. Diagnostic studies help the podiatrist determine the precise nature of the deformity. He or she can determine the extent of the problem with the big toe and how much the second toe is involved. Your podiatrist will assess your standing and walking to determine whether or not your gait is affected. Your range of motion will be tested as well, and a vascular and neurologic assessment will also be made prior to treatment.

Conservative treatment of bunions

Before surgical correction of bunions is undertaken, the podiatrist may treat your bunion with conservative measures.

Conservative treatment modalities include:

• Activity modification, rest and elevation of the affected foot;
• Changing to footwear that puts less pressure on the tender area;
• Soaking the foot in warm water;
• Anti-inflammatory medications;
• Steroid injection into the area surrounding the affected joint;
• Orthotic devices;
• Using cushioned padding in the shoes;
• Taping the foot to retain normal positioning;
• Physical therapy, including ultrasound therapy or whirlpool baths.

Surgical correction of bunions

If nonsurgical treatment is not successful, your podiatrist may suggest surgery. Studies show that 85-90% of patients who have bunion surgery are satisfied with the results. The goal of such surgery is to relieve your pain and correct your foot deformity.

If your bunion causes foot pain that restricts your everyday activities, you may benefit from bunion surgery. Other indications for surgical correction include chronic inflammation that does not improve with rest or medication.

Dr. Gennady Kolodenker is a bunion surgery specialist in Orange County. Irvine, CA

Preparation for surgery

If you decide to have bunion surgery, your podiatrist or your personal physician will assess your general health. You may need preoperative clearance from your primary care or treating physician. Conditions such as diabetes, rheumatoid arthritis, or circulatory difficulties could negatively impact your healing and could increase postoperative pain.

Be sure to tell your podiatrist what medications you take regularly, including herbal or natural remedies. Follow your podiatrist’s instructions on which medications you should or should not stop taking before surgery.

You may or may not be required to have blood tests, cardiac testing, chest X-ray, or urinalysis in addition to foot X-rays or other imaging studies.

The usual surgical outcome

Most patients have a significant decrease in pain after surgery and greatly improved alignment of the big toe. Your outcome will depend on how severe your bunion deformity was before surgery, your medical condition, your age, and your compliance with postoperative instructions. In general, there may be some degree of swelling of the foot for three to six months following surgery.

Your podiatrist will follow you closely during this postoperative period and recommend exercises or physical therapy to improve foot strength and range of motion. Depending on the extent of your condition, you can expect a recovery period of at least six to eight weeks, or longer. During that time you may be required to wear a special shoe or boot, or even a cast to provide stability to the foot. Your doctor will tell you when you can walk on your foot again.

Risks of bunion surgery and potential complications

Even the most minor surgical procedure has a degree of risk. Your podiatrist will go over the most common problems that have occurred after bunion surgery. These include infection, recurrence of pain, nerve damage (which could be chronic), recurrence of the bunion, poor healing, bleeding, scarring, blood clots, or allergic reaction. Most complications are treatable, but may increase your recovery time. Although it is rare, you could experience stroke, heart attack, loss of a limb, or death.

Your podiatrist will go over all these possibilities with you so you have a full picture of what to expect. After he or she has described these potential risks to you, you will be asked to sign a form called an informed consent form. Be sure to ask questions if you are uncertain about what you are being told, and make sure your questions are answered to your satisfaction. Your signature on this form indicates that your questions have been answered and you have been informed of the risks and potential complications of bunion surgery.

Types of bunion surgery

Your podiatrist will determine which type of surgical procedure is right for you. There are many different types of surgical procedures for treating bunions, many of which are named after the doctors who developed them. Examples of these are Keller bunionectomy, McBride technique, and Austin osteotomy. Ask your doctor to explain the type of procedure he or she feels is best for you.

Many bunion surgical procedures are done as outpatients. You will be asked to arrive at the outpatient facility one to two hours before the surgery, and can usually go home an hour or two after the surgery. The procedure itself will take about one hour.

The type of anesthesia used will depend on the type of surgery done, your condition, and the anticipated length of the surgery. Most bunionectomies are done with a local anesthetic agent to numb the area. In some cases you may have general anesthesia. After surgery you will go to the recovery room. You will have one or more scars after the surgery, depending on the type of surgery performed.

Postoperative recovery

It is important that you follow your podiatrist’s instructions completely following the surgery. You will be following up with visits to your podiatrist regularly for several months after your surgery.

You should call the office immediately if you notice any of the following:

• Fever of 101^oF or higher and/or chills;
• Persistent, uncomfortable warmth or redness around the dressing;
• Persistent or unbearable pain;
• Bloody drainage;
• Nausea and/or vomiting;
• Pain, redness, or swelling in one or both legs;
• Feeling anxious;
• Chest pain, shortness of breath, or coughing.

You will be sent home after surgery with a dressing to hold your toe in the realigned position. You may or may not receive a special surgical shoe to wear for some time. You should notify your podiatrist if your dressing comes off or gets wet, or if you notice blood or other drainage on it. It is very important to leave the dressings in place and not get them wet or dirty. If you have difficulty with your dressings, call your podiatrist.

Postoperative office visits

Ordinarily you will see your podiatrist three or four days after surgery for a dressing change, and postoperative X-rays may be taken at that time. About two weeks after surgery your podiatrist will remove the stitches. Once the stitches are removed, you may be able to bathe normally. Be sure to ask your doctor for instructions.

Your doctor will let you know when you can start to wear shoes, and the best type for you. You should continue to faithfully do the exercises your podiatrist has given you. Apply skin emollients, such as aloe vera or vitamin E, around the healing wound as directed. Your doctor will instruct you on when you can walk, drive, and resume other activities.

The postoperative course varies for individuals. For some patients, swelling may last longer and healing may take more time than anticipated. You should try to keep your foot elevated as much as possible immediately after the surgery. Your doctor may instruct you to apply ice to your foot. If so, ask him or her to provide you with specific instructions on how to do this. You could experience some swelling in your foot for several months following the surgery. Contact your doctor if you have questions about your swelling.

Exercise

Be sure to engage in the exercises your podiatrist recommends. These exercises will help restore your range of motion and your foot strength. Do not engage in any strenuous or weightbearing exercises that are not recommended by your podiatrist. 

This Bunionectomy Patient Education Tool was developed by Data Trace Publishing Company.

For a Surgical Bunion Consult Contact Dr. Kolodenker in Orange County, California