How to decide about your Foot and Ankle Surgery?

 

Let’s face it. Nobody wants to have surgery. Patients & doctors should always leave surgery as a last resort after all the conservative measures have been exhausted. Yet even when the patient feels they had enough of the conservative treatment and they are still experiencing problems, the decision to go for surgery is not easy.

So here are some things to think about if you are unable to make your mind:

  1. How big is the problem?

The bigger the impact, the foot and ankle problem is having, on your daily activity, the more justifiable it is to proceed with surgery.  You should think about the things, this problem, are preventing you from doing and evaluate their importance to you. This is very variable from one patient to another and depend on many factors like age, general level of activity and general health. Doing your favourite sports could be the main thing for one patient while short walks might be the thing for others.

  1. Have you really exhausted conservative treatment?

There are simple measures that can make foot and ankle problems better. Not all of them are convenient, but when weighed against surgery they would possibly make a lot of sense. Wearing comfortable stable shoes is always a starter. Resorting to less impact-exercise, like cycling and swimming could make a difference. Sometimes simply using a walking stick. It is easy for doctors to ask patients to lose weight. Obviously, it is difficult for someone to exercise to lose weight when they are in a lot of pain. However, there are always other measures that could help weight loss and invariably these improve foot and ankle symptoms even to a small extent.

  1. How big is the procedure?

Many operations are small interventions that could leave a big impact on your symptoms. A good example is excising a symptomatic large Morton Neuroma. Such operations are easier to decide about as the recovery period is generally short and the long-lasting relief is certainly worth it. For a bigger procedure like a complex fusion of joints in the hind foot the case is different. The recovery will take much longer both in plaster and to rehabilitate after. Bigger procedures could still be justifiable if you pain is more significant and if you have exhausted the conservative treatment.

  1. Is your foot or ankle problem your limiting factor?

You need to ask yourself “What is preventing me from doing the things I want to do?”. If the answer is something else apart from your foot and ankle problem, then maybe you need to address that thing first before you consider surgery. A good example is a patient with advanced ankle arthritis who is offered an ankle replacement. Ask yourself what is preventing you from walking? Is it the ankle or is it shortness of breath or chest pain for example? If it is the ankle then surgery could make you walk better and improve your general health, whereas it would not change much if the latter is the case.

  1. Are you prepared for surgery?

If surgery is the way forward, it pays a lot to be prepared. Being prepared makes the decision easier. This could be in the form of moving a bedroom downstairs or asking a neighbour or relative to help or sorting out the kids and the dog. If you get those aspects in order you have more peace to focus on your problem and will make you far less stressed after your surgery.

 

Although the decision to have surgery is a big one, and although each procedure carry certain risks, often if surgery is done for the right reason and it go to plan the impact on your symptoms is great. Patients go for surgery to improve their quality of life, being to go back to sport, to be able to work, to enjoy their life with their kids or to walk their dog again. Whatever your reason for considering surgery, thinking about it rationally using the points highlighted above hopefully will help you to make the right decision.

Hisham Shalaby

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