I wasn’t put under any pressure to have surgery but as a surgeon myself it was clear that this wasn’t getting better and all the future promised was a worsening of symptoms, and development of arthritis in the distorted foot bones over the next year or so, which would than be more difficult to then treat and probably involve fusion of foot and possible ankle bones to prevent the damaged joint surfaces rubbing against each other. I already had the nickname Mr Limpy, from my dear colleagues, the rats, so the die was cast.
Surgery it had to be. This I was told would involve removal of the inflamed remnant of the tibialis tendon beyond where it had snapped and replacing it with a tendon transfer using a small muscle close by intended to bend the toes down, the flexor digitorum longus or FDL for short. The damaged spring ligament supporting my arch would need repairing and strengthening with an internal synthetic fibertape brace. To realign my foot I needed the large heel bone cut in two, the top bit moved about a centimetre allowing my foot to point forward again and not to the side and then fixed in its new position with a metal plate and some screws, that’s a calcaneal osteotomy. Finally my calf muscles seemed tight from months of limping so he recommended an achilles tendon lengthening as well.
I also sought a second opinion from another respected ankle surgeon who agreed with Mr Malik about the diagnosis and proposed treatment plan. As a patient you shouldn’t feel reticent about asking for a second opinion, no self-respecting and competent surgeon will be offended by that and of course you will hopefully get the added reassurance that you are on the right track. That of course can take time to arrange in the NHS, which is probably why most patients don’t ask, but a second opinion can be easily arranged privately, just ask your GP for another recommendation or do your own research which is usually quite easy. I also had the advantage of knowing the local orthopaedic surgeons but I didn’t want one of my immediate colleagues to have the burden of having to treat me. From personal experience, although it is an honour to be asked by other doctors to treat either themselves or their family members, if it’s a major condition there is increased stress, in doing so. Also I am only too well aware that sometimes things don’t always turn out as well as hoped for, not due to anyones fault necessarily, and to see my surgeon frequently in the same hospital might be awkward. I felt it important to be treated as a ‘normal patient’ by someone who didn’t know me and that decision to put myself in Mr Malik’s hands I am sure was the right one for me.
Why private? I chose the private sector for several reasons. I spend 90% of my working time in the NHS and see daily the pressures the service is under. This is worse now than for several years and particularly at winter time lots of routine operations get postponed because all the bed are filled with emergency and urgent cases. I didn’t want to be one of those statistics as any delay would play havoc with my arrangements for being off work, my locum cover and other matters. Also I believe that those who can pay for treatment should do so, to take at least some pressure off the NHS, indeed a lot of routine operations are now being carried out by private hospitals, not a practice I really approve of however. We did have medical insurance for many years but with the children being dropped off the policy when they reached 18 years and BUPA significantly raising the premiums a year ago we decided to drop it, not perhaps the best decision I have made as things turned out. Never mind, I often joke with my more elderly patients that if they put their insurance premiums into an ISA they could have a decent operation every couple of years and still come out on ahead, so now I had to practice what I preached.
My Flatfoot Surgery Recovery 