So today I went back to my fabulous orthopedist to review my MRI results and talk about my options. Upon arrival I met another one of his residents [he has a LOT] who poked around my foot a bit then called my doctor in. It would appear that I will have the distinct pleasure of major bunion surgery. Now there’s several different ways to operate on a bunion but given my RA and its severity I will be having the more extensive version. This means they will loosen the joint capsule, shave the bone protrusion down, and break the base on my big toe and reset it straight. My orthopedist did say that were I a 60+ patient he would have fused the joint but didn’t want to do something so extreme on me at my age [thank god]. The recovery time is 6+ weeks so we are waiting until after the wedding and have it done in December. I’m not thrilled about this but we have tried all of the alternatives with little success, additionally the skin near the bunion is paper thin due to steroids and bone pushing against it. I asked my orthopedist why I had such a severe bunion at my age and he said he felt the RA fed the bunion and vice versa causing it to just keep getting worse. To put icing on the cake my Orencia IV will have to be pushed off post-op. I’ll have surgery 2 weeks after my IV then can’t have it for 6 weeks after the surgery for fear of the foot not healing. I’m going to be talking with my rheumatologist about this as I’ve never gone that long without treatment before and see what she says. In the meantime I was prescribed a topical anti-inflammatory to get me through to December and given a standing appointment should my foot get too bad between now and my pre-op consult in November. I will update as this progresses.