Looking through the keyhole at bunions and foot health – Marinella’s story

Marinella Salientes patient story.jpg

For finance professional, Marinella, from Tunbridge Wells in Kent, ongoing pain in her feet and a change in their appearance prompted her to seek answers. Being in her early 50s with an incredibly active life, including being a regular gym goer and a keen skier, she was incredibly concerned that things would deteriorate if something wasn’t done – and that she would be left unable to exercise, or at worst, completely immobile.

To maintain a busy career with constant travel and her enjoyable and very active lifestyle, something needed to change.

Having booked an appointment with her GP for initial advice and further investigation, it was clear that bunions (bony lumps that grow out from the side of the feet) and bunionettes (smaller bony lumps that form where the little toe meets the foot) had developed over some time. 

Taking the first step

Marinella was soon referred to Mr Kumar Kunasingam, a consultant orthopaedic surgeon specialising in keyhole foot and ankle surgery, based at The Lister Hospital in Chelsea, south west London.  At the first appointment, after an examination, X-rays of both feet were taken. From this, a plan of action was drawn up. 

“Mr Kunasingam advised that it was really clear what needed to be done. Putting me at ease, I had confidence that he would look after me. He reassured me that having the procedure done via a minimally invasive “keyhole” method would mean that my recovery time would be pretty quick, and I wouldn’t need to be in hospital long at all. However, we would need to operate on one foot at a time to minimise as much disruption to my life as possible.”

Setting off on the left foot  

In August 2023, Marinella’s left foot was operated on, with the first keyhole bunion and bunionette correction. Following surgery, Marinella was allowed to weight bear wearing a protective shoe and using crutches for two weeks. Managing the pain with only ibuprofen and paracetamol, the stronger painkillers she had been prescribed prior to discharge were not needed. She was supported with gentle physiotherapy a week after the bandages came off in the hospital, where she was guided through gentle stretching and balancing exercises to build up strength. After her first physio session, only one crutch was needed. 

“Mr Kunasingam equipped me with the right information and beneficial exercises which would – no pun intended – get me back on my feet as safely and quickly as possible. I was advised that as soon as my foot started to throb that I should rest and elevate it. I followed this by the book so I could expedite my recovery.” 

Marinella was discharged from The Lister Hospital after her day surgery, with an estimated recovery period of two weeks in a bandage before proceeding to wearing training shoes. Mr Kunasingam advised that it would take around six weeks for the bones to heal and roughly three months for then bones to show solid union. 

As she already had a personal trainer (PT) and regularly kept fit as part of her everyday routine, Mr Kunasingam encouraged discussion with her fitness professional, ensuring any exercises being performed would complement the medical advice provided on discharge.

“A conversation was had so that nothing was too much or involved too much impact for the stage of recovery I was at. Around a month after surgery, my PT started incorporated stretching bands into my routines. We also involved balance pads and balls in order for me to regain strength in my foot again, as well as in my core. It’s almost like having to learn to walk again after this type of surgery, despite it being minimally invasive. It affects every part of the body, and you don’t want to move incorrectly and then overcompensate in another area.”

Part Two

In March 2024, Marinella had the exact same operation performed on her right foot. But there were a few changes made to the preoperative care this time. 

“I knew what to expect, and what I needed to prepare to ensure I was feeling good before and after surgery. The notable change this time was that a nerve block was given directly into the foot instead of being managed with pain relief medication. Whilst I had coped relatively well before, this was incredible. I was able to weight bear even faster than the first operation, and to be honest, it didn’t even feel like I had had anaesthesia – the recovery time was certainly quicker.” 

“Quite honestly, my sensitivity to touch and pain in general was far lower – I was incredibly impressed and relieved that both feet had finally been dealt with.”

Finishing her course of physiotherapy two weeks after her second surgery, PT activities resumed and again, Mr Kunasingam was involved in her exercise plans. 

“Mr Kunasingam wanted to make sure that I was doing the right exercises as part of my recovery and that I wasn’t pushing it too much. He had known from before that I wanted to get up and about and back in shape – but I knew I had to take my time rather than rush and risk another injury.”

Key takeaways and tipping points

Marinella was lucky that her bunions and bunionettes up until the point of surgery hadn’t been debilitating but there were enough concerns that meant she was keen to get them looked after before she got older. 

“For me, it wasn’t an urgent surgery but I think if you are in general good health and have the means to get something sorted if you can, then do so. Going through menopause and being on HRT, I knew that osteoporosis and reduced bone density was likely to only make my issue worse in due course – and the possibility of that was more concerning than any pain I was feeling.”

“The older you get, the longer it takes to heal – and age does make everything much more difficult. I wanted to have the issue resolved, recover well, and know that I could still enjoy exercise and travel – getting back to full health was my motivator.”

And as for Mr Kunasingam…“It’s so important to have a consultant that will explain things to you clearly, discuss your options and personalise your care throughout. It was good to have things laid out in black and white to make a fully informed decision – and I got this and more, especially when it came to explaining the role that women’s health had to play.”

“It’s brilliant that greater attention these days is being placed today on the role that menopause has when it comes to physical health. It’s no longer just hot flashes or cognitive decline that are the focal points of menopausal discussions. The role that hormones alone have to play in musculoskeletal degeneration is really important to know about – and I am thrilled that the outcome I have had has set me on a positive path as I get older. I would urge anyone who is deliberating about surgery to seriously think about it and be preventative, not reactive, in their approach to healthcare. 

“A painful problem that would have only got worse has been nipped in the bud. I am in the best shape I have been in in years thanks to this surgery and the expertise of Mr Kunasingam.”

 

For further information on the minimally invasive or keyhole bunion surgery service, read Bunion removal.  To book an appointment with Mr Kumar Kunasingam, check out his clinic details.  

 

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.