After two weeks of wearing the surgical "shoe" - basically a board strapped to my foot - and showering with said foot in a plastic bag I went for my follow-up. 48 hours ahead I got x-rays. I'm now back in normal shoes that have inserts and I need to buy new sneakers.
The most lasting effects were from not being able to walk normally for two weeks, which left my hips and back in pretty bad shape. I've been slowly getting back to walking - on Saturday I did an unintentionally intense hike uphill through dense underbrush for about 2 miles and survived that OK (though I needed a nap and most of Sunday off from walking). Monday I walked about another 3 miles around WPI campus, about which more in another entry.
The foot is occasionally sore particularly when the dog stomps on the less-protected toe, but it's getting better. I really need new walking shoes, though. Details and longer-term stuff behind the cut (nothing gross)...
The lab results and X-Rays confirmed the podiatrist's diagnoses. The infection was indeed fungal. In theory I should be continuing the antifungal treatments for up to six months but I've fallen off that.
The x-rays also showed bone spurring pretty much exactly where she said it would be. The inner spurs are indeed narrowing the gaps between foot bones and likely leading to the pinched nerves. The ankle x-rays looked good so we'll chalk up the tight tendons to situational; I should stretch them more. To deal with the spurs I've got shoe inserts she crafted out of cut-up pieces. They both give the foot more support and encourage the bones to spread out, relieving nerve entrapment.
Doing anything about the actual spurs would require serious surgery that she thinks isn't advised. But she does want to do another day surgery to treat the ball joint that attaches the big toe to the foot. Her assertion is that this new-fangled treatment (about which I need to get a lot more info) will help stave off degeneration and counteract some of the effects of arthritis. In effect it's a stalling tactic, but she thinks it ought to give me 8-10 more years before I have to do something drastic like a fusion.
I've got the dubious eyebrow going on this one as it involves things I know nothing about like injecting stem cells into the degeneration sites to encourage regrowth of the supporting tissues. I have a follow-up four weeks from the original to see how things are going and we'll likely talk more about it then. I'm firmly committed to getting a second opinion before doing any more surgery (even day surgery).