A lot of people have asked me if amputating my toe was a difficult decision or told me that it must have been.

Lying on my hospital bed, rolling into the operating room Wednesday, I kissed Maria, held her hand, said goodbye (just in case) to my toe, and thanked it for years of loyal service.

I said a prayer that for my sake and Maria’s, this would turn out to be a good decision. If it went sour (if I were to die or be gravely ill) she would be the one to suffer the most for it.

I told myself that a toe or body part wasn’t a simple thing to let go of. I started to tear up a I little as they inserted a needle into the IV and I decided to joke with the nurse instead. She loved my tattoos.

This morning  it was a rough and sleepless night) I wanted to spell out how I decided to make this difficult choice for my own sake and the benefit of people who are making or might have to make the same decision.

That would bring some understanding to some people and some closure to me.  I know now that it will be all right.

My most important decision was not to make it into a crisis or drama. Illnesses are often a drama magnet for people; they evoke so much fear and uncertainty.  Many people want to relate what they went through, and many get very alarmed.

I can’t make a good decision in a crisis or drama.

This is life; one way or another, we will all come to it, or it will come to us. I want to do it carefully and thoughtfully.

I told my friends and family members I wouldn’t be available for a while to have some silence and space to make a good decision.

The only person I spoke to about it was Maria, my rock and salvation. Answering texts and e-mails is not a good way to think clearly; it can be distracting and unnerving.

I was grateful for the good words but needed to figure it out inward and by myself. I need to think about it, not talk about it.

My doctor,  Doctor Daly, a prominent surgical podiatrist, has been trying to save the toe for nearly two years. The toe had moved the wrong way and was interfering with the rest of my very flat and collapsed foot, making it painful and dangerous for me to walk.

Every day for months and months, Maria has had to apply a bandage and antibiotic ointment to their foot, and Dr. Daly had to regularly and often and grimly cut the callouses growing on the toe because it was pressing against my shoes, bottom, and side.

I had to go and see Dr. Daly almost every month to contain the callouses and ensure there was no infection from the ulcerated wounds caused by them (not diabetes.)

One of these days, she said, one of those ulcers would get infected.

It would happen quickly, she warned, and present a severe danger to the foot.

It seemed almost inevitable that this would happen since the ulcers could never heal with the toe stuck where it was. I’ve had trouble with that foot for years, but it was more serious this time.

My orthopedic specialist could build a new brace without the toe to help me walk naturally again.

Because of the toe, I had to give up walking, something I love to do and which is also suitable for me.

I split the decision into two elements: practical, emotional, or spiritual, if you prefer.

The practical decision was simple. Without the toe, I could get a brace that would shore up the flat foot and point it in the right direction.

There would be no callouses, no ulcerated wounds, and no danger of infection.

And I could walk as often and far (within reason) as I liked. I won’t be climbing mountains, but the roads and hills around me would be no problem.

The emotional part was, of course, more complicated.

I wouldn’t say I liked the idea of removing any part of my body that was in any way due to aging or anything else.

I’ve always promised to die with all my natural body parts intact. Until this problem, I was keeping the promise.

I also understood the risks inherent in invasive surgery, especially for a 75-year-old man with heart disease and diabetes, and severe sleep apnea.

And yes, I had a tough Covid experience.

But no one can really keep a promise like that.

This morning, it’s done, and it hurts a lot, and yes, as predicted,  I am drained and exhausted.

The recovery process will take nearly a month—no showers, everyday shoes, regular pants, no this and that.

I was given a walker when I left the hospital. I’m taking it to the Mansion this afternoon and donating it to them. I don’t want it and don’t need it. I used it once to go to the bathroom.

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I hesitated once or twice to agree to amputate the big toe on my left foot.

I knew the doctors, cardiologists, primary care nurses, pulmonologists, (urologists, and anesthesiologists would put me through the wringer with X-rays, blood tests, echocardiograms, and physical examinations before agreeing to this, and they did.

All of them had to agree that there would be little or no danger to me in undergoing surgery and any anesthesia. I expected Dr. Daly would use a nerve block and I would be given a mild IV to make me calm and sleepy.

But I had to get clearances from all of these doctors, all of whom had their tests and standards, and any of which could have blocked the surgery with a veto.

Boy, was I gone over. Maria and I rushed to the testing center every other day.  They always wanted more or forgot something they needed.

We are now close friends with a deli along the road to Saratoga.

(The anesthesia is a big deal; it would be more intense if there were any breathing problems. The anesthesiologist grilled me for a half hour about my health and past medical history. That alone was scary.)

I didn’t want to go through that kind of examination for obvious reasons and because doctors with remarkable new diagnostic tools almost always find something wrong.

The good news was that I quickly passed all of these tests and exams and found that, despite the toe trouble, I am in good shape.

I could live with the toe and keep it if I was willing to have it examined and tested (with Maria’s involvement) for the rest of my life.

I think that was perhaps the clincher. It was, a nurse said, like walking on a minefield. It wasn’t fair to her either, although she never complained about it.

Almost immediately, the practical reasons outweigh the emotional fears and feelings.

Maria was initially a bit warier about the procedure,  but after a while, she agreed wholeheartedly.

She is usually more cautious in making decisions than I am, and I am always more impulsive. That makes for a good combination when difficult choices have to be made. This thinking carefully about things is an interesting new idea for me.

I am notoriously stubborn but know when to listen to smarter and wiser people. It’s a hard-learned lesson, but I’ve learned it.

Another factor in my decision was my faith in Dr. Daly and her fantastic staff.

She is impressive, direct, and experienced, and I trust her judgment without reservation.

I was the one who brought up the idea of amputation; I suspected she wouldn’t want to be the one who did that. When I mentioned it, she jumped at it. She said she was completely comfortable with the idea and her ability to do the surgery; she has done it many times.

Dr.  Daly is a doctor of few words, but when she speaks, they carry. Doctors are like vets in one way; they never suggest the worst; it has to come from the patient or the human. When she agreed so totally, then my decision was made.

My doctors, Dr. Daly and Maria, and my own reasoning told me to do it. So I did.

After some initial thinking, I have never waivered or hesitated; I have no regrets now that it is done. Sometimes, medicine can do too much for us; sometimes, it can be just right. But there was some sadness and emotion. I was very sorry it came to this.

This morning, I feel the promised pain; I’m taking Ibuprofen and made another decision: not to take the opioids I was prescripted, now or in any form. I can handle the pain; it will only get better.

I am back at work just one day after the surgery, which went perfectly, and I remember being back at work three days after my Open Heart Surgery in 2014. I was proud of that.

My aging body has its issues, but it is still coming through for me when I need it to, and I am learning to take good care of myself. It is not too late; it is never too late to be healthy, and I feel healthy.

I feel that life is always a contest between practical, emotional, and spiritual. Sometimes, that has torn me apart. This time, it brought me together with the people I trusted.

Thank you again for the support, encouragement, and trust from the other side of the blog.

It really mattered. I’m learning to embrace it and not hide from it.

This kind of support always surprises me and makes me proud. I thank you.

So yes, it was, of course, a difficult decision.

This is how I made it.