Heather Winslow, 40, is a nurse anesthetist, wife, mother and marathon runner. She’s also a big advocate for getting a second medical opinion.
So is her orthopedic surgeon, Dr. Stuart Saunders of Novant Health Orthopedics & Sports Medicine – Clemmons.
Winslow became a second-opinion proponent the hard way: A surgeon at another system operated on her foot a few years ago – but the surgery didn’t alleviate her pain. In fact, she was left in so much pain, she worried she might not run again.
And running is more than exercise to Winslow. It’s much-needed “decompression time” from a high-stress operating room job and parenting two active daughters. (Claire, 12, swims and plays soccer, and Jordan, 9, loves to run and has joined her mom in several 5Ks. She also helped compile this reel of her mom’s recovery.)
Don't let joint pain keep you from enjoying life.
The family includes four dogs, and two or three of them – all Boykin spaniels – often accompany Winslow on her runs. (The 17-year-old schnauzer/poodle mix has retired from running.)
In October 2020, Winslow had foot surgery in the triad region. But the hardware her surgeon implanted ended up causing her so much pain that when she met Saunders in January 2021, he recommended revision surgery. Revision surgery, where a procedure is redone, is not uncommon in orthopedic medicine and comprises about one-third of Saunders’ practice. They may be needed if the patient didn’t heal properly or if the problem was under- or over-corrected.
Winslow is passionate about running. She ran the day she delivered her oldest daughter, thinking it might help speed up labor. Being on bedrest during part of her second pregnancy kept her from running then. Last year, Winslow didn’t miss a single day of running two or more miles.
Her alarm goes off most days before 4 a.m., which allows her to run four or five miles before work. Bad weather doesn’t deter her. She’s on her third treadmill after wearing out the first two.
The Greensboro native and High Point resident started running in high school to stay in shape for tennis. Even then, her feet were troublesome. “An orthopedist had to make special inserts for my soccer cleats as a child,” she said. “I've always had super-flat feet.” Achilles tendonitis, arthritis, shin splits and plantar fasciitis are among complications flat feet can cause.
At 22, Winslow ran her first marathon. She’s done eight more since, most recently in January at Disney World. Her family came along for that one. “I wasn’t too concerned with my time because we were there on vacation,” she said. “I went to the park straight after I finished, and our family stayed the whole day – a day I took 70,000 steps.”
Marathons get tougher as you get older, as Winslow will tell you. But she’s not stopping. Having already run the Boston and New York marathons, she plans to take on Chicago in 2025.
But there was a time she thought marathons were behind her. That was before Saunders corrected her 2020 surgery – an aggressive operation he wouldn’t have performed on someone so young.
‘Willing to do anything’
The first surgery – not performed by Saunders – was done to treat her severely collapsed left foot. It was subtalar fusion surgery. The subtalar joint helps the foot adjust to uneven surfaces. Your foot needs to roll while you’re walking or running, and it’s the subtalar joint that makes it possible. When it’s not working properly, you don’t have the stability you need to get around.
A complication from that procedure led her back to the original surgeon, who operated again just five weeks later, to clean out an incision that wasn’t healing properly.
After the second surgery, however, things still weren’t right.
She was having progressively worse pain in her left fifth metatarsal because her mid-foot was now turning out. “After my foot was fused, it could no longer turn inward,” Winslow said. “Instead, the middle part of my foot began turning outward. Eventually, I had a stress reaction, which is one step away from a stress fracture and could have been an even bigger hiccup in my training. Something had to be done.”
At that point, she decided it was time for a second opinion.
A friend referred her to Saunders, saying he was an excellent orthopedic surgeon who was fellowship-trained in foot and ankle surgery and up to date in clinical advancements. Saunders sees a lot of athletes, ranging from high school students up to “weekend warriors.” They’re all “wired the same way,” he said; they’re eager to return to high-impact activity.
She and her husband, Matt, drove 35 minutes – from High Point to Clemmons – for an initial consultation. “It was kind of a haul,” she said. “But I was willing to do anything.”
Saunders, a former soccer and baseball player himself, has a similar attitude. “We will do everything we can to get you back to activities you love,” he said.
Winslow was in tears during that appointment. “I was in a dark place,” she said. “All I wanted was to run again. Dr. Saunders was honest and said he wasn’t sure I’d be able to get back to marathons. I told him I’d do whatever it took.”
She meant it. “Heather’s one of the most motivated patients I’ve ever seen,” Saunders said. “If anyone was going to do it, I knew she would.”
Saunders recommended aquatic physical therapy two or three times a week, and Winslow was happy to comply. He monitored her progress along the way. He wouldn’t perform the revision surgery until she was a full year past the first operation to allow the foot to fully heal, even though the foot wasn’t fused in the ideal position.
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More surgery down the road
One year later – in October 2021 – Saunders performed his first surgery on Winslow. “He took out the old hardware,” she said. “And because I’m so active, he used special cement to give me extra protection. I couldn't run for six weeks. But I could walk with a boot on. We thought I was good to go.”
Saunders used cement because it remodels into new bone, which provides more stability as well as potentially reducing the risk of a new fracture in someone as active as Winslow.
Once she began running again, she noticed her left foot was still turning outward.
“Her foot wasn’t landing properly,” Saunders said. “When you walk or run, your heel should hit first and then your toes. Her heel was hitting the pavement, but then she’d land on the outside of her foot, due to her prior fusion surgery.”
In May 2022, Saunders performed a second surgery. That was a midfoot osteotomy, a corrective procedure that realigns bones within the foot. That would allow Winslow to regain a more normal walking and running gait.
At the same time, he performed forefoot corrective surgery that included a plantar plate repair and a metatarsal shortening osteotomy, which – as the name implies – cuts and shortens the second metatarsal and decreases pain felt at the base of the toe and ball of the foot.
At her August 2022 post-op visit, Saunders OK’d Winslow’s gradual return to running. As she continued to heal, her milage increased and now she’s planning on future marathons. Her progress has been astounding.
Saunders has warned Winslow that she’ll likely experience the degenerative effects of aging faster because of how much she runs. She’s likely to develop adjacent-joint arthritis and need surgery. But for now, she’s enjoying running without pain. “I try not to take it for granted,” she said. “I know anything could happen any day.”
Winslow’s journey is instructive for other athletes – or anyone contemplating orthopedic surgery.
“You can’t go wrong by getting a second evaluation before surgery,” Saunders said. “A lot of patients say, ‘I don’t need to; I trust you.’ And patients should trust their doctors. But it never hurts to get a second opinion.”
Saunders’ advice: “Get several opinions and then choose the doctor you feel most comfortable with to perform your surgery.”
He adds that “anyone who isn’t satisfied with a previous orthopedic surgery should know: You don’t have to live in pain or with results you’re not happy with. That's not to say there will be a fix 100% of the time. But in most cases, there are things we can do to make it better.”
