A question from Amber:

I sure hope that you can help with some toe advice. I have never had toenail problems in my life, ( I am 29 years old), but since the birth of my daughter in January it has been one sore toe after another. My left big toe finally got so bad and infected I had to go in and have it removed. I wasn't really nervous as the doctor assured me it would be just a sliver and a quick and easy procedure. WELL,  IT WAS HORRIBLE. First, the injections were so painful I cried ( I didn't cry during childbirth). I have a big black bruise ring around my toe from the injections. Granted, I didn't feel the procedure, but I certainly felt the shots. It has been 3 days and my joint is still bruised and sore. In addition to that, the doctor took more than a sliver. I was told the skin would fold over and you could hardly see it. I have at least 1/8th of an inch of showing with no nail on it.

 

Finally, on to my problem. My other big toe, same side, is now severely sore, red and swollen. I am terrified to go in for another procedure so I tried to cut it out myself. It was torture, and though it appeared to help a little, still has not resolved the problem. I am still on antibiotics from the first infection, though they are about gone and doing soaks 2 times a day. I don't know what to do. Is there any chance that if I just leave it alone it will grow out and be O.K., or am I just going to have to bite the bullet, subject myself to more pain and do the procedure again, i.e. better now than later. Any help would be much appreciated. 

 

Thanks, Amber P.

Dear Amber:

I am truly sorry that you had the disappointing experience you describe. It does not have to be that way. As you can see elsewhere on this web site, the anesthesia of the toe can almost always be accomplished without pain and the only part of the nail that needs to be removed is the part under the skin where it cannot be seen. Pain and unattractive toes are not required parts of the procedure. That being said, I must say that two or three times a year even I have patients that experience a lot of pain even though I do everything in my poser to make it painless. I am not sure I can explain why some people experience so much pain. It may be because a very inflamed toe has a change in pH (the acid-base balance) that causes the nerve to experience more pain than usual. Regarding the shape of the nail, taking too much nail is, unfortunately, common. I just think that some doctors are afraid of having facing the possibility of the ingrown nail not being "cured"   or else no one ever showed them the right way to do the nail procedure. Properly done, the nail should not look disfigured in any way. This is what I stressed when I taught the procedure at one of the colleges of podiatric medicine.

I would strongly suggest that you give another doctor a try. Select a podiatrist who is a member of ACFAS or ACFAOM (click the name to go to the appropriate web site to find these doctors) as your doctor. An for goodness sake, if you do not feel comfortable with this doctor don't have the procedure done. Instead say that you need to schedule it for a more convenient time and you will call the office to make you appointment. Then go to another doctor. Do not loose control of the doctor-patient relationship. If any doctor tries to push you into the surgical procedure, even a nail surgery, they he or she is not the person you want working on your foot. 

I hope this helps

l