(The images shown here may be graphic to some or my hairy, bloody toes may offend you. If you’re worried, stop reading right now. For a look at what complete toenail removal and what getting that infected is like, click here.)
My name is Tyler and I’ve been in an abusive relationship with my nails for as long as I can remember. For all my childhood and the first decade of adulthood, I chewed my fingernails. I chewed them to the nubbins until they hurt.
Sometimes they bled. There were hangnails every day. For years, I had no idea that what I had WAS a hangnail, and had always heard about hangnails being such horribly painful maladies. Ridiculous, I know, but I thought what I had was normal. I’d be approaching 30 by the time I overcame that nasty habit.
And that’s where I thought it ended. And then I started running more. And then I noticed that my toes hurt.
Every step hurt. Every step always hurt. Not just when I ran, but whenever my toes had pressure on them, like say, at the end of a bed with tucked in sheets (I kick the sheets out to avoid pain, not because I had some weird claustrophobic thing). More so after I played sports that required lateral movement, like tennis and basketball, but I figured the pain in my big toes was just part of that. What I didn’t know was that the nails curved inward at each edge, digging into the sides of each one. Man, that hurts to think about it that way.
Clippers and nippers hurt! Way painful. No matter how hard I tried, I could never cut off enough. One time, while I was recovering from pilonidal cyst surgery, I’d managed to angle cut down almost to the cuticle of the outside of my big toe (outside being relative to my body) and went to my normal doctor. She brought in some old dude who shoved pliers into the side of my toe, sending painful shocks through my body that made me convulse, which irritated my still-open wound hole.
It hurt so f***ing bad.
While the acute pain subsided after the skin on the side of my toe healed, the nail eventually grew back and dug in again. Instead of trying to trim it, I went the opposite way and let it grow back out, hoping that the problem was just that I sucked at toenail cutting. After three-ish months, the nail came back and my left toe hurt again. Like before, I ignored it and went about my running.
Five half marathons, a few years and hundreds of training miles later, the outside of my left toe hurt so much that removing the toenail seemed like a great idea. Remembering that my nurse practitioner was a distance runner, I asked her what to do. She referred to me Dr. Serrina Yozsa, a podiatrist working out of the office adjacent to Scottsdale Hospital on Osborn by the Scottsdale Giants stadium. I walked in, she did some ingrown toenail surgery and sent me home. Recovery was quick and spring 2011 is the first time in my life that athletic activity didn’t make my left toe hurt worse.
While the nail eventually did start to curve into my flesh again, her trimming job allowed me access to the offending area. A quick snip and file solved that issue. But now that the outside of my LEFT toe no longer hurt, I realized that the inside of BOTH big toes hurt a helluva lot, too.
Have you ever tried to use nippers and clippers on the inside of your big toe? Holy hell that area is sensitive. No matter how long I soaked my toes in hot water, no matter how careful I was with the cutting and no matter how many painkillers I took beforehand, I just couldn’t trim enough of the nail back to alleviate the pain. And because the area was so inflamed, I usually ended up cutting the skin on my toe, adding to the pain.
Don’t think my toe LOOKED all that bad, though. While the area was red, it was impossible to tell anything was wrong, which is why I was so hesitant to get it taken care of in the first place. I’m not sure if I was waiting for it to swell up and start draining pus, but I just couldn’t bring myself to get checked out by Yozsa again. And then I started playing tennis again, with the lateral movement re-igniting the digging and the pain. After completing the Tough Mudder, I headed back in to Yozsa for another round of ingrown toenail surgery.
(I don’t have health insurance, which was another barrier to getting this checked out. My bill for all three surgeries was around $250 per toe, which was totally worth it and I’d pay it again.)
The procedure was the same as previous: three shots at the base of my toe (six for my right toe, because it was slightly sprained from Tough Mudder and far more sensitive), then a mini log-splitter-ish tool to separate the ingrown part down to the cuticle, then pliers to rip that part out, followed by a wooden kabob stick with its tip dip in some kind of chemical that burned and killed my root. It looked far more painful than in felt. Well, that is until I woke up a few hours later when my numbing medication wore off and my toes screamed, “holy hell you ripped a nail out of us! And you cut us up in a really sensitive area! What the hell?!”
I spent 2-4:30am that night alternating between gently laying a bag of ice on my flat-on-the-ground feet and then laying on the floor with my feet up on the couch. It hurt, I could barely walk and all I wanted to do was fall back asleep. Mercifully, that throbbing pain was nearly gone the next morning. Good thing, as my post-op care involved SCRUBBING THE WOUND WITH A TOOTHBRUSH.
Yeah, seriously. Twice a day, I was to soak my toes in warm water with vinegar and baby shampoo, then scrub with a toothbrush, then soak in some anti-bacterial spray, then apply wound dressing, then cover it with at first gauze and wrap, than large bandages. Twice a day for a week, then once a day for a week and then…healing?
It worked. Just like last time, I healed in about two weeks without any infection complications or horrific pain beyond that initial shock during the first night. While I couldn’t wear shoes or Vibrams for ten days, it was a small price to pay for pain-free walking, running and tennis playing for the rest of my life.
In the following gallery, you can see images from my surgery (including the pieces they tore out of my foot. Notice the angle on those pieces, as the small part is what I was able to trim back. Nuts that my nails dug so deep.) as well as pictures from a few days after the initial surgery. I’d guess that mine was a fairly typical case, as we were never much worried about infection. I was able to play tennis 12 days after the surgery (not well, but I could move) and am pain free three weeks later. There’s still some healing to be done, and some dead skin to be trimmed back, but I can’t feel the digging in anymore.
If you’re having problems with your nails and fear ingrown toenail surgery, don’t. It’s totally worth it.
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Here are the products I used and how I used them:
Apply directly to wound 2x daily until seepage stops, then mornings only. I was told not to use Neosporin until the wound was small enough for a bandaid, which was about two weeks. The only time I used Neosporin right away, I developed an infection, though there were contributing factors.
Mix with warm water and Epsom salt in bowl, soak toe at least 1x daily before bed until wound closes (2-5 weeks), ideally 2x daily until seepage stops (5-10 days).
Mix with warm water and baby shampoo in bowl, soak at least 1x daily before bed, for 2-5 weeks. I’ve found that soaking in the morning is more pain than its worth, and the evening soak really helps with pain overnight.
Cut these diagonally and use to wrap wound. Bandaids work okay, but tend to be overwhelmed easier by ointment, seepage, and general sweatiness. You can get the regular ones to save a few bucks, but be prepared to rip your scabs off if you do.
Don’t bother with the bigger wraps, paper options, or reusable stuff. It’s a pain in the ass to have to worry about. These self-adhering bandages, when paired with non-stick pads, make for a far better protected area. If you need to use the whole pad to cover the tip of your toe, this tape can easily be extended to wrap that area, too.
After seepage stops (5-10 days), apply once daily either directly or as drops in soaking bowl, in the mornings. Can be used at night to dry out seepage, but I like this in the mornings and Epsom salt at night.