Welcome to my ingrown toenails page, the place where you can find information about the second most common medical problem affecting the human race. I recently had an operation to repair these ingrown toenails. This page is for people curious about the operation. If you are about to have one, don't worry, it's not as painful as these pictures look.
I am not trying to scare, just inform. If you have any questions about the surgery, or would like to contribute your own ingrown toenail experiences, visit the newly-created ingrown toenail forums.
An ingrown toenail occurs when part of the nail curves into the flesh of the toe and becomes embedded in the skin. It can occur on all toes but usually affects the big toe. Sometimes callused or red granulation tissue (pyogenic granuloma) grows over the embedded edge. If dirt and sweat enter this area, infection can occur, causing the skin at the side or tip of the nail to become red, swollen, and tender. In addition, a small amount of pus will come out of the edge.
Truthfully, I really do not have any idea what causes ingrown toenails. I will try to find out why on my next trip to my doctor, but I have heard many things, including:
The correct way to trim your toenails is straight across. Do not trim down into the corners. I think this is what caused mine to be the way they are, but the reason I trimmed into the corners was because the nail itself was going too deep into the edge. Many times before I avoided surgery by trimming deeper and deeper. This only made it worse. I eventually had no choice. They had become too serious to trim.
There are some alternatives to surgery, but in my opinion, surgery is the best because it prevents recurrence. Some other options include:*
I've had ingrown toenails for a long time now. It started about a year or two ago. The bilateral edges, great toes (the sides farthest from the centerline of your body on both big toes) would always become ingrown, and I would cut them deeper into the edge. They would grow back worse and worse. Once, my mom used sharp surgical scissors and performed her own surgery. They did okay, but about five months later they just came back. I managed to deal with them myself, and yet they came back again, each time worse than the previous.
On July 11, 1997, I went on a trip with some classmates and a teacher to Europe. Halfway through the twelve-day trip, they began to look bad again. After I got back, the right toe was badly ingrown. The left was also ingrown, but not as severely. A few weeks after I got back, the right toe had some kind of red 'balloon' of pus coming out of the corner. It would solidify every few days and a chunk of dead skin would flake off. This 'weekly shedding' continued until the edge was removed.
I finally decided to visit my doctor. She looked at the toes and said it was an ingrown toenail with pyogenic granuloma. She wanted to remove them right then, in the office while I was awake. I wanted to get it done too before I went to Jordan. She wasn't on the health insurance. It was going to be $500.00 per toe. She recommended me to a podiatrist clinic.
My entire trip to Jordan I was in constant fear that some huge infection would take hold, and I would have to go to a Jordanian hospital. Both toes got even worse to the point where both were equally gross. I could squeeze each one and get a drop of pus out every hour, or let it collect overnight and get maybe two or three drops. I was glad to get back in the USA with all my toes.
I finally wound up going to a surgeon's office at the Knoxville Orthopedic Clinic. This was the third time I expected to have the surgery done in the office. The surgeon took one glance at the toes and scheduled an appointment for an outpatient operation at East Tennessee Children's Hospital.
I checked into East Tennessee Children's Hospital at 12:40PM on Thursday, September 4, 1997. We then filled out all the required papers. They gave us some more papers that we took to 4th floor (short stay). They checked my vital signs and gave me a room. I stayed there and watched the US Open until about 1:15PM when one of the anesthesiologists came down to talk to me about the anesthesia. About 45 minutes later, a PCA gave me 11mg of Valium and a gown.
There was my name on a sheet of paper listing all the operations of the day. TF is 'to follow,' BIL is 'bilateral,' and OPS is 'outpatient surgery.' The surgeon's name has been removed for privacy reasons:
|OPERATING ROOM 6|
|DAYAH,MICHAEL JAMES||14||REMOVAL INGROWN NAIL
While I was still in my room, they put this topical numbing cream on both of my hands and put a clear sticky thing on top of it. This is to numb the skin so it won't hurt as bad when they put in the IV. About 10 minutes later my mom rolled me up to 6th floor (surgery). She is a surgical technologist at Children's Hospital. She parked me outside of the operating room and one nurse peeled the sticky thing off my left hand and attempted to start an IV, shoving and jabbing in and out. This attempt proved unsuccessful, because my veins were "swimmy." Another nurse tried with the right hand and got it in on the second time. This was the most painful part of the operation.
They wheeled me into OR 6 next to this long, skinny operating bed and told me, "Hop on." They then started painting all of both my feet brown with betadine using a sponge. The last thing I remember was some red fluid flowing through my IV. The surgeon says I was telling him about my trip to Jordan and visiting my grandparents. While I was asleep, my mom took pictures of the operation.
I woke up in the Recovery Room. I tried to sit up but they told me to lie down. I asked if this was the new recovery room on 6th floor. They probably did answer but I don't remember. I think they said it was the old one. I remember them getting my vital signs again. I couldn't focus my eyes yet. A few minutes later they wheeled me down to my room on 4th floor.
I was wheeled back to my room where they gave me Sprite®. They were surprised I was able to hold the can by myself. I drank it and then drank another entire can. They said I could only eat soft and bland foods today and brought me some cheese on wheat crackers. I gobbled them up. The nurse then came and talked to me. She asked how I was feeling and said she was going to get some antibiotics from the pharmacy down stairs. Five minutes later she came back with two syringes. One had saline and the other some yellow antibiotics. She put the antibiotics in my IV, which did sting a little, and pushed the rest of it on through with the saline.
When I was ready to go, they brought a wheel chair for me to sit in and one of the nice PCA's wheeled me down to the car at 5:15PM. I got in and my dad drove me home.
When I got home, I still did not feel anything. I took my pain pills every four hours and never felt a thing. It is fairly difficult to walk. Plus, my feet need to be propped up or they throb painfully. I slept well that night.
I woke up pretty much dying of pain, screaming for pain pills. I held my feet high above me. This helped some, but not very much. After about 15 minutes, the pills took effect, but my toes still hurt a little. As I'm working on this page now, I'm not feeling any throbbing or other pain.
It wasn't as bad this morning, although it wasn't that good either. I woke up in a little pain, but the pain pills quickly took care of that. Then, when I went to lay on the couch and prop up my feet, I feel asleep until 4:00PM. I woke up needing the pills again. Later that day I took a shower and had to put wrappers around my feet so they wouldn't get wet. One toe did, the other didn't. I had to use a hair dryer to dry the wet one off.
I'm doing a somewhat better than yesterday. Elevating my feet is no longer required to keep them from throbbing. I don't know how the pain can get much less. I guess as long as they're not bumped. It is still hard to move around, but it's getting easier.
Felt much better today. But I couldn't walk good enough to go to school. I woke up with a small amount of pain. It seems to be getting much better. I am going to the surgeon tomorrow to have the toes looked at and the bandages changed.
I woke up this morning in almost no pain. When I took a shower both toes got fairly wet. I guess this was for the better since water would make the bandages come off easier. When I went to the surgeon, the nurse removed the dressings and I noticed huge holes where part of the nail and a lot of the skin was. I thought I saw the bone through some blood, but I'm not sure. I can guarantee I'll get some great pictures of that. A few minutes later the surgeon and a doctor-in-training came in. He was telling him what it was, and what he had done in the operation. He gave me a prescription for some gauze and told me to soak my feet twice a day for 15 to 20 minutes in dishwashing soap while the nurse re-wrapped my toes.
The night after I got home from the surgeon around 12:30AM I decided to take off the dressings and soak my feet. Easier said than done. For hours, I was trying to remove the gauze that had stuck to the wound. Every little piece I pulled off made it hurt for about five minutes. Then, I soaked longer and tried again. It was finally all removed six hours later, literally, at 6:00AM. From then on, I sang the praise of Non-Stick Pads.
I went to the doctor today for the last time. He looked at my toes, this time with a different trainee. He described the procedure again to her and told me my toes looked "good." He also mentioned that there was a very low chance of recurrence because the procedure was done in the hospital where they could take their time.
Both toes are in perfect condition.
Doing great. There's a tiny piece of nail coming out of a fake corner, but it's nearly invisible. It's been there for a few years, but never caused any problems.
Almost cosmetically flawless. When trimmed, difficult to detect any surgery was ever performed. No problems running, either. A few tiny pieces of nailbed did grow back, but they merged up with the main nail which now has a small ridge.
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|IV Just Put in Hand
No More Nail
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