Friday, August 1, 2008

Foot Notes - Part 2

As I told you yesterday, I've never had a pedicure, but I have been receiving regular foot care from trained nurses, for well over a decade. The nurses have tried to cut the nails to prevent ingrown nails, but the nails don't seem to want to cooperate. Having the nails cut and trimmed had become excruciating.

This past May, I reached the breaking point. My regular foot care nurse was unavailable and I ended up waiting 5 1/2 weeks instead of 4 to get my nails done. The right toe was badly ingrown and when I finally got it cut, I literally SCREAMED BLUE MURDER in pain! Even the trick of putting Ora-Gel on the toe didn't help! I booked an appointment with my Doctor and asked her to do a nail resection on both big toes. Just over a week later, Tuesday June 10/2008, I had a nail resection on my left big toe. The right big toe was done 4 weeks later on July 8/2008.

My doctor who is a fan of "The Muppet's", shall for the purpose of this post be called Dr. Bob. Her assistant, asked that he be called Nurse Janice. Dr. Bob, did the procedure in less than an hour in her office. She started by cleaning, then freezing the area around the toe. Once the toe is frozen, the toe is thoroughly cleaned. A tourniquet is placed at the base of the toe and then a piece of nail on either side of the nail bed is removed. A special type of acid is then applied to either side at the base of the nail bed. This prevents the nail from growing to the sides and becoming ingrown in the future - providing that the nails are cut correctly. A pressure dressing, gauze padding and netting are then applied to protect the toe as it heals over the next couple of weeks. You can read more about ingrown toenails at;
http://en.wikipedia.org/wiki/Ingrown_nail

If all goes well, the dressing is changed on the 3rd, 7th and 10th day. The last dressing is removed on day 14. The toe will still look pretty ugly for a few weeks but the ingrown nails should be history. Short term inconvenience for long term relief.

Dr. Bob and Nurse Janice kept the atmosphere light and the three of us shared many bad puns and silly humour to make the time go even faster. The right toe was actually harder to do than the left. For some reason, the freezing didn't take as well, so it took twice as long to freeze the toe! Every few minutes Dr. Bob reached over with a pin to see if I felt anything. It took several additional shots of freezing before it was numb enough so that she and another nurse - Lucy could start. Nurse Janice returned to do the final dressing and torture me with more bad puns!

The fun part was trying to walk with a HUGE dressing on the big toe. You can't walk at the same pace or place the same weight as normal on the foot. So, you do a type of step and limp. Your sense of balance is way off! If you ever have to get a toenail resection, make sure you get it done in the summer months, as you CAN'T wear socks and normal shoes for the first two weeks. You need open toe sandals that are adjustable across the top to allow the foot to move easily in and out. Also even the weight of a sheet, a light blanket or duvet can be very painful on those first few days!
The first several days, you also have to elevate the foot on a regular basis. It is also a necessity to slightly elevate the foot at night and definitely less painful if you keep the toes vertical. This however is not exactly easy for those of us who are side sleepers. I've never been able to get a decent nights sleep on my back and it is almost impossible for me to fall asleep on my back - even with my feet elevated to relax my back muscles. Tylenol 3's and Tylenol Extra Strength helped over those first few nights but it was rough!

I wasn't able to do my regular workouts for about a week. I actually found myself really missing that outlet and was thrilled when I could finally start again - even if I had to wear my walking sandals to do the Gazelle and the exercise bike! I made up for every day I missed.

I missed taking showers almost as much as I missed my workouts! It's not that I was doing anything that would work up a sweat - I was sitting around most of the time. It's just that I couldn't get the dressing wet. So, for the most part, it meant sponge bathing and washing my hair in the sink. YUCK! I LOVE my showers and really missed the feeling of the hot water running over my body!! I did try wrapping my foot in saran wrap, then "double bagging" my foot in plastic bags and taping them to my leg to keep the foot dry. It actually worked pretty well, but trying to keep your balance on one good foot and the other in slippery plastic made the shower more tiring than relaxing!

I did as much grocery shopping and food prep as possible in the days before the surgeries. Standing for more than a few minutes at a time or walking more than half a block or so was about all I could handle the first few days. It was always a bit easier after the first dressing change as the wrapped toe was only about 50% larger rather than double the size the first days!

Dr. Bob, Nurse Janice, Nurse Lucy and the rest of the nurses and staff at the clinic I use, have all been fantastic in helping to get me through this. My dear friend, who is my regular foot care nurse and my other loving friends have also been very supportive and kept me laughing with their emails and calls.

Two thumbs up - no make that two big toes up to all of you!!

dn

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