There is nothing in the chemistry of a toenail that predicts the existence of a human being.

June 4, 2008 8:55 PM

I need treatment advice or doctor advice for my ingrown toenail. Difficulty: desperate rock climber.

I see there've been a few threads about jacked up toenails in the past — I would love a one-two punch of palliative advice and physician relationship advice. I saw our family doc about the toenail back when it went south (it was already weird and then my lady love stomped on it). He helped clear up its infection, but it's been a month and it's still got a painful hemorrhoidlike 2mm flappy bit that hurts and bleeds when I poke it. GROSS.

So on to goals. I'm trying to figure out how to unjack the toe while still being able to rock climb. I have kept climbing between sitz baths but it's painful enough that I'm starting to flip my shit. The doc said he would do a wedge resection if it didn't clear up by now, which he said his athlete daughter took four weeks to recover from. My first child is due in July and it's gorgeous weather outside. Slothful recuperation seems immoral in such circumstances. As for my doctor, while he's a distracted general practitioner who I feel isn't really on top of his game, I have had bupkiss luck finding a better doc in my area.

So what would you do? I am completely failing to think outside the box here.

posted by mindsound to health & fitness (11 comments total)

Podiatrist. This is a huge part of what they do for a living. I just had my two long time ingrown toenails removed - and the roots treated with some kind of acid so that they won't ever come back. I was totally numbed up for the procedure and only had very mild pain once that worked off (having done enough home surgery to know what your toe looks like right now - I can say definitively less pain then you're in now). You'll have to clear up your infection before they can do the procedure - but once they do - it's a few days of keeping your toes dry then a couple of weeks of band aids and you're pretty much done. I found my podiatrist on yelp - ask around for a recommendation.
posted by Wolfie at 9:07 PM on June 4, 2008

Go to a podiatrist. I did for the first time for a messed-up toenail when I was eight months pregnant. He fixed it right in the office without any pain meds (none needed, I didn't feel a thing). Once the baby came, I was doing a lot of kneeling to change diapers, and had I been kneeling on that nail, I would have been howling the kind of stars and other characters you see cartoon characters yelling in comic strips.

Why the heck would a wedge resection, which I've never heard of but looks a lot like what I had done, take FOUR WEEKS to recover from? I don't think so. Podiatrist will probably have better info for you than your GP.
posted by GaelFC at 9:09 PM on June 4, 2008

I had that procedure done a couple of years back, and it didn't take anywhere near four weeks to recover. I had it done first thing in the morning and then went to work--I spent the rest of that day (and maybe the next day or two, I can't recall for sure) in a surgical shoe and popping ibuprofen every few hours. Then it was on to tennis shoes. I'm no rock climber, but I was back in hard-soled shoes and walking painlessly in a week or so.

By the way, the pain from the procedure was far less than the agony of the infected nail. The anesthetic injections were by far the worst part of the whole ordeal.

On preview, thirding the podiatrist.
posted by serialcomma at 9:12 PM on June 4, 2008

Hey mindsound, I'm a climber and I've had the same problem. Tight climbing shoes really exasperate the problem and I wear my shoes really tight. The only thing you can do is do get that wedge chopped out of there. They'll need to cut it way back and in some cases cut it so far back to the root that that portion of the toenail is going to stop growing from here on out. Honestly though I don't think the recovery time is going to be 4 weeks. More like two. And even then it shouldn't be so bad that you can't walk on it. But, you probably won't want to be putting on your climbing shoes and definitely not toe-ing down onto dime size edges during the recovery period.

I think you should do it right before the baby comes. You'll be too busy with the new baby to climb anyway so you can take care of the baby and the mama while you're healing up. Shoot, in the two years since my kid came I've gone from climbing 3 or 4 times a week when the weather is good to about 3 times this whole last year. Luckily I still get to snowboard a lot. Priorities.
posted by trbrts at 9:16 PM on June 4, 2008

Fourthing what wolfie, Gael and Serial said. I had the identical mini-procedure and almost immediate recovery.
I had years of pain. every vacation (lots of walking) was something to be worried about. Then I happened to hear about that treatment. No idea why I never heard about it before then (in my 50's). But it was 5 minutes per toe and a fabulous, quick result.
posted by JimN2TAW at 9:21 PM on June 4, 2008

I had problems with this for some time. I would go to the podiatrist, they would cut on me, it would help for a while, and then it would come back. What solved it was, after the last podiatrist visit, for me to give it attention much more frequently than I would go to the podiatrist. So I would constantly check it, cutting on it myself for any offending regrowth and using bits of cotton to attempt to block it from digging in. Eventually everything healed up and it hasn't been a problem since, probably because the initial problem was due in part to improper boots. Importantly, by the point at which I took matters into my own hands it was not as bad as it had been - no infection, for example.

The doctor did not cut on you yet? It's not that bad. The later times I just went without the anesthetic because to me the shot in the toe was worse than the unanesthetized pain of the wound and the cutting, although I may have a high tolerance for pain considering that my lack of expressed pain during the cutting made the podiatrist ensure that it was, indeed, hurting or else he'd tell me to get checked for diabetes.

I can't speak to the value of having the regular doctor vs. a podiatrist cut on you.
posted by TheOnlyCoolTim at 9:42 PM on June 4, 2008

I wouldn't say that you'll necessarily be rock-climbing the day after (and if that rock-climbing is rough on the feet or involves constricting shoes you should consider it as a possible source of the problem) but recovery is quite fast.
posted by TheOnlyCoolTim at 9:44 PM on June 4, 2008

Sounds like the podiatristists have it... man, a quick snip and a week of band-aids sound so much more okay than a month of hobbling. Thank you all for your testimony. :)
posted by mindsound at 9:56 PM on June 4, 2008

Go for the resection. I had one done about 15 years ago and haven't had a problem with that toe since then. Recovery was fairly quick - a week or so. Growing out the nail took a long time (several months, hard to remember the specific time frame), but it didn't interfere with anything.
posted by deborah at 1:35 AM on June 5, 2008

honey, go to a podiatrist. i had a fucked up wedge resection done when i was wee, and now my toe looks nasty PLUS the nail structure is weak and it's prone to cracking across the toe at the slightest bump (which i presume happens when rock climbing). don't let your "distracted gp" do it for you.
posted by misanthropicsarah at 8:49 AM on June 5, 2008

ACCIDENTALLY stomped on it. :( And was really sorry afterwards too.
posted by GardenGal at 10:55 AM on June 5, 2008