Monday, 27 May 2013

25 weeks - toenail drama

This post might seem a bit out of the blue, because having looked back over the blog it seems I haven't really talked about this very much, but I think that is because previously it didn't seem a big deal.

Way back when my casts came off at seven weeks, I talked about how my left middle toe was very very painful, red and swollen in this post. I thought it had been crushed by the cast a bit and so wasn't overly concerned.

I did raise it with my surgeon in my email to him, and his reply, which I posted here .

Basically he said: "I am sorry to hear that your left middle toe is very red and if it is clear that the plaster has been rubbing then I am sure this will settle quickly. If, however, it continues to be uncomfortable I might suggest you ask your GP to see it."

Now, I feel rather let down by this. I think that if he or one of his colleagues did not feel they wanted to look at it, they should have told me to make an appointment with my GP.

As it was phrased, I felt the subtext was: "Hey, silly patient, it's fine, stop worrying about nothing. But if you are a total hypochondriac, go and pester your GP and waste his precious time."

I certainly didn't feel encouraged to go and see my GP to get it checked out, and so when I continued to have problems with it, I didn't even talk about it on here, so convinced was I that it was nothing.

Well, more fool me.

It did start to become clear that the toenail had been damaged, but after reading up on runners' forums about toenail loss it seemed to be a minor cosmetic issue that would eventually resolve when the broken nail grew out and a new one appeared beneath.

So when, in the bath one day, the old one came off, and I could see a small new one below, I thought it was all sorted.

Then, when that new one became discoloured, I wasn't overly bothered as I had read that sometimes bad damage to the nail bed took a nail or two to resolve.

Well, a few weeks ago I was concerned enough to try and get an appointment with my GP. The nail was white and thick, and obviously lifting off the nail bed *boke*. My appointment is tomorrow but I have now self-dagnosed with the help of Dr Google, and it is clear that the original damage and infection have resulted in a fungal nail infection which is now very well established.

Of course, had I not been made to feel that I were being a hypochondriac, then I would have gone to the GP earlier, and got treatment earlier. Fungal nail infections are notoriously difficult to treat, and to make matters worse, most treatments can't be carried out while breastfeeding or when pregnant or trying to conceive.

I currently tick one of those boxes, will soon be ticking two, and hope that shortly I'll be ticking a different two.

Does that make sense? Basically I breastfeed the Little Lady and we are going to TTC (try to conceive) as of next month (I know, I know, TMI!) and hopefully will soon be pregnant.

So I can't treat it!

Well, there are some home remedies I might try but I'll see what my GP says when I finally get to see them tomorrow (yes it took about two weeks to get a simple appointment).

I am really upset and cross and feel so let down. If Mr Nugent had just said "go and see your GP about your toe" then I could have had help so much earlier, before it got this bad. And now, my feet are still ugly and horrid, because while the toes are straight, my toenail is grimsville.

In fact, today I pulled the second dead toenail off and underneath is just soft nail bed and white stuff, which I assume is the fungus *double boke*.

The strong of heart may enjoy the following pictures. EVeryone else should scroll to the bold part quickly.



off you go, squeamish ones




Ok, here we go then. Here is my bokey toenail before I pulled it off.

You can see that it looks white and a bit fringed around the edges. And I can tell you that it was just held on by virtue of being tucked under the skin at the edges. It was so easy to just prise it off gently.

This picture shows what it looks like now, sans nail.

My poor toe! It looks all gammy and grim. The white stuff does scrape off a bit but I'm worried about transferring the fungus to my fingernails, so only did that a bit before realising it was a bad idea. I think I should probably try and remove it if I can, but the skin is tender.

The next two are shots of the toenail that came off. It's really just a nail remnant, and it is very white.


And underneath:

I chucked it in the bin before thinking I should have taken it with me to the GP so they can test it, but I bet they wouldn't have anyway.

Squeamish people return here.

My Googling has found that a lot of people swear by the following home remedies for fungal nail:

1 - vinegar

2 - gentian violet

3 - Vicks Vaporub

4 - tea tree oil

Those are in no particular order. Now, as gentian violet is often touted as a remedy for nipple thrush (the things you learn as a breastfeeding supporter!) I can see that it might work on toe fungus too.

Vinegar is very popular, and as I have white vinegar in the cupboard, I may well have a go at that. I'm very intrigued by Vicks Vaporub and would love to know if anyone has tried it.

The only good thing about my nail having come off is that it is easier to get at the fungus which would otherwise have been covered by it, so I'm hopeful that perhaps in the month I've got available before we TTC, I can at least get the fungus on the retreat, and then I can stop using any prescribed treatment (as the Little Lady is nearly four and feeds about once a day, I won't bother telling the GP I'm breastfeeding and I know they won't ask as they won't expect it at this age) and get going with the vinegar (or Vicks).

I'm still really fed up about this unexpected side effect of the surgery though.

21 weeks - approaching normality

HUGE APOLOGIES! I thought I'd published this but it was still in my drafts. Sorry! I think I was going to add some pictures, but instead I'll just get this posted and do pictures for you another time. I do have videos I've been doing but I have so much trouble getting them uploaded to YouTube I may give up on them. Anyway, hope this is still useful/interesting and I'll get writing more I promise.

*should have been published a month ago, whoops*

It's been three weeks since my last update, and I'm now 21 weeks post-surgery.

Last week I picked up my new, custom, orthotics from the hospital. That marked the end of my hospital appointments at the Royal Berks, apart from when I need the orthotics replacing in about two years' time.

The orthotics are as slim as they can make them. You can see from the picture that they are really thin, but the curve of them where they support my arch and heel means that they push my foot up, which means I need to be careful what kind of shoes I wear.

I am working on a post looking at shoes, but basically my orthotist would like me to wear big, clunky shoes with very rounded toes, either completely closed or with a wide strap, and generally pretty ugly.

So far I've found I can wear my orthotics in my flat ballerinas, which have a rounded toe, because although they have no strap they grip the back of my heel and my heel doesn't slip out of shoe when I walk, which is often a problem with very open shoes.

I also wear a pair of sporty styled shoes with two velcro straps over the foot.

As the weather warms up, I probably won't wear the orthotics as often as I should, because you cannot wear them in sandals, but I do make sure that I am conscious of my foot positioning and pronation, and I hope that will be enough to make up for it. I'll definitely wear them all winter.

Right now, I can't wear them the whole time anyway. The orthotist told me I had to build it up by wearing them for half an hour the first day, then an hour the next day, and two hours the next, and so on.

I find they do make my feet and legs ache, because the muscles are adjusting to the new positioning, so I'm still working on increasing the time. I can't wear them in the house unless I wear shoes inside, and I usually wear slippers, so it's taking me longer to build the time up, but I think that's OK.

I also saw my physiotherapist again. I know Ed has been reading the blog, so "Hello Ed!" *waves*

I had to admit I've not been doing my exercises as much as I should have been, because they make me hurt, so I have promised that over the next month I will do them regularly, and wear my orthotics, and hopefully when I go again he will discharge me.

I did go back to yoga and have done two sessions now. Surprisingly, it wasn't as hard as I expected.

During my recovery I have been making sure I did foot exercises, and calf stretches, and I found I was no where near as stiff as I thought I'd be. My teacher, Minna (who also reads this so "Hi Minna!" *waves again*) does try to tell me to take it easy but I like to push myself and I never do anything that is painful.

As expected, it was a challenge to roll over my toes to go from all fours into downward dog, for example, but I either do it one foot at a time, or I do both together but put a lot of my weight onto my hands and arms.

Over time, it will definitely get back to normal, I'm sure.

I am actually really pleased with my recovery; with my range of motion and with my lack of pain. I know I've worked hard on my recovery but I also feel very lucky and blessed.

I do still have the problem with my toenail on my left foot, but I can now see that there is a new nail growing under the old one, and the old one is growing out, so in six months that is going to be back to normal. It's irritating, but a temporary annoyance.

So there we are! I'm still doing my exercises, building up my general stamina for walking and standing, and sometimes overdoing it a bit! Some days I'm fine, some days my legs and feet really ache, but the progress is in the right direction and soon, in terms of medical appointments, I'll be flying solo!

As usual, please ask any questions or make any comments below.