During my years of practicing podiatry I have been fortunate enough to help numerous people with their problematic nails. This has ranged from simple cutting technique advice to complex nail surgery to assist in permanently correcting the curved growth of their nails.
One person who sticks in my mind is Michael. Michael is in his sixties and had recently moved to the area with his wife. He came across the clinic in an online search and decided to give me a go.
During Michael’s appointment he explained that he had been seeing a podiatrist every 6 weeks and always knew when his appointment time was approaching as his nails were constantly sore.
So I questioned him further “How long have they been sore for?”
He responded with “I don’t really know, but quite a long time. I’ve had to stop umpiring cricket and I can’t stand for prolonged periods of time otherwise my toes hurt too much”.
Once Michael was in the treatment chair it was very obvious what the problem was. He had involuted nails. Otherwise known as curved nails. In Michael’s case it was on each side of both of his big toes.
This becomes a problem when the nail no longer sits flat and has an increased curvature along the width of the nail. This causes increased pressure in the nail sulci (section of skin where the edges of nail rest). Due to the increased pressure you get a build-up of callus (hard skin) and are at a greatly increased risk of painful ingrown toenails.
So I asked him “Have you considered having nail surgery to correct the problem on a permanent basis?”
Michael was surprised and asked “What do you mean?”
I went on to explain “There is a procedure you can have performed where I remove a small piece of nail on the side which is problematic and apply a chemical which will stop the nail growing back permanently”.
Michael was both very surprised and excited at the same time “What’s involved? How do I get it done?”
I could see that he was thrilled at the possibility of having a solution to what has stopped him from doing the things he enjoys most. I continued to explain the procedure is performed in the clinic under local anaesthetic. I told him “You will be given a needle on either side of your toe to make it numb and from then all you will feel is pressure. I will remove a small section from each side of your nail and then apply a chemical called phenol which will prevent the nail from regrowing”.
“What is the recovery time? When can I have it done?” he asked.
I explained “That typically it takes 2 – 4 weeks to heal to the point that you no longer need to redress your toe and about 4-6 months to heal to the point that the skin grows up to the side of the nail and it looks normal again. As for when you can have it done, you just need a few consecutive days where you don’t have too much planned. On the day of the procedure you will need to keep your feet up for the rest of the day and then need to see me 2 days after to have your toes redressed and I will also show you how to do the redressing yourself”.
At this point it was a matter of scheduling in a time which suited Michael. Since he was going away for Christmas we waited until after that and I managed to get him in a few weeks later in early January.
On the day of the procedure, admittedly he didn’t like the injections, which is a common response; however, Michael was pleasantly surprised at the lack of discomfort after having the procedure performed.
The most rewarding result for me was on the day this photo was taken when Michael told me with a big smile that he had returned to umpiring cricket. He had umpired 2 games already this season and would now be able to continue to umpire for many years to come.
Whether it’s helping someone walk pain free, kick a football with their friends or children, wear a certain pair of shoes for that special occasion, or even just being able to cut their own nails without the fear of getting an ingrown toenail is a very satisfying feeling and a very rewarding part of my career.
What are your nails stopping you from enjoying?
(Name has been changed)