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Problems after ingrown toenail surgery

Discussion in 'Ask your questions here' started by Unregistered, Oct 23, 2008.

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  1. MML

    MML New Member


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    Oh, ok. Well, that makes me feel better! Well, not that it grew back, but that the % of re-growth is higher. Thanks!
     
  2. Unregistered

    Unregistered Guest

    Two weeks ago my wife had a local Podiatrist remove a portion of her big toenail that was ingrown.

    He did the proceedure in his office after numbing her toe. He then put her on an antibiotic (Cephalexin 500mg), said to soak it in epsom salts and redress twice per day till the next scheduled visit in two weeks.

    After four days her toe was very red and sore so we called and went back to the Dr. He looked and said that her antibiotic was not working on the infection and prescribed another antibiotic (Sulfameth/TMP). He said to contiinue with the soaks and redressing twice per day and said he would see her back in another week. (I thought it was strange when he told her to continue taking both antibiotics at the same time)...

    Yesterday we went back to the Dr for her follow up and her toe is still infected. He perscribed (Penecillin) and told her to continue the soaks and redressing at least once per day.

    After leaving his office I took my wife to our GP who we have seen for 10 years. When she told him the story about the three visits, mulitple antibiotics and other issues I am not posting here, our GP said that the Penecillin was weaker than the other two antibiotics the Podiatrist prescribed so he wrote her a prescription for Cippro (sp).

    He also said not to saok it and redress it but to stay off of it and clean it when she showers.

    We are at a loss and don't know what to do. We will NOT be going back to the Podiatrist. His phone was disconnected and he seemed very weird and shady.

    It has been two weeks since her original proceedure and her tow is still red and slightly infected and VERY sore.

    Any input would be greatly appreciated.
    Thanks
    Rick
     
  3. MML

    MML New Member



    I would think that going to your regular doctor and getting a new antibiotic would take care of the infection, but you do need to find another podiatrist so that you can follow-up with the surgery. I'm so sorry that you had this done by a shady doctor.

    I would like to share, however, that infection isn't uncommon after this type of surgery. I had ingrown toenail surgery by a great podiatrist and not only did my toe get infected but a piece of the nail grew back, which had nothing to do with my doctor. I forgot what antibiotic my podiatrist prescribed, but it worked. It did take a while for the redness to go away from the infection. I think all of that was just me and the way my body heals itself.

    Tell her to keep soaking it in epsom salts and redressing the surgical area after each soak. I think I soaked my toe twice per day/15 minutes per soak in warm water. Also tell her to use neosporin ointment on the surgical area everytime she changes the dressing and try to find another podiatrist quickly so that she can get in to see him/her. Good luck and keep us posted on her progress.
     
  4. Foot Doc

    Foot Doc Guest

    Before I can meaningfully comment, I have to know if you went to the podiatrist with an INFECTED or NON-INFECTED ingrown nail, and if the procedure you had was intended to permanently correct the ingrown nail or treat the infection if one was already present . . or both.
     
  5. Unregistered

    Unregistered Guest


    It was already infected...

    The proceedure was intended to permanently correct the ingrown nail.....

    Thanks
     
  6. Unregistered

    Unregistered Guest

    So, what should she do? Soak it like the Ped said or do what our GP said?
     
  7. Unregistered

    Unregistered Guest

    i really need some help... i had ingrown toenails removed on all 4 corners(both big toes) i had it done at about 12 yesterday and i had to go back to work im a cosmetologist so i was on my feet all day. i workerd until 8pm and i wasnt in ne pain. but last night i got no sleep the pain woke me up numerous times and i am getting ready for work now, another 10 hour day,and the pain is unbearable. i tried to call my podiatrist and their office is closed today. i would jus like to kno if this is normal and what can i do about the pain cuz i have to work all day
     
  8. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    *************************************************
    First of all, do you really mean to tell me that you are being treated by a doctor who did an invasive procedure on you and did not give you a phone number where you could call him or at least the phone number of a service that could get in touch with him and have him call you back? That, if so, in my opinion, would be OUTRAGEOUS, and I think that your doctor needs to be told that by you in no uncertain terms. In MY practice, I personally contact each and every patient on whom I have done any sort of surgical procedure on the night of the surgery to find out if there are any problems. I do so, not because there are often problems, but as a courtesy to the patient who has trusted me and chosen me to treat him/her and who may have some concerns which were not fully addressed or understood prior to surgery. It says, "I care," as can few other things a doctor might do for a patient. Secondly, what in the world would make you think that you should return to a 10 hour work schedule on your feet immediately after the procedure and while the toes were still numb so that you couldn't know if there were a problem?

    Now . . to answer your question . . Is it normal to have pain the evening of and the day after such surgery, ESPECIALLY when one has spent the entire day on his/her feet working? Yes . . I would thing that that might be expected, but that doesn't necessarily mean that there isn't something ELSE dramatically wrong which needs to be brought to your doctor's attention. Does it mean that you probably shouldn't compound your problem by working another 10 hours the next day? . . Indeed it does. What you probably could do about the pain is to get off of your feet, take whatever pain medication was recommended by your doctor, and get in touch with him/her at once . . and THEN, give him/her a major piece of your mind for leaving you hanging out to dry. THAT, in MY view is a prime example of sorry doctoring.
     
    Last edited: Mar 12, 2010
  9. Unregistered

    Unregistered Guest

    i had both toe nails[ingrown]cut on the inside.This was done under local numming shots.
    there was 8 stiches in each toe with holes drilled through each nail and stiched up.
    this was fine until the numming jabs wore off.then the pain started. i was then taken back to the doctor he gave me pain killers.these worked fine for a few hours,so back to the doctors he gave me sleeping tablets, plus wet my feet in salt water.when the pain started again back to another doctor.he sent me to specialist how could not do anything then back to my doctor.how sent me to a podiatrist how got a girl to clip my nails and charged me $40.00 and sent me on my way.This happened 2004 now 2010.my souls of my feet are burning and the pain stops me from walking more then 100 meters.
    i am very sorry that this happened but 69 years old,little money,cant work,no one seems to care.if the foot doctor replys to this i would give my email address and give indepth details JUST HOPE i think no doctors at fault just i dont know what to do,dont want to go on with these feet of mine
     
  10. Unregistered

    Unregistered Guest

    I'd be interested in comments on the possible complications of performing a permanent partial nail avulsion with phenol on an ingrown toenail WITH some infection present. I went to my podiatrist 10 days ago with an ingrown toenail that was quite inflamed across the top of the cuticle, although it wasn't clear if it was infected. When the podiatrist was performing the partial removal (I elected to do both sides of the toe since it had been a chronic problem) she commented that there did seem to be some infection after all. I ended up with quite a reaction, apparently to the phenol, and now 10 days on it's still extremely red, swollen and tender across the top of the toe. I started taking antibiotics 3 days after the procedure because the inflamation was looking more like infection. The redness and swelling is now more localized, but I'm surprised that after a week and a half the top of my toe is still too sensitive to touch or wear a shoe. I've also noticed that there is some drainage on one side of the nail, but on the side that is most swollen nothing is draining. Could it be blocked or abscessed? I'm going back for a 3rd check-in on Monday, but to date the podiatrist says I've had a "reaction" and should just ride it out. (btw, for context, where I live in Quebec medical doctors do not specialize in podiatry and podiatrists are not medical doctors, can't prescribe meds, etc.)
     
  11. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***************************************************
    First of all, I was unaware that podiatrists in Quebec cannot prescribe medications. If that is really the case, in my view, a doctor who cannot prescribe medication should not be allowed to do surgery. I cannot imagine performing invasive procedures which have the potential to cause pain and sometimes infection and not have the ability to prescribe medications to take care of such eventualities.

    Secondly, it is a basic principle of medicine and surgery that, other than for drainage and/or debridement, elective invasive procedures not be performed in area of an infection, as invasive procedures can cause the infection to be driven deeper and possibly systemic.

    Thirdly, as demonstrated in THIS case, because phenolization of the nail matrix typically cause local inflammation, redness and drainage which often is difficult to distinguish from an infection, it leads, as in this case, to confusion as to what is really going on and what to do for it.
     
    Last edited: Mar 19, 2010
  12. Unregistered

    Unregistered Guest

    ***************************************************
    First of all, I was unaware that podiatrists in Quebec cannot prescribe medications. If that is really the case, in my view, a doctor who cannot prescribe medication should not be allowed to do surgery. I cannot imagine performing invasive procedures which have the potential to cause pain and sometimes infection and not have the ability to prescribe medications to take care of such eventualities.

    Secondly, it is a basic principle of medicine and surgery that, other than for drainage and/or debridement, elective invasive procedures not be performed in area of an infection, as invasive procedures can cause the infection to be driven deeper and possibly systemic.

    Thirdly, as demonstrated in THIS case, because phenolization of the nail matrix typically cause local inflammation, redness and drainage which often is difficult to distinguish from an infection, it leads, as in this case, to confusion as to what is really going on and what to do for it.[/QUOTE]

    Thanks for the quick response. I was also surprised when the podiatrist gave me a referral back to my GP to get antibiotics, even though she uses the designation DPM (I am continually mystified and frustrated by the health care system in Quebec, but that's another story). Apparently, not having prescription rights is not that uncommon outside the US - someone has tried to summarize the various regulatory standings of podiatry by country, state, province on Wikipedia: a bit of a dog's breakfast.

    Recognizing that the mix of phenol and infection causes confusion and that you can't diagnose a specific case over the Internet anyway, let me just ask another general question or two. Based on your experience and assuming no infection, would phenol burning of surrounding tissue (whether due to bad technique or bad luck) result in symptoms such as I described persisting beyond two weeks after surgery? Is it common to need additional intervention to help drainage or do even severe phenol reactions/burns just resolve on their own?
     
  13. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***************************************************
    I frequently caution my patients who might be going out of town after having a phenol nail matrix destruction performed that if they have a problem and need to see a general physician, and especially if they are seen in an E.R., that they inform the doctor that what might look like an infection may be only an irritant reaction from the phenol. Such is frequently indistinguishable without a history. It is very common for the drainage caused by the procedure to be thick and sticky (almost like glue), and if there is not frequent enough soaking, the portal of drainage can become sealed, causing back pressure, severe inflammation and acute pain. This then generally necessitates an aseptic probing of the portal to open it and re-establish the drainage. (something that should only be done by a professional). My care for the chemical burn is generally only supportive with soaks and dressing, but obsessionally, I prescribe Silvadene (Silver sulfadiazine) Cream or Cortisporin Otic drops.
     
  14. Unregistered

    Unregistered Guest

    I am sorry to hear that you are in so much pain. However, the surgery may not be related to the pain you are having now at all. There can be many many reason for painful feet. And some of those issues get worse with age. You don't say if the problem has been ongoing all this time. Nor do you say that you have been to see a doctor in all this time about the issue. And based on the information given and without a thorough examination, it's literally impossible to give you any solid advice other than the most valuable: Start by going to see your doctor or if your insurance doesn't require a referral, then o straight to a Podiatrist. But go to a doctor before it gets any worse. If you don't have insurance and are low income, check with your local senior center for low cost/no cost programs in your area. There are resources available and living with constant pain is awful (speaking from personal experience here), so please seek help. Good luck and I hope you find some relief.
     
  15. Unregistered

    Unregistered Guest

    Please help me, too! I am having similar problems to this person (post#33) after a phenol matrix removal of the left great toe. It was slightly infected when I had the procedure done. The pain and spur were in the top corner of the medial side. Now, 2+ weeks out and with RELIGIOUS care, soaking and dressing of the site, the lower corner is still purple, painful, draining the "glue-like" substance you describe above. The top corner has healed beautifully, but the bottom, where I had no problem before, is now awful. I am on my SECOND round of antibiotics (first Keflex and now Augmentin) and I'm wondering if this is a reaction to the phenol, are the antibiotics just being wasted? My podiatrist is also a "DPM" and I'm wondering if I don't need to see a foot surgeon next. I was concerned there might still be a spur or foreign body in the corner of the toe since it is still oozing and hurts so much. If it's just a phenol reaction, do those resolve on their own? The mere thought of having my toe blocked again makes me ill! Please help...
     
    Last edited: Apr 13, 2010
  16. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***************************************************
    First of all, I see no excuse for performing such completely elective surgery in an area where there is any infection at all. This, in my view, is a "prime directive" in medicine and surgery. Secondly, such events as you relate are so very common when a phenol matrixectomy is performed that, in my opinion, any podiatrist who holds him/herself out as capable of performing such a simple procedure needs to have the expertise to deal with such common side-effects and/or complications. Now, I don't know if your doctor is as befuddled about the problem as you seem to imply, and perhaps he/she is handling it as standards of care dictate. I don't know . . . but perhaps your doctor failed to fully inform you of the potential for common side effects and complications during the informed consent discussion which should have taken place, or maybe you didn't pay sufficient attention or signed the consent without sufficient curiosity. It CAN be difficult to discern the difference between an actual post-operative infection and a severe reaction to the phenol and/or destruction of tissue as is intended by the procedure, ESPECIALLY when the procedure was performed in the midst of an infection as you relate. But the use of antibiotics and general infection care is often simply a reasonable prophylactic attempt to cover all bases. As I have described in other posts, one of the more common causes of such inflammation and pain as you describe is the blockage of drainage by the sometimes glue-like exudate oozing from the phenolized site. Whether an infection is present or not, general precepts of care would call for mechanical opening of the blocked portal or the abscess, if that be the case, and the establishment or reestablishment of drainage, followed by frequent soaks. This mechanical opening should only be performed by a trained qualified person. Such action would generally be helpful whether an infection is present or not. In the end, it is not the doctor, but the body which generally does the healing, The body has magnificent capacity to heal many ailments on its own, but a doctor's responsibility is to enhance that capacity and place the body in optimum position to do so. If local anesthesia is necessary for appropriate intervention, it is something which needs to be tolerated, unless you would prefer the pain attendant to intervention without anesthesia. I think the thought of THAT is what should make you ill, not getting another needle. If you do not have confidence in your doctor's ability to care for you, seek an alternate doctor whose abilities you trust.
     
    Last edited: Apr 13, 2010
  17. Unregistered

    Unregistered Guest

    Hi. I had my ingrown toenails removed surgically a month ago. The left one healed nicely but the right one inflamed even though the nail has been removed. There's still a wound and it hurts when pressure is applied. The doctor advised to soak my foot twice a day in warm water and massage it. But it still hurts. What should I do?
     
  18. Foot Doc

    Foot Doc Guest

    The first step in offering meaningful advice as to the resolution of any problem is knowing what the specific cause and nature of the problem is. Either go back to the doctor who is responsible for your care or seek a second opinion from a well-vetted doctor who can examine you and make the recommendations you request. There is no one-size-fits-all answer to your question.

    FOOT DOC
     
  19. Unregistered

    Unregistered Guest

    Hello, I had surgery to remove ingrown toenails on 3 of the 4 sides of my big toes. Unlike several people here my surgery was a great success...i believe i was playing basketball 3 days after the surgery. I had my ingrown toenails for years and they became very bad with puss build up that would drain out of the corners of my toe. Needless to say the relief after i had the procedure was unreal!

    Ok, on to my question. While the pain is completly gone, and the nails never became ingrown again the situation has left my toes looking 'fat' because of all the scare tissue. Is there a procedure I could have done to help restore my toes to the way they looked before my nails became ingrown or at least close to it? would the doctor that performed the procedure on my toes be able to help or do i need to go see a different doctor. I went to a podiatrist for the ingrown toenail procedure.

    Thanks in advance for any help!
     
  20. FootDoc

    FootDoc New Member

    You toe would have to be evaluated to determine the cause of its being "fat" before it could be determined what, if anything, can be done to resolve your complaint.
     
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