Wednesday, September 28, 2011

The Saga of the Toenail


I've had this ongoing....issue.  With my toenail.  For, um, years now.  The fourth toenail on my left foot is...thick.  And it looks like there's something underneath it.  And while it never looked like any fungus I've ever seen, I couldn't imagine what else it could be.  Oddly, it resolved when I was pregnant with Grace, then returned with a vengeance after she was born.  Resolved a liiiitle bit when I was pregnant with Katie, again returned with a vengeance after she was born.  This makes ZERO immunologic sense, as you are immunosuppressed when pregnant and then have a surge of immunity following childbirth.  (This is why pregnant women always have colds.) (This is also documented by people with autoimmune disease, who typically feel fantastic while pregnant and then become extremely ill about a month to six weeks after their babies are born.) So, clearly, this is all very confounding.  Also, like I said, it just didn't look like any fungus I'd ever seen.  I even suspected warts for awhile (you can actually get warts under your nails), but it didn't look like that either.  I was STUMPED...and rather than deal with it, I ignored it.  For years, people.  YEARS.  Because although it bothered me, and although I greatly enjoyed the pedicures I had when I was pregnant with Grace, and sorely missed them when I had to stop, the foot shame was too great to overcome and actually make a podiatrist appointment.

Well, there was pride, and also the fact that if the podiatrist ever wanted to do anything to my feet, I was always either training for something or pregnant, so that wouldn't work.  And also because everything I read about toenail fungus said that it wouldn't respond to oral meds anyway, and here, try these home remedies.  Vicks vapo rub, soaking in apple cider vinegar- both of which I tried, both of which failed.  THEN?!  After the half marathon?  Oh man.  The second and fourth toenails on my right foot started looking...suspicious.  CLEARLY something needed to be done.

So, my mom told me to go see her podiatrist, I made an appointment, she babysat, I went.  The medical assistant who did the preliminary assessment kept asking all kinds of questions about my running habits.  At first I thought she was making conversation, and felt awfully silly about halfway through when I realized she was actually taking a bit of a history.  The podiatrist came in the room, took one look at my feet, and told me I have runner's toes.

RUNNER'S TOES.  I spent all that time avoiding pedicures and applying various ridiculous home remedies to my toes for RUNNER'S TOES (I already told you about the fungus cures.  I have not discussed the wart treatments I attempted, thinking I had one of THOSE).

Runner's toes?  WELL.  Apparently, toenail fungus in young people is unheard of.  Thickened toenails are not the result of any fungal infection, they're the result of trauma.  Whether that trauma occurs from infection, running, or something else, the thickening is just hyperkeratosis (piles upon piles of keratin getting churned out by the nailbed.)  Only 50% of thick toe nails are caused by fungus, and all that fungus is seen in old people.  The rest of us?  RUNNER'S TOES.  But, but, what about the nasty toenails people sometimes get after pedicures?  I started to ask, and realized the answer as I asked the question.  Ever had an aggressive pedicure?  It really hurts.  And it is TRAUMATIC.  You do the math.

But!  It turns out there's something I can do!  He prescribed a keratinolytic that I can apply to the toenails which will cause them to thin out and flake off, and a new, normal nail will grown in.  If it keeps happening, he said I can go up half a shoe size and get a special insert to keep my toes from knocking into the front of my shoes, preventing the trauma altogether.  Yay!!  Pedicures!  ....Boo.  Not sure if it's safe for breastfeeding.  But, you know, I've been dealing with this for, like, ninety years, so I guess I can wait five more months.

And this is all kind of disgusting, I know.  But?  This entry?  Gets like eleventy bajillion Google hits each week, and I think maybe this information would be really helpful to some runners out there, too.  I'm trying to think of the right combo of key words to bring people here and let them know they probably DON'T HAVE FUNGUS.  Like, runner thick toenails?  Runner you don't have fungus?  I dunno. 

(and in case you are here trying to figure out what's wrong with your toes: I will not be posting pictures.  I'm sorry.  I do still have some pride, and seriously: NASTY.)

1 comment:

Melony said...

I wonder if being a nurse counts as trauma? Like all those 12 hour shifts on your feet? Hmm...