layton Posted July 18, 2003 Posted July 18, 2003 So my limiting factor for climbing right now is not that I seriously broke my feet 2 months ago. I had both big toenails fall off a while ago and are regrowing. But, they are at the point where they are trying to push up over the fat part of the top of my toe, and are pushing right into my skin on their slow journey outwards. Any suggestions on how to accelerate toenail growth, or ways of lessening the discomfort, or an estimate of how long it's gonna hurt for? I'd say it's a 7 on the 1-10 scale. I can't cut it back, cuz the problem would reoccur later anyways. I tried taping it...nothing. Wearing socks...nothing. Quote
Courtenay Posted July 18, 2003 Posted July 18, 2003 Ouch! I'd ask a podiatrist, they MAY actually have some insights into this one. My guess is it's probably going to hurt for a while; I've heard that gelatin has nail strengthening properties, though I can't say whether that applies to "speed of growth". As for helping the pain, have you been taking any pain killers at all? Call a doc and see if they have some insights. Or the nurse hotline if you're in King County: MED-INFO. As for the "off yourself, man" suggestion, I'd say BALONEY. Try some USEFUL suggestions, guys. Here's one I'm sure SOMEONE will bring up: think of the climber who recently sawed off his arm to save his life; this can't possibly be any worse, can it? Quote
Pencil_Pusher Posted July 19, 2003 Posted July 19, 2003 Toenail polish really accelerates toenail growth. Better yet, just have some milf to help out your crippled-butt. Lovely foot photos, btw. Quote
layton Posted July 23, 2003 Author Posted July 23, 2003 Still hurts like hell, but found two possilble solutions. The one I tried is taping a cotton ball over the nail to pad it and distribute the force. Problem is the thing pulls off every time you take your shoes off. My 2nd option I haven't tried. Lidocane (hemeroid creme). The pharmasit says it;s the strongest over the counter topical antiseptic available. Dab some one the cotten ball and tape it on. Won't be able to try it for another week or so b/c I agreed to guide two 3 day trips for the outdoor center. Quote
jon Posted July 23, 2003 Posted July 23, 2003 I've lost my big toe nail many times, in fact I'm in the process of loosing at least one right now. How I remember they grow back is where the nail was that is soft skin becomes a thin nail. Then you get a bulge at the cuticle which starts pressing forward how a nail normally grows. I don't remember it being all that painful though. Is the problem that the front of your toe has a lot of skin sticking up and the nail is growing into that instead of over it? Quote
Norman_Clyde Posted July 23, 2003 Posted July 23, 2003 I had this exact problem in May, which was how long it took for my left big toe nail to grow in after I lost it in October. I've lost toenails before, but they had always grown in smoothly. This time, the end started growing under right at the most distal portion. I tried to get it up over the skin again, but it was too deep. After a few attempts at surgery without anesthesia, I considered performing a digital block on myself (numbing the entire toe with lidocaine, the way I do when I fix other people's toenails), but I thought it would be too awkward to fix on my own. So I went to the podiatrist, who gave me a fairly painless digital block and trimmed away the offending portion of the nail in about five seconds. It's grown all the way out now, and feels fine. You should be able to go to a podiatrist or most MDs to get this done. Let me know if you need a reference. Quote
layton Posted July 24, 2003 Author Posted July 24, 2003 I need a reference. What is a digital block? My reg doc says leave it alone and it'll fix itself. Quote
Norman_Clyde Posted July 24, 2003 Posted July 24, 2003 It just means putting the entire digit (i.e. your toe) under local anesthesia by putting the lidocaine right where the nerves go. Unfortunately, it tends to be pretty uncomfortable just to get the medicine in. Now and then people get lightheaded or pass out during the numbing procedure. Regarding leaving it alone vs. intervening: you'll know when something has to be done, once the pain gets so bad that you can't think about anything else. Just be sure you won't have to wait two weeks for an appointment once you get to that stage. Quote
layton Posted July 24, 2003 Author Posted July 24, 2003 I'll give it a week of no rock-climbing(not by choice) and see how it feels next time I go craggin'. If it still hurts, I'll call a doc. What kind of doctor should I get? ps, thanks Norman for the info. Quote
Thinker Posted July 29, 2003 Posted July 29, 2003 This guy put off having a good doc look at his problem....pretty gnarly. The best part of his page, I think, is the links. Quote
D-dog Posted July 30, 2003 Posted July 30, 2003 Super glue. Lather the regrowing nail and surrounding soft/sore tissue with super glue and let it dry before you put your climbing shoes on. It'll form a nice, hard barrier and keep the nail from pushing on the soft nailbed as it is growing out and under pressure in the shoe. The glue will last only 1-2 days and will flake off harmlessly after that, but for short-term fixes of nail problems it is a wonder to behold. In the "old days," many of us regularly glued all sorts of gobies, gashes, flappers, etc. to keep on climbing. Never heard of any adverse reactions, and I also have it on good reference that similar chemical compounds are used by the military to field treat flesh wounds and stop bleeding. It can be a bit warm as it dries, but nothing uncomfortable even on torn or sore skin. I have two fingernails and one thumbnail that regularly fall partly or all the way off (due to old traumas from climbing, i.e. too many overhung thin cracks and one lost on a lieback problem at Joshua Tree when my entire nail and a big chunk of the finger itself simply tore off from too much pressure). I am regularly dealing with one or two fully-exposed nailbeds as the nail grows back. . . only to fall off again and start the process over. This has been going on for years. I'd take photos and post but that seems too much like work. Anyway, I use glue to paste over the nailbed whenever it is sore and getting bumped during everyday use. For a day or two, problem solved! No downsides. You can even paint pretty nail polish over the glue and pretend the whole nail is intact, if that's your thing. The polish will flake off with the glue in a day or two, fyi. Superglue is a wonder tool. It is one of my "ten essentials" for backcountry work, in addition to amphetamines, opiates, pr0n, and of course suture material. Peace, D-d0g Quote
Fence_Sitter Posted July 30, 2003 Posted July 30, 2003 Never heard of any adverse reactions, and I also have it on good reference that similar chemical compounds are used by the military to field treat flesh wounds and stop bleeding. they already use this in some ER's in canada... i have used it before... lil'dab'l'doo'ya Quote
Thinker Posted July 30, 2003 Posted July 30, 2003 from here (not exactly the JAMA): Can We Really Use Super Glue Instead of Suture? The Real Scoop on the Use of Tissue Adhesive for Wound Closure From: AFryeMidwf@aol.com (Anne Frye) -------------------------------------------------------------------------------- For several years there has been increasing interest in the midwifery community regarding the use of commonly available "Super Glue" types of adhesives for wound closure. Midwives who have done a little research have found that the cyanoacrylate glue (Super Glue) sold over-the-counter and medical cyanoacrylate glues are apparently identical in composition and rumored to the be same as the tissue adhesive used extensively during the Vietnam War. Some midwives have even used over-the-counter Super Glue (Krazy Glue) successfully in lieu of suture to close the perineum. In readying in the 5th edition of Healing Passage: A Midwife's Guide to the Care and Repair of the Tissues Involved in Birth, I felt it was important to address this issue. This article offers an expanded version of the information you will also find in the new edition. History and development: In 1959, a variety of cyanoacrylate adhesives were developed, some types of which are now used for surgical purposes in Canada and Europe. These glues polymerize on contact with basic substances such as water or blood to form a strong bond. The first glue developed was methyl cyanoacrylate, which was studied extensively for its potential medical applications and was rejected due to its potential tissue toxicity such as inflammation or local foreign body reactions. Methyl alcohol has a short molecular chain which contributes to these complications. Further research revealed that by changing the type of alcohol in the compound to one with a longer molecular chain, the tissue toxicity was much reduced. All the medical grade tissue adhesives currently available for human use contain butyl-esters, which are costlier to produce. In 1964, the Tennessee Eastman lab submitted its first application for new drug approval to the FDA. The military learned of this new glue and became extremely interested in its potential for use in field hospitals. MASH units in Vietnam were overloaded. Many solders were dying from chest and abdominal wounds, despite the best efforts of medics. In 1966 a special surgical team was flown to Vietnam, trained and equipped to use cyanoacrylate adhesive. A quick spray over the wounds stopped bleeding and bought time until conventional surgery could be performed. The possibilities were immediately seized by the medical communities of Europe and the Far East. Meanwhile the FDA changed standards and kept requesting additional data until Eastman was reluctantly forced to withdraw his application. (Jueneman, 1981) Histoacryl Blue (n-butyl cyanoacrylate) has been used extensively in Europe since the 1970s for a variety of surgical applications including middle ear surgery, bone and cartilage grafts, repair of cerebrospinal fluid leaks, and skin closure. It has been available in Canada through Davis & Geck Canada, with no adverse effects reported to date. Further, laboratory studies have been done which concluded that it has no carcinogenic potential. Tissue toxicity has only been noted when the adhesive is introduced deep in highly vascular areas (the perineum qualifies). While I always take claims of harmlessness with a grain of salt, if used as directed, these adhesives appear to be basically safe. (Quinn & Kissick, 1994) Current use: Although not labeled as such, over-the-counter Super Glue products contain methyl alcohol, because it is inexpensive to produce. Cyanoacrylates cure by a chemical reaction called polymerization, which produces heat. Methyl alcohol has a pronounced heating action when it contacts tissue and may even produce burns if the glue contacts a large enough area of tissue. Rapid curing may also lead to tissue necrosis. Midwives have not noted such reactions because minimal amounts are being used for perineal repair. Nevertheless, with a greater toxic potential, over-the-counter products are inappropriate for use in wound closure. (Quinn & Kissick, 1994) Medical grade products currently available contain either butyl, isobutyl or octyl esters. They are bacteriostatic and painless to apply when used as directed, produce minimal thermal reaction when applied to dry skin and break down harmlessly in tissue. They are essentially inert once dry. Butyl products are rigid when dry, but provide a strong bond. Available octyl products are more flexible when dry, but produce a weaker bond. When used for repair, ideally the wound to be closed is fresh, clean, fairly shallow, with straight edges that lie together on their own. The glue is applied to bridge over the closed edges; it should not be used within the wound (on raw surfaces), where it will impair epithelization. The only currently FDA approved adhesives suitable for use as suture alternatives are veterinary products; n-butyl- cyanoacrylate tissue adhesives Vetbond (3M) and Nexaband liquid and octyl-based Nexaband S/C (intended for topical skin closure when deep sutures have been placed). Histoacryl Blue (butyl based) (Davis & Geck) and Tissu-Glu (isobutyl based) (Medi-West Pharmaceuticals) are sold in Canada for human use. DMSO (dimethyl sulfoxide) or acetone serve as removers. (Helmstetter, 1995; Quinn & Kissick, 1994) How to use tissue adhesive: Although not specifically recommended for perineal repair, tissue adhesive has been successfully used by some midwives. However, Hisotcryl Blue was used in place of interrupted or subcuticular stitches in a small study of the closure of the superficial layer in mediolaterial clitorotomy (episiotomy). (Adoni & Anteby) In this study, the yoni (vaginal) mucosa and subcutaneous layers were closed with conventional suture techniques. It might be a good alternative to offer when women refuse conventional sutures. Tissue adhesive works best when the wound is moderately shallow. Midwives report that extremely shallow wounds tend to pull apart as healing occurs and usually require no closure of any kind. The wound should also have no pockets to collect lochia and should not require other sutures. However, as the study mentioned above demonstrates, it can also be used instead of subcuticular sutures after placing basting stitches. Tissue glue is only applied to outside surfaces to bridge over edges; do not apply it directly to raw surfaces. The wound edges should be straight and lie together naturally. Insert a tampon, then clean and dry the skin thoroughly. Have your assistant stabilize the wound edges from top to bottom (be sure the edges are matched correctly). Insert your finger between the edges and pull it out to bring them forward slightly. This is to ensure that the wound edges are not rolled inward toward each other, but meet perfectly. It could also be accomplished with a tissue forceps. Hold gauze against the area immediately below the apex to catch and drips as you apply the glue. Apply tiny dots of glue sparingly at intervals where the wound edges meet. Or, apply a bead of tiny droplets to bridge the edges. (Thick applications do not enhance bonding and tend to crack and loosen prematurely.) Products dyed blue are easier to see. (If using Histoacryl Blue, attach a 27 g. syringe needle to the ampoule hub to help control application. After use, the needle should be discarded and replaced with a new needle that does not have glue within its lumen.) Be careful to apply the glue on where it is needed; glue removers should not the used in the genital area. As long as no part of the tube tip or the attached needle contacts the tissue or bodily fluids, the tube can be reused. Use a hair dryer or fan the area dry, which takes about 30 seconds. Adhesive will stiffen when dry. Women should observe the same precautions as those who have refused sutures entirely. Bathing is not contraindicated but prolonged soaking should be avoided. Expect the adhesive to flake off in 3 to 7 days. Allergic reactions are very rare, but may include inflammation and swelling. References (Various midwives 1993-95) Adoni, A., & Anteby, E., "The Use of Histoacryl for Episiotomy Repair," Br. J. of Ob Gyn, Vol. 98, May 1991, pp. 476-8. Heimstetter, G., personal communciation, Permabond Internat. Bridgewater, NJ, 1995. Jueneman, F, "Stick it to um," Industrial Research & Dev. Aug. 1981, p. 19. Quinn, J., & Kissack, J., "Tissue Adhesives for Laceration Repair During Sporting Events," Clinical J. of Sports Med., Vol. 4 No. 4, 1994, p. 245. Sources of tissue adhesives: Animal Care Products, 3M Health Care, 3M Center Building 225 1N 07, St. Paul, MN 55144-1000, (612) 733-8477. 3M produces Vetbond Tissue Adhesive. Veterinary Products Laboratory (800) 548- 2828 distributes Nexaband products which are manufactured by Tri-Point in Raleigh, NC (919) 790-1041. These products are restricted items sold and approved for veterinary use only. Davis & Geck-CANADA (905) 470-3647 distributes Histoacryl Blue, which is manufactured in Germany by B. Braun. Medi-West Pharmaceuticals markets Tissu-Glu. Quote
layton Posted August 21, 2003 Author Posted August 21, 2003 Toenails finally grew out. Took long enough! Lidocane didn't work, in fact it didn't even numb it a little. The only thing that worked was putting tincture of Benzione on it, a couple small cotton balls, and wrapping it in tape to spread the load. Bottom line: don't fuck w/it cuz if you break off the tip, you gotta wait even longer(which i didn't do thank god). Quote
mtn_mouse Posted August 24, 2003 Posted August 24, 2003 Frostbite removed both my big toenails years ago. End of toenail problem..... Quote
Thinker Posted August 26, 2003 Posted August 26, 2003 Hey Layton, got any photos? I'd like to see. check out the photos on this thread Quote
AlpineK Posted September 18, 2003 Posted September 18, 2003 I've got some major problems with one of my big toe nails. After years of frostbite and abuse (I've lost my nail about 30 times) my nail grows back in this super thick yellow lump. The nail is way to unflexable to grow out to full length. Right now I have to whittle and carve it every few months to keep it from being too painfull while wearing rock shoes. I've heard of pills you can take for toenail fungus (if this is my problem) And I've thought about asking a doctor to kill the nail(I'm not sure if this can be done) Any thoughts Yes it is really gross. Quote
Dru Posted September 18, 2003 Posted September 18, 2003 dude, im glad you had your own tent on our last trip in order to keep that yellow lump far away from me Quote
chucK Posted September 18, 2003 Posted September 18, 2003 PineyK, I talked to a guy about those toenail fungus pills. Turns out they are hard on your liver and they cost a sh*tload of money, as in hundreds of dollars! I'd say keep on whittlin'. Let me know though what your doc says about killing the nail. Seems like all those toenails do for you is get in the way anyway. Quote
layton Posted September 19, 2003 Author Posted September 19, 2003 Dude, Kill your nail forever at the Doc's in the next couple o' months during the shitty inbetween season. It'll be so worth it. Takes a couple weeks to heal after the minor in office surgery. Quote
lummox Posted September 19, 2003 Posted September 19, 2003 i think some docs can just shoot it with something so it drops off. then it will grow back without the fungi. maybe. toes are aid anyhow. just ask reinhold messner. Quote
layton Posted September 19, 2003 Author Posted September 19, 2003 no, they can actually put some real freaky shit on it so it will NEVER grow back. Had it done to my ingrowns (the side of my big toenails are gone forever!) ...tighter rock shoes too. Quote
Brad_CA Posted April 23, 2004 Posted April 23, 2004 What is the name of the procedure to have part or all of your toe nail removed permanently? Anyone? anyone? My big toes are all f'd up. I busted one in a couple places so now it looks like a damn hammer. I get the ingrown nails in the corners too, which for those of you who "know", is a miserable experience. I've had em cut out a few times and now am religious with my TP wad stuffing to keep those bad boys propped up, but was wondering what the procedure is to get em out forever since its really a pain in my ass. Thx Quote
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