Will my toenail come off?

This post is not for the fainthearted as it contains graphic images and textual descriptions. YOU HAVE BEEN WARNED!

Stub your toes hard enough and the thought of losing the toenail will not be the first thought to enter your mind. With me it was “Will I ever walk again?”.

I don’t want to go in to details but let’s pretend I hurt my toe whilst performing a manly and heroic deed, suffice to say the big toe on my right foot was travelling at full speed when it was halted instantly, and painfully, by an immovable object. My body was scalded by that very special type of pain that insists “You’ve broken a bone here”, a primeval knowing that was confirmed by a couple of x-rays at Poole hospital A&E.

I think it is general knowledge that x-rays is about the limit of 21st century medical care when it comes to broken toes, they can confirm a bone is broken in your toe but then you’re on your own, nothing more can be done. While that sounds harsh and even uncaring the truth is many people break toes without realising the extent of the damage done, they feel the pain but if they can still walk they tend to think the damage is just bruising. The advice I got from the A&E doctor was that my big toe will heel itself in 2-3 weeks and that during that time I was to rest my foot.

But I didn’t want to rest, I had activities I wanted to do, I didn’t want to put life on hold whilst my foot had a holiday. So I experimented with exercise regimes that didn’t tax my foot too much, but my toe did complain. In fact it was hell bent on stopping me enjoying most things, including sleeping – and so it became a battle of wills between me and my broken toe.

Here is a journal of our conflict
– I dedicate it to all dancers and gymnasts for whom the black toenail is a frequent and unwelcome visitor.

Day 1

Day 1 - A few hours after the toe was broken

I felt a fraud sat in A&E. Okay, I couldn’t walk but I had little to show for it. Other patients’ injuries looked far more dramatic than my bruised toe.

Almost right away I had to keep the pressure off the toe, which meant adopting a shuffling walk whereby the right foot rolled width-ways rather than length-ways with the foot pointing at almost right-angles to where it should be pointing. I was actually quite nippy!

Day 2

Day 2 - 24 hours afterwards

The only way I could get through the night was to sleep with my foot on top of the covers, the touch of the bed covers was too much to bear.

While in bed the toe felt fine but as soon as I became vertical the toe swelled up and started a hot, throbbing sensation. To counter this I kept my foot elevated when I could otherwise I wrapped the toe in bandage, like a little G-suit.

Day 3

Day 3 - 48 hours after the break

OOOOOOOOOUCH!

Even the little G-suit I prepared for my toe could not prevent the build up of fluid UNDER MY TOENAIL …yikes!

It was now that I realised the truth that my toenail and I were destined to go our separate ways (sigh). The toenail had clearly been lifted off the nail bed was now detached from its root and pressure along my cuticle rather painful. The bone itself only complained if I put any weight on it, so  I didn’t. Through experimentation I discovered that I could put all of my weight on my right foot, up to the ball of my foot and even up to the first knuckle of my big toe if I stood on a step and had the toe dangle over the edge. Indeed, it was a physical relief to do that since my whole foot had been in tension since the bone had broken – a few knuckles cracked, oh joy!

However, I was missing exercise and I needed to do some, not least because my shuffling walk was throwing my hip and lumbar out and they needed flexing. I reasoned that cycling was in order as my toe wouldn’t take any weight during pedalling if I thrust through the ball of my foot. It was a success – I COULD RIDE A BIKE (Hooray!).

Day 4

Day 4 - I lanced with a needle under the base of the nail

Presented with an over-ripe melon for a big toe I decided that rather than have it explode at a moment of its choosing I should strike first, and so I did.

Apologises for not taking a photo of the big toe before I popped its bubble but I was a man with a mission and I could not be distracted by such things. I took a sewing needle, heated it red hot to sterilise it and then stuck it through the skin under the nail at its base. Boy did that squirt! But the relief from the pain was instant.

From now on the toe had to be dressed almost constantly to gather the drainage of fluids.

Day 5

Day 5 - Now that looks much better

With the swelling given an exit route living with my broken toe became a lot easier. The only pain I had was when I put any pressure on the toe, but the pain only became extreme if the very end of the toe was touched – where the bone was broken. Over the next few days I would concentrate on walking as normally as I could without putting pressure on the toe. I also discovered that I could exercise on a rowing machine without the toe complaining, since the foot is strapped in to a foot plate and the foot cannot flex, so the toe is excused from taking the strain.

Day 11

Day 11 - The swelling is almost gone

Walking was becoming an easier task to perform and I was able to cycle and row to my hearts content without problems. There was also little need to dress the toe now as there was almost no leakage.

It was apparent that the cuticle was drying out and becoming plastic in appearance.

Day 13

When dry, the skin around the toe was hard and rigid, but during washing the skin would easily rub off. In doing so  the base edge of the nail was revealed and water became trapped under the nail. So after washing I could see through the nail  and watch bubbles moving around under the nail. Part of the drying process was then to push down on the nail to squeeze the water out – fun!

Day 14

Day 14 - The skin around the nail is becoming flaky

The skin around the nail, which forms the connection with the cuticle had become very flaky and the nail was beginning to move independently from the rest of the toe.

Day 16

The area around the nail was becoming more unpleasant than the broken bone. The skin was inflamed, flaky and irritated by the rubbing of the edge of the nail, that was now quite mobile. Clearly my body had decided to cast-out the nail, yet the nail was still clinging on much to my dismay.

I had started wrapping the toe in dressing again to prevent the nail getting dragged off by clothing or bedding. Successive attempts to remove the nail had failed because the cuticle on the left and right was still too tough. Yet clicking the nail sounded like clicking a pistachio nut shell, hollow and empty.

Day 17 – The day I lost my nail

The nail was now catching on everything, and the dog was paying it more attention than I was comfortable with. The nail had to come off.

After washing the skin was nice and soft and so I did the deed:

ADVISORY: You can watch what happened in the video that I’ve included here, but be warned, it is not pleasant viewing (You may need to double click the video to get it going). However, I must say that I felt no discomfort at all since the skin was totally insensitive.

Once the nail was off it was quite a relief.

…and here is my newly unburdened toe.

Day 17 - My open top toe (ideal for those hot summer days)

It feels very wierd not having a nail, and you would never believe how heavy water drops are when having a shower until one lands on your toe where a nail should be.

Footnote (oh the irony)

…don’t break your toe.

If and when the mood takes me I may add photos of my new nail as it grows. I may well video its first clipping … ha …video clip, get it?

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Last updated by David at May 13, 2012.

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