The dreaded Ingrown Toenail on CRPS Foot
 

I have been battling with an ingrown toenail for a while now. It seems to feel better after a few weeks of soaking and treating with Dr. Scholls Ingrown toenail Pain reliever but then it resurfaces.

I have never had these issues prior to 3 months ago. I think it is probably because my feet swell at an increased rate and I was wearing closed toe shoes all the time. ( I now wear my sandals so my feet can breathe)

During 2 of my ketamine treatments no one in the hospital would touch it and referred me to a podiatrist. Finally after the toe was infected and flaring my CRPS I went to the podiatrist. The podiatrist wouldn't even touch my foot because of the CRPS. We sat in the examining room and watched my foot turn colors about 5 times within 3 minutes. She said it would be best for me to go under general anesthesia w/ additional ketamine to help prevent a flare up.

Sent home with directions to soak and pull the skin back from the nail and take antibiotics. Tomorrow I head back to the pain docs to see if they will back the idea of surgery.

This sucks. Simple procedures that would take a few minutes I now have to be hospitalized and undergo surgery. 2 months ago I had surgery for dental issues because of the spread of CRPS and it was hell. I still am not able to chew tough foods and my pain never went back down to the baseline even after 2 ketamine treatments.

I'm really afraid this ingrown toenail could set off a series of very painful events and even affect my ability to get a shoe on and walk.... Anyone had experience with this? I would appreciate any feedback. Thank you!

I'm so sorry...this sounds awful. I had an ingrown nail on my CRPS foot...but that was back when it was "just" in my ankle and the podiatrist did the nail removal in the office. Pretty sure that's when the CRPS spread to my foot...but it was awful. I agree that they should be cautious about it and hopefully after the podiatrist's recommendation you can get the care you need without too much fight. Don't want it to turn into something worse. So sorry for what you are going through.

I never had an ingrown toenail before CRPS, but I have battled them too many times now. Both sides of both big toes has been ingrown at least once and 3 of them twice.

I had an amazing podiatrist who did my surgery on my ankle that started the whole CRPS thing. I had him do the first one and that is the only one that did not grow back. I had waited so long I had a granuloma growing up and around the toenail and that was brutal. He did a block all around the toe and even gave me extra. I'm not going to lie it hurt but I was able to get through it.

Due to a health insurance change I could no longer go to him for the others. So I made the stupid mistake of going to an urgent care when I had both sides of one big toe. I actually filed a complaint on him. He ran a CBC and my white blood cells were normal indicating there was no infection. But he ordered IV antibiotics and after they ran in he told me the WBCs came back normal and he wanted me to come back for 4 more doses! I notified the board that he ordered extra tests and treatments in order to make more money.

The last 3 times I found a podiatrist that knew what he was doing and the procedures went well. He knew what CRPS was without me having to explain it so that made me feel better. The blocks that he did lasted several hours after the procedure.

It is definitely something you need to get taken care of as soon as possible. I admit I am surprised that they want to use general anesthesia. Personally I would weigh the pros and cons of each to see which is the best option. The other thing you may want to try and find a podiatrist that is familiar with CRPS.

I know how painful those stupid ingrown toenails can be so I hope you can get relief soon. Good luck and keep us posted!:hug:

Ingrown nails
 

Sorry your dealing with this,you can use the dr scholls,that helps to soften the nail and dull the pain,I get them so often now I perform my own type of surgery.i have a nice pair of ingrown toenail snippets that can do the job on its own some times,when that doesn't work I use my utility knife,now you must be somewhat skilled to perform this.what I do is I go to the top of the nail on the ingrown side,you place the razor down in between the nail and the outside of your toe,once you get below the nail ,you bend the nail up by pressing down and to the rights side of the foot,this will pop up the ingrown nail and if your good like me you can slice it off with the blade,this takes practice ,or just have another pair of scizzors bye to cut the exposed nail,it takes patientce to perfor and you could bleed alittle if it's deep,if you go to a dr ,they butcher your nail and it looks painful from what I saw ,best of luck and be careful,must use a new razor blade nothing dull

So sorry you're dealing with this...

I agree with Nursekris about not understanding why the need for general anesthesia. Anesthesiologists will stay away from nerve blocks on people who had an identified nerve injury. Unless you had one (don't remember) I would think that regional block would have many benefits and longer lasting effect. They could always do IV sedation and low dose ketamine at the same time.

Consult your PM on the block issue and see what they say.

In growns
 

I know the pain it causes,I get them all the time since my crps.my pain gets so bad I take a razor knife " very carefully" I go down straight down til I get girlie the nail ,sometimes you have to go a little rite of the nail or left if it's on the other toe ,once I get below the nail I pry up and the nail comes bends up to wear you can see the ingrown part,and with the knife holding it up.I just slice off the nail,I'm good at it now I've probably done about 30 now and it could be more.you must be good with a razor knife ,I sometimes draw blood ,but what they do to you at the podiatrist is much worse.also if you don't want to try that ,order ingrown toenail cutters,they basically do the same thing ,but there not a razor.im just letting you know what I do.i also use the dr sholls if I can't get it rite away ,that takes the pain away and softens the nail and then I'm able to get it.best of luck to you my friend

I highly recommend you do not try to remove your ingrown toenail at home. There are several things that can go wrong without having CRPS.

When done in your doctor's office the removal of the nail is a sterile procedure to reduce the risk of infection. Some doctors even prefer to use a prophylactic antibiotics but others don't feel it is necessary. After talking it over with my doctors I elected not to use an antibiotic unless there are obvious signs of infection. I am instructed to call if any signs of infection appear.

As slip of the knife, or whatever instrument you are using, could cause a serious injury. When you are at home you may have no way to stop the bleeding. Also you could damage the nail bed which will only cause more problems.

If you do not get the whole portion of the ingrown toenail there are several complications that may result. One of these complications is a severe infection. The nail will continue to grown back ingrown if it is not properly removed.

Personally I could not imagine removing an ingrown toenail without a block or adequate pain medication. It can be very painful for someone without CRPS so you can imagine how bad it must be for one of us. When I get an ingrown toenail I can't even tolerate someone touching it let alone trying to remove it. I actually had a long talk with one of my podiatrists about which is worse the pain from the needle stick for the block or the procedure itself. I chose to do the block but to not use the "cold spray" they use to help numb the area while doing the stick.

This is all my opinion but please let a professional remove your ingrown toenail. And learn from my mistake and only let a podiatrist do it not an urgent care. My preferred podiatrist uses a zinc stick on the nail bed after removal to prevent the nail from growing back. Since my last procedure I have not had any problems and my nail edges are nice and smooth.

Follow up on this
 

I wanted to follow up on this post to provide more information on this issue.

I didn't have a good or quick turn around. In fact I am still out of work (its been 24 days) and still on pain medication. I was hoping I could do this without dilaudid and stay on my low dose naltrexone but that wasn't the case.

The surgery to remove the toenail (I was drugged heavily and they ran ketamine during the procedure but they didn't use general anesthesia because it makes me so sick.) went well but the flare up is still raging.

I had a 5 day ketamine and lidocaine infusion inpatient and then was discharged. I spoke about the hospitalization here in my blog: (video) CRPS Ketamine Infusion – the invisible warrior

since then I have had to have a lumbar sympathetic block as a series of 5 to stop the flare. I have also had to use a wheelchair more. I have had people without CRPS tell me that having a toenail removed was painful for months so it is no wonder this was so painful for me.

I'm continuing on. Day by Day. Silly how something this small makes our lives flip upside down.

hugs to anyone dealing with this issue :grouphug:

Thanks for the update and I am so sorry that you are still dealing with this. It's incredibly frustrating when something throws you out of whack like this. You work hard to get to a certain point of function and mobility and then to experience a setback...at least for me it has been a big blow to realize that I have to go through the process of working back to where I was before. I hope that the process goes quickly for you to get back to where you were before (and even better if possible). Thank you for sharing your experience...I had really hoped it would go better for you with all the precautions taken. Hugs.

Hi Inspiretoday,

Yes, thanks for your update.
I, too, am sorry you have had such a challenging time with this.
I can imagine it's very difficult.

Thanks, too, for sharing the link to your blog.

Warmly,
Dejavu