Caution, this post contains graphic images and videos of medical techniques. It's not for the faint of heart, or stomach.
It all started one muggy Sunday evening....
Just about every week people from the community meet up at HIS for Sunday night soccer. Paige and I just recently started joining them. Please note we are no where near their level!! Most of them played soccer growing up or/and in college, and all of them are extremely fit. I am for sure out of my league but they are all so encouraging and simply a blast to play with!
One game my feet get tangled with another player's and their heel comes down hard on my left foot. After the play they apologized for walking on me but in my mind it's apart of the risks when playing, no apologies necessary.
The night continued, and the pain in my foot increased and began to localize to my big toe. By the time I got home it was throbbing and hurt to walk. I knew I had probably bruised the nail (I had nail polish on and couldn't see it) but I wasn't too worried. I've been stepped on many times by horses and my nails never bruised. So what could a person's heel do?
Well let me tell ya, 130-150lbs coming down on one toe is a lot different than 1,800lbs spread out over the entire foot (plus boots help). The pressure under my nail only increased as the days passed. Until finally, I took off the nail polish to have a look at the damage. *I know, I know not good nursing practice* To my surprise, the nail bed was a nasty gray-ish color. Paige, being the awesome nurse she is, told me she had a plan to relieve the pain. I was all in! We found a large needle and got it red hot and burned holes through the nail. Almost immediately, ooze started coming out of the holes (Serosanguineous for all you medical professionals). And just like that, the pain decreased significantly!! I could walk without limping and actually wear shoes! I knew the nail would fall off on its own, just a waiting game at that point.
Fast forward to the Outdoor Education trip. Long story short (as told in OE Part III) I hiked through the Papuan highlands like Pocohontas. Barefoot most of the time. As I was half pulled, half crawling up the steepest terrain I've ever hiked I could feel my toe nail being pull and snagged. But what was worse was that I knew mud and pig feces (yes! Pig poo! I know, I know aweful nursing practice) was getting packed under the nail and there was nothing I could do about it.
Fast forward again, I survived OE and was back in Wamena waiting for my flight to Sentani the following morning. That's when I noticed my nail oozing and smelling quite foul! I knew without a shadow of doubt the nail bed was now infected. How could it not be?! There wasn't much that could be done in the short amount of time in Wamena so I decided to wait until I got back to Sentani and in touch the medical team I know and trust.
So jump ahead some more, I'm back home and it's getting worse. Increased pain, increased odor and ooze (becoming slightly more purulent and Sanguineous), and my toe is red, hot, swollen. OH! And the nail was now a sickly black-green-gray-yellow color. Nasty is what it was!! But to make matters worse, every single doctor we have on our medical team was out of the country at a medical conference. Everyone. Even most of the nurses were gone!! We could, however, message them. So from hundreds of miles away I was told the dreaded news,"The nail has to be pulled ASAP."
But a new problem arose. Neither Ruth, Wendy, Paige, nor myself (all of us RN's) had ever given a nerve block. We'd only watched the procedure! So what do you do when there are no doctors around? YouTube, of course! No joke. Ruth and Paige watched YouTube videos. After 2 or 3 they had a good enough idea. The video showed the general idea of where to put the anesthesia but it didn't answer questions like, how deep does one go? If we hit the nerve, with the needle, could there be permanent damage? Etc... So we figured, if we hit bone then they've gone to far and we'll pray about the nerve damage part.
So Ruth started it off with lidocaine (without Epi!) aiming for the 2 nerves that ran on the top of the toe. It stung like a wasp but soon the lidocaine started doing its job, thankfully! Paige and Wendy both got turns at pumping my toe with lidocaine. And we did accidentally go to far... How do I know? Well when the needle sticks out the other side of your toe and lidocaine squirts the opposite wall, you've gone too far (yes that did actually happen).
Ruth got the honor of actually pulling it. Although I don't know if she saw it as an honor at the time. Most of the nail was completely detached, but there was one bit that was still very fleshy and hanging on! After quite a bit of tug-o-war, Ruth won and off came my nail. Praise the Lord the nerve block worked through out the procedure!!
Right after OE, my toe wasn't looking so great...
Disclaimer: Watch these videos with caution. They are unedited and very raw. Also know that I completely, 100%, volunteered and was glad to be a guinea pig [even if some back home squirm at the idea] becuase I trust the amazing medical team we have here. So, if you too want to learn how to take off a toe nail, enjoy!
This first one is after they had blocked the top 2 nerves that feed the toe, but the bottom 2 nerves were still needing anesthesia. And... they may have gone a bit too far, but hey at least the nerve block was working!
https://goo.gl/photos/
Time to remove it!
https://goo.gl/photos/
| Yay! It's off! |
This is before we cleaned it. The left (my left) corner is obviously where the infection was, with all the black sludge.
| After cleaning and looking SO much better! |
| Happy toe! |
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