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Black toenails and drilling

Discussion of medical or rescue topics related to climbing and mountaineering.
 

Black toenails and drilling

Postby MoapaPk » Sun Mar 07, 2010 5:10 pm

I had a black toenail from a trail run Wednesday, followed by a snowshoe Saturday. A big toe was seriously throbbing and inflamed, so today in desperation, I tried a trick that even my internist recommended: I drilled holes through the toenail.

I started with a hot paperclip (red hot initially), and when I felt the pain of the heat, I stopped and finished with a small drill bit turned by hand (after treating the bit and the nail with alcohol). I drilled three places, and at each one, blood-tinged lymph oozed out (I should have made a video for youtube).

Now that I've done the dramatics, and bandaged up the toe with a liberal dose of neosporin, I have to wonder:

...does this really work? If opinions are positive, I'll also try it on the other black toenail.
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Postby billisfree » Sun Mar 07, 2010 5:18 pm

Keep your toenails short!
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Postby MoapaPk » Sun Mar 07, 2010 5:19 pm

billisfree wrote:Keep your toenails short!


I keep them short (as I can), and it doesn't seem to help.
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Postby billisfree » Sun Mar 07, 2010 5:20 pm

I share your grief... I got two black toenails at the moment.
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Postby MoapaPk » Sun Mar 07, 2010 5:50 pm

Back to the topic-- I'm curious if anyone else has tried the drilling, and if so, did it really seem to help?

When trail-running in light shoes, my toes will often jam forward, striking the tops of the nails on the inside of the toe guards, especially when my foot is bent.
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Postby tigerlilly » Sun Mar 07, 2010 6:41 pm

I've used hot paperclip and it worked. Your basically melting a hole in the nail. Nasty deed.

I found it was a huge pain relief and would do it again. Your nail will eventually pull away and fall off. It will be ugly for sure. The next nail will grow in. All this takes time. Your feet will not be winnning any beauty contests for the next few months.

----> bottom line, keep the nails short. very very short. Wear shoes with a good box. Shoeshowing up a steep incline will do this ~ especially if your step kicking.

Hang in there!!
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Postby MoapaPk » Sun Mar 07, 2010 6:47 pm

tigerlilly wrote:I've used hot paperclip and it worked. Your basically melting a hole in the nail. Nasty deed.

I found it was a huge pain relief and would do it again. Your nail will eventually pull away and fall off. It will be ugly for sure. The next nail will grow in. All this takes time. Your feet will not be winnning any beauty contests for the next few months.

----> bottom line, keep the nails short. very very short. Wear shoes with a good box. Shoeshowing up a steep incline will do this ~ especially if your step kicking.

Hang in there!!


Thanks! I've lost many, many toenails before. I've read this drill procedure is supposed to prevent loss, but I can't imagine how, unless the nail bed somehow reattaches. Because my nails are so curved, it's very hard to cut them down, and sometimes I actually cut the quick. I try!
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Postby kiwiw » Sun Mar 07, 2010 7:37 pm

hot paperclip works great, the one time I used it my toenail didn't fall off but it was black for about 5 months, make sure your boots fit, and tighten them up on descents!
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Postby Dow Williams » Sun Mar 07, 2010 7:49 pm

I am real close to trying permanent removal on one just to see how it feels. If it works, I will keep going with it. I know Drs don't like it. But I wonder.
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Postby MoapaPk » Sun Mar 07, 2010 8:05 pm

Thanks all. The problem started with the shoes I described in a parallel thread -- I tighten the top laces all the way, and still my foot slides forward. This is the first pair I've had with this problem. The shoes are not too big, but seem made for people with normal toes and otherwise high-volume feet.
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YES!

Postby sgica » Mon Mar 08, 2010 12:16 am

I initially did this 20 years ago after borrowing some ill-fitting ski boots for a day. That night when the pain was unbearable (As you described!) I drilled through the big toenail with the smallest bit I had. Disinfecting it with a lighter, I simply rotated the bit between my fingers and it quickly did the trick. The relief was almost instantaneous. I have since spoken with a few carpenters who say that they have employed the process on the jobsite after a misplaced swing with the hammer.
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Postby MoapaPk » Mon Mar 08, 2010 12:31 am

Dow Williams wrote:I am real close to trying permanent removal on one just to see how it feels. If it works, I will keep going with it. I know Drs don't like it. But I wonder.


One of our SP women did have her toenails removed, with the roots burned so the nails wouldn't grow back -- I think she described that as a good decision. Her initials are KW.
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Nail surgeon

Postby Tim Stich » Mon Mar 08, 2010 12:41 am

Really, there is no need to drill directly through the nail. Just insert a sterilized needle underneath the toe nail and it will pierce the blood blister and drain that way. The nail is already partially lifted from the nail so you don't have far to go. This should be painless, also. It was for me. I had heard about the hot paper clip technique and decided to try something else. Glad I did!
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Postby MoapaPk » Mon Mar 08, 2010 1:30 am

In my case, the blister was not exposed near the cut part of the nail. (I have popped blisters that were near the cut edge before.) In addition, there seemed to be several blister cells, as I didn't stop the oozing till I had drilled 3 holes.
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Postby fossana » Mon Mar 08, 2010 4:28 am

MoapaPk wrote:When trail-running in light shoes, my toes will often jam forward, striking the tops of the nails on the inside of the toe guards, especially when my foot is bent.


I run in trail shoes that are 2 sizes bigger than my street shoes partly b/c I use high volume orthotics and partly b/c I needed the extra length to avoid the problem you mentioned. I recently got a pair of moldable insoles from REI. I've noticed the surface is slicker than my custom orthotics and my feet jam to the front of my shoes on technical downhills.
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