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Posts Tagged ‘injuries’

Unhappy feet

First, a little background. One of the reasons I didn’t go into internal medicine was that old people’s feet gross me out. I didn’t want to deal with the yellow toenails and musty smell of ordinary old-people feet, let alone the deep ulcers that diabetics can get. Yes, babies poop and vomit, but babies also have a fresh baby smell, and their hands and feet are really cute.

I’ve also been lucky enough to be generally pretty healthy and have never needed to go to the ED, never sprained let alone broke anything. But lately my feet have been acting up. It all started in November 2009 when I got my right foot trapped between two rocks while trying to cross a beach with giant waves in Hawaii (also the same day I got engaged and Scott ended up with a huge scar on his arm from trying to help me, but I digress). It got scraped up, and despite my best efforts at keeping it clean while camping, it got infected. Cellulitis, to use the medical term, that required a week and a half of antibiotics. Ok, fine, I now have a faint scar on the top of my foot, no biggie. Except a year later, while in Peru, I got some bug bites on my right ankle and leg that developed into giant blisters that wept yellow fluid and my right foot got really swollen, presumably from the fluid that hadn’t been able to drain out of the blisters. I think my feet don’t really like tropical environments.

Cut to Tanzania, when after the quick descent from the top of Mt. Kilimanjaro, I end up with a few “black toes,” which is apparently pretty common after hiking Mt. Kilimanjaro. Subungual hematomas, to be more precise, essentially a bruise where the blood collects underneath the nail. Normally not a big deal, but if it does get big enough, it can cause some pressure to build up underneath the nail and can get rather painful. To relieve the pressure and pain, you can poke a hole in the nail to let the blood drain out. The subungual hematoma underneath my right big toe wasn’t that big, but after a couple days, started to become really swollen and painful. Finally, Anna persuaded me that she should trephinate (poke a hole) in it while we were hanging out at the open-air bar in Hotel Tilapia, a beautiful upscale hotel in Mwanza. We went to her room and she grabbed a lighter and paper clip. She heated up one end of the paper clip with the lighter and then placed it on the center of my toenail, but even after about 20 attempts and a visible depression in the nail, she still hadn’t made it all the way through the nail. We then discovered that it’s better to heat the paper clip by holding it near the top of the flame instead of the bottom, and after a couple attempts with this technique, she was through! It didn’t hurt, but when I felt the paper clip go through, I instinctively yelped and jerked my foot up, then sheepishly told the startled Anna that I was fine, just surprised. What was also surprising is that most of the fluid that came out (about a tablespoon’s worth, which doesn’t sound like a lot, except imagine it building up underneath one toenail) was not really as bloody as I had expected it to be, but more yellow or serosanguinous. It also drained quite a bit of fluid in the next few days as I walked around the hospital in Mwanza in flip-flops and a Snoopy bandage covering the gauze dressing. I’ve decided that after my right foot cellulitis, the lymphatic drainage in my foot is all messed up so that every time I get any sort of injury to that foot, I build up a bunch of lymph fluid that can’t drain properly except through blisters and holes in my nails. I’m only in my 20s, too, so imagine the foot problems I’ll have 40 years from now. That’s what I get for being so anti-feet.

Apparently my toenails also grow really slowly. I expected a couple of them to fall off by now (they’re dead once a subungual hematoma is big enough, and new toenails should grow in their place), but they’re still hanging out on my toes despite the sides being detached. So I’ll probably be missing some toenails during my wedding this summer. I don’t know if that’s going to stop me from wearing flip-flops underneath my wedding dress, though.

Look, you can see the hole in my big right toe!

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