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911Doctor
911Doctor, Doctor
Category: Health
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Experience:  Board Certified Emergency Physician
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I had my toenails cut & a corn removed a week ago

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I had my toenails cut & a corn removed a week ago. While the doctor was cutting (new dr for me) I never had such pain, I was almost screaming for him to stop. I've had this procedure for 20 years, due to R.A. It has never hurt. Uncomfortable yes, but never never like this. Again, this was my first trip to this man. After a week it started throbbing (big toe & one next to it), I should mention when he removed corn on 2nd toe, he sent it to be cultered as he thought the white pus was infected. Two days ago I took off his bandage (he also told me to use bacetracion-which I did). The big toe had blood color all around nail and sideways down the toe. Second toe was red-purple. I called his office & they got me in to another doctor who was alarmed and cleaned out around the big toenail. she did not think they were infected and the first doc had put me on cefadroxil anyway. Took wrapping off (gauze) this am and big toe is same color (red, like rare roast beef) and now goes all around top of big toe. I called her & she said to take sock off and bandage & leave it out---still has no answer and it's the weekend. I suffer from R.A. and severe Perifial Neuropothy. I'd like your thoughts Thank you

Submitted: 1 year ago.
Category: Health
Expert:  911Doctor replied 1 year ago.
Welcome,
My answers are for educational purposes only. Remember please, that we do not get paid if you do not click 'accept' / give positive ratings!

There is simply no way to tell if this is an infection or not. From the way you are describing it I am certainly concerned that it might be.

I would not hesitate to go and get a good Urgent Care or ER doc to look at this... If this is an infection of the wound then you need to be on antibiotics to prevent serious compilations.

Blood work might be needed but is not nearly as important as a good exam by a competent physician.

I am standing by if you have any questions about my answer.

Best
911Doctor, Doctor
Category: Health
Satisfied Customers: 5084
Experience: Board Certified Emergency Physician
911Doctor and 3 other Health Specialists are ready to help you
Customer: replied 1 year ago.


The first doctor put me on cefadroxil right away. been on it for two weeks

Expert:  911Doctor replied 1 year ago.
my answer is the same, if you have infection it may be resistant to the antibiotic and you may need a change.

also, since you just had a shave procedure on your toe it is important that they look for evidence of infection of the bone... this would be called osteomyelitis, and it would be the most feared complication.

I am sorry I can not reassure you about this online.... you definitely need another look from a doc, and you probably need an Xray too.

I do you hope you get this resolved quickly

standing by if you have further questions.

best
Customer: replied 1 year ago.

Hi---this question has to do with previous question/answer re toe infection. It is end of Feb, and I'm still not able to walk/wear shoes because of that corn on second toe. Have been to numerous docs and frankly, the don't know what it is. All I've been told is is "do not walk on & do not wear shoes that rub against shoe top"--meaning any shoe. I live in Boston, and not wearing shoes is out of the question. I have split a hole in top of a moccassin, and that's what I use. Sent for vascular tests & they were ok. Saw Head of Podiatry at one of hospitals here in Boston & and he & my rheumatologist had talked. They insist the first podiatrist probably did nothing wrong (!) and gave me an antibiotic again. This morning, the big toe is very red with the same pain I had when he originally cut the nails too close, which is something they all agreed upon. The doc said yesterday I may lose the toe. On 11/19/ 2012, I was fine. On 11/20/2012 this doc I never met before worked on "cutting nails & getting rid of a corn", and now I may have to have toe amputated. There is something very wrong here,and yet the docs say "it probably would have happened anyway". I do not believe it for one minute. Please give me your thoughts. Thank you

Expert:  911Doctor replied 1 year ago.
dO YOU HAVE OSTEOMYELITIS? aN INFECTION OF THE BONE OF THE TOE?
Customer: replied 1 year ago.

Hi


No, that was one of the first things the podiatrist told me yesterday---no bone infection.

Expert:  911Doctor replied 1 year ago.
And have they looked at the circulation to your toe with any form of ultrasound study or vascular study?
Customer: replied 1 year ago.


Hi, Yes I"ve had a vascular test to rule out vascular problems. Came back negative. Should also mention I do take Enbrel for RA & the docs keep mentioning that could be reason for slow healing.

Expert:  911Doctor replied 1 year ago.

Enbrel could be the offending agent.

 

I'm afraid I don't have much to offer except these two suggestions....

 

1. Speak with your prescribing physician re the Enbrel. Would it be possible to discontinue it to see if your toe can heal?

 

2. If you are not seeing a wound-care specialist, this absolutely needs to be done. It seems that the proper testing has been done, but wound care specialists have a wide array of modalities at their disposal including special wound dressings and even hyperbaric treatment (high pressure oxygen therapy). This is my best answer. If you are not being seen regularly by a wound care clinic or physician this absolutely needs to happen.

 

Best

 

911Doctor, Doctor
Category: Health
Satisfied Customers: 5084
Experience: Board Certified Emergency Physician
911Doctor and 3 other Health Specialists are ready to help you
Customer: replied 1 year ago.

Relist: Incomplete answer. The question & answer just cut off at bottom of page---not sure if that was all he could help me with. Had to do with infected corn on toe.

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