Nail removal on affected lymphedema leg

[Blade1]

So I have lymphedema in my leg, had cellulitis, and took 2 weeks antibiotics and now on 8 weeks prophylactic antibiotics.

I also have a fungal nail infection on two toes on the foot of the affected leg. My leg was originally swollen, now my ankle and foot after EVLA surgery, but not toes. I am in a dilemma - do I take fungal meds, which can cause liver damage, or risk a minor surgery that, if done, could cause infection, and if not done, is a risk factor for cellulitis?

My podiatrist suggests I get a compression garment (which I understand is more to prevent swelling, promote fluid movement, and not so much reduce swelling), take any antibiotics to reduce chance of infection and have a nail avulsion. She said the infection only lives on the nail and nowhere else so this will sort that problem out, plus is a very quick treatment. Terbinafine, on the other hand, can cause liver damage.

What do you guys recommend?

Also, can a warm shower aggravate a cellulitis in remission?

[patsy1702]

I have bilateral LE from toes to waist have had nail fungus on 5 toes on one foot and 4 on the other. Tried everything including fungal lacquer on perscription.... nothing. Started taking the pill about 5 months ago and at last results. You have blood test 3 monthly for the liver. Good Luck.

[Blade1 in reply to patsy1702]

Did you try nail avulsion? If so, what was the problem with this?

[patsy1702 in reply to Blade1]

Just got fed u with nothing working so went for the pills.

[Blade1 in reply to patsy1702]

I see. So you never tried nail avulsion?

[patsy1702 in reply to Blade1]

It was never mentioned and try not to have any surgical procedures unless there is no option on my LE limbs.

[Blade1 in reply to patsy1702]

Yeah surgery is a risk, but so is terbinafine. Thanks, looks like I need to speak to doctors. The surgery is in a part of limb not affected by swelling though, so that should be ok? Again, will discuss with doctors before commiting.

[AnneBury]

I have lymphoedema (below knee, both kegs/ feet). I had fungal medication (for one toe nail), along with regular liver checks. Medication worked brilliantly.

[lovesradio]

Podiatrists are pretty good at nail avulsion and you have been given really good advice re avoiding infection, and you sound reluctant to take Terbinafine.

[DeadfootMo in reply to lovesradio]

What is nail avulsion?

[Blade1 in reply to DeadfootMo]

Nail avulsion is removal of the nail with or without phenolisation (that destroys the nail bed so the nail can't grow back - not sure if this is recommended with LE).

I'm reluctant either way as both approaches aren't risk free. Some doctors say that liver damage is highly likely, some say they are not. Podiatrist did say check with a liver specialist if possible and if I am worried that much.

Like most of us, I have enough health issues to manage and I don't want to add on the list with another significant problem.

My podiatrist is quite familiar with LE too which gives me confidence.

[DeadfootMo in reply to Blade1]

Thank you for the information. I can understand why you wouldn't want this. I have heard that having a nail removed can affect balance in some people. i don't know if this is just a minority or if this is a lot of people, i do know one person who had a nail removed on her foot and eventually she lost the ability to walk. She was only in her forties and had over the years suffered with pain in her feet and infection after infection in the nails. She also suffered two or three bouts of recurring celucitis , the infection of the skin in one lower leg and foot. She now hurries around using a mobility scooter. I hope your issues ease.

[Blade1]

Wow I've no idea how nail removal can effect balance? Not saying it is not true, there must be more involved? I've had nail removal done before for problematic nails, way before my LE developed, no issues. I don't know how significant it is but my toes do not have lymphedema. Anyway, I guess I need to discuss this a bit more. It's good to hear people's experiences.

[redbirdcat44]

People's Pharmacy had a list of possible natural solutions, if you want to take a look. Just scanning through, it looks like iodine, hydrogen pyroxide, and vick vapor rub have worked. here's the link. peoplespharmacy.com/health-...

[ezee]

I had my big toe nail removed on my lymph leg. I had it done by surgery (instead of acid), and had a 2wk course of antibiotics after. It was absolutely fine. Good luck.

[304473]

Hi Blade1, sorry to hear of your ordeal. I have lymphoedema on my right leg to my waist. I have previously had to have a skin graft with skin taken from most suitable donor area i.e. on my right hip which took many months to heal due to an aggravated infection which I suspect is from the lymph buildup on that leg especially since I was not able to wear my compression garment for duration of that wound. I also suffered fungus on my both my big toenails of which I started a lengthy period of treating with bicarbonate of soda and apple cider vinegar which has worked wonders and has killed the fungus leaving my nail and nail bed looking beautiful again. Soak your feet in lukewarm water with quarter cup bicarbonate soda for as long as you possibly can (softens nail and nailbed nicely), towel dry well and between your toes, using sharp clipper, trim nail as short as possible, using rough nail file, file OVER entire nail to roughen the entire nail itself, attempt trimming more of nail and cut away nail at both sides of nail bed, using tip of nail file or tweezers scoop bicarbonate of soda onto entire nail and into both sides of nail closest skin and also on trimmed edge of nail..thus covering all exposed area on and around the nail, NOW using apple cider vinegar from a small spray bottle, spray lightly onto the bicarbonate of soda covering the toe, keeping spray bottle at good distance to allow a gently spray onto the bicarb, you will notice the bicarb bubbling and will feel a tickling on your exposed skin around and under the nail..leave it to dry for short while and spray gently again. I then apply little bit more of bicarb to allow it to soak nicely into filed nail and nail bed, spray gently and once dry, I cover the paste of bicarb with a strip of micropore plaster and leave for the day. This routine I do every two days and trim the nail every few days, to allow cutting away of nail from nail bed to rid the softened or killed fungus. It's a long process and requires much patience but the rewards to having a beautiful healthy nail bed and nail is worth the effort.. good luck if you willing to try this..

[BedfordBoy in reply to 304473]

Hi, That sounds great! I'll give it a try. When I was having acupuncture, my therapist always soaked my feet before hand in warm epsom salts and that seemed to help get rid of the fungus too.