Bleeding big toe

[BedfordBoy]

Hi everyone, I have had ingrown big toe nail problems for over 45 years now and both have been surgically removed multiple times.

However for the last couple of years the right big toe constantly bleeds. It got so bad that it would drip out even sitting watching TV, and walking made it worse. My GP said the nail should be removed in hospital but as I suffer from lymhodema and cellulitis and raised bmi, I am a risk! I thought he was joking but apparently they won't do it in the surgery anymore and the hospital thinks it's risky. I was bemused by this as I wasn't asking for heart surgery, just nail surgery!

Anyway, as a temporary solution I found a good chiropodist who I see every 4/6weeks (my nails grow super quick). She cuts out the sharp nail and cuts of the granulated skin growing around the nail. Apparently this is a common problem. She then applies acid to the skin and hole where the nail was cut out to cauterize it. It goes jet black and a scab forms which is quite big.. At first it was great. No pain and no bleeding but for the last 6 months or so it just won't stop bleeding. It looks gross!

I always let the scab come off on its own so it's not like I'm picking at it. But with summer here and sandles worn most days, it's a bit messy and I'm wondering if it's a bigger problem than I thought.

Anyone else had this problem?

[Lynora]

Not had the problem myself, but have seen it. Can you see your chiropodist ASAP ? She should be working again - or at least ask for a telephone consult.

[BedfordBoy in reply to Lynora]

Hi lynora,

I spoke to my chiropodist about it and she said ideally that it should be removed surgically so that the whole nail bed can be accessed.

She knows about my lymphodema/cellulitis problem and is happy to take it off providing she has a qualified anaesthetist working with her. And they don't come cheap! Mind you, if I add up all the treatments I've had with her, I'd have enough to cover the cost of the anaesthetist! I don't think I realised how long the bleeding would go on for.

Come to think about it, 10 years ago I had the other one removed in hospital, and that bled profusely for only 2weeks! I went to the GP after a couple of days to change the dressing and he couldn't believe it either!

Years ago before I had lymphodema, I'd had both nails off and no excess bleeding, so I'm thinking the excess bleeding is lymphedema related.

Can I be the only one though ?

[Perido]

I agree with Lynora about getting back to your chiropodist.

Whilst I haven't experienced the problems you describe about your nail I do have a bit of a problem with one of my big toes on the foot with lymphoedema. The nail is thickened and had a tendency to grow inwards and starts to cause me discomfort. As soon as I notice any discomfort I trim the nail and gently pick and scrape away any dead stuff using my fingers and maybe a wet wipe. Then I dry the area and moisturise all round the nail with sudocrem (contains antibacterial and antifungal agents). I probably need to do this a least once a week on top of my usual routine of keeping my foot clean. dry and well moisturised. Basically I'm meticulous with my foot - I inspect it every day. I'm going for the prevention is better than cure approach. I'm also ensure shoes fit well and don't constrict my toe, I also try and alternate shoes to allow time for sweat to evaporate. I hope this doesn't sound like a lecture just thought I'd share in case you might find any of my ideas helpful. I wish your nail a good and quick recovery.

Would it help it you were to soak your foot with the troublesome nail in warm salty water to help reduce the risk of infection?

[BedfordBoy in reply to Perido]

Hi perido, yes I have used sudocrem and it is very good. I also soak my foot in Epsom salts for half an hour to get the dead skin off which helps me a bit. I moisturise my whole leg and foot with zero double (which used to be called double base).

I'm open to trying any other ideas, thanks for your advice.

[Perido in reply to BedfordBoy]

Are you keeping your leg elevated where possible? Would massaging your foot help - so as to improve the circulation?

[BedfordBoy in reply to Perido]

Hi perido, yes keep my leg elevated every chance I get and the foot massage is something I find hard to do properly so I ask the wife! Luckily she is good at it. But it still bleeds, especially after walking round the shops etc.

I'm wondering if there is any veins under the nail that have been cut?

[Perido in reply to BedfordBoy]

I'm not an expert but my uninformed suggestion/guess is that lymphoedema slows the healing process so if a vein has been cut it would probably take a while to heal. If it's not a vein maybe slow healing has led to you having a bigger wound than if there no lymphoedema. So the maybe the ongoing bleeding is maybe just an indicator of a large non healing wound and not a direct result of lymphoedema? Hope that makes some sort of sense? This is all just guesswork on my part, I'm always trying to work out why I get the problems I get - with a little help from the doc of course.

My instinct is that the chiropodist is correct about needing access to the whole nail bed.

[BedfordBoy in reply to Perido]

Hi perido,

An update on my strange bleeding big toe.

Like most of the others on this site, I have a whole lot of medication that I have to take. I have been on aspirin tablets for about 14 years, and I ran out of them around a week ago. Well I meant to get some more but somehow forgot to.

And when I take my sock off now, there's hardly any blood now! The scab from the nail surgery is still there but I'm amazed at how much the blood loss has ceased.

Now the dilemma is, do I carry on with no aspirin or am I being risky?

Obviously they were prescribed by the doctor as precautions against a heart attack etc. I wondered if anyone knows what alternatives are available for aspirin.?

[Perido in reply to BedfordBoy]

My thought would be to check with your doctor about aspirin. Also it is possible that it could be coincidence that the bleeding has slowed?