Ahhh… my toe!

Fungal infections of the toes/fingers are unlikely to make headlines anytime soon. It is not life threatening and really one should bear their fungus quietly while the world deals with ‘big’ diseases.

But try telling that to a person who has spend the night awake, unable to bear the dull pain of a throbbing in-grown toenail as a result of a fungal infection. Tell that to a person who can’t wear closed shoes for the pain the infected toe causes. Tell that to a person for whom washing clothes or dishes is a real ordeal

I have a feeling you are not get teary from this but stick with me. For me, my teeth (the story for another day) and my toes have been the main cause of many a sleepless night. I am not whining, am very grateful to God that these have been some of my biggest ailments but I have to tell you this one.

See, I have these two ‘alpha’ toes that have really never been kind to me. In my childhood – my mother’s needle never failed to pull out a jigger from one of them after returning from gishagi. Typical of most of my wounds those days, the little hole left by the jigger promptly got infected. My mother and I trooped to the District hospital. Without fail, the nurse would give me an anti-tetanus jab. Those days, it seemed like every wound needed to be dressed, followed by an anti-tetanus jab. The needles were way bigger than they are these days and warm from their last wash. Yap – those were the days when needles were recycled. Ok, now I am seriously digressing here……………

It was about my ‘alpha toes’…..

So when I moved to Kilifi, I promptly got a fungal infection on both my ‘alpha’ toes. In the beginning it was just unsightly, so I ignored it.

But now it had gotten to the stage where I was scared of my children stepping on the toes by mistake. Scared of playing football with my son Matt, who would expect a game with me every day after school. I also wanted to get to wear a closed pair of smart looking shoes one of these days without walking like a person who has never worn shoes in their life for the pain and discomfort of it. And I hated those sleepless nights with the dull pain from ingrown nails.

So the other day, I was at Allure laser skin and aesthetic center at the Nyali Mall ……..finally getting something done about these toes nail of mine.

http://www.allurekenya.com/

Dr Suhail Muravvej runs the clinic. He trained as a doctor at the University of Nairobi before proceeding to South Africa to return as a dermatologist (general and cosmetic). A pleasant young man, unhurried and willing to discuss issues dermatological with infectious enthusiasm.

As I had already tried a dose of anti-fungal drugs before, my options were laser treatment or pulling out the toe nail before taking more antifungals. I asked daktari a few questions and yes, the questions have been tampered with for effect. It’s always interesting talking to specialists about their field of work.

Why oh why me?

‘Toe or finger fungal infections are extremely common in the Coastal area due to the heat and sweating. People think it’s due to poor hygiene but that is not true. Anyone can get it,’ said Dr Muravvej.

But oh why, why me, what did I ever do to deserve this?

‘Footwear and environment is the main reason for fungal infections . If you have sweaty feet, get that sorted, wear open shoes. Don’t go for manicures or pedicures in places you are not sure about in terms of sterilisation. It is possible to pick it up from instruments used in such places,’ said Dr Muravvej.

It’s true a lot of the people I know in Kilifi have an infected toe or two. I have tried many things before coming to Allure .

I tried applying some nail lacquer for anti-fungal toes – for months nothing happened. I was told try henna. Again months went by with no success. I was given some grey powder concoction which I mixed with Vaseline and applied to the toes. My mother advised Aloe Verra. When I finally gave up and went to the first dermatologist, I took Itraconazole for 3 months in 1 week pulses. Nothing. The toenails were looking bad and feeling worse.

So I decided I had had enough of this toenail… it was a bit like a troublesome boyfriend/girlfriend that you think you love but he/she keeps dogging on you…..it needed to go. The only painful part of the procedure was the injections of local anaesthesia around the toe. But it was over pretty quick. The operation itself was rather pain free and I proceeded to read my book. Dr Muravvej pulled the nail out after freeing it a bit.

I contemplated putting a photo of the toe without a nail right here ….. if ‘the people’ petition, I shall oblige….

After the toe heals, I will be on oral antifungals – Terbinafine, a tablet a day for 4 months.

Antifungals may interact with other medicines so I was warned not to just take any drugs without first contacting the doctor. As toe nail infections are not life-threatening, it’s is advised that pregnant women and breastfeeding mothers avoid these drugs. Anyone with liver problems is also advised to avoid the drugs too as it can lead to liver disease or failure in those who already have a problem with their liver.

I will let you know the progress of the nail treatment – I know you will be dying to know how this goes! I am hoping to be reminded of what my toes looking in my early twenties in about 6 months.
Success is not guaranteed. I don’t know how many of you read that small paper that is always stashed in the box with the drugs you buy – the ones in such small print, you want to borrow my glasses to read. Well, I went through that small paper and Terbinafine has a 15% relapse rate. If I am really unlucky, I might be back at Allure.

I hope to be lucky because if not, I will ask Dr Muravvej to administer the final option. I will have phenol placed at the base of the nail bed to prevent any future growth of the toe nail. Seems extreme – but I do not intend to have sleepless nights over a toe nail as a result of fungal infections again.