Angelo Pricolo faces up to his fears—and his feet—but at least he was able to come prepared
After enduring the pain of two ingrown big toenails for most of my adult life I finally found the courage to face my demons. Like all good surgical procedures, the recovery time was way beyond the best-case scenario discussed with my practitioner and this made me ponder the possibility of wearing thongs to work.
I’ve spent more time talking about the curvature of my nails this month than about COVID-19. If only it was a more exciting topic to banish the virus to second place!
My wife is horrified every time we encounter friends where a throwaway line like “How are things?” sounds like “How are thongs?” and will end up focusing on my modified nails. My two boys now get up in the morning and instead of saying good morning they ask how my toes are.
The same two boys have been targeting my feet since they could walk. So for Leo that’s eight years and for Oscar it’s seven years of inadvertently standing on my toes. The pain like an electric current shot through my foot and it took all my energy to stop it flying out of my mouth in an expletive that would not make its way onto the pages of this reputable publication.
As the boys grew heavier so did their impact, and the need to explore my options also grew, until an inevitable visit to the local podiatrist. Highly recommended, this specialist was in for a grilling before I even considered un-harnessing my feet from my thongs.
I was scared. I was so scared I talked to the receptionist about it, to the point where I thought she was going to come around the counter and give me a cuddle. I used the power of words to help her feel my pain.
It is estimated that 20% of people visiting their doctor have a problem with an ingrown toenail. Most podiatrists believe that the nail grows into the skin fold causing pain and inflammation and new granulating and scar tissue grows around the damaged area.
Careful management can sometimes avoid any surgical intervention but eventually in chronic cases the scalpel rules. Lots of factors can alleviate the pressure, like careful trimming and appropriate shoes, but when pinch comes to squeeze it is time.
The procedure was explained to me in painstaking detail. I felt like lots of the explanation was legal and some medico but nevertheless it was definitely extensive. All the talk could not prepare me for the reality of seeing my two toes prepped for the incision and seeing the syringe that would deliver the anaesthetic.
At this point I did reflect that at no stage had the idea of a general anaesthetic been mentioned. It was starting to feel like it may have been an attractive alternative.
My hand covered my closed eyes and my head was turned at ninety degrees as if I was looking out of the window. Three levels of security to ensure I wouldn’t see what I hopefully couldn’t feel.
We had discussed the one toe option but sensing this whole affair was going to be my “childbirth” experience I knew that memory cells would come between achieving mirror image toes and that second appointment. So unlike the popular cataract procedure where only one eye is modified per visit, I was preparing for an all or nothing response.
Time seemed to stand still as we made small talk. The local anaesthetic, which is designed to avoid pain, was so excruciatingly painful that it defeated the purpose. Then just hearing the clanging of metal instruments as they were removed from their thin plastic autoclave packs was the last straw.
The podiatrist proceeded to remove wedges of nail embedded into tissue and I regularly asked how it was going. Which toe, first or second side? I could not bring myself to look, which confirmed my unsuitability for a career as a surgeon.
As the clock ticked I sent my wife Larissa a text to postpone my pickup. This prompted an unwelcome explanation from the podiatrist for the slow progress.
“I haven’t seen this much nail embedded for a long time.”
“There is an awful lot of scar tissue, I’m trying to get it all out.”
This is not what you want to hear your podiatrist say while you are texting your wife and trying not to steal a glance where the action is taking place. I can think of lots of things I would prefer to hear while sitting in the reclining torture chair.
“You have great looking toes.”
“Have you ever been asked to model sandals?”
Talk about scar tissue and granulating cells got me thinking about dressings. Now I’m not sure how many people BYO dressings to their own surgery, but I do (and I know Geoff Sussman has!)
I was horrified to hear what the podiatrist usually applied after surgery so part of the initial consult was spent discussing the virtues of moist wound healing and the difference between active and passive dressings.
Unsure whether he would take on my advice to use a foam dressing that had a silicon film layer, I came equipped. He was impressed. I was relieved. The silicon layer makes dressing removal atraumatic for the wound and the patient.
Invited to view the four wedges removed after the procedure, I was so impressed I took a photo. The cause of decades of pain was sitting on an outstretched gloved hand. Bloodied and battered I smiled awkwardly, as if I’d just had a tooth extracted.
I carefully fitted my thongs around the gift-wrapped digits and tentatively walked towards the door. My gait was similar to a 90-year-old and it felt like everybody was smiling except me.
Two bandaged big toes on a grown man look funny. Unless they belong to you.
I tapped my card on the EFTPOS machine and had the same feeling as immediately after a dental appointment. Pain you pay for.
My sentiment was justified. The first 24 hours were filled with pain and an uncomfortable sensation that made me question the wisdom of the intervention. I felt fortunate that my profession informed my dressing selection and pain relief, which undoubtedly improved the situation.
I wanted to get to the point where some of the benefits would become apparent as the wounds started healing. I wanted to test the previously painful areas and enjoy the new sensation. I knew that time was close.
But as dressings were replaced, painkillers were swallowed and Netflix bingeing prevailed, I came to enjoy the luxury of the loungeroom sofa. I used the toes to get the boys to brush their teeth and go to bed on time. I enjoyed the power of the toes.
If the toes were visible they were more powerful, so I was reluctant to cover them with socks. I was hesitant to show signs of improvement as I enjoyed the attention and power.
Alas work was the driving force to blow my cover and admit the procedure was a success. So if work wanted me back prematurely, it would have to be with my model feet in my Havaiana thongs. Surely if I maintain eye contact no one will look at my footwear anyway?
Angelo Pricolo is an addiction medicine pharmacist and former National Councillor of the Pharmacy Guild of Australia.