so this is our marathon runner what name would you like to use
so this is our marathon runner what name would you like to use bill bill this is bill our marathon
runner and you've got pretty thick nails on many of them but your third and fourth toes on both the
nails are normal very long but more normal and it's not uncommon to see that people will have
like every nail is affected except one and it's the same one on both feet why is that i don't
know it's got to be a circulation kind of thing probably so what we're going to do is we're going
to trim everything up and then we'll smooth it out using a little power sander kind of thing so we're
going to trim the ones that don't appear to have fungus on them first we'll do that on both feet
what causes fungus it's just out there in the environment okay and all it needs is a little
damage to the toenail all right and it's in okay and you can just go wide there can you see these
so these aren't fungal they're just very long
so yeah and some people's immune systems are better at fighting it off
than other people's for example i had a i think a five-year-old girl in here last week
who had fungal nails and her dad has them and her grandfather her dad's dad has them and so the only
thing i can think that's genetic because that's very young for us to see them is that their immune
system just doesn't recognize the fungus to fight it off and that would be the genetic component so
we'll come back to the left foot
is this something that you've ever treated or thought about treating because this
i know this isn't the reason you came in i know it hasn't that well i actually i've thought about
it but i haven't been sure what the what the treatment well by the time it looks like this
so that the fungus has now gone all the way down under the cuticle to where the nails being made
the nail's being produced with the fungus in it so doing a topical won't work for these
so we would have to do an oral medication which is okay i've put hundreds of people on them we
just follow your blood tests and you're not on any of the medications that would
that would cause complications interactions but we test your liver before we start and then we um
test it every few months while you're on it and you stay on it until the whole nail starts to
grow out more normal okay because i have law i mean i've actually lost nails you know from the
when i was running more yep they've fallen off and they've come back
the same way so exactly because the nail where it's produced back under here the fungus is
already gone back underneath there okay now sometimes people get thick nails from trauma
like this hit the top of your shoe with every step you took running a marathon and you could
lose a nail but i can look at this and tell you from what's underneath here that this is
it's fungal okay so if that's something you wanted to treat we could definitely
do a blood draw today and you know i'll think about it okay and that's fine too um
so yeah the medication that i would recommend for you if you choose to do it would be one
that you just take once a week and you do that until the whole nail grows out so for an adult
big toenail that could be anywhere between 10 and 18 months
and i just test the blood um every three months while you're on it okay so it's an
option something to think about you can let me know you don't have to decide by this minute
yeah but just for the record bill came in for something completely different
and i got all excited when i saw his nails and he graciously allowed me to trim them and film it so
we appreciate that well i could tell you'd like to challenge me and then this one that
is a nice long one how long do you think it's been since you've turned them oh several months
and we have our winner
all right so now i'm just gonna shorten them a little bit more and thin them out
you know those are actually pretty combos
all right so beautiful they are not but they'll be a lot more comfortable in your shoes now
and they should be a little bit easier for you to manage now yeah on your own so really i think
the two on this left foot here are the only two that were not affected by the fungal infection
so all right does that feel pretty good there yeah okay that one too
yeah okay all right so we'll see you back then um when your orthotics are
you