What's going on to all my toes out there!
It's Jonathan, a.k.a. the Toe Bro and finally with the update video on
this nail surgery. So I'm really happy with all the comments and the likes and
the engagement from all of you guys out there. The videos have been doing awesome!
I can't believe how fast everything is growing. I get so excited!
I can't believe that this month this will be my fifth video that I'm putting out.
So I'm getting a lot more frequent with the videos. You guys are giving me tons of motivation.
So I'm really excited and happy to be sharing
what I do with all of you guys because like I said before, this is not only my profession; it's my passion.
I love doing this! So here we go with the update video.
So if you guys haven't seen the full original video, please check out the link in the description box below
so you can watch the full video from start to finish. I'm just gonna play a clip now of
the interesting part, where we separate the nail from the nail bed,
cut the ingrown nail portion,
and then pull it out with the hemostats. So you can see how big of a piece was in there!
So I'm gonna give you guys a little breakdown of this case, for the people who haven't seen the full video.
This was a young 20 year-old female who is visiting Canada from Jamaica and
she has been suffering from chronic,
recurring ingrown toenails. They are always getting infected, always causing her pain. She's a type 1 diabetic so
sometimes it's hard for her to control her blood sugar level and she was getting recurring
infections. She had had nine surgeries before seeing me and all of them, unfortunately, were unsuccessful.
So after meeting her, I really felt for her.
She's really been through a lot and I really promised her that I was gonna do my best to take care of these ingrowns.
Again guys, this is not the full
video; it's just a clip of it So if you want to see the full video, please check the link below.
I'm gonna let the video finish off a little bit longer with the actual audio from the procedure
and then we'll continue with all the follow-up photos and then how the toe is looking afterwards.
I'm hope you guys are really excited to see how everything turned out.
TB: Big piece! Are you feeling okay?
P: Yeah, I'm good.
TB: So something ever doesn't feel good or something's bothering you, you let me know.
P: Okay.
P: Does any patient come back to you with more toenail problems?
TB: In the last four years, I've had one, two people.
P: Okay.
TB: Two people and then I redid it and
off we were. All finished.
P: The doctor always told me that with 25 years of her being a podiatrist, she's never seen a toe like mine.
TB: It also depends on how many procedures she's doing as well.
TB: So very big.
You okay?
P: Yeah, I'm good.
TB: You'll survive, right? (laughs) That's that's your theme; you'll live!
P: I'll live!
TB: I wish I could show you, but I won't. I'll show you afterwards, okay?
P: Yeah, afterwards. I prefer to see it afterwards.
P: And your name is "Dr. Jonathan?"
TB: No "doctor", just "Jonathan". You can call me Jon, Jon-Jon!
P: Okay.
TB: And Jon's fine or Jonathan.
So do you remember you had that big piece of that yellow tissue on top?
P: The yellow tissue on top?
TB: That was kind of hiding?
P: Are you talking about the...
TB: The flesh. Yeah. I removed that because if we don't,
it'll be there permanently.
P: When I was doing the one surgery, it was infected really bad, too bad, it was really, really...
TB: Was that there before the wedge or after?
P: This happened before and after because after I did the wedge, I thought it would go down.
But the swelling after months, did not go down. It stayed there and it kept growing.
And I had to keep going to different doctors
for them and they kept removing spikes from the side of the same place where the flesh was.
TB: So, what we call that is "hyper granulation tissue".
So, when there's a nail in the skin, what the body does, it sends
cells and
all the good stuff to try to
heal the wound. But because the nail is
still in the skin, those cells can't heal it and they just start they start to collect and build up and it builds up, builds up builds up,
and it never goes away unless you physically remove it. So that's what we just did.
P: Okay.
TB: Okay?
TB: So I'm really making sure I'm being very (thorough).
Usually, this only takes me five to seven minutes for whole procedure.
For you,
I'm making sure there is nothing, and you're feeling no pain at all?
P: No.
TB: So this is a first!
P: This is a first!
TB: (voice over) You guys really make me laugh sometimes!
So I've seen quite a few comments that people always wanted to see what came out or the piece that was removed.
So the first picture we have here are the two pieces of
ingrown toenail that I removed. So you can see it was still very, very wide,
very jagged and that's why I could really see why this was causing her so much discomfort. So after nine
procedures, there were still so much nail left behind or that the nail was not properly destroyed
which is why it grew so wide still.
Because my patient lives in another country and would not be able to come in for all her scheduled follow-ups,
I got her to follow up through email on a regular basis.
So here's a picture that she sent 24 hours after the original procedure.
So you can see the wound is very moist.
The whiteness around the rim is from the chemical burn; it creates a very moist, moist wound.
So really, it's really early to see any signs of infection. We do see the redness on either side of the nail.
That's where the nail was digging into the skin and that's also where the soft tissue
I trimmed it back. So you can see it's a very
exposed wound, very moist. So this is 24 hours after, you can see the toe is quite swollen
and it was a little bit uncomfortable, for sure, but patient was okay.
Numbing lasted around 10 hours, so it did give her quite a bit of relief.
You can already see how much healing has happened one week after the procedure.
Those deep wounds, where the nail was was growing into the skin, have now filled up.
They're very flush to the level of the skin. The wound doesn't look as moist to me.
No signs of infection, a little bit swollen, but not like before so to me, this is a healthy, healing toe.
It's a little bit moist still with white
whiteness around the sides of the toe. That just means that the skin is holding on to too much moisture.
So what I had to do was switch from an antibiotic cream
to an ointment called "betadine" or "iodine" and that's gonna still give some antibacterial protection
but help dry out the wound. So that's what she did.
One week after her procedure, she wasn't really having too much discomfort.
It's a little bit tender and sore to put on closed-toe shoes, but she was managing pretty well.
I did get an email two weeks after saying that she had a little bit of a time period with high blood sugar and
it did lead to her getting an infection in a toe. So she sent me this picture, just to get my opinion
and I told her yes, it looks a little bit irritated and inflamed.
It's becoming a little bit moist on the left side of the nail so she did take a course of
antibiotics. It was starting to increase in discomfort, so instead of letting it get worse,
she let me know
what was going on. She got a course of
antibiotics and right after taking the antibiotics, everything went down and really started to dry up.
But you can see that the scabs are really starting to form on either side of the nail. That's a great sign
and
just like that, we made it to the one month mark so she sent me this picture.
You can see she's not dressing it with any sort of ointment. The sides have completely closed and already she was very very
excited there was very little to no sensitivity or discomfort at all. She was back to her normal routine.
She did not feel any sort of pain. So at this point, she was saying, "Thank you! I'm so happy
it's all finished!" and I told her hold on, wait.
Usually, you have to wait two to three months after a procedure.
That's the time it will really takes for a nail to start growing from the bottom,
underneath the skin, up above the skin to see if something's happening. So I said, " You know what? I'm happy that everything's looking good but
don't get too excited. Let's wait another month or two and let's see what's going on." So from this point
she was happy; no pain, no discomfort, no infection,
no need to dress the toe. So that's where pretty much when we said that's an awesome sign! If something's going on, you
let me know but we should be checking in in a couple months.
So that was pretty much my last interaction for a while until I got an email from her this summer.
Started from the bottom, now we're here!
Woof!
Here we go, my toes. So this is eight
months after the original procedure.
So she came in and I was so happy to see her. She had the biggest smile on her face! No pain, no discomfort,
nothing ever going on since we did the procedure. So she had no more problems with any infection.
Nothing is bothering her whatsoever. So when we look at this toe,
it's completely different. There's no
discoloration at the base of the nail.
There is no hard skin buildup on the sides, the toe looks completely different and yes,
this is her toe. As you can see, the nail has become narrower.
That's what happens when we do an ingrown toenail
procedure. The sides of the nails that we remove and we use the acid, will not grow again.
So you can see the sides have completely closed up, and it's a sealed area, and now we just have a thinner
middle nail that's gonna continue to go straight.
As you can see, the new nail growing in is attached, it's pink,
it looks healthy and I'm very, very happy with that. The next photo, where I put a little red
rectangle, is a part where I filed down, when she came in. So this was the nail
that was probably growing at the time
we did the procedure. So when it was getting near the end of the nail, it was becoming a little bit lifted;
it was a little bit chipped. So what I wanted to do was just file it smooth, get rid of that last
damaged nail that was growing out from the time
we did the procedure eight months ago
and just to have a nice looking new nail. So what will happen is that the base of the nail, that green
rectangle that you just saw, will continue to go straight all the way to the very end and she's just gonna cut her nail across
like she would any other nail without having to ever worry about any
ingrown, toenail or creating a jagged edge that will cut into the skin.
It really makes me so happy to see the nice before and after photo!
You can see how different the toe looks completely. The amount of swelling and
hard skin buildup on the right side of the nail, where that big nail spike was stuck in the skin,
it's completely gone. You can see how much smoother and
narrower the toe is.
Everything is just looking so nice and the most important thing to me, beside it looking nice,
is that the patient's feeling really, really, really good.
I put another photo
side-by-side you can see, with the circles the red and the green one, where that nail was digging into the skin
on the top of the nail, with that red circle, the left before picture and afterwards eight months later,
you can actually still see how much of an indent and pressure that that nail had left into the skin.
So this is the one thing I like to say to you guys:
it's better to treat these ingrown toenails that reoccur sooner than later because sometimes the skin changes
the growth or the width of the of the tissue because of long-term
ingrown toenails can become permanent. So by treating them
effectively and with a good, permanent
measure, we can really change the way the toe looks for the better and hopefully it's gonna make the toe look nicer and
of course not have this recurring in ingrown toenail. So again,
I'm really, really happy with this result. It looks really
amazing to me and she is so happy with it so that was the icing on top of the cake!
I really, hope you guys enjoyed this update. I thought this was a really good one. It was very thorough.
We got to see the healing process every step of the way and of course a nice finished product eight months after the procedure.
I hope that answers some of the questions for you guys about, you know, what it looks like afterwards, the healing process,
and I answered some of your questions you might have in your mind.
Other than that, I really tried to get a video with
Papa Toe (my dad). I really like Papa Toe but he was not feeling
too good the last week, so that's gonna have to wait.
Unfortunately, I'm going away for the next two weeks, at the end of this week,
but I'm gonna try to get some videos timed out so you guys still have your fix of the Toe Bro!
I'm trying to make these as educational as possible. Please, please do not flag my videos!
They get removed. They get age restricted. I try to put warnings,
I try to, you know, not make them as gory as possible. This is for your benefit.
I just want to create the awareness for feet and what a foot specialist like myself as a chiropodist
or other podiatrist out there can do for you guys. Please, please, please support me and try not to put the videos down.
I really again appreciate all the love and support
and I hope you guys really enjoyed this and are looking forward to the next video. Toe Bro, out!