Patient: Go ahead. Toe Bro: --shot of this.
P: And now my mom's calling me. I’m so scared, I’m so scared.
[inaudible]-- I’m really bad with, like, pain tolerance - very low.
TB: Well, I'll let you finish your call with your mom and then we're gonna give you that quick little needle; that's the only hard part for today.
P: Is it-- it doesn't hurt, does it? It's like getting out your tooth or no?
TB: Similar.
P: Okay.
TB: You'll be okay.
Nice.
[laughs] So, this is the big thing - just removing a toenail normally, like, that's damaged like yours and letting it grow back won't fix it
because the nail cells are still damaged, the nail bed's-- but what we're doing is by applying that onyfix - that band - we're hopefully
going to cause a better seal to allow the nail to stay attached because it is detaching at the very end
but how long has the nail been like that?
P: Years.
TB: Years. Another specialist, again, said that it's just permanently damaged, right? You had it tested--
P: I asked him, I was like, "should I cut it down or remove it?", he said no.
TB: And, again, what we're doing now is for a lot of people who aren't doing the surgery, we're just doing option one
which is the trimming it back short, putting on the nail reconstruction just make it look nice
or you give it a go doing this where we remove the nail surgically, let the new one grow in
and we put the band on to try to create a healthier nail or then you have your last option which is remove nail forever.
P: No, I don't want that one.
TB: Are you sure? We could do that one.
P: Nooo. TB: I'm just teasing ya. [laughs] Okay, let me set up the injection, I’m gonna do that first.
P: I just get really-- TB: You're already getting nauseous? P: Yeah, I get really--
TB: Okay, let me wipe down the toe.
We're not gonna start yet.
So, what I’m gonna do - I’m gonna just tilt you back already because you're-- you're gonna faint on me, I feel it.
P: [laughs] TB: Let me pull you back, get you nice-- P: I'm sorry. [laughs]
TB: That's okay.
P: Are most people like this or no?
TB: People all treat things differently so I’m gonna put you back, hold on to your phone though. P: [breathes out]
TB: And you just go like that and you just breathe. P: [laughs]
TB: [laughs]
P: I’m so nervous. TB: Don't be nervous; and it's okay to be nervous, it's nothing wrong but it's nothing-- you're in a safe place, nothing serious is gonna happen,
it's just a small little pinch and then you don't feel a thing. So, what's gonna happen -
I’m gonna be holding your toe and a count of three you're gonna feel a little pinched; when you feel the pinch,
don't move your foot. What you can do is push your foot right down like that if it hurts.
P: Like this, right? TB: Yeah.
P: Okay. TB: Okay?
So, we're not not going near the top at all, it's near the bottom of your toes so nothing up here.
P. So, where are you putting it? There? TB: Down here, yeah, which is away from the sensitive area so you'll be okay.
P: Okay, but I’m not gonna feel nothing when you pull it out.
TB: No, you're not gonna feel anything. P: Eeeh, I still can't say that word.
TB: Okay, so you hold on tight.
I'm just put my finger here so a little pinch - here we go.
Awesome.
You okay? P: Yeah,
that's nothing. TB: That's-- that's all it is.
Nice job.
You doing okay? P: Yeah.
TB: It's not bad, right? P: Yeah, I’m just trying not to think about it, that's all. It's not the pain, I'm just thinking about the toe.
TB: Did you really tag me?
P: Yeah, why? TB: Oh my God. [laughs]
P: I thought you said don't-- I thought you said-- TB: Yeah, you can, there's no problem, that's awesome.
P: It's good promo for you.
TB: It is!
Okay, nice job.
We gotta do one more side.
Okay, here we go - another little pinch.
This one's a little tougher so just breathe, just breathe.
It's gonna go down pretty quick.
Nice job.
You okay? P: Mhm-mhm.
Don't remove the toe yet.
TB: No, no, we're not doing anything yet, I gotta set everything up.
P: Okay.
TB: Don't worry, I let-- I test the area first to make sure it's completely numb, I wouldn't just yank it.
This is not-- this is not a home surgery, this is a serious thing today, we're going to be dressing you up or dressing me up and--
All good, that was the hard part.
How was that? P: It was okay. [laughs] TB: It was not bad, right?
P: Just scary. [laughs]
TB: Don't-- don't be scared. P: I'm scared because I'm always supposed to look at my toe after. [laughs]
TB: [laughs] You just-- P: Do I have to change the thing or does it--
TB: You will have to change the thing.
P: Oh my God. TB: You'll be okay, you'll be okay. P: How often?
TB: Twice a day, I'll give you all the instructions afterwards; you just chill out.
P: Okay. [laughs]
TB: So, I’m just wiping down your toe for a second.
P: Huh?
TB: I’m just wiping down your toe for a second. P: Okay.
TB: And putting on that elastic band so there's very little to no blood and so you're just gonna feel a little bit of pressure.
What are you listening to? The Spice Girls?
[laughs]
She has her music on.
P: Oh, do you hear me?
TB: Yeah, I was just asking if you're listening to The Spice Girls. P: No, no. [laughs]
TB: Backstreet Boys?
P: No.
TB: Lil Bow Wow?
P: No. [laughs] TB: Okay.
So, a little bit snug.
P: Yeah, that's okay.
TB: So, yep, we're gonna do one last check in a second.
P: Let me know when to put the music on. TB: I'll let you know in a second.
P: Okay.
TB: So, before you get to putting music on, you said your friends pushed the nail back in?
P: No, not in, down.
TB: Down back?
P: So, the nail went-- was up-- TB: Yeah. P: And it was still attached at the bottom
and then they pushed it back down. TB: Ah, gotcha, gotcha.
Okay, we're gonna do one last little check so this is the last time I'll need you. Do you feel anything sharp here?
P: No.
TB: Anything sharp here? P: No.
TB: And how about down here?
P: No.
TB: Okay, perfect. Put on your music.
P: Aah...! TB: [laughs]
So, we can see--
she's already freaking out but it's already done.
That was the nail bed that still kind of got attached to it at the base.
You see where it kind of got separated?
So, her nail's permanently damaged so the bottom is attached but the top is always been lifted. P: Ah!
TB: You okay? It's already done.
So, I'll get some of this basking out. So, her nail bed was basically a wet wound
and just leaving it on-- this is gonna get really infected, it's gonna get nasty so,
normally, I trim it back while without numbing but hers - she needed to be numb.
So, everything's gone.
And I’m gonna see, because her nails not attaching at the front, I’m going to clean up the front end to see maybe as the new nail comes in,
get some of that old scar tissue - bad tissue - and let the new-- hopefully the new nail can reattach a little bit.
What song is that?
Nurse: I don't know.
TB: Oh, sorry, you only listen to K-pop, right?
N: I don't listen to K-pop... TB: [laughs]
Oh my God, I hear some bad words.
Okay, you're all done.
Put a little bit more so nothing really gets stuck on, so, get the gauze.
[laughs]
P: It's done?
TB: No, we're just gonna start, so--
P: Oh, I thought you started already!
TB: No, we're waiting for you.
P: Oh... really?
TB: No, we're done. [laughs] P: Oh, really?
TB: No, you're all done. [laughs] P: No way, really?
TB: Yeah, we're all done. P: Oh my gosh.
TB: You okay? P: Is it covered?
TB: Yep.
P: It's covered? I can look? TB: Yep.
P: Okay. [laughs]
TB: So, I'll tell you - it was bad underneath.
So, what happened - you had a wet wound. So, now it's hard for you to see.
I'll show it for the camera too. So, you see the bottom white part? P: Yeah.
TB: This is where your nail was growing attached and it was this top half that was damaged, the nail bed was scarred and it was always growing lifted. P: Yeah.
TB: The nail bed was completely wet, soggy, this was like a wet wound. If that was left on, it definitely would have turned into a really nasty infection so it's really good that we removed it this way.
So, what I’ve done is - remember how you talked about how-- how dry that nail bed is in the top?
I did scrape it down, clean it up a little bit to see if we can restart have fresher healthier skin so as your new nail is growing in,
we're going to put on that onyfix band to see if it can reattach so once it grows past this point, it all-- the whole thing is attached.
P: Oh my God.
Is that my souvenir?
TB: Yeah.
P: Can I see? So-- flip it back over.
So, this part was inside my skin?
TB: No, so, that was the healthy part of your nail that was healthy that was attached and that was the top half that was completely detached but it was only hanging on on the sides, it was completely lifted in the middle.
So you basically had a loose, loose nail that's completely open - not good.
You want to take this one home?
P: Sure.
TB: I knew you would.
If I see anyone tagging me on social media with their toenail then now I know who it will be. [laughs] P: [laughs] I cannot believe, my own toenail. [laughs]
TB: [laughs] You only had half of a toenail to start off with so you're not that much different now.
P: Oh my God.[laughs] I gotta record this. [laughs]
TB: Are you gonna record? You gotta have this guy in here too.
P: Oh my God, do you think it's okay to show it? TB: Yeah. [laughs]
P: [laughs] Oh my God. Guys, I don't have a toenail anymore.
He removed it, that's my old toenail.
TB: We can just stick it back on. P: [laughs] TB: [laughs]
P: Yo... Yo... Oh my God, I’m so sad. [laughs]
I’m sorry, like, it's so weird.
I didn't feel anything but I felt like you guys were using a lot of arm strength... no?
TB: I was putting a little bit of pressure on it, not a lot but--
P: Oof, okay, so--
TB: What you're gonna do later tonight - you're going to take everything off, they're here--
P: Not me, my mom. There's no way I'm touching that. TB: Okay, your mom.
She takes everything off and puts on cream and a band-aid. Now, if it's still bleeding, I’m going to give you some gauze-- I'll give you instructions so you'll have-- P: Yeah.
TB: I’m going to give you some gauze and some wrap just like this so, if it's bleeding, she can wrap it back up with the gauze.
But tomorrow morning shower with the dressing on, then take everything off, then you can put just the cream and a bandage.
P: So, tonight I can't shower?
TB: You shouldn't, not tonight; wait for tomorrow.
So, every day you're gonna dress it morning and night with cream and a band-aid.