TB: So I would say probably every two, three months...
Patient: Okay.
TB: That's when I would come back.
P: Okay.
TB: So you weren't able to reach your feet to trim the nails?
P: No, I can't. I can't get my feet up. I can't.
TB: Yeah, it's hard.
P: My knees are shot (don't work).
TB: And these nails didn't bother you at all, huh?
P: Not a bit.
TB: This is a little bit of pain.
Okay. The good thing, they're not really thick, thick, thick.
They're just long. They're just long!
P: Well they fit my boots, right? (laughter) My boots have been training them.
Like I can't even wear socks.
TB: No.
P: Because I can't fit them on.
TB: You gotta get a sock with a sunroof on there just to have that one poke through.
Okay, but no problem. We're gonna trim all the nails,
make them look nice, and like you say, you may be dancing tonight!
So if anything gets a little bit sore or sensitive, you let me know, okay?
P: Yeah.
TB: So next time, now you know where I am,
the moment the nails start getting long,
it's really important you come in sooner than later.
P: Okay.
TB: Because you see, on that left big toe how the nail got ripped off?
P: Yeah.
TB: We can get an infection,
actually can lead to possible amputation of the toe. We don't want things like that to happen. So that's why, in the future,
when they start to get a little bit long, you know where to go.
P: Yeah.
TB: So if anything bothers you, you let me know.
P: But all these years, my feet never really ever had problems.
Well when I was in my 20's, I had athlete's foot but that was from dirty socks and
not changing them enough. I used to Work 12 Hours a day outside so
but that was easily solved with Absorbine Junior.
TB: Yeah.
P: Two, days it was gone.
That's the only problem I ever had.
TB: When do you think the last time these nails were cut?
P: Guesstimate, two years ago.
TB: Two years ago.
P: I did them.
I had great difficulty.
I used to sit on the edge of the bathtub, pull my leg up and uh
I fell backwards into the bathtub and that was the end of that.
TB: And that was the last time! You learned your lesson, uh!
P: Yeah.
TB: Okay, we're getting to the good stuff.
So we got this one here. So if this one gets a little sensitive, you let me know.
Luckily, none of the nails have grown into the skin.
Another patient earlier today who had the nail grow in, in, in, in!
It was in bad shape so...
P: That would be surgical?
TB: Well, we had to freeze the foot, freeze the toe to get it out because it was very painful.
So, you're not at that stage like you said, your shoes betrayed you, man! they let you go this long.
They made it through.
P: It won't happen again.
TB: Oh, that's good.
I'm happy that
it's nothing worse than just some long toenails.
So you knees are shot. You must have been a super athlete back in the day! What was your sport?
Did you play any sports back in the day, Jim?
P: Oh yeah; it was football.
TB: Football, huh?
P: I was the smallest guy on the team.
TB: But you were the smallest guy with the biggest heart.
P: I played two seasons at the University of Guelph.
TB: Oh, you, did? That's awesome. What position?
P: Halfback.
TB: Nice.
P: RIght half.
TB: Any pain?
P: No.
TB: There's one piece.
P: Do you need vice grips for that one?
TB: No. We got our good wire cutters here so we're okay.
So, we're just going to trim this guy,
as much as we can.
P: Yeah.
Catch the rest next time.
TB: No, we're gonna get, cut it down to its normal length.
Okay. So that nail was pretty much completely lifted.
P: You mean like this one.
TB: Yes, underneath. It wasn't attached at all and that's why there is a lot of dead skin and junk underneath here.
TB: Okay.
That wasn't so bad was it?
P: Didn't feel a thing.
TB: That's no fun! That's too easy!
P: You would have had this in your face. (laughter)
TB: No that's why I always got to hold down the nail before I
cut it. You learn the hard way; you don't want to get a nail in the face.
P: So this other one will grow back in then?
TB: Yes.
TB: There you go. We'll do the other one.
We'll lift this one. Your knee is still okay?
P: Yes.
TB: That's okay?
P: Yes.
TB: So, we'll trim this one as well.
P: Is there any solution I can use when I soak my feet?
TB: You can use just even a little bit of Epsom salt is fine.
P: Epsom salt?
TB: Epsom salt.
TB: And that's about it. A nice little soak.
The most important thing after you soak your feet, Jim, is just
in between the toes, dry very, very well. I know it's a little hard to get to but
you don't want athlete's foot to start all over again.
You can use a towel and use it one foot
over the other to try to push the one toe in between the toes to try to get that out;
get all the moisture out. Or you really need to let your feet dry before you put on socks or anything like that.
P: Okay.
TB: Moisture can cause a lot of problems for people.
Doing okay?
P: Yep, no problem.
TB: They say, "No pain, no gain" but no pain for you.
Did that one hurt, the big toe?
P: No.
TB: When it got ripped off?
P: No. I didn't even know it until the next morning; it came off in the night.
TB: Then you had blood all over the place, huh?
P: A little bit.
TB:It looked like there was a murder scene?
P: Not much; it didn't bleed that much.
TB: Was it just as long as your other big toe?
P: Uh, about half (as long).
TB: Okay. So if this one gets a little sore, you let me know.
So see how the tips of these nails are all yellow and greenish?
P: Yeah.
TB: When a nail is not attached, a lot of dead skin
even fungus can get underneath that.
That's why it gave your nail a different appearance. But your actual nail at the back, is healthy and clear.
P: Okay.
TB: Because the nails are so long they allowed dead skin to get trapped underneath.
Once we clean everything up, it should be much, much better.
TB: So,
You just lost like 10 pounds, man! This is an instant diet! (patient laughs)
You're going to fly out of here! You won't be walking; you'll just be floating.
This is all this, the dead skin. The good news is the back of your nail is all healthy and pink.
This one just has a scab, they're no signs of infection. The scab will come off in time and it will just get better.
P: Maybe it's an advantage I don't wear socks.
TB: It can be. Yes, yeah.
So we're just going to file the nails then we will clean up the toes.
No pain?
P: No pain.
TB: Awesome.
Well I'm happy it was nothing too serious. You've got no hard skin on the bottom of the foot, no callus, no corns.
You got nice toenails, now you've got your nice shirt on, it's Friday...
P: I'm ready to go!
TB: You're ready to go!
Look at that!
P: No nail polish yet. (laughs)
TB: Maybe you can get a nice shade of green to match your shirt; that would be pretty nice!
There you go; look at that foot!
P: It's like brand new!
TB: It's like brand new; that is right.
So we're just going to file this one.
So if you really want to be on top of things,
you could do two weeks.
P: I could do which?
TB: I'm sorry! Two months, two months.
P: Okay, every two months.
TB: Well, you went two years so
technically you could push it a little bit longer if you wanted...
P: No, no. I'm staying on top of it.
TB: So what we do normally, I'm very honest with my patients,
we come back in two months. We see how much of the nail has grown back, okay?
P: Okay.
TB: If it really hasn't grown too much, the next appointment, we'll do at three months.
P: Okay.
TB: And we kind of find that sweet spot.
So if your nails don't grow too fast,
maybe we'll do three months.
P: I'll try to.
TB: But we start with two. We definitely start with two to see how that is.
Look at that!
Definitely gonna go, you gotta go open toed shoes now!
P: I can wear sandals next year!
TB: That's right! Look at that. Looks good.
Normal feet again. Okay?
P: Thank you very much!
TB: Well you're welcome, you're welcome. It was a pleasure. Let's turn this off.
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