Toe Bro: So--
Patient: All right.
TB: This is-- we did all the other nails, we'll file them down too.
So this is the big thing - you have a lifted, tented nail.
Yellow, discolored, more crumbliness underneath
and the streak goes all the way down. This is a fungal infection.
What probably happened-- I think you probably banged your toenail, something-- P: I did.
TB: --something caused it to get lifted but now the fungus got in.
The sides are good, it's just this middle streak.
So anytime you treat nail fungus, the most important thing is removing any dead, lifted, damaged fungal nail.
Dead, lifted, damaged fungal nail.
P: Okay.
TB: So the medicine that you apply topically actually gets in.
P: Oh, okay.
TB: So today we're gonna trim back all that yellow lifted section, any bad nail, we're gonna buff the nail extremely thin.
P: Okay.
TB: You have that medicine, Jublia.
P: [inaudible], yeah.
TB: You're gonna start applying it morning and night.
The package says once, the pharmacists, the doctor will say once but you should do it twice, morning and night.
P: Okay.
TB: We're gonna come back in six to eight weeks and buff the nail again
and we're keeping the nail as thin as possible, remove any build-up of dead or fungal nail
so as the new nail grows in pink and healthy, the bad stuff grows out.
P: Now, when I apply it--
TB: Yes. P: --because it's topical--
TB: Yes. P: --there's chance that it comes off--
TB: And that's fine. P: --so what do I do?
TB: So in the morning--
P: So, for example, in the morning-- TB: --and at night.
P: --it's okay because I'm not going anywhere, I put on my slippers, that is fine.
But at night, I put it, I go to bed, it's gonna rub off on the sheets--
TB: So you give it at least 15 minutes.
P: Before I go to bed.
TB: Yes. Or, yeah, 15 minutes-- P: Or if longer, the better.
TB: Yeah, cause it's an oil, so oil works better for nails versus spray or cream
but oil, give it 15 minutes and you should be good.
P: Okay.
TB: Okay? So we're gonna trim back all this dead lifted nail, nothing should hurt so if anything's sensitive, you let me know.
P: Okay.
TB: Did your brother show you his video?
P: Oh, he showed me the foot-- not the video but the pictures and I said, "how did your foot become like that?!"
TB: It was pretty bad, huh?
P: It is! It was-- [inaudible].
TB: It was not looking good.
His nail was in bad shape.
P: I hit this sucker.
TB: That's what happened, right? You banged it and you didn't do anything about it for so long.
P: Woah, it was easy for you to cut.
TB: Of course, I got the good stuff.
So we're gonna trim back as much of
the bad stuff as possible
and then we'll use the--
the light is so bad on this camera, something happened.
So everyone, you know, it's completely lifted and most people would just apply the medicine right on top
but it won't get in, it won't actually touch the nail bed
and so that's why anyone who's treating nail fungus, they have-- have to get this nail trimmed back, filed down
or else they're just wasting their time with the medicine.
P: It was good the time I spoke with my brother about it so that he just said, "okay, I mean,
the two guys are closed because of this--"
TB: COVID.
P: --COVID." So he said I should apply Beta-- Betadine.
TB: Hm-mhm.
P: And I started putting it, it was so-- when I started putting that, that I felt some relief
otherwise it was just terrible, I was feeling pain and stuff.
TB: And I think just the nail too, the nail--
[phone call ringtone]
P: Oh, I'm sorry. [phone call ringtone]
TB: That's okay. [phone call ringtone]
[phone call ringtone]
P: If you don't mind, I'll just--
TB: Yes, yep.
P: [on the phone] Hey.
Not too bad, how are you?
Yes, I am busy now. Let me call you back in about an hour.
Okay.
Well, did you read my message?
TB: Sir, did your nail ever turn black or blue anything like that?
P: No.
TB: Very interesting. So, after filing everything down and re-looking at it, I have a feeling this is...
maybe not nail fungus but possible nail trauma.
You might have had a pocket of pus or fluid build up and that's why it was painful so when I keep-- keep it--
when I take it all the way down, there's a bump in the middle but it didn't break away like normal, it was almost like a pocket
and I feel that's why it was hurting you so much.
You might have bruised or--
P: You know, this little and this one--
TB: Are different. P: --they-- no, they've been the same.
How this one look like this-- TB: Because--
P: --is beyond me.
TB: And I think this could have been repetitive trauma.
Again, you have a bigger bunion on this one than the other foot.
P: Okay.
TB: Who knows? But I don't think it's truly nail fungus but we'll still treat it the same.
I believe that you had trauma that caused a pocket of pus or lifted the nail up
so what's happened, as I cleaned it up, you see how much healthier it looks?
It looks-- there's no more yellow.
So what I'm expecting is, as the new nail comes in, all this damaged, banged up nail grows out.
We should still apply the Jublia because traumatized nails like this that become lifted or exposed
are very easy to catch fungus so we're gonna protect it and I feel this will just grow much normally.
So, originally, I think there might be still fungus but the main issue is because you traumatized
or bang the nail so bad that that's why you have pain in the beginning.
P: [laughs] That's possible.
TB: Very similar to like your brother except your whole nail did not come off, it only got lifted in that corner.
P: I am very-- what do you call it? Sometimes, my wife get-- she says, "can't you open your eyes and see?", "I don't know!"
TB: But you're not having any more pain, we're gonna treat the nail, we're gonna come back in two months,
file the nail like we did today
and let everything grow and then I think it'll be fine from now on.
P: Okay.