difficult child has seriously infected toe - what fun!

Discussion in 'General Parenting' started by Shari, Jun 1, 2009.

  1. Shari

    Shari IsItFridayYet?

    Both of my difficult child's picked their toenails to the point they bleed. difficult child 1 finally quit when he was about 15 and had to get his second big toenail surgically removed.

    Wee difficult child is having his first "toenail" experience as we speak.

    He came to me last night, without shoes, as is the norm, and I noticed his big toe was HUGE and PURPLE. I asked him if it hurt. "Uh, not really."

    been there done that with difficult child 1, so I took him to the doctor today and just what I suspected. Its infected from picking his toenails to the quick and beyond. doctor is fairly worried about it...put wee difficult child on antibiotics (he's only 3 days off a Z-pack, so he's got a good one going) and we're to go back if it doesn't look at least a little better in 2 days; provided it calms down, next Monday, they will remove part of his nail and open it to drain and hopefully not have to drill thru his whole toe - which is new one to me.

    In the meantime, doctor wants him to wear socks. ROFLMsocksO. Actually, wee difficult child agreed to wear one sock. We'll see, hopefully he will. I'm checking the sites for seamless socks as we speak.

    These kids... I tell ya.
    Last edited: Jun 1, 2009
  2. gcvmom

    gcvmom Here we go again!

    easy child has had that happen to her twice. Her toe ended up peeling afterwards because it had swollen so much. I keep telling her to leave her toes alone! Part of the problem is that she has such wide feet... I have to really be careful with the shoes I buy for her so that her toes aren't crowded.

    Hope the drugs clear it up quickly. Maybe you should try putting mittens on wee difficult child? :p
  3. LittleDudesMom

    LittleDudesMom Well-Known Member Staff Member

    Shari, hope the wee one keeps a sock on it! I do hope the anitbiotics work - it hurts just to think of the alternative.

  4. therese005us

    therese005us New Member

    Do you have potassium permanganate in US? If so, a 1/4 teaspoon in warm water and get little one to soak his foot in it for 20 mins. It will turn brown, but it will cure it quickly. It is a powerful disinfectant. We used to have the old folks soak their bots in it when they had bed sores and haemorroids.

    If he won't keep a sock on, make him wear mittens, or has that already been suggested?
  5. Marguerite

    Marguerite Active Member

    It sounds like the problem is the picking at it, on top of the current infection. You can treat the infection but if the interfering with it continues, the infection will come back.

    I second the potassium permanganate (we call it Condy's crystals).

    But here is another and perhaps simpler method (also less purple). I got tis form a microbiologist neighbour, if the child is also on antibiotics, it can only help. But I've used this in the absence of antibiotics, with my doctor's support (I can't take antibiotics, notwithout a lot of careful medical supervision).

    Treatment is based on knowing that the most likely bug is staph aureus. It lives on your skin quite happily, it is the bug that causes pimples. ON your skin it grows in the presence of oxygen in the air; when the bug burrows into your tissues (having been introduced there by contaminated little fingers) then it changes its character and begins to multiply anaerobically (ie in the absence of oxygen). It can get REALLY nasty in a flesh-eating kind of way, if the bug from a sore throat, strep B, gets in on the action also multiplying anerobically. The two bugs work as a team to turn the flesh into mush and the skin into soggy white stuff stripping off the flesh underneath. You need to stop these bugs when this starts happening.

    So, what to do - the bugs multiply by cell division (mitosis). It's exponential growth - the number of bugs doubes every time. After two divisions you have four times as many. After 6 divisions, you have 64 times as many. So don't delay. All those bugs cause a lot of inflammation and swelling (as well as a lot of pus) and all that pressure causes A LOT of pain.

    BUT - the bugs hate heat. Heat actually interferes with cell division in the bugs. It 're-sets' the mitosis, the bug stops dividing and the process has to start again. Now, bugs MUST divide within a certain interval, or they get too big to survive. As bugs age, they grow. They are single-celled, and after a certain size, they simply can't survive because it takes too long for raw materials etc to find their way through the (larger) cells. So the longer you can interrupt the cell division, the more you can prevent the infection getting worse and after a period of time, the bacteria will be unable to divide and your body can begin to clean up the damage.

    So to stop the cell division - you dip the affected appendage (the toe, in this case) in water as hot as you can stand it. If you use salt in the water, it will kill bacteria on the surface and wherever the salty hot water can reach. The heat will get to the deeper tissues. The added bonus of the heat is to expand the blood vessels in the toe which allows any antibiotics in the circulation, to get to the area of infection. Trying to treat such an infection with systemic antibiotics is always tricky, because peripheral circulation is not the best anyway, plus the swelling from the infection often makes the blood circulation even worse (from the pressure due to the infection).

    The staph aureus bugs prefer to divide every 4-5 hours or so, I was told. So you need to get the heat treatment onto the toe at 3 hour intervals. As hot as he can stand it, then as it cools, add more hot water. Allow him to control the heat because your hand might feel it's OK, however an infected toe is a lot more painful and responds differently. However, the hotter the better. Just don't cause burns. Make a note of the time. I usually keep the toe in hot water for half an hour or so, then I mark the 3 hours from when I take my foot out of the hot water.

    Now for the most important trick - DO THIS AGAIN. You must keep the repetition to under the 4-5 hour mark, and aim for at least 3 consecutive treatments, on 3 consecutive days.

    Something else I have done with this - I have used hydrogen peroxide directly on the wound, after the hot water treatment and before putting on a fresh dressing. If there is nowhere for the infection to drain, then forget the peroxide. Similarly, I've used ti-tree oil on the wound following the peroxide, to keep the surface clean at least.

    As I said, I can't take antibiotics so I've had an immunologist okaying my use of this technique, with such an infection.

    Danger signs to watch for - the alarming red streaks running from the infected area back up the body towards the heart - go straight to the emergency room. Also watch out for a fever, general aches & pains, feeling of unwellness (all of which you can get with or without red streaks, which are a sign of lymphatic infection). These can be signs that the infection is going systemic and this requires the doctor to get involved urgently. It can still happen even when you're donig everything right, so keep an eye on him.

    IN the days before antibiotics, people died from infections like this. Or they lost limbs. He needs to know that doing this sort of picking is very dangerous. If he's going to pick, he neds to learn to treat the problems he has caused. The hot water treatment may feel like punishment, but it is in reality natural consequences.

    Good luck with this one.

  6. Shari

    Shari IsItFridayYet?

    He did his hot water soak in addition to his bath this morning and put on socks to go to camp. He complained several times on the way to camp that the socks were bothering him, but he said he's leaving them on so his toe will get better. And it really is less red already.

    I just find it so...curious....tho that both he and difficult child 1 did/do this. Oh well. Life with difficult child's is never boring.
  7. graceupongrace

    graceupongrace New Member

    It's always something! :tongue:

    Epsom salts in the hot water are also helpful -- they draw out the infection. Very cheap at any pharmacy. And Marg's idea about the peroxide is a good one. We use it all the time to clean scrapes, bug bites, etc. You can just pour it over the affected area, or use a clean cotton pad or Q-tip to swab it on.
  8. Marg's Man

    Marg's Man Member

    Shari you said
    Make sure he does it as often as possible if his schedule cannot manage Marg's three hourly schedule. This will make it more comfortable until you can get the time to keep the schedule possibly at the weekend. By starting on Friday evening you can get a couple of treatments in before bedtime and continue through Saturday and Sunday

    ANY sort of salt will work just as well. The idea of the salt is to further mess up mitosis because the high salt concentration draws the water out of the cells (makes them 'thirsty').

    Peroxide is also good but watch the concentration you use - here in Australia it's easy to get 3% and 6%. If you leave it open the water content in it evaporates a bit and the concentration goes up to about 10% which burns (nothing serious but it is painful). I should have known this would happen but I had to learn the hard way while treating an infected toe on myself.

    Marg's Man
  9. therese005us

    therese005us New Member

    Another tip is to soak the feet in warm water and vinegar (nice and cheap) as it changes the acid levels and kills fungal infections.
    Good luck with it. I remember having to take my little sister to the doctor to get her toenail half removed, and it was most distressing (for me too!!)

    Just my tuppence worth
  10. Marguerite

    Marguerite Active Member

    I had half a toenail removed a few years ago, because of recurring infection in one area. I've had infections in other toes, but due to the shape of my toenails, the treatment 9whether conventional antibiotics or my own vesion) never worked for long, reinfection was always a problem. Since the surgery - no worries. However I'm glad I wasn't a picker, because it has left my toenail looser than normal, a picker would be able to easily remove the whole nail and then there would be trouble.

    difficult child 3 is a picker - notb as bad as he used to be, but he has scars on his arms from pimple picking, as well as a few deep scars on his scalp from past wounds become major due to picking.

    It's a problem. I wish we could put collars on our kids, like you put on a dog's head to stop it from scratching...

    The sock is your best bet.

  11. Kjs

    Kjs Guest

    Toe picking - OMG. difficult child is and has been doing this that I know of for about a month. I found out by blood spots on the floor. He has like 1/4 a nail on his big toes. He is constantly picking them. Then I noticed a lot that he asks husband for the clippers and he would be clipping. I had to HIDE all the clippers. Now he uses his fingers. I try to make him keep socks on. I constantly brush his hand away from his feet. i remind him of infection and losing his nail. But he is saying he HAS to clip it or pick it because it "hurts so bad if he doesn't". I told him I want his nail to grow to the end of his toe. (that would take years from what it looks like)

    What to do about this? Do I take him to the doctor? What are your solutions?
  12. ML

    ML Guest

    I just have to say thank you for this information. Just one more thing about this CD family for which I'm grateful. Manster isn't a toe picker, more of a shirt biter lol. But this is great information just in case.
  13. Shari

    Shari IsItFridayYet?

    Wee difficult child eats his shirts, too.

    KJS - I wish I knew how to make them stop. difficult child 1 only finally stopped when he had a bad enough infection from his picking that he was in a LOT of pain for an extended period of time and couldn't even wear tennis shoes. Seems every other deterrent I tried did not work with him. difficult child 2 looks like he is going to be the same way. He seems to have a little more will-power than difficult child 1 did at this age, and yesterday, despite the fact that he HATES socks (sensory thing), he did keep one on for the whole day (he took the other off). So we will see...he's a bit afraid of infections (for whatever reason) and maybe this will be bad enough to stop him from picking.

    That and when I noticed his toe, I literally had just finished relaying a story to a friend about an older man who passed away last year due to an infection in his foot from blisters from new shoes. He was diabetic and unaware and didn't notice the infection until he had gangrene, they had to amputate part of his foot, and he still did not make it. I'd have never told difficult child that story on purpose, but I noticed his toe immediately after relaying it...