Question
Hello -

I'm looking for some advice.  Back in September, I was diagnosed with mild toenail fungus and given a prescription of Penlac by my primary care doctor to use daily.  The toenail got worse and my primary care referred me to a podiatrist.  By then, the fungus had spread and the toenail just about fully detached from the nail bed.  The podiatrist recommended removing the nail and said that we'd discuss how to care for/treat the toe once it was removed (about three weeks ago).  Well, she removed it and wouldn't give me any straight answers to any of my questions as to what I could expect with regrowth or how to care for it.  Since then, it seems the skin where the nail was has formed some kind of scab-like surface - what I don't understand is that if the toenail was already pretty much detached, why would this happen?  Is this going to eventually fall off or is this some kind of infection that I'm not aware of?  The toe itself is a little redder than normal and aches every once in awhile - the area where the nail used to be is quite an eyesore.  I want to go to another podiatrist and get a second opinion but am afraid that I'll get the same reaction as the first and I don't really want to go through that again.  And I also need to mention that I'm still nursing my baby and plan to continue for quite some time.  I know that limits what I can do to take care of things as well....but there should be something I could do!  Are any of the home remedies like apple cider vinegar or tee tree oil worth a shot?  A few lactation consultants said that I could take Lamisil while nursing but none of the doctors are willing to prescribe it and I think I'd only take it as a last resort.  Does laser treatment actually work?  If so, how much is the cost since I assume that it's not covered by insurance?

Thanks!
Michelle

Answer
ANSWER: This Chicago, South Loop & Elmhurst Orthopedic Podiatrist of AnklenfootCenters.com says.......

Dear Michell,

Laser for toenail fungus may be 65-89% effective-depending on the laser used & the technique of the doctor. Most patients need a second treatment & sometimes a third.Laser for toenail fungus is not covered by insurance and so make sure you get the total price of the treatment. Full treatment is around $900-$1100. Make sure you get directions to prevent recurrence(e.g. not wearing same shoes for 2 days in a row-allow them to dry,drying toenails thoroughly,  before applying polish, etc)
If you do Lamisil-wait until you are done breast feeding. I like pulse dosing Lamisil-It works better and has less side effects
Your pediatrician will let you know of the safe drugs(like motrin, etc)
Penlac does not work.
Avoid taking drugs while breast feeding-especially Lamisil-Your specialists are wrong!
Apply Tea Tree oil and/or Lamisil daily where the old nail used to be.
Gently file the dead skin to allow penetration of the topical meds.
Go back to your podiatrist and tell them of your concerns. If you can't have this conversation-then get a second opinion.


Hope This Helps
Good Luck !!!

Favorable Ratings are always appreciated-Thank-you

The podiatrists of AnkleNFootCenters.com are specialists in foot& ankle second opinions.
We are located within 30 minutes of both Chicago airports
We are Podiatrists in Chicago & Elmhurst
Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.