Wednesday, September 5, 2012

How I Beat Onychomycosis





How I beat Onychomycosis

I was doing my pre university college (PUC) near Mangalore in 1983. This place really pours in rainy season. And it is really cold and damp in rainy season. You do not see sun for many days. In my second year of PUC I my left thumb nail was getting yellow and thick. Over time it really got thicker and filled with a kind of powdery nail below the nail. Nobody knew what the hell it was. And doctor there also did not know what to do with it.

The next year I joined medicine (MBBS). And my nail was really sick and ugly. I could not show anybody as it really looked very bad and I always covered it with my index finger.

Six months to one year down the line in my first year medicine, I went along my senior friend to dermatology department. The skin specialist saw that nail and told us that it was Onychomycosis the fungal infection of the nail. Then he sent me to microbiology department for scrapings to be sampled for tests. Of course it was fungal infection of the nail. Yeah,  What can I do? The place where I got this, even our clothes used to get fungal infection in the form of black dots.

Then I went to the doctor again for which he asked me why I was I bothered, as I was not getting married. Then he told me I may have to take Tab Griseofulvin for six months to one year.

Over time I went on forgetting it and continuing. Again in my second year medicine when I got in to clinicals, I started reading about it again and again. But treatment was same. I was really tired of this. There was nothing much I could do about it. Every time I used to start tablets and stop it after few months as there was no change. I used to scrape that nail regularly hoping it will go till the nail bed bled. But nothing happened. I tried topical cream also for few months and stopped.

The nail by itself never bothered me. It was only the cosmetic purpose it bothered me.   Again I went to the doctor who had the same answer and no new medical miracle had happened to solve my nail. At that point of life that was the only thing I was praying for other than the routine. And you know the jokes with that kind of nail.

Onychomycosis is the fungal infection involving the nail bed. Not the nail. As the nail is made of keratin which is dead by itself it cannot get infected. But the nail bed infection where the nail is formed causes the nail to be transformed in to a dirty and thick nail. So applying antifungals on the nail does not work. The nail bed is very vascular (rich blood supply). Since the nail bed itself is infected it has to be treated systemically, that means you need to take the drug and it has to go through the blood stream in to the nail bed and over time it has to kill those fungi. This is a long process as the fungi who are involving the nail bed take time to be treated. After fungi have been cleared the newer nail can grow. Nail takes long time to grow. Whatever is infected and has grown has to grow further and get out making way for the treated and fresh nail. That is a long process.


Having read about it and thought about it for at least four years and having approached everybody and I could not solve it. I was waiting to finish my medicine and get in to my internship. Once I got in to internship, I planned a treatment for myself. I thought I will approach this in multimodal way. So I started Tablet Griseofulvin, which was the treatment of choice at that time which 1991.  After taking this tablet for two to three months, I went to my surgery post graduate and asked him to take off my nail surgically.

Though reluctant initially he agreed to knock it off when I insisted. I got my nail surgically removed. Few days later I removed the dressing, I started to apply antifungal cream. I continued the drug and cream till the new nail came. Over two months my nail came back and it was new and normal. I had achieved my dream of a normal nail after almost seven years.

Whoever is trying treatment of this has to meet a doctor and go according to the recent times. Newer Antifungal drugs have come in to practice. I only did this as I was a qualified doctor.


Watch what you Eat

  Watch what you eat Other day we were in a very expensive restaurant for dinner. I just ate a piece of mutton chops, and when I just bit ...