Tuesday, March 6, 2012

Get with the program, Toe

I met with Dr. Oncologist on Friday to discuss the results of the colonoscopy.  She too was delighted that there was nothing to biopsy.  My elation faded, however, when she answered my question, "what happens if my colon is still glowing on the next PET scan?"  She said that that is when things get more complicated.  Either we continue to watch it, or if the region has increased in metabolic activity there might be some exploratory gut surgery in order.  Ugh!  I don't actually believe that this will be the outcome, but one never knows, does she?  So we'll just hope that the glowing colon will go the way of the glowing spine, lungs, and chest wall and stop glowing in time for the next PET scan.

My next PET scan is at the end of May.

In the meantime, a body part from the peanut gallery has decided to participate in the post-cancer fun times. I have been having an issue with the big toe on my left foot.  I wasn't even going to mention it in the blog, because I thought it wasn't cancer related, but the podiatrist has mentioned certain possibilities that close the gap between my big toe and cancer.  Gulp.

One day before we left for Santa Fe, I noticed that my big toe was hurting around the nail bed.  I thought nothing, literally nothing, of it.  It's a toe.  Also, sometimes things hurt periodically and then they stop hurting.  Right?  Surely you all have experienced some random pain somewhere in your body, and you don't know what caused it, and when you wake up the next morning it is better if not resolved entirely.  This was me and my toe.

Well, in Santa Fe it got worse:  redder, angrier, more painful.  ("More painful" is not a comment on the pain level itself, just a comment on an increase in pain.  I was not limping or anything).  So I soaked it in epsom salts and smeared neosporin on it.  No resolution.  As a side note, it is not an ingrown toenail because 1) I have good toe hygiene! and 2) the reddness is around the nail plate at the base of the nail, not the sides of the nail.  Also, there was no injury or incident that I remember between me and my toe.

Darn it if the thing hasn't been getting worse.  The pain has stayed at the same low level, but it is now a little bit black-and-blue under the nail bed while being red and inflamed on the nearby skin.  I took my audience with Dr. Oncologist on Friday as an opportunity to get her medical opinion on this 2-week-long toe issue, and she in turn sent me to Dr. Podiatrist.

Dr. Podiatrist has an excellent bedside manner, a soft spot for microbiology, and a gift for explaining the possible causes of and outcomes for my problem.  In short, I am a fan.  (Why couldn't HE have gone into gastroenterology?)  Unfortunately, my toe doesn't fit any textbook phenotypes, so he couldn't make a conclusion without a biopsy.  We agreed that it is a bit too soon to rush into a biopsy.  So I am on a course of antibiotics in case it is an infection, and I am to watch it for changes.

And here's where the connection is made to cancer:  his concern is that it could be a melanoma (skin cancer) that just happened to develop under my nail bed.  It happens, albeit rarely.  So if it suddenly becomes irregularly shaped or continues to increase in size, a biopsy of my toe and toe nail is in order.  I forgot to ask if this would have showed up on my PET scan a month ago.  Are my feet even scanned?  I have no idea.  

Also, who on earth has to worry about melanomas under their big toe nail?  Apparently the girl who had inflammatory breast cancer.

My preferred hypothesis is that it is an infection.  Cancer is still to blame for this possibility, I think, due to a continued weakened immune system.  Please join me in cheering on the powerful antibiotic cephalexin (I used this antibiotic to make discoveries in graduate school!) and hoping is makes it all the way down to the toe peanut gallery.  


  1. Hi Heather,
    Been lurking around here without leaving comments as it seemed more like a family-and-friends space, but just to say that I admire your strength and attitude (okay, that sounds totally trite, but anyway...). I had a PET scan recently and they scan you from the middle of your eyes up to your thighs. I have no idea why, but your feet are not scanned. Hope the antibiotics clear up your toe issue soon. Take care.

    1. Thank you for your support! Good to know about the PET scan.

  2. This is probably not the reason, but I thought I'd share anyway as I have had similar toe issues. For some reason *just* the base of the nail bed of my big toe hurt (no ingrowing on the sides, no strange appearance other than the cuticle not being visible on the bottom).

    No idea why... we thought maybe it was b/c of a bad pedicure (cuticle cut back to far)... but I've had it recur several times in the ensuing 7 years. It hurts to the touch, but usually doesn't prevent me from doing anything. I noticed after several months (and some toe nail polish & comparison to my other foot) that the damn nail stopped growing! The last time I had the doc look at it, she pushed my skin back to look a little at the cuticle & then it started growing. I noticed a HUGE ridge appear on the nail as it grew out. It is like the nail keeps growing over top of itself. Very strange. It has been happening again, and I usually try to "push" the nail forward to help... but pregnancy seems to be the cure this time as it finally started growing out.

    Toe nails are weird (not to mention ugly)... I hope it is simply that your toenail is growing on top of itself too. Good luck!

    1. Thanks for the story! It gives me hope that there are lots of weird things about toes that have nothing to do with cancer.