ALZHEIMER’S, ONYCHOMYCOSIS AND TOE NAILS

cartoon of toe nail fungus

Many people with Alzheimer’s have other health issues to deal with including Onychomycosis.

January 11, 2013 — I wrote about one of our adventures with this particular doctor’s visit a few years ago, but with Alzheimer’s you can’t get too much information when you’re a spousal caregiver.

A FUNGUS AMONG US

Onychomycosis is an extremely contagious fungus that lives and breathes toenails (rarely  fingernails). Unfortunately, or fortunately, for the victim there is a medicine which can be taken orally, but after I listened to and read all of the possible bad side effects I doubted I would ever recommend it to anyone.  Yet, because Ken has had the fungus for as long as I can remember, and his toenails are so incredibly yucky the desperate idea of asking for a prescription periodically pops into my mind. That consideration was prompted only by an account by my dear friend Pat, her toenail fungus, the successful use of the medication and its healing results.  (I have also learned that Laser treatments are now available.)

HEALTHY MAN WITH A FEW CHRONICS

Then I remembered that Ken doesn’t do well with by-mouth prescription meds because of the three feet of missing intestine due to his chronic Crohn’s disease, which is not cured but somewhat controlled because of the surgery. So as his caregiver, I’m constantly looking for help and more information.

A few years prior he had suffered from continuous bladder stones forming one right after the other.  At the time Ken was a runner.  Often after a workout or run he would have blood in his urine.  Removal of the stones was accomplished by exploding the mass and removing the tiny pieces through the urethra tube – under anesthesia – of course.  Eventually abdominal surgery and a thorough cleansing of the bladder did the job and no new ones formed. I suppose, that once the problem is gone it is no longer considered chronic.

However, for those problems which Ken has dealt with over his lifetime doctors can be certain of one thing:  they can never know if or how much of any vitamins or medications are being absorbed without a complete complement of intestines.   As a result Ken must have a vitamin B-12 shot on a monthly schedule.  Other medications and supplements have been issued or suggested and taken by mouth.  Whether his body receives the full benefit is never really known.

Ken’s above-mentioned data of well being is probably of little interest to the public in general other than a person’s history is often beneficial in putting together as complete an Alzheimer’s picture as possible.  And I want to pass whatever help I can on to other caregivers. No matter, this still leaves him with three chronics:  Alzheimer’s, Crohn’s, and toenail fungus.

PODITRIST APPOINTMENT EVERY THREE MONTHS

I have also mentioned that getting from the comfort of our home to the Podiatry Clinic (or any other doctor’s office) is an event.  The weather this week was sunny, but cool.  I was glad there was no rain. Making  the appointment well in advance, it is difficult to have guaranteed weather conditions.  Today worked well. Crizaldo was on duty and this was his first experience with having Ken’s toenails done.  “Do you need me to be with Mr. Ken,” he asked.  “Oh yes,” was my unhesitating reply.  “You must hold his legs so he doesn’t have the opportunity to kick anyone.”

I am always amazed at Ken’s lack of combativeness while at a clinic or doctor’s office.  At one time I might have given the credit, and his subdued respect, to everyone wearing white.  That hasn’t been the case for a very long time with today’s medical personal wearing scrubs in varying colors and nurses in colorful tees.  Without white there is no longer the “awe” of identification for the medical faculty.  So, there must be, somewhere deep inside of Ken’s Alzheimer’s functioning brain, a tolerance and an acceptance of discomfort or pain when being cared for away from home.  I know for a fact that he would never allow either of his professional caregivers, or me to trim his toenails.  Yet he sits quietly in the chair, feet propped up, but held in place, while the nails are clipped, trimmed and “sanded” with only an occasional grimace or “ouch.”  And then we’re on our way home.

TIPS FOR THE FUTURE 

“Did you soak his feet before you came in,” the specialist asked as she clipped and trimmed?  “He had a shower earlier this morning.  Was that enough soaking,” I replied, feeling a bit guilty that we hadn’t done all there was to do in getting him ready for the appointment?  She continued clipping, suggesting that a good long foot bath and soaking an hour before we left would be better, making the nails soft and more easily cut especially because of the thickness caused by the fungus.

“And what are you using for the skin,” she continued?  “A lotion,” I answered, naming an expensive brand.  Later I thought we Americans are truly very gullible people. We had been using this lotion on his body for a long time, but when I noticed some areas around his groin were becoming red I suggested to Ben that we switch to Vaseline – petroleum jelly – as had been ordered for me to use following a significant skin cancer surgery.  Ken’s reddened skin cleared right up.  Now, here we were still using the expensive lotion on his legs and feet.

“Should I be using petroleum jelly,” I asked?  “Actually,” she continued, “Vick’s VapoRub would be better on his toes.  Vicks?  I remember it well from my childhood as Mother swabbed my sister’s and my skinny little chests and necks with the smelly salve, and then placed a white cotton sock around our equally skinny throats.  Lastly she smeared a swipe of rub under our noses and off to dreamland we went – our coughs and colds under control.  Returning from my brief reverie as she removed her protective smock our foot expert added, “There seems to be something in the menthol that appears to be good for the feet.”

APPLICATION:  I PROMISE 

While I know the importance of keeping Ken’s feet in as good a condition as we can, I must admit that the entire toe, feet and nail procedure is my least favorite caregiving service to him.  Those gross toenails, even after trimming, can only be defined as “Yucky.”  However, the goal for this particular Alzheimer’s patient, who is the man I love, is to be as free from discomfort, pain and any invading illness or infection as possible.  So, Vick’s here we come. I will make sure that the three of us are taking every precaution to keep these important appendages and his never-ending fungus as happy and healthy as possible.  Who knows, there may be a chance that Onychromycosis won’t like the fresh, menthol smell of Vick’s VapoRub. I can only hope.

Originally posted 2013-01-12 17:10:00.

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