My youngest bites his nails almost down to the bone. They are routinely bleeding. I mean, these things are awful and painful, especially when everything is so dry in the wintertime.
In the OR the other day, we were comparing whose kids are the grossest. We were swapping stories of nosepickers and booger-eaters and on from there. I figured I had the winner with a kid who not only eats his fingernails but also his TOENAILS!
How gross is that?
Then one of the nurses beat me. One of her kids absolute destroyed toenail eating. How is that possible you may ask? How about picking up your sister’s poop from the within the toiled and… wait for it…. eating it! OMG! Now that kid was like 1.5 or 2 years old but still. WoW!
I’m telling you all of this disgusting information to get to the point where my kid’s thumb had an awful looking scabby thing by the nail, and from the tip of the thumb to the DIP it was an angry nasty red color.
I had him soak his thumb while he watched a show for about 30 minutes and then he hopped in the bathtub. After all that warm water, his thumb and nail were all nice and softened up. I unroofed the scab, and a little puss came out. Yuck! I warned him (I’m painfully honest with my patients) and then I squeezed it really hard. Now he is a tough kid, and he just about hit the ceiling. I mean this was the chandelier sign in action. (Not generally a key term for this dx)
It was unbelievably painful. The problem is you have to get the pus out of there. Pus under pressure is a very bad thing. It took me about twenty minutes to get him to let me do it again.
The next day I bumped into a general surgeon who I’m friendly with and I told her the story.
“You may be the meanest parent ever.” She was shocked the kid survived without local anesthesia.
We got him some oral clindamycin at 10mg/kg for 7 days, and he healed up beautifully.
Here’s the point of the story: What is the name of that little painful infection?
Grab a copy of The Final Step, and you might just remember something like that.
Brian Wallace
P.S. Here’s the answer spelled backward if you can’t stand not knowing: aihcynorap
P.P.S. Starting on Thursday I’m going to make the Dream Job Package available. Good news if you’re interested in finding a job as a new grad with COVID making things a little difficult.