What is a Paronychia?
Quickcare or ER?
Most persons have this nail infection for days before seeking medical care.
Although I have taken care of paronychias many times in the ER at 2 am, these should really be seen in Quickcare during normal hours
What will your doctor ask?
Your doctor will want to know your symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
- How long has your finger been that way?
- What makes it better?
- What makes it worse?
- Did you smash or crush it?
- Have you noticed any discharge or pus?
What will your doctor look for?
Your doctor will look for signs. Remember, a sign is an objective finding that a doctor discovers upon examination.Your doctor will look for the extent of the infection.That is, is the finger infected in the nail or in the skin also?
Is this simply a cellulitis?
Furthermore, are there red streaks going into the hand? Red streaks imply that the infection is spreading.
What is the treatment of a Paronychia?
This infection is locked under the nail. The healing process will improve when the pus is released.
I routinely numb up the finger by injecting Lidocaine. (Yes, that means a shot) I then place a scalpel (knife) between the cuticle and the nail. Once the pus drains, relief comes. Aaaahhh.
How long will you be sick?
Most times, these clear up within one week. Once the drainage starts, the healing speeds up tremendously.
Let Me Tell You a Story
“Doctor, I am sorry for bothering you. I know how busy you are. But my finger is killin’ me,” said Roger
Sometimes the best part of being a doctor is just listening… I love hearing most patients’ stories. Who are they? Where do they come from? What makes them tick? What are their fears? What are their aspirations?
I love hearing what they do for a living. How do my patients make it in this world? How are they providing for their families?
When I sat down with Roger, I was amazed at what he did to put food on the table.
He wakes up at 11:30 at night. The company truck that he drives is about the size of a large delivery vehicle. After a quick cup of coffee, he takes his truck to fast food restaurants that specialize in fried foods. These greasy places cook up their meals causing fat to splash up the shute. The vents, after a while, get cluttered with the sticky oils. It is Roger’s job to clean it up.
So, he takes his truck to the restaurants. With a power hose in hand, he climbs up the roofs and he washes down into the flutes. The high powered pressure shoots both water and grease down into a basin. Invariably, some of the debris splashes all over Roger.
For just barely over minimum wage, he works all night and goes home filled with the smell of old burgers and fries.
Every night. Without fail. Week after week.Month after month. Year after year
I take my hat off to all the “Rogers” in the world. I just don’t know how they do it.
In Roger’s case, the pain was local, sharp for a 3 days. No injury preceded the pain.
When he showed my his finger nail, he looked like a little boy showing his Mommy his booboo.
He took the shots well but got squeamish when I showed him the knife. I always have patients lay down when I cut into them. You never know when or if they will pass out.
I hope this helps
David Reyes, MD