Monday, June 24, 2013

wtf is wrong with my toe???

Seriously, WTF is wrong with my toe??? Subungual bluish raised mass under my right big toenail. It's been there for over 15 years, since my mid twenties, maybe only getting slightly larger during this time. A dermatologist told me 15 years ago it was a hematoma, though I had no recollection of injury and it had been there for a long time (maybe a year or two at that point). The same dermatologist told me a month ago it was a bad case of onychomycosis, a proceeded to cut my toenail about half way down, and it did bleed some. He told me to soak it in vinegar daily, and wrote me a prescription that I took back to his office to be ground up and water added for me to put one drop on my toe at night. The nail looked really gross for a while, warning graphic pictures! I diligently soaked my feet in straight vinegar daily for 30-60 minutes, and filled away on the top of the nail a little bit everyday. The vinegar was surprisingly refreshing and felt so good to soak my feet in. I just got a plastic container big enough for my feet and filled with straight white vinegar until my toe nails were completely submersed. After soaking I use one of those foot cheese grader looking things to scrub the bottom and sides of my feet. My feet have never looked or felt better in a long time. However with my constant filing away of the top of the nail, the subungual bluish mass became more prominent and seemed separate and different from the onychomycosis. Shortly before my one month followup with the dermatologist, I wondered if it could possibly be a tumor. At my appointment with the dermatologist, he glanced at my toe and said it looked much better. I then brought up my concern it might be a tumor, he looked at it briefly again and said he highly doubted it was a tumor and that it is a hematoma. Really, a hematoma lasting over 15 years, I had my doubts!!

I starting doing a bunch of research online and have come up with a list of possibilities. Maybe it is an AVM (Arteriovenous Malformation or Arterio Venous Malformation) or as it was described in my 16 year old daughters pathology report as Arteriovenous Hemangioma that was surgically removed from her hand and visually presented itself as a painful raised bluish lump between her index finger and thumb for over 5 years due to misdiagnosis as ganglion cyst. Could it possibly be Acral Lentiginous Melanoma? I'm part Sioux Indian, and darker ethic populations have a higher incidence of Melanoma of the nail.  I'm really quite fair skinned with freckles, but do tan easily. I did spend my entire childhood until late teens barefoot constantly every summer. Or, maybe it is a Glomus tumor? I do have nerve damage in my toe from bunion surgery when I was 16, a regretful unnecessary surgery. At this point I'm not totally sure what is wrong with my toe.

I went to my primary care doctor last week convinced that it is a AVM Arteriovenous Malformation / Arteriovenous Hemangioma. The doctor actually agreed with me and diagnosed it as a vascular tumor / Hemangioma. I asked for it to get MRI'ed, but the doctor worried my insurance might deny the imagery, so I suggested they order an Ultrasound instead as it would show vascularity on the color doppler.  I got the ultrasound of my toe last week. I think it was the technician's first time using an ultrasound on a toe. She was having difficulty getting an image at first, so I suggested she use copious amounts of the gel as I read online was best for ultrasound of the toenail. She got good imagery, and I will post the ultrasound pictures that shows a hypervascular soft tissue mass in my big toe.

MRI is scheduled for tomorrow morning with the report and images available by the next day. The MRI should definitely let me know exactly WTF is wrong with my toe!!!!!!!!!!!!!!!

Here is a recent picture of my toe:

UPDATE:  Biopsy confirms it is a blue nevus!!!

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