Paronychia

In this post, I’ll be talking about a finger infection I caught recently. It is purely a personal experience and the description and pictures may be a bit unpleasant, even macabre.. so read on at your risk!

Last month, I woke up one night with a weird feeling in the middle finger of my left hand. It felt slightly painful to apply force with the finger, e.g., by pushing it on something, and specially with applying any sideways force. I thought it must be a sprain or a hairline fracture, although I couldn’t imagine what I had done for that to happen. I didn’t think much of it and went back to sleep.

The next day, the finger was noticeably swollen and more painful. The swelling and the pain was around the nail, extending down to the top finger joint. It hurt to even apply a slight pressure on it. As one does these days, I googled around for my symptoms and concluded that they mostly matched those of a hairline fracture. So I went to CVS and got a finger splint to immobilize the finger. I even went Salsa dancing later that day with the finger splint which was an interesting experience.

I had trouble sleeping that night. By the next day, the swelling had increased and I could barely bend the finger around the top finger joint. I could also feel a throbbing pain in the finger. I somehow got through the work day and again went to the CVS in the evening to get some painkillers and check if the pharmacist would have any suggestions. The pharmacist said that my finger looked more infected than broken and wondered if I had paronychia; a infection caused by either bacteria or fungi that gets into the skin. This can happen when the skin around the nail is injured because of biting, chewing, or picking at the nails. It can also be caused by pulling on hangnails. She recommended an anti-fungal cream that I should apply around the nail couple of times I day.

I got the cream and applied it liberally around the nail and read up all about paronychia. The symptoms were indeed a very good match. The information I found didn’t seem that alarming which was a relief. Most articles mentioned that it takes around 7 days for a bacteria induced paronychia to recover and usually home remedies such as soaking in warm water are enough. I popped a painkiller and went to bed hoping and praying that the cream would have some effect. To my dismay, the finger was even more swollen and painful the next day..

I thought that well may be it will take a couple of days for the cream to take effect (although I was beginning to suspect the cream wasn’t doing anything). So I went through two days of pain and misery. I had started a new job just about a month ago and it was quite hard to focus on work. Even simple activities such as washing dishes, typing, opening doors became difficult. Sometimes the throbbing was so bad that I had to hold my hand above the head to reduce blood flow into the finger. Sleeping was impossible without taking a painkiller. I had to keep the hand propped up on a pillow to sleep. Times like these remind us what a delicate and finely tuned machine the human body is. We scarcely pay attention when it works as expected, specially not to seemingly insignificant parts such as the tip of the fingers. However when it is injured, that insignificant fingertip can capture all of our attention. Everything else – significant others, the stock market, social life cease to be important.

After waiting a couple of days, religiously applying the anti-fungal cream (and watching it do nothing) and searching for the 100th time “how long does it take for Paronychia to get better” on Google, I considered getting an antibiotic. I’m generally a very healthy person and rarely get sick. I couldn’t remember the last time I had taken an antibiotic. In the U.S., you need a prescription to get an antibiotic. Despite my misery, I was hesitant to get a doctor appointment, take half a day off from work, deal with co-pays and the other joys of the U.S. healthcare system.. may be Bernie Sanders really is onto something with his medicare for all (just kidding about that). It is probably unwise to admit this on a public blog, but I was able to get some antibiotics from a friend who took pity on me after hearing my sob story. I was really keeping my fingers crossed that the antibiotic works some wonders and my finger magically starts feeling better, but alas it wasn’t to be..

So after taking the antibiotic for another day or so, and seeing no benefit from it, I finally decided that enough is enough and went to the CVS walk-in clinic. I tried to get there early in the morning right when they opened, but there was already several people waiting ahead of me. After waiting for nearly 2 hours, I was finally able to see the doctor. The doctor informed me that my finger was swollen because it was full of pus which needed to be drained. Draining would mean making an incision which was going to hurt. I’m a bit of a wuss with pain so wasn’t feeling enthusiastic about that option. The doctor then suggested going to an urgent care facility where they can administer local anesthesia to numb the area before making the cut. That sounded like a much better option. The doctor also gave me another antibiotic (I suspect mostly to make me feel better) which is more effective for Paronychia.

I went straight to work from the CVS clinic, but my mind wasn’t on work at all.. I was constantly agonizing over whether I should go to the urgent care facility or just continue taking the antibiotic for a few more days..you will not believe what happened next.

The next day I decided to try poking a needle into the part of the finger that looked the most full of pus. I was hoping to open a pathway out for the pus and then squeeze it out. Somehow that seemed like a better option than going to the urgent care facility. To my disappointment, poking the finger with the needle accomplished nothing. I got a few drops of pus out, but that didn’t even make a dent to the swelling. A few minutes later, as I was using a knife to do something, the knife slipped out of my hand and happened to hit the heart of the pus filled abscess on the finger..that hurt like hell, but did the trick. The pus flowed out in a torrent and the pain immediately felt better. I drained out as much pus as I could by pressing the area around the cut and then went to the local CVS and got some dressings. Later I visited the health clinic at my work and got the finger properly bandaged.

Draining the pus was the major turning point. The pain almost completely dissipated after that and the finger rapidly got better. Just to be sure, I continued taking the antibiotic for few more days. The pus had damaged the skin and other tissues around the nail and it was fascinating to see the damaged skin peel off over the next couple of weeks and new skin emerge. The area around the nail also went through some dramatic transformations over the next few weeks.. Now the finger is completely back to normal, as if nothing ever happened. The regenerative powers of the human body are quite amazing!

I was surprised by how quickly my hand adapted to manipulating objects and doing other tasks using the healthy fingers only, without using the affected finger. Even after my finger got better, It took me some time to readjust to using the finger again.

Swollen, pus filled finger
After I accidentally cut myself and the pus drained out. There is still some pus oozing out of the cut
The skin around the infection area completely reorganized itself after the infection healed. It was pretty incredible to see the damaged layers peeling off and being replaced by new skin.

This episode also gave me new found appreciation for what sufferers of chronic pain must go through. During the infection, I could think of little else but the pain. All of the other things that were so important just a short time ago were completely subsumed by the pain.. and I felt so joyful after the finger got better..

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