A Very Strange Trophy, Unexpected

It’s been a month since Rick and I walked the second Five Mile MS Walk this Spring. Within six weeks, we succeeded in walking nearly ten miles, and were very proud to complete the second walk successfully, even though we were the last to cross the start/finish line.

But a few days after the walk, I noticed that both my large toes had bruises under the nails … pink and purple blotches that seemed to grow a bit day by day. I’d had a habit of getting up in the middle of the night to go into the bathroom, and sometimes stubbing my toes in the dark, so didn’t think much of it But by the end of the week, my right toe nail was nearly fully covered by a black bruise, and the left was a deep purple and red. Neither toe, though, had any discomfort, nor any swelling. I continued to believe that this was just bruising and would clear up in a few more days.

By the second weekend after the walk, my toes looked exactly as they had the week prior … black toe nail on the right, and red with purple on the left. Rick and I talked about what to do, and whether to call a doctor, and which doctor would be the best to call … our family doctor, or Rick’s podiatrist, or my dermatologist. Why a dermatologist? Because melanoma is always on my mind. I see the dermatologist every three months for a reason. With two primary sites of malignant melanoma, checking frequently for more is paramount to keeping it in control.

I turned to the internet, and Googled black toe nail. I found a medical site that explained possible reasons for a nail turning black.  The one that clicked with me was that runners of marathons, or runners who ran daily, were often subjected to black toe nail. It was a bruising caused by the repetitive bumping into the front of the shoe, over and over and over again, causing a major bruise, and sometimes, even a broken bone.  Another reason for black toenail is a fungus, in which case there would be an odor, and a pain or itch at the toe. I had neither of those, so ruled that out. And the third that I read of was something called “acral melanoma.”

Acral lentiginous melanoma, or ALM, is the zebra in a herd of horses. In other words, it is the least likely reason for black toe nail. It happens most to people with dark skinned complexions. It most often has a narrow vertical stripe on the nail. That is unlike my toenail. So I’m pretty sure this is simply bruising.

I’ll see the dermatologist in another two weeks, which will be six weeks after the five mile walk. The advisors on the melanoma research foundation’s bulletin board suggest that a black toe nail caused by bruising by running or walking a distance would take about six weeks to begin to show clear nail near the nail bed. So when I see the dermatologist in a few weeks, we should be able to see some clearing. If so, maybe we can avoid having to have the nail removed to check for melanoma via a biopsy.

Those who followed Rastafarian musician Bob Marley know that he died of ALM. His religion did not allow cutting into the body, and so he refused to allow his toe removal when ALM progressed. If the dermatologist says there is a chance that this is melanoma and he needs to remove the nail for a biopsy beneath it, I have no reservations about pursuing that treatment, and any following surgeries.  100_3923

It’s important to remember that there are more horses 100_3924than zebras in the world.

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3 Comments

  1. You got this right, Terry! It’s called “traumatic sub-ungal hematoma. It has a long weird name … but, like you stated, it’s the repetitive bumping against the front of your shoe. No major deal .. the only thing is that you, most likely will lose that nail. Why? Because there’s blood pooled there that separates the nail from the nail bed. Underneath that area, the new nail will start to grow. It’s only a matter of time …. right now I am dealing with one of them. Assure you that this, too shall pass …. I’m sure that is no fungal infection; nor is it related to any kind of cancer.
    Be well ….. 🙂

    • Thanks, Dr. Rex. I’m relieved to hear medical experts agree that this is most likely a common, non-cancer-related condition that, as you say, will pass. And I’m pretty happy with myself for not panicking and rushing off to doctors asking for treatment that may not be needed. Anxiety really is under control this year, despite unexpected challenges here and there! 🙂

      • Good to hear that!! Be strong and stay well!!!

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