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What causes fungus in toenails? - Online Doctor Chats

Date : 18-Apr-2014
User rating for this question
Very Good Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
User:hello doctor, i am 35 years old and have had some strange health symptoms for the last few years. 4 years ago i had a gall bladder removal surgery go wrong , they cut the wrong thing and messed me up pretty bad. i was in the icu for a few weeks (in hospt. total 6 weeks) got mercer infection(they cut a hole in my belly to drain also a pic in the side of me) dropped 43 pounds lost hair and had home care for a few months(had pereotanitus also).I started to get better gained weight back was able to move right again then i started getting a crawling feeling all over my body. I also had my toenails turn white. a few months later i got a fungus in my toenails. doctors thought it was allergies or scabies. i went to an immunologist ( i also got pnemonia 2 times) and started allergy shots because when they tested i was allergic to almost everything. The doctor was concerned about the pneumonia and found out i only had 2 antibodies against it(this is after getting it twice)when normally she said even small children have more than this. I got pneumonia shot (havent gotten it since). then 6 months ago my legs and feet started swelling up . i have to lay down at night with my feet raised so i can even walk the next day. My health has been getting much poorer, my doctors sent me to see a rhumetologist because they are really concerned. i thought maybe i just had a weak immunity because i had almost died and i have tried changing my diet and thought it was just weird allergies. I have strange looking veins going up my legs now and they have done many blood tests and nothing is unusual. is there anything that can cause the feeling of something crawling on you that could also give you like whole body dandruff that would also if left untreated cause circulation issues. I have to see the doctor next week. i went to hospital 1 week ago because my heart feels weird when i put my legs up at
User:night. I am sorry about the spelling and i realize this is way too much info at once. i am 5ft11 180lbs
Let me read your query for few minutes to be able to have a good discussion here.
User:sounds good it is kind of broken thoughts so if you have any questions
Doctor:You have a difficult situation going on
User:my heart the e.r. said blood tests came out good but i have slightly enlarged right axial ( not sure what that means). i also have been tested for lupus and lyme both negative. skin bruises easily and pores and general elasticity are bad. used to have oily skin , now it is always dry. I just dont even know if i am seeing the right kind of doctors or even what tests to get done.
User:yes i know
User:i dont expect an answer just a direction to go
Doctor:I suggest you see a skin specialist
User:i have
User:they said dry skin
Doctor:have they done any skin scraping tests?
Doctor:what did he/she have to say?
Doctor:Was any infection proven any time?
Doctor:and what about your white blood cell counts?
User:that is about it that i had a dry skin type(even though i never did) then they gave me creams that didnt work
User:my legs are my biggest concern right now
Doctor:can you explain a bit more about what happens with your legs
Doctor:what time of the day do they swell up?
User:my sight is getting weak and get palpitations. my legs and feet are swollen all day
Doctor:and do you have any pain in the legs
User:yes but not horribly, they just look bad
Doctor:have you done thyroid levels
User:i have normal
Doctor:what about MRI scan of the brain?
User:only things bad are high triglycerides and low vit d
User:i have not gotten that done
Doctor:in that case you need prompt correction of vitamin D deficiency
User:i have quite alot of metal parts in my left leg and hip
User:i take 2000 mg aday
Doctor:that complicates it further
Doctor:I guess there are ways to do MRI if the metals are not magnetic
User:i am still functional i am a full time student and work , but it is getting real hard
Doctor:I can understand your diffculties
User:yes possible that they are all titanium which is not magnetic
Doctor:it is not easy to go through such frustrating condition
Doctor:I would advice you to go for Functional MRI of the brain
User:i just wanted to know do you think i should be seeing a rhuematologist or an endocrinologist
User:how would that help
Doctor:Your symptoms fit three possible conditions
Doctor:1. Autonomic neuropathy
Doctor:2. Vitamin D deficiency
Doctor:3. Hypothyroid storm
Doctor:Since your thyroid levels are fine and you are taking Vitamin-D, it leaves the autonomic neuropathy to be ruled out
Doctor:so a functional MRI would tell us the functioning of the control center on the brain, that is the "hypothalamus"
User:o.k.. i am going to the rheumatologist on monday. It has taken along time to see him . no one has done more than simple blood work
Doctor:You can see the rheumatologist
Doctor:After that you should probably consult a neurologist
Doctor:Is there anything else I can help you with?
User:do you believe i should take fungal med for my toes and something for skin. i basically never took them because my legs got so bad i wanted to get to the bottom of this. now it is taking so long i am thinking i should just deal with the symptoms. I think i will go to a neurologist also. i have read many things online about similiar symptoms but the people all have weird lesions all over them and i do not. i dont have any parasites and i eat a decent diet.
User:i guess that is it i will try more specialists. i only recently started to see them because i thought it would go away.
Doctor:It is best to get a skin scraping test done to rule out any fungal infections
Doctor:you can do that at home if you have a microscope
User:i do have a microscope. i am a geology student , it is more set up for crystal structure though
User:what magnification should it be
Doctor:You can use 10X
Doctor:or 40X
Doctor:that should be fine
User:oh that is it to see fungal huh
Doctor:But you need to put a few drops of KOH on the skin scrapes
Doctor:Put a few drops of KOH
Doctor:wait for 5 minutes for the skin cells to disintegrate
User:thank you for your time. i will continue to get tests and see what happens
Doctor:then look under the microscope
User:o.k cool thank you
Doctor:compare what you see with picture from google images
Doctor:Thanks for consulting me here
Doctor:have a great day ahead
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