Secret Side Effects

by Ashley PentecostPatient, Breast CancerOctober 1, 2021View more posts from Ashley Pentecost

Today my right, big toenail fell off. I had just given our new puppy, Lola, a bath, when I felt a catching sensation of my bare foot on the carpet. I pulled my foot out from under me to see that the toenail had lifted. ‘Great!’ I thought, as I rolled my eyes to myself. Although, I admit I wasn’t that surprised, as I have had chronic nail issues for the better part of my treatment now. First I visually assessed the situation and nervously wondered what was beneath the polish. I braced myself for the pain and gave my dangling toenail a prod. It was a goner, that was for certain. Not 100% of it, but about 80%. It was hanging on by a thread (kind of like me sometimes, ha).

“Oh well, at least it doesn’t hurt,” I concluded as I stood up to head to the bathroom to give myself a “pedicure”. Because of the aforementioned chronic nail issues, I had a tub of supplies at the ready.

Sitting on the floor, I started to become overwhelmed with all the ways this stupid toenail was a literal analogy for my life since cancer. Sure, there are a lot of worse things I could be dealing with/have dealt with, and nail problems might not seem that bad. Still, if it weren’t for cancer and chemo I wouldn’t be dealing with losing this stupid toenail today AT ALL. There are many things I can say that about.

Over the past several months I had paid particular attention to my fingernails and developed a ritualistic system, as I was determined not to lose them. So, every seven to ten days I worked through this system: soak in salt water, clean with hibiclens antibacterial, trim as low as I could, apply keratin serum, and finally a strengthening polish – mostly to hide them (from myself and from others). Mind you, this was after I went through the phase of sloppily taping off each finger with paper tape and Band-Aids. And after that stage, I started wearing latex gloves nearly 24/7. My nails would become pus-filled easily, so I had to figure out a way to keep them clean and dry, while also keeping infection at bay. With the gloves, I learned that I could cut off the thumbs and still use my phone as needed, as well as get some other things done with a bit less pain. They hurt pretty badly at one point in time, but once they lifted, the nail bed would die out and thicken. Then, it just became a game of not moving my hands too quickly, so as to avoid catching them on anything.

MY NAILS. Such tiny little things, in comparison to what my whole body was dealing with. But it became yet another familiar side effect graciously bestowed on me by one of my chemo drugs (Taxol). And like all side effects, something that with time I would learn to better manage.

I tended to my fingernails diligently every seven to ten days. I could tell when they had gotten too long, because they would start to ache and feel funny in a way I can’t describe. Over time, thanks to my efforts and likely some supplements too, I am happy to report that my nails are doing much better! My thumbs, index fingers, and pinkys are nearly healed. My two middle fingers on each hand remain still partially detached, but let me tell you, I was STOKED to get my thumb/pointer fingers back in use.

As for my toenail, I didn’t even realize that it was that loose. I’d spent so much time paying attention to one area of healing, that I’d forgotten about another part that needed my care too (and to be truthful if you know me well, you know I have never been a mani/pedi girl anyways). Despite my lack of awareness for my feet, my body subconsciously did its best to fight off the infection, but my toenail still had to be sacrificed.

When I removed my polish (that had been on for longer than I care to admit) I could see all the nasty gunk and dried blood that had been hiding under several nails, and I learned my left big toenail wasn’t far behind. When I clipped off the thread that my right toenail was hanging by, I was able to see that my nail bed beneath had completely hardened, so it was not even a little bit painful. “Wow!” I thought. Given the history of my fingernails, I was surprised by this. My body did its best to protect me even when I was unaware of what was happening. 

“We know you’re going to lose this toenail, so at least we will make it less painful… You’ve already got a lot going on… We will do what we can to shield and protect you… to make things more manageable,” I imagined my little soldiers saying. Anyways, I digress.

I suppose my point is that although my nails and my toenails appeared nice, fine, and healthy enough at a glance, there was something so much more uncomfortable beneath the surface. I can think of occasions where I received well-intentioned compliments about my outward appearance. Receiving those words always made me a bit uncomfortable and I never knew exactly how to respond, as I was/am juggling so much internally (both mentally and physically). Those close to me know I have struggled with this. Even though my nails were pretty and polished, I couldn’t pick up my classroom calendar number cards when teaching my students, I couldn’t do the simple chore of changing a garbage bag at home, and I definitely couldn’t open my own beverage can. And there’s something particularly annoying about not being able to scratch an itch with your own hand (because at one point in time my nails were barely attached, and the slightest pressure would cause them to painfully wiggle behind the cuticle where they are rooted). Because of this side effect, I was and am rendered unable to do a lot of basic tasks, which I previously took for granted with my pre-chemo, fully attached nails. Again, I can say this about many things.

Cancer is hard. Treatment is hard. Side effects are hard. Remission will be hard. Life is hard! And it doesn’t take but a little bit of makeup or “polish” on the outside to hide what’s going on deeper beneath the surface. The same can be said for all of us, even those who thankfully will never be able to relate to my silly nail woes. Someone will always have it worse than you, and someone will always have it better. But most importantly, all feelings are valid and I think it’s so critical to honor that: even the small, seemingly insignificant, manageable struggles we all face each day. Thankfully, time heals many wounds. And it’s not without effort, but we are ALL stronger than we know! Even when we don’t choose it.

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