Ingrown toenail - granuloma and infection conundrum
I suffer from RSD/CRPS, and also recently had an ingrown toenail, which for reasons which probably reflect poorly on my sanity, I allowed to get really bad before I took it in. It wasn't very painful or swollen and there wasn't much noticeable pus, but it did bleed a lot and developed some huge granulation tissue (about .4" wide and .25" high over both top and bottom of the nail). I suspect my RSD has something to do with this - I tend to not walk much, and walk slowly and carefully, thereby reducing the pain I would otherwise feel, while the RSD's exaggerated inflammation response might have made the granulation worse. Towards the last 1-2 weeks or so it was a bit smelly and occasionally there would be a little milky fluid, although it mainly just bled.
I finally took it in and the podiatrist was appalled by the size of the granuloma and said I was at risk of losing the toe from infection, and decided he would permanently remove the entire nail and cut away and cauterize all the granulation tissue. I was afraid of invasive procedures with the RSD so I sought a second opinion, and ended up with a guy who favored "natural", non-invasive cures. He just removed enough nail to extract the offending nail spicule (which he thought was unusually large) and left it at that, and while he thought it was infected, thought it was minor and not yet dangerous and would clear up. He also thought the massive granuloma would subside once the irritant went away, advising that I apply heat to it. I am taking an antibiotic.
So far so good, the pain is much less and there was no significant RSD reaction, although the granulomas are still huge and tend to bleed.However, what the earlier guy said is still freaking me out and I'm wondering if I made the right decision. Should I still be worrying?