Onychogryphosis is not only unsightly, but it may also be painful, interferes with walking and balance, and is an underappreciated risk factor for falls.
I'm starting to have difficulty cutting my toenails, but my sister helps me when she can. (She jokes I only invite her over so she can cut my nails lol). I am 56, so I can only imagine how much more difficult it will get with time. I just looked up and my provincial health care will cover up to $135 per year. I have no idea what the cost of a nail cut is, but hopefully that covers it? None of my providers have asked if I am able to cut my nails but I haven't mentioned it either.
I appreciate you not sugar coating the realities of MS. I wish more neurologists would talk about the underbelly of MS and the general public understood more about how insidious this disease it. Thank you for all your information and education. You're a true gem.
The mechanics of something so prosaic as cutting toenails are such that it provides a meaningful index for HCP's to gauge someone's real condition. For myself, I'm now struggling and a couple of extra inches on the handles of my nail pliers would be handy!
Inflexibility, spasticity, coordination, balance, hand/grip strength, eyesight - they're all in there, in one simple activity.
Podiatry care for pwMS is the topic of my PhD. Particularly, the development of PROMs of foot health and quality of life in pwMS and associated neurological conditions.
PROM in the making! I can provide you with general foot care advice though. I’m talking with the RCOP to try and get them to be stakeholders in the importance of lower limb health of people with MS, and get them connecting with the MS charities.
I totally agree that these things need to be mentioned. It's the nuts and bolts of living with a disability. It's not just about medication, it's recognition of everyday life difficulties.
A hugely important aspect of MS and other conditions, and one which is often overlooked. My nearby podiatrist shut down during Covid, and finding others in the area is not easy. I wish there were a podiatrist on every corner, like dental surgeries, but because our feet are usually hidden, it’s an area sometimes neglected by PWMS and their HCP.
I agee that unless the harsh side of having MS is discussed, nothing will change.
I was severely neglected by my family and the NHS. I had no access to healthcare. For decades. Since I was a child. I never did and never would have gotten an MS diagnosis through the NHS. Having no access to diagnoses/treatment, meant I also had no access to any other support. I thought at the time, and still think, that part of the reason for denying access to diagnoses is that one then can't access services.
Eventually, I managed to get internet access, correctly diagnosed myself, got a credit card, and went private.
I never found any help within the NHS. In hindsight, I'd say go to the press and MP (or whatever your government representative is called). But, honestly, that wouldn't have worked without a diagnosis anyway. Catch 22. 🤕
I struggle to cut my toenails and tried to self refer to podiatry with my gp. I was told I did not qualify and was not disabled enough to be eligible. My toenails are ok at the moment but it gets harder as time goes on.
Sorry to hear this. Surely pwMS, who are disabled, should be able to self-refer? Self-referral is one of the basic tenets of self-management. Maybe we should start a petition?
Foot care from podiatry here in the states is limited (it seems to me) to diabetes. I never thought I would need assistance with foot care but balance, tremor, fatigue etc. make it quite difficult now to fully scrub my feet and properly trim my nails. I don’t quite trust the “mani-pedi” spas. The foot baths are are often too hot, and the sterilization of tools are a concern. (I plod on by myself due to the cost of these spas as well.) Thanks for this. It’s an important subject no one talks about that I perceive a “normal” person may feel is simply an annoyance! 🌷
I have problems cutting my toenails (even more now that I have developed nail fungus and onychomadesis on aubagio), and my pedicure takes care of that. She also removes corns, which I expect many other pwMS also develop as they get walking difficulties and overadjust. I'm open about that and I still wear open shoes when it's hot.
I couldn't agree more, Prof G. A very important topic to highlight. I wish all HCP were as holistic in their approach to their patients. Kudos to you, as always!
Seriously your patients are so lucky to have you. I agree with everything you say. My GP keeps a close eye on my overall wellbeing however the only other person that has checked on my self care was the benefits advisor at Maggies Centre. As you list its not just the problems cutting toe nails but all aspects of care that need to be kept an eye on, to reduce longer term more serious health problems. I am so sorry you are left with the issues you have, but glad you made it out alive and functioning. Take care of yourself
I too have a very painful arthritic hip preventing me from cutting my nails, my husband does them for me. Obesity can also be an issue with this task. My NHS Trust Podiatry service page online says they don't accept self referrals.
Thank you for writing about this. I can cut my own toenails, but it is difficult. I pursivere because I am stubborn! It would be helpful if all HCP's asked questions about personal health care and because some patients might feel embarrassed, have to hand a leaflet of some kind pointing out what help may be available. The MS Trust and MS Society could put this information on their websites too.
Thank you for bringing these things out in the open, we all need to be honest and try to live without shame at how tough it can be sometimes.
I'm starting to have difficulty cutting my toenails, but my sister helps me when she can. (She jokes I only invite her over so she can cut my nails lol). I am 56, so I can only imagine how much more difficult it will get with time. I just looked up and my provincial health care will cover up to $135 per year. I have no idea what the cost of a nail cut is, but hopefully that covers it? None of my providers have asked if I am able to cut my nails but I haven't mentioned it either.
I appreciate you not sugar coating the realities of MS. I wish more neurologists would talk about the underbelly of MS and the general public understood more about how insidious this disease it. Thank you for all your information and education. You're a true gem.
A very insightful article.
The mechanics of something so prosaic as cutting toenails are such that it provides a meaningful index for HCP's to gauge someone's real condition. For myself, I'm now struggling and a couple of extra inches on the handles of my nail pliers would be handy!
Inflexibility, spasticity, coordination, balance, hand/grip strength, eyesight - they're all in there, in one simple activity.
Podiatry care for pwMS is the topic of my PhD. Particularly, the development of PROMs of foot health and quality of life in pwMS and associated neurological conditions.
Are you able to share your PROM with us or do you have any general advice you can give to people with MS? It would be much appreciated. Thanks.
PROM in the making! I can provide you with general foot care advice though. I’m talking with the RCOP to try and get them to be stakeholders in the importance of lower limb health of people with MS, and get them connecting with the MS charities.
Do you want to send through a document that I can post on your behalf? This would be very helpful for our readers. Thanks.
My overall goal is to get pwMS checked on a six-monthly or annual basis by NHS Podiatrists, as is the case with Diabetic patients.
I totally agree that these things need to be mentioned. It's the nuts and bolts of living with a disability. It's not just about medication, it's recognition of everyday life difficulties.
A hugely important aspect of MS and other conditions, and one which is often overlooked. My nearby podiatrist shut down during Covid, and finding others in the area is not easy. I wish there were a podiatrist on every corner, like dental surgeries, but because our feet are usually hidden, it’s an area sometimes neglected by PWMS and their HCP.
I agee that unless the harsh side of having MS is discussed, nothing will change.
I was severely neglected by my family and the NHS. I had no access to healthcare. For decades. Since I was a child. I never did and never would have gotten an MS diagnosis through the NHS. Having no access to diagnoses/treatment, meant I also had no access to any other support. I thought at the time, and still think, that part of the reason for denying access to diagnoses is that one then can't access services.
Eventually, I managed to get internet access, correctly diagnosed myself, got a credit card, and went private.
I never found any help within the NHS. In hindsight, I'd say go to the press and MP (or whatever your government representative is called). But, honestly, that wouldn't have worked without a diagnosis anyway. Catch 22. 🤕
I struggle to cut my toenails and tried to self refer to podiatry with my gp. I was told I did not qualify and was not disabled enough to be eligible. My toenails are ok at the moment but it gets harder as time goes on.
I’ve tried to self refer to podiatry previously and been told that only people with diabetes are eligible to nhs podiatry in my trust area.
Sorry to hear this. Surely pwMS, who are disabled, should be able to self-refer? Self-referral is one of the basic tenets of self-management. Maybe we should start a petition?
Gimme a pen, where do I sign? 👍
Sue, I am in the states. Podiatry appears to be for the diabetic as well.🌷
Foot care from podiatry here in the states is limited (it seems to me) to diabetes. I never thought I would need assistance with foot care but balance, tremor, fatigue etc. make it quite difficult now to fully scrub my feet and properly trim my nails. I don’t quite trust the “mani-pedi” spas. The foot baths are are often too hot, and the sterilization of tools are a concern. (I plod on by myself due to the cost of these spas as well.) Thanks for this. It’s an important subject no one talks about that I perceive a “normal” person may feel is simply an annoyance! 🌷
I have problems cutting my toenails (even more now that I have developed nail fungus and onychomadesis on aubagio), and my pedicure takes care of that. She also removes corns, which I expect many other pwMS also develop as they get walking difficulties and overadjust. I'm open about that and I still wear open shoes when it's hot.
I couldn't agree more, Prof G. A very important topic to highlight. I wish all HCP were as holistic in their approach to their patients. Kudos to you, as always!
Seriously your patients are so lucky to have you. I agree with everything you say. My GP keeps a close eye on my overall wellbeing however the only other person that has checked on my self care was the benefits advisor at Maggies Centre. As you list its not just the problems cutting toe nails but all aspects of care that need to be kept an eye on, to reduce longer term more serious health problems. I am so sorry you are left with the issues you have, but glad you made it out alive and functioning. Take care of yourself
I too have a very painful arthritic hip preventing me from cutting my nails, my husband does them for me. Obesity can also be an issue with this task. My NHS Trust Podiatry service page online says they don't accept self referrals.
Thank you for writing about this. I can cut my own toenails, but it is difficult. I pursivere because I am stubborn! It would be helpful if all HCP's asked questions about personal health care and because some patients might feel embarrassed, have to hand a leaflet of some kind pointing out what help may be available. The MS Trust and MS Society could put this information on their websites too.
Apparently I am not eligible for NHS podiatrist even though I'm immobile from my waist down and in my right hand and arm.
Thank for highlighting one of the many, many activities that are taken for granted.