The big toenail: should it stay or should it go?

I saw my podiatrist this morning. On the table: possible removal of my left big toenail.

I first lost it after the Flying Pig marathon in 2003. Just as everyone said could happen, it turned black as a result of repeated downhill running and then a few days later lifted off, easily. (And yes, my shoes are the requisite half-size too large.) (And don't tell me I should go with a full size too large, as my big toe is inordinately larger than the rest of my toes and a full size too large is too big for my feet, says my doctor.)

Problem is, after that marathon it never really grew back quite right. It was a lot weaker, for starters, and then it just doesn't really hold. Periodically - when I've been running more, but not necessarily only then - it will peel off from the bottom and completely remove itself. This causes some pain and the risk of infection.

My doctor explained the physiology of it to me, about how the the flexing of my toes and the size of my toes, coupled with the general make up of my foot and my arch and my weight, contribute to this. Complementing my particular situation is the fact that I take blood thinners: my propensity for bleeding, profusely, means that any sort of trauma (even micro trauma, like that inflicted when walking around all day) takes much, much longer to heal. In other words, short of staying off my feet for some time while this heals up, I'm likely to stay in this cycle for some time.

I quite like the doctor, and he's a former runner. He seemed optimistic that I can keep the toenail, although I'm pretty much over it already. He wants to see me/it again in a month after it's had some time to grow back - given that it doesn't really bother me on a daily basis and isn't anything more than an annoying eyesore, he wants to let it grow back and see if he can figure out what exactly is wrong with the nail before deciding for certain. That seems more balanced of an approach than my vote, which would basically have been to take the stupid thing off right then and there with my bare hands and no numbing agents. I'm kind of frustrated with the whole thing.

I'm really not at all vain about my feet. Nor do I consider the loss of a toenail to be some sort of war injury that I can be proud of. It just is what it is. I want healthy toenails that will stay on my toes. Barring that, I'd rather have no toenails than to have these bastards peeling off all the time.

But I'll give it another go!