Dear Know-It-All:

A nasty fungus resembling something out of Aliens has been gnawing at my toenails. I don’t want the sight of my leprous-looking athlete’s foot—if that’s all it is—to cause my fellow beach-goers to stampede wildly into the waves. What to do?

—Toe Jam

Dear Toe:
You—and, even more, my merciless editor—will be relieved to know that Nurse doesn’t have a foot fetish, so my admittedly unruly passions won’t interfere with my professional advice. That’s all to say that you’ll be back playing “This little piggy” before you can pronounce onychomycosis. Yes, that’s the wacky word for the fungus that’s turning your toenails itchy, brittle, brown and fashionably black. Onychomycosis is one of those lousy little lower-life forms that seem to prefer positoids. But don’t fret; there’s a veritable smorgasbord of solutions to send the mischievous mycelium on its merry way.

Step 1: Follow Nurse’s Golden Rule, and have your doc check out your tootsies. If my diagnosis is correct—and when have I ever been wrong?—the tried-and-true prescription for terrible toenails is itraconazole (Sporanox), 250 milligrams per day for 12 weeks. (If that foul fungus is infiltrating your fingernails, it’s 200 milligrams; or try terbinafine hydrochloride [Lamisil], 250 milligrams daily for six weeks.) Creams are also at hand to get you back to your pedicurist, particularly Loprox (ciclopiroxoloamine 1 percent).

And lest my holistic devotees start their grousing, Australian tea tree or Vitamin E oils—natural elixirs found in health food stores—can also help you put your best foot forward. Baste nails and adjacent regions, and let marinate overnight. Repeat until fungus has fled.

On the other hand, if athlete’s foot is the problem—you’ll know it by the itch—it’s easier to treat with over-the-counter sprays, potions and powders like Desenex. But three words of warning: Dry ’em good! Nothing’s more inviting to spore-bearing critters on a hot summer day than those warm, dark and moist breeding grounds you call your sweaty shoe-and-sock-imprisoned feet. And if, like Nurse, saunas, steam rooms and communal showers are your Achilles’ heel, Good Lord, spend a few bucks on flip-flops.

Help me, Nursie!

Talking’s way out of the question and swallowing’s slow suicide. I’d scream but it would only worsen my woes. I’ve nowhere to turn but to you, my lady in white. Can you find in your bag of medical tricks a surefire remedy for a searing sore throat?

—Ora Lee Oppressed

Listen, Ora Lee:

This is my column, and I’ll do the screaming, got it? And let me tell you those screams will be directed your way if you use that tired old “sore throat” excuse for not taking your meds. “Oh, Nursie, I can’t swallow, so I skipped a few dosie-wosies.” Yeah, right. You know what I have to say to that? Get over it! There. I feel so much better. Sometimes you patients do take the starch right out of my uniform.

To be sure, Ora Lee, sore throats are nothing to giggle about, as they can be caused by some rather nasty infections like streptococcus and thrush. To get to the root of the razor blades, fly to your physician. But to help you to speed the healing on your own, here are a few tips from Nurse’s fabled roster of remedies, guaranteed to soothe the AIDSy and un-AIDSy alike. When gulping is agony, gargle: Mix a gram (four teaspoons) of sodium ascorbate—the salt form of vitamin C—into a glass of water and swish it well (I’m sure you know how to swish). But don’t use ascorbic acid, the acidic form of vitamin C itself, as it may pour gasoline on the flames licking at your larynx. If you can’t get the sodium ascorbate, try plain old table salt and warm water; it’s done the trick for millennia.

If your throat’s so bad that the guillotine sounds good, your doctor may try antibiotics to return you to your sweetly singing self. If so, remember to pop acidophilus supplements to restore the good bacteria that those carpet bombers take out along with the bad. And, since you’re in no condition to argue with me, a final word of advice: Keep eating! Use an over-the-counter spray anesthetic such as Cepacol, Chloraseptic or one containing chamomile to numb your feeding tube enough to enjoy a meal and down those handfuls of pills that are keeping you alive.

To Confidential: Thanks for the buff Gif. As Nurse Know-It-All, I can only respond to your medical needs, but when I get a rare off-duty hour, I can give you so much more TLC. Send me another e-mail at the address below, subject title: Naughty Nightingale. 

This column offers self-help for nagging health problems. Send your own complaints to Nurse Know-It-All at 349 W. 12th St., New York, NY 10014, or e-mail