<p> Dr. Jane Graebner Dr. Drew Belpedio Dr. Martha Anderson</p><p>1871 W. William Street Delaware, OH 43015</p><p>740.363.4373 www.faawc.com</p><p>Nail Fungal Infections Frequently Asked Questions</p><p>What are my treatment options? 1) Daily application of a topical medication such as Formula 3 or prescription Penlac with a 7% cure rate; 2) Daily use of a prescription oral medication such as Lamisil with a 40 % cure rate and the need for blood tests to monitor for liver damage; 3) Trimming and burring of the nails without medication providing comfort but no cure; 4) Use of a laser to eradicate the nail fungus with a reported 90% success rate. What can I expect from successful treatment? Successful treatment of nail fungal conditions may reduce the thickness of the nail, decrease discomfort associated with the involved nails, improve the appearance (color and shape of the nail) and should make trimming easier. The various treatment methods all have differing success rates and no treatment option has a 100% success rate. How does laser treatment work? The Foot and Ankle Wellness Center uses a Q-Switched NdYAG laser, which is one of the most advanced dermatological lasers currently available. In 3-10 billionths of a second impulses of laser energy pass through the nail plate to the nail bed and growth areas with typically no damage to the nail or surrounding skin. At the time of the procedure the infecting nail fungus is expected to be destroyed. However, no visible change is seen in the nail until the nail begins to grow out. In a few months a more normal appearing nail is expected to appear with complete regrowth of the nail taking from 6-12 months. Is the laser treatment covered by my healthcare insurance? At this time healthcare insurance does not cover the cost of the laser treatment for fungal nails as the procedure is considered a cosmetic procedure. However, you may use Health Savings Account or other health care spending dollars to pay for this procedure. Is laser treatment uncomfortable? Most individuals report that they do not feel any discomfort during or after the treatment. You may however experience slight warmth or feel a mild snapping like a static electricity discharge during the procedure. If you have any discomfort during your treatment, you should let the doctor know and appropriate adjustments will be made to decrease any discomfort. The use of local anesthetics is not recommended or required for the treatment of fungal nail conditions.</p><p>What is the recovery period? There is no recovery period. After your treatment, you may immediately resume all normal daily activities including exercise and sports. You may resume normal daily showering or bathing. You may reapply nail polish immediately after your treatment. We recommend using Dr. Remedy’s Nail Polish which contains natural anti-fungal ingredients. If you do have any concerns or questions after your treatment, please contact our office and we will be happy to answer your questions.</p><p>How long does laser treatment take? The treatment time of your nails varies depending on the degree of involvement and the number of nails infected. Significantly thickened nails will need to be thinned to a more normal thickness prior to treatment to provide you with a better result. The actual laser treatment of the nails only takes a few minutes for each nail and does not require local anesthetic. Total treatment time for initial evaluation and treatment of ten nails typically takes 30 minutes. Can the fungal infection return? The fungal nail infection should improve with just one treatment. For nails that are misshapen, you should not necessarily expect a normal appearance to the nail. The fungal infection can and does over time cause permanent damage to the cells that grow your nail plate. This cell damage is not repaired by the laser even through the fungus is destroyed. As with most medical procedures, 100% guarantee of success cannot be given for this laser treatment of your nails. That being said, the philosophy of our office is to always provide you the very best up-to-date medical care for your foot and ankle conditions. This new laser technology is recommended to you because substantial improvement of your fungal nail infection is anticipated and a high level of satisfaction is expected. Re-infection can occur as fungus is present in our daily environment, particularly our shoes and showers, but we have advice and strategies to reduce the chances of this occurring. Is the laser FDA approved? The Q-Clear laser is FDA approved for the treatment of dermatological conditions of the soft tissue; the nail unit which consists of the nail bed, nail growth cells, skin surrounding the nail and the nail plate itself is considered soft tissue; nail fungal infection is consider a dermatological condition of the soft tissue. Other conditions the Q-Clear laser is used to treat would include the removal of warts, pigmented skin lesions and tattoos as well as the elimination of spider veins. How much does laser treatment cost? The cost of the treatment varies depending on the number of nails involved and the severity of the infection. FAAWC is using one of the most state-of-the-art lasers available and can provide exceptional treatment results with a shorter treatment time. Our fees range between $295.00 up to $995.00. You will receive a written quote including the number of nails requiring treatment and the total cost prior to treatment. Two additional evaluations within 12 months of your original treatment date are included in your treatment cost and we will provide laser treatment of any re-infection that occurs at no additional cost. </p><p>Fee Schedule for Laser Treatment of Fungal Nails One Nail $295.00 Six Nails $795.00 Two Nails $395.00 Seven Nails $845.00 Three Nails $495.00 Eight Nails $895.00 Four Nails $595.00 Nine Nails $945.00 Five Nails $695.00 Ten Nails $995.00 All nail polish, lacquer and decorations must be removed prior to treatment.</p><p>Consent for Laser Treatment of Toenails I understand that the laser that will be used to treat the fungal nail infection of my nails will be the Q-Clear laser which is FDA approved for the treatment of multiple conditions of the soft tissues of the body. In my specific case I understand that laser treatment will be administered to the entire nail unit even the nail plate. I understand completely that no assurance or guarantee has been given to me that I will have total resolution of my nail fungus or improved appearance of the nails being treated. I also understand that re-infection over time is possible. I have been advised that there are no specific known side effects of this form of treatment. However I do understand that with any form of treatment there is the possibility of injury to normal soft tissues. I have been told that I will be required to wear approved protective eyewear during the treatment and I understand that removal of the eye gear prior to the end of the treatment may result in blindness. It is critical that you do not remove your protective eyewear until the laser is turned off and you are told by the doctor that it is safe to remove your eyewear. I have read the above consent and information; I understand this information and consent and have requested laser treatment of my fungal nail infection. I have been told that _____ nails on the right hand/foot will be treated and _____ nails on the left hand/foot will be treated. </p><p>Left foot 5 4 3 2 1 1 2 3 4 5 Right Foot I have been quoted the cost of ______for my treatment Patient Signature: ______Date: ______Witness Signature:______</p>