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If you want to see what it looked like before we went to see the doctor this afternoon, click here. (You have been warned. If you squick over such things, don't click!)
Doctor Shannon Rush at Palo Alto Medical/Mountain View had a look at Lisa's foot and immediately said that the toenail had to go. There was no point in trying to save anything. Lisa agreed with him, especially as this was what she expected. Dr. Rush injected the toe with lidocaine (incidentally hurting Lisa much less than the Urgent Care doctor did, but OTOH the acute infection and inflammation may have had something to do with that) and a nurse prepared Lisa's foot. Once the toe was nice and numb, Dr. Rush came in and with a minimal amount of effort pulled the toenail off. It popped right off, and Lisa didn't even realize it had gone until I told her. I doubt the nail was all that deeply rooted, but nevertheless, it was somewhat surprising how easily it came off.
Dr. Rush applied solution to the nail root to kill the nail. After removing the entire toenail like this, you actually don't want it to try growing back, because that's apt to do more harm than good. He bandaged up the toe, wrote Lisa a prescription for a solution to apply to the toe after cleaning, and gave her some written care instructions for how to treat the area. He also gave her a second sandal so that she could wear them on both feet; this will help because she can walk evenly rather than clumping along on mismatched shoes.
We went to Walgreen's and collected the prescription, Epsom Salts, hydrogen peroxide, bandages, and sundry other stuff per the doctor's orders. By then the anesthetic was starting to wear off and Lisa was getting a little uncomfortable, but she decided that she felt up to making a trip to HSC Electronic Supply, which we'd never visited, but which bovil had told her might have some of the things she wanted.
She was looking for a small rack panel to use up at Fernley House. HSC has lots of large rack panels, some at very good prices, but none of the small ones. As bad luck would have it, they had sold their last small one that morning. OTOH, we encountered some small desk microphones that might be a good addition to the Match Game SF setup. We bought one; we'll have to go back and see if they have six more of them.
We returned to the apartment, and, per the doctor's orders, about two hours after the surgery, Lisa removed the dressings and soaked the foot in a solution of Epsom Salt and warm water, then dried the foot. Here's what it looked like without the toenail. (Again, you've been warned. Complains about medical squickery will not be be tolerated here.) She cleaned the area with hydrogen peroxide and applied the prescription drops and antibiotic ointment, then redressed the toe. She'll have to do this for a few days — a month at the most, said the doctor — until the nail bed heals and hardens back up.
All in all, the entire toe procedure went much more smoothly than I think either Lisa or I expected. Kudos to Dr. Rush at PAMF for his efficient work and cheerful manner. I think we were there less than an hour before we were on our way. Lisa is thinking she may be good to go driving again as early as Friday, and probably no later than Saturday.