Making progress

I decided from some of the comments I was getting that NOT seeing my leg wound was making it sound worse than seeing it.  Besides, it seems to me that it is so much better this week that I'm quite optimistic about the outcome.  Here are the photos.  I tried to edit them so they were as close as possible to the same orientation and size.

Nov 9

The size of each picture is approximately 6" square, about 6" below the knee.  Although far from healed, the wound has lost virtually all the hypergranulation and is actually starting to grow healthy replacement tissue on the outer edges.

Nov 14

This morning I was seen by a wound specialist who changed the compression dressing and with silver nitrate cauterized a couple of the edges that looked like they would have trouble healing.  She was reluctant to say how long the healing process would take but it would be several weeks.

She explained my diagnosis (stasis dermatitis associated with venous insufficiency) requires that I wear compression stockings - probably the rest of my life or I can expect further breakouts like this to occur. This one was complicated by bacterial infection.  Fortunately, I have good arterial supply to my legs.

Thank you all for you concern, prayers, and well wishes.

You don't want to see it

My leg, that is.  When they removed the dressing this afternoon to check the status of the wound, I took a couple of pictures but I've decided they might be a little too graphic.  If you imagine what a leg would look like if a pit bull bit into it and pulled off a piece of leg 2 inches in diameter and 1/4 inch thick, you'd be pretty close.  It's not that regular looking but it's just as ugly.

I've been referred to Kaiser's "wound care specialist" who's supposed to call me within the next 7 days.  I think that is both positive and negative - positive in that if they thought it was flesh eating bacteria I'd be in the hospital right now and negative because they're needing to escalate the care already.

As you're  probably aware, nurses don't tell you anything without clearing it with the doctor and mine wasn't available today.  But I had three of the office nurses look at my leg with great concern written on their faces.  And one of them muttered the word "hypergranulation".  Granulation is a good thing.  It promotes skin growth over large wounds.  Hypergranulation (sometimes called proud flesh), on the other hand, retards skin growth.  So you have to "wound the wound" until the hypergranulation is eliminated and the normal healing process can begin.  I'm guessing that's what the wound specialist does.

In the meantime, it's back with the tightly wound dressing on my leg and showering with my leg in a garbage bag to keep it dry.

From bad to worse - my left leg

I have been nursing two problems with my left leg for several months: swelling from the knee to the toe; and an open sore about 3/4 in in diameter.  Neither problem seemed that serious when I discussed each with my doctor.  The support hose and lasix didn't help the swelling and the anti-fungal salve was only slowly helping the open sore.

Then last Saturday I put a different band-aid over the sore after rubbing it with the prescribed salve.  It was one of those band-aids that is like rubber in that it deforms easily and sticks well even to wet skin.  The next evening my skin was all red around one end of the band-aid.  It felt like a bad sunburn or chemical burn.  When we removed the band-aid the skin came off as well.  The new wound was bigger and uglier looking than the original.  So we placed the salve on both sores and placed a band-aid over the new sore.  Yes, we're smarter than the average bear so we place the band-aid at 90 degrees from the previous one and (I can't believe this) we used the same flexible, sticky band-aids.  The next morning (you guessed it!) removing the band-aid tore a 3/4 inch piece of skin.  The other end had generated a blister 3/4 inch in diameter and a 1/4 inch high.  The blistered had punctured and was leaking it fluid.

I got an appointment with the doctor Monday morning.  He said to stop using the salve and the band-aid that had caused the trouble (duh!) and had his male nurse dress the wound with 4 x 4 gauze sponges.  The doctor prescribed an antibiotic, prepared a specimen from the weeping blister, and told me to come back two days later to see how the wound was going.

Two days later, the wound isn't growing but it is uglier.  The culture indicated that another antibiotic was called for.  The nurse decided that it would heal better if the leg were not swollen.  After dressing the wound, he proceeded to wrap my leg with four layers of gauze, foamy stuff, ace bandage type cloth, and netted tubing.  I complained that I wouldn't be able to see the wound healing and he sympathized by saying he wouldn't be able to either.

I can still get my leg into my pants and my foot will fit into my sports shoe even with socks on.  (It won't fit into my dress shoes with or without socks)..  And I will wait until next Wednesday to look at the wound again.

Takin' it easy

Edward came over with his family today.  This isn't unusual for a Saturday as he and the boys have been so good about keeping our lawns mowed and edged.  But this time he let Tim and Jake do all the work while he rested and talked.  Although it doesn't appear that the stroke he last Wednesday left him with any lasting deficits, it still is a life changing event.  His sense of humor is still evident.  He said that whenever he can't remember something, he'll clasp his head and say, "That darn stroke!  Wiped out that memory!"

A stroke of luck

I was going to blog about my sore leg (or leg sore) but thought I'd better get the word out about Ed's situation.  It's really his story to tell so if you get the chance, call him and get the straight scoop.  But I'll try to give a summary as much as I know.

Wednesday, late afternoon, Ed was picking up Camdan from the day care center when he discovered he couldn't control the muscles in his left hand.  He's left handed and couldn't sign Camdan out.  Later, as the family was getting ready to sit down to dinner, Tiffany was on the phone with the "Emergency Call" nurse for Kaiser who encouraged Tiffany to take Ed into the emergency room.  By now he was slurring his speech.  If there's anyone who would recognize speech changes, it is Tiffany.

Tiffany called Carolyn to ask her to come watch over the kids while she and Ed went to the ER.  Carolyn instead suggested she take the whole family to the ER where she'd pack the kids up in our van and take them home.  That would shorten the time for Ed.

Because Tiffany had been talking to the nurse, he was quickly admitted to the ER where his symptoms were quickly validated.  However, initial reports were mixed.  To be on the safe side he was admitted for at least an overnight stay.  Thursday, Kaiser ran several tests and verified that he had indeed had a stroke but it appears not to have permanently affected his abilities.  Conversations that I've had with him on the phone indicate he can talk as well as ever and he certainly hasn't lost his sense of humor.  For those who remember Ed's phobia of needless and all things hospital, you know that is significant.

Ed is due to be discharged today (Friday) noon about the time I am writing this.  He ate a good breakfast and is just anxious to get out.  If you have the time, I'm sure he would be tickled to hear from you.  We certainly aren't happy he had a stroke but are grateful about the outcome.