Mon Dec 8th, 2014 at 01:34:25 AM EST
I want to note that I have been dealing with health issues lately. I was hospitalized in mid September and then again on the 2nd of December. All of this arises from an exquisitely ridiculous bit of prat-fall. I have been using a mobility cart at large stores for several years due to my knees. In early August I drove one out to my car, started to get off by placing my left foot off the cart, then decided to reposition the cart further left and proceeded to do so without putting my foot back on the cart - thus running the cart over the foot with my 270lbs and the cart's ~ 100 lbs resting on the side of my left ankle. Then I had to reverse the procedure.
The skin was not broken, but a deep hematoma formed and, within a week, became inflamed. I went to the emergency room on a Saturday and was diagnosed with cellulitis. I had no idea how serious that could be. After close to six weeks of outpatient antibiotic treatment I was admitted to the hospital for IV antibiotic therapy. It was not until after I was discharged that the first sore broke the skin, and it tested negative for bacterial infection. While in the hospital I was diagnosed with venous insufficiency, which had resulted in edema, loss of hair growth on my legs below the knees and a brown plaque from the iron in hemoglobin via catabolism, and recommended for venous closure via catheter of the left superficial vein, which I underwent over three weeks starting October 14 on an outpatient basis. It seemed successful as hair started to grow again all the way down to the foot and some of the swelling subsided, but the sore turned into an ulcer with a layer of newly deposited fat, likely, IMO, deposited to absorb remaining catabolic debris, on the bottom of the wound, now close to an inch in diameter.
After determing that it was not going to heal its self anytime soon, I was recommended for surgical debridement in November. After the biopsy from the first outpatient debridement came back showing strept and staph bacteria I resumed antibiotic treatment, but no sign of healing was found. Thus I was readmitted for a more thorough debridement under anesthesia, followed a day later by installation of a "wound vac" and accompanied by additional IV antibiotic treatment. I was discharged on the 5th, Thursday, and am learning to live with a vacuum pump attached to my left ankle, though not without incidents.
I remain able to walk and the vacuum pump has an ~ 8hr life, so I can travel short distances around town, but I am limited in what I can safely do. And I cannot drive, per the requirements of Medicare. The wound vac is doing a wonderful job of keeping the wound clean and I have in home support from a unit of the hospital, with all of this paid by Medicare. I expect to be able to replace the dressing myself, and thus be able to drive again, and I can hope that further deterioration has been slowed and healing has begun, but the wound is now about 1.5" at its widest. It is supposed to grow in from the margins and then be suitable for a skin graft. Come the day!