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My left foot

by ARGeezer 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!

This sounds awful, and I wish you very much that your foot will recover quickly and fully. Get well soon!
by Katrin on Mon Dec 8th, 2014 at 04:42:24 AM EST
Come the day indeed! That's a horrifying sequence. Let's hope the wound is on the mend. Though it's understandable you want to get around, it sounds as if rest with your feet up is indicated for some time yet!
by afew (afew(a in a circle)eurotrib_dot_com) on Mon Dec 8th, 2014 at 05:28:41 AM EST
Sounds awful surely. Best look with healing!
by das monde on Mon Dec 8th, 2014 at 08:46:28 AM EST
Ouch! Get well quickly.

At least you can still write and post.

"Life shrinks or expands in proportion to one's courage." - Ana´s Nin

by Crazy Horse on Mon Dec 8th, 2014 at 09:07:14 AM EST
Oh dear, that's awful for you, especially being such an active person. Do you have a hammock? They are a blessing when it comes to moderating oedema in the legs, ankles and feet.
That long an antibiotic treatment must be playing merry hell with your gut bacteria. Are you compensating for that with probiotics like yoghurt or miso?
I wish you a rapid healing from now on, it sounds like you have suffered way past enough for that moment of inattention.
I had a similar 'machine rebellion' a month ago while drilling through some metal with a high powered drill. It caught and flipped my hand, breaking two fingers and spraining a knuckle our two. Trying to work/play with two fingers swollen and bruised has been discomfiting enough, I can't imagine what you must be going through!
Your phlegm and morale sure sound like they're holding up fine, hats off to that!

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty
by melo (melometa4(at)gmail.com) on Mon Dec 8th, 2014 at 01:06:27 PM EST
crikey, you have my whole-hearted sympathy. Sorry to hear it and hope all works out now that major interventions have started

keep to the Fen Causeway
by Helen (lareinagal at yahoo dot co dot uk) on Mon Dec 8th, 2014 at 01:58:58 PM EST
Thanks to all for the good thoughts and wishes. I have indeed spent the last few months keeping 'my toes above my nose' several times a day. I have even figured out how to use the computer in that mode, however not how to post except single finger mode. Not being able to drive, due to Medicare requirements, is the biggest problem for us just now, as my wife is overdue for cataract surgery and has trouble driving at night or in any glare, and is used to my doing the provisioning. But it will get her out of the house more. :-)

I am torn between taking over the re-dressing of the wound two times a week, which would allow me to resume driving by stopping home health care, but would also deprive me of the 24/7 support security blanked I now enjoy. In the first two days home I stepped on the hose with my right foot while moving my left foot twice, neatly popping the suction attachment off my foot each time. The first time was late at night as I was going to bed in the dark and left the basic bandage intact. I was able to install a new attachment successfully and a nurse came the next day on schedule to replace the bandage. Then I did it again the next night, this time requiring a complete re-dressing, which I performed adequately to get me through to the next visit, though with the pump working harder than I would have liked due to a poor seal. The plan is to have the nurse supervise me on the next couple of visits until I am proficient. I now routinely tape the hose to my leg under my pants, emerging at the waist and carry the pump on a belt around my waist. That seems to protect the assembly acceptably.

At least no shortage of excitement!

"It is not necessary to have hope in order to persevere."

by ARGeezer (ARGeezer a in a circle eurotrib daught com) on Mon Dec 8th, 2014 at 03:19:21 PM EST
Well I really wish you a quick recovery!
by Xavier in Paris on Mon Dec 8th, 2014 at 06:50:26 PM EST
[ Parent ]
That sucks, man.  Hope for quick heal!

She believed in nothing; only her skepticism kept her from being an atheist. -- Jean-Paul Sartre
by ATinNM on Mon Dec 8th, 2014 at 03:55:07 PM EST
Wishing you a speedy recovery...

A society committed to the notion that government is always bad will have bad government. And it doesn't have to be that way. — Paul Krugman
by Migeru (migeru at eurotrib dot com) on Mon Dec 8th, 2014 at 07:38:46 PM EST
Best wishes to you geezer. We old folks always heal; it just takes a bit longer.;)

Hey, Grandma Moses started late!
by LEP on Tue Dec 9th, 2014 at 06:11:56 PM EST
Good to see you, Len.

A society committed to the notion that government is always bad will have bad government. And it doesn't have to be that way. — Paul Krugman
by Migeru (migeru at eurotrib dot com) on Tue Dec 9th, 2014 at 07:16:14 PM EST
[ Parent ]
Thanks mig.

Hey, Grandma Moses started late!
by LEP on Tue Dec 9th, 2014 at 07:20:44 PM EST
[ Parent ]
In my case a lot longer, Len. But some good news. See below.

"It is not necessary to have hope in order to persevere."
by ARGeezer (ARGeezer a in a circle eurotrib daught com) on Tue Dec 9th, 2014 at 11:43:46 PM EST
[ Parent ]
What Migeru said.
by afew (afew(a in a circle)eurotrib_dot_com) on Wed Dec 10th, 2014 at 01:46:28 AM EST
[ Parent ]
Got the first good news today. I had thought that the flesh around the wound not covered by the foam under the wound vac looked healthy. My surgeon confirmed that it did and suggested that, in a week or two, they could put me back in hospital, take a skin graft off of the epidermal layer of my thigh, run that ~ 0.5 mm x 3.5 cm diameter patch of skin through a high tech perforator  and then place it on the raw flesh now exposed under the foam over which the wound vac goes. As soon as a week after that we may be able to dispense with the wound vac. I would be a great way to start the new year. I was resigned to having the thing through the spring. It is good to be able to at least imagine that I have plumbed the depths of this particular affliction.

"It is not necessary to have hope in order to persevere."
by ARGeezer (ARGeezer a in a circle eurotrib daught com) on Tue Dec 9th, 2014 at 11:47:22 PM EST

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