Tuesday, February 17, 2009

Toe be or not toe be...

...that is the question.
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous pain in said toe
Or to take arms and replace the toe with an entirely knew limb...

Leave it to me to take Hamlet out back and beat him senseless. Still, I come bearing news of the toe and what happened at the doctor's office yesterday.

It starts with the nurse, who took my vitals. My temp was 98.4, which is not that unusual, except that I usually hang around the 97.6 range. Still not worth worrying about. My BP was 140 over 90; that was obviously a sign of the stress I was experiencing, as normal for me is 110 over 70. Then I unwrapped the toe, and instead of having to wait for the doctor, she ran to get him.

The doc walked, took one glance at the toe, and said to the nurse, "Wounds always go to the surgery room." He repeated this several times during the transfer of rooms. This must have been his way to berate the nurse, who didn't know when I came back that I was sporting such a wound. Not fair to her, but what am I supposed to do about it? He barely listens to me about me...how can tell him it wasn't the nurse's fault?

The next phase was the doc rattling off orders to another nurse, and my foot was soaked for several minutes in a warm iodine solution.

While that was happening, I explained how I ended up discovering the status of the toe, how I was hit by that smell of rotting cheese when the bandage came off, and how I was terrified this was going to turn into a hospitalization that included taking the toe off. Between the doc, the nurse, and another doctor who just happened to overhear my concerns, I was told my worrying was justified. The toe - surprise, surprise - is VERY infected...but not as hospital stay status. Also, that smell didn't hit us when the new bandage I'd applied came off. My doc also said I was missing one symptom that would indicate the toe needed to come off, and that was red streaks traveling up the foot from the toe.

My toe was air-dried, and a new dressing was put on. I spoke up while the nurse did this, telling her to be sure she didn't put it on too tight. One of the grand things about caring for a diabetic foot wound is putting bandages on too tight. Allow me to explain...Circulation in diabetic extremities decreases over time. When an infection sets in, swelling can choke off the blood supply to the infected area. It's instinct to want to apply a pressure dressing to reduce the swelling, as well as make sure gauze and the like stay in place, but that would further cut off the blood supply. Without blood flowing to the wound, there's no chance of healing, and odds of the extremity literally dying increase.

On to the final step, which was getting prescriptions. Since my morphine sulfate would run out before my next appointment, I got a month supply of those. I would also be running out of Percocet, so I got a 22 day supply of that. (I was told new laws now make it impossible to give me a 30-day supply, which would be 240 tablets. Not that I ever received that many, but 180 tablets is now the legal maximum.) Finally, I was given the most important prescription, Dicloxacillin. This is an antibiotic that attacks infections that would normally be resistant to penicillin and other common antibiotics. I asked the doc if it was stronger than 10 men, and he assured me it was. To show how serious this infection is, I was put on a dose of 500 mg., four times a day.

Now...Some of my recent posts have been about how I'm in emotional crisis. While this toe adventure is terrifying, there are EXTREMELY GOOD SIGNS mixed in that show where my mind is truly set. If I was truly suicidal, I wouldn't care at all. I'd let this infection go until my blood was poisoned and it killed me. You'll also notice the quantity of painkillers. I have these on hand to deal with the aches and pains brought on my diabetes and deteriorating joints. While it crosses my mind to do something stupid with them when I'm at my lowest, I don't so much as look at the bottles. I wouldn't even need the painkillers to do me in; I have insulin, folks. An overdose of insulin would be a relatively fast way to go without ever even noticing.

No...Despite my extreme lows of late, I'm sitting here, doing my best to fight to stay as healthy as I can be. It's a good sign, my friends. As depressed as I've been, I'm still fighting the good fight.

Be well.

1 comment:

Anonymous said...

As I said in GitP... among the bad news... the best. I'm glad you're still fighting... and I just hope that the bad things give you a bit of a break for once.