Thursday, August 4, 2011

My day of terror

WARNING: Parts of this post may be a bit gross. I recommend reading on an empty stomach. I have this wound on my second toe on the left foot. It's right between the second and great toe, which is a horrible place for a wound to appear. How did it appear? Well, the whole right foot becoming a problem led me to start relying on the left foot more and more. That caused rubbing. Rubbing created a small wound AND a callus. Combined, they formed a sealed environment for bacteria and stuff. And so it became inflamed, and turned all sorts of scary colors.

The other day, in preparation for the visit to the special specialist, I took a shower. While showering, I waited for the skin of my foot to soften so I could clean that wound of some of the dead flesh around it. In doing so, I discovered a hole in my flesh. I thought little of it, as it had become a status quo kind of thing. I put prescription antibiotic ointment on it, covered it, and went about my business.

My main issue was that, while treating this wound, I realized that it stank. It smells...well, like a foot. No big deal, except that it's bacteria that creates such smells. And a hole in one's foot while surrounded by stinky can see how this might be a problem, I hope.

And so I called my podiatrist after seeing the special specialist and made an appointment for as soon as possible. That turned out to be this morning at 8:00 AM.

The visit began with a pleasant chat about the progress of my Charcot arthropathy. It was good news all around, as I'd beaten the time table for casting by about a month. Casting should take three to nine months, and here I am, a mere six weeks after we started casting, and I'm ready for a brace.

But then we turned our attention to that pesky wound. He used a scalpel to cut away some of the callus. He then probe the wound with the wooden end of an applicator...and was able to make contact with the bone. The only thing stopping him from actually SEEING said bone was the blood that leaked out.

What I have learned about diabetic ulcers, osteomyelitis, and wound care all dictate that what we were seeing was all very bad. This toe is acting as though there's an infection in the bone, and that the infection is creating a bore hole outward so it can drain. And because of its positioning, this was promising to be a rather complicated mess in terms of any kind of healing.

Heck...Healing?!? The way the doc saw it, there was probably no hope of healing. If there was a bone infection, then the only real option was to just take the toe off. It would be too much of a fight to get any healing done, especially with such a serious infection. As I left to get x-rays, the doc said there was a pretty good chance I'd be losing this toe in the near future.

You want to turn me into an instant wreck, just start talking seriously about the amputation of my body parts. Becky and I rushed to get the x-rays taken, and, as usual, took the disc home to look at the x-rays. From what my unprofessional eyes could see, there was nothing to see. The toe is thoroughly dislocated, but there's little to be done about that. In fact, the dislocation would appear advantageous, seeing as how it leans the second toe away from the great toe.

As instructed, I called the podiatrist to get the x-ray report, and the news is that there doesn't appear to be any bone infection. Translation: I get to keep the toe for now!

But now comes the other issue...This whole smoking thing. I have been accused of making excuses so as not to quit. The patch gives me a rash. (That's a medical thing right there, so not so much an excuse.) I'd swallow nicotine gum. (That's a reflex. I have always swallowed gum, and have never done so consciously. So, again, not an excuse.) Cessation pills have very dangerous complications, especially with the meds I'm currently on. (There's that medical explanation again, not an excuse.) So it all comes down to me simply having the willpower to quit this really bad habit.

There's a serious problem with that. Y'see, almost all of my willpower is divided between coping with my physical and mental issues. The last time I attempted a third division, so as to include the quitting process, I ended up attempting suicide. I went artery hunting in my left wrist, and have the scar to prove it. Now, some people have proclaimed their disbelief rather loudly, but when I was hospitalized after that, I sat down with a psychiatrist to explain what happened. After mentioning my attempt to quit smoking, he said, "You really have too much on your emotional plate right now to accomplish that. Do us all a favor and don't quit right now." (To this, I inserted the joke, "Great. Can you write me a prescription for cigarettes?" That didn't fly so well.)

Yes, a medical professional was telling me to NOT quit smoking. As contrary as this may seem, it actually happened. And since that time, there just never seemed to be a time when I existed with so little on my emotional plate that I could find the willpower to quit.

To some, these seem like excuses not to quit. To me, they are explanations as to why it seems so much harder for me to accomplish that goal. Trust me, there are better places my money could be going, and my health wouldn't suffer for it either. But every time I try to tackle the task of quitting, I become so emotionally overwhelmed that the stress, itself, starts to physically affect me.

It's being debated right now as to what I should do. One person should be writing to me soon as to how he got it done. It was also suggested recently that I try hypnosis, but no one knows if insurance will cover it. It's just, after today's scare, and knowing better circulation would be beneficial to me, the concept of quitting seems like a better idea all the time. But getting it done...that's where a whole new nightmare begins.

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