The Best Bad Development Yet

Okay... I've mentioned several times that I'm overweight. It's reach the point that the moment when I mention that I'm a diabetic, there's that brief look in other people's eyes that sarcastically says, "You don't say!" Reflexively, I immediately follow up with, "Type 1 since the age of seven, not Type 2 as it appears." I might even gesture at the thing medical science calls a human body.

The weight came from my inactivity due to Charcot foot... and a few other sources. That weight I gained when I was taking that high dose of gabapentin, for example. I lost most, but not all of the weight. The utterly ridiculous situation where I sneezed and separated a rib from my sternum resulted in me being prescribed steroids, and the steroids caused me to put on 30 pounds. Unlike the gabapentin, I don't know why the steroids did it. Heck, I don't even remember the name of the steroids! I just know that when I was done taking them, I was bigger. 

At this stage of my life, once the weight is there, it doesn't come off unless there's A LOT of work done. I brought this up with my doctor, complaining that in a country like Japan, I'd be hospitalized, given a much healthier diet, subjected to physical therapy, and they wouldn't stop until I was no longer in danger of dying from weight-related causes. "What's a 'weight-related' cause of death, Rob?" Lugging around what could be considered the total weight of a separate human being, my heart could wind up saying, "Nope. I'm done." And then I fall over, dead from cardiac arrest.

It is NOT beyond the realm of possibility.

This isn't to say that I didn't try to lose the weight. I bought an inexpensive stationary bicycle, figuring that a one-legged guy could make use of it and not have to worry about dodging traffic. 

HOWEVER, there was a brief period when I did an incredibly stupid thing. I got lazy and decided it was a waste of time taking the shoe off of my prosthetic, and then have to fuss with it later when/if I had to go out. So I left the shoe on... but I went barefoot on the other side. The result was a wildly uneven gait, and my left hip was getting tilted at an increasingly painful angle.

I didn't seek treatment for this one because, frankly, it was embarrassing. Besides, why bother? I didn't need a medical degree to know I'd done damage to my sciatic nerve. My symptoms were a spot-on match for sciatica. (A pinched sciatic nerve.) The pain was pretty intense, but I chose to ignore it as best I could. Of course, I started removing my shoe from my prosthetic to normalize my gait, but it would take about six months for the pain to go away completely.

EXCEPT...! The damage to my lower spine from my weight gain, arthritis, and degenerative disc disease constantly put me at risk to trigger the pain again. Lo and behold, after assembling the stationary bicycle, I tried to get on it... and it felt like someone shoved a sword through my lower back and down into my leg.

Oh, I was never going to do THAT again, even if it meant that $150 was sacrificed to the gods of consumer regret.

What annoyed me most was that if it had been a regular bicycle, I would have been able to get on it. Because instead of having to contort my body to get my leg over the stationary bike's rigid frame, I could have lowered the bicycle and simply stepped over it to get my foot on the other side.

My weight, my spine, my amputated foot, and Charcot foot have made getting around extremely difficult. It's my weight and spine that come together to become the real villains of the story. Once I stand up, I have two to five minutes before I have to lean on something or sit to remove the intense pressure on my lower spine. My least favorite activity is washing the dishes, not because it's an annoying chore, but because the pain starts climbing... and climbing... until I'm standing there, panting and praying for death.

Now let me add some legislative stupidity to my life. Where I'm living, blood testing supplies can't be delivered by pharmacies. Why? Because smaller pharmacies used to submit claims for glucose testing supplies without actually distributing said supplies. After discovering that they were being defrauded, the government passed laws that required a signature from the patient or someone the patient knew in order to hand over the supplies. Mind you, this was only if a doctor prescribed them. Out of pocket, 50 of the test strips I use will cost around $35, and I need 100 to last me 25 days. And that's if I don't have any failed tests. (Failed tests are when you don't have enough blood in the strip for whatever reason; you couldn't squeeze enough out of your finger or managed to smear the blood instead of getting it in the stick.) 

The signature requirement made me NUTS! I couldn't get to my pharmacy by foot, even though it was technically a five-minute walk... if I COULD walk! By pure chance, one of the pharmacy delivery guys was also a diabetic, so he was willing to drop sign for them and drop them off after work. Mind you, he had to wait until he was off from work. Otherwise, it would be akin to the scam that got us in this jam to start with.

Additionally, there were other little things that were frustrating me. Like if I started running low on food, I couldn't go out and get more on my own, and I'm too technologically inept to do online shopping for local markets to have them deliver. There's a mall nearby, and I've never visited it because I can't walk. I've wanted to get a COVID booster, but those are only distributed by pharmacies for some silly reason. Thus, I have been trapped at home beyond the restrictions of the global pandemic.

After discussing all of this with my PCP, he finally agreed that I would benefit from a motorized mobility device and began the paperwork for me to get one.

Medicare, being the extremely friendly and helpful organization that it is, made this SUPER easy! No, wait. Hang on. I got that wrong. What they actually did was tell the one-legged guy that he had to jump through a few administrative hoops first.

The one that presented the greatest challenge was getting a physical therapist's assessment of my living conditions to PROVE that I would benefit from such a device. There are no PT specialists that do home visits in my area. NONE. ZERO! 

Enter the third party company that helps broken people like me get the equipment they need. A technician was sent over to take measurements of my apartment, and he then called a physical therapist and did a walkthrough of my apartment using the camera on his phone. (Ain't technology grand?) In the end, they said that I SHOULD qualify for a motorized device, but they wouldn't promise because Medicare likes to invent more and more hoops for the disabled to jump through.

Initially, I was rejected. But that's because someone forgot to check a box somewhere on the submitted forms. The next letter I received was acceptance. Yes, "Hop-Along Round-Man" qualified for the device. This was in May. Thanks to global supply chain difficulties, I could expect to receive it in September or October.

The waiting game began. Would I be a good boy and wait quietly? Not on your life! I called a month later for an update. No news. Okay. Called after another month. Still no news. Getting antsy, I called around 10 August, which was another month later, and not only was there no news, there was no nothing! There'd been no order status updates since my last call, which surprised them. The said they'd look into it and call me back.

When next they contacted me, it was to ask if I could accept deliver on August 31. YOU BET YOUR SWEET BIPPY I COULD! 

With the assistance of a few people more able-bodied than me, some furniture was moved around my apartment to make room for my new wheels. And here they are!

I'm gonna go cruisin' for chicks with

this baby!

Now you're saying, "Rob. This is great! You'll finally have the freedom to do stuff!" And you're right. But I also feel like this is the final flag that's declaring me crippled, (as though the near-countless other reasons didn't do that).

~ sigh ~ I need my beautiful, scantily clad young woman. Where is she?

There she is... but annoyingly

overly clad.

NOTE: I don't know if anyone's noticed, since y'all never leave any comments, but I've essentially started making posts every other day. I think if I went with daily entries, I'd run out of things to talk about too quickly. This one is posted off schedule because of the date it occurred.

More Than a Pain in the Butt

Wasn't the story about the loss of my foot fun? It's the kind of story that you can tell at dinner gatherings, showing off pictures that I provided and everything. Trust me. There's nothing quite like bringing up meal-destroying material during family get-togethers. If they argue politics, you can bring it to a stop with pics of diabetic feet in varying states of distress. You don't even have to use my blog. Just let Google ruin the appetites of those you despise. 

I think it's time I concentrated on something I brought up during The Saga of the Foot. Pain management. If you don't control your diabetes, you're going to experience a measure of diabetic neuropathy at some point. Personally, I have some bonus pains. The osteomyelitis in the third metatarsal of my right foot that healed a bit goofy is aching as I type this. The Charcot foot also provides some interesting pains in the collapsed arches. And as a bonus, I once put on weight so swiftly you'd think I'd gotten pregnant, which would be a neat trick for someone without any female parts. That excess weight - concentrated in the trunk of my body - puts crushing weight on my lower spine, which has become arthritic, as well as showing signs of degenerative disc disease. 

The practice of medicine is constantly changing. What was once thought of as perfectly normal treatment is viewed with a frown or worse later on. Once upon a time, cocaine was an over-the-counter item at your local pharmacy. Go ahead and try asking where it's shelved now. I'll wait.

So the old view of pain management: give the patient the amount of painkiller that's appropriate for their level of pain. Tell them they can take that dose so many times a day and to call for a refill when they run out. The baseline of this tended to be 120 tablets of a narcotic that's taken every six hours as needed. For me, this was Percocet. It's a mix of oxycodone and acetaminophen.

But my doctor between 2006 to 2010 did BETTER! He prescribed a baseline painkiller to go with the short-acting stuff. MS Contin. That's Morphine Sulfate Continuous release. 

You already know this story, right? When you take narcotic painkillers like clockwork, you develop a tolerance to them. To counter this, the doctor increases the doses. My dosing when I started: Percocet - 5/650 - that's 5 mg. of oxycodone and 650 mg. of acetaminophen - every six hours and 15 mg. MS Contin every eight hours. Within 10 years, I moved up to taking straight oxycodone, 60 mg. four times a day and 75 mg. of MS Contin three times a day. 

When people heard these doses, they stood in wonder at the fact that I was conscious and at all functional.

There's one other medication that was mixed in there that I have some complicated thoughts on. When I first started taking it back in the mid-90's, it was called Ultram. Today it's known more commonly by its generic name, tramadol. It was labelled a synthetic opioid from the start, but wasn't classified as a controlled substance until 2 July 2014. Tramadol has been the only medication that effectively addresses my diabetic neuropathy without side effects. My understanding of it was that your body didn't develop a tolerance to it the way it would common opioids. When I started taking this medication during my very first symptoms of neuropathy, I would take up to 100 mg. four times a day. That's because I wasn't controlling my blood sugars, so my pain was continuous and intense. (That dose has dropped since then.)

For me, if my tramadol doses were suspended for whatever reason, it meant nothing to me. I didn't suffer withdrawals. Not even a little bit. All I'd ever feel was an increase in my neuropathy pain.

But others... If they had a history of opioid addiction, tramadol was a trigger for them. I saw this first hand with a roommate I had. He was prescribed 50 mg. three times a day as needed for pain from fibromyalgia, a different neurological disorder that causes pain. The problem was that there was once a point in his life when it was entirely possible 80% of his body was made of opium. Like anyone with an addiction, he would go through his 30-day tramadol supply in less than 30 days. He would then have to wait for his doctor to refill it, and his doctor was in absolutely no rush to do so. In that time, he would suffer withdrawals, along with the pain the medication was supposed to address.

I thought he was insane. Tramadol isn't addictive. That's what I thought. anyway. As I've said several times before, every patient is different. So I guess it really was a trigger for opioid addicts.

There are other medications beyond controlled substances to control pain. Like Neurontin, also known as gabapentin. It's an anti-seizure drug that has a few off-label uses, like pain management and as a mood stabilizer. And boy, do I have a story about this one!

I was in the hospital for depression. Yes, your charming host and narrator had attempted to - What's the phrase all the kids are using these days? - unalive himself. I was successful and have been writing this blog from beyond the grave. (Okay, maybe not. Would have made this blog a lot more interesting, though, wouldn't it? 😁) My doctors - all psychiatrists - knew that gabapentin was used to control neuropathy pain. I was already taking 300 mg. three times a day, but I was still experiencing pain. To address this, they doubled my dose.

This is where things started going wrong for me. I became absolutely RAVENOUS! I wasn't just eating what was on my meal trays, but also whatever other patients didn't want from their trays. I couldn't control my hunger, and it wasn't really sated by eating. That's when I started gaining weight. 

I was told by one of the med nurses that gabapentin can hit with a double-whammy on the side effects front. Not only can it increase hunger, but slow down metabolism. That's what seemed to be happening to me.

By the time I'd tacked on 20 extra pounds, I explained to the nurses that controlled the ward that I needed to be seen by a neurologist or pain specialist. They said they'd call for one, and I waited. A week later, having packed on some more weight, I told them that I REALLY needed a doctor to come and address my problem with gabapentin. They said they'd call again, and I waited again. Another week went by, and by the end of it I'd gained an extra 30 pounds in about 30 days.

Remember when I brought up The Patient's Bill of Rights? Well, I could easily refuse to take the gabapentin, but I wasn't being treated with tramadol at the time, so I would have suffered a lot of pain. Besides, that would take a few days to become a problem. I needed a faster solution.

As the med nurse was making his rounds the next morning, he handed me my insulin syringe... and I handed it back. "No thanks," I said, remaining neutral to what was obviously not going to go over well in a psych ward! When asked why I would refuse my life-sustaining medication, I replied, "Well, I've insisted that I need a doctor to address my neuropathy pain. It's two weeks since my first request and no one's shown up. Since it's my right to refuse medications, I'll skip the insulin and more than likely become incredibly sick. That's when I'll be moved to a medical ward, and then some will HAVE TO come see me."

As insane as the idea seemed on its surface, it made a lot of sense. And by keeping my cool, I came across as perfectly rational. The head nurse eventually came to discuss the situation. He ASKED that I take my morning dose and he would personally call for a neurologist or pain specialist. I agreed, but warned that my lunch dose wouldn't be taken if no one showed up.

Two hours later, I was discussing treatment options with a pain specialist. This was the doctor who took a liking to my phrase "pain seizures." What can I say? I have a way with words and word-like substances. 😉

Because of where I'm currently located, finding proper pain management has been difficult. I'm actually scheduled to see a new pain doc in two weeks, so we'll see how that pans out. I came away from the last one determined to never see him again, despite him saying he was willing to treat me. (Maybe I should cover good and bad doctors soon?)

Meanwhile, my PCP has been handling my pain. It becomes somewhat difficult to do that with me because something on me is always breaking. This will sound insane, but just after I started seeing him, I sneezed so hard that I separated a rib from my sternum. It even has a name, costochondral separation. And this was the second time this had happened to me! Every breath was absolute agony.

So what can I say in summation to all of this? I mean, you're going to experience some intense pain if you're not controlling your diabetes. When and if that happens, what should you do?

1. Talk openly and honestly with your doctor. I've said as much before, but it warrants repeating. If you're not communicating with your doctor, you're in for a world of trouble. Improper treatments and medications can make things much, much worse.
2. Always, ALWAYS, ALWAYS, ALWAYS, ALWAYS discuss other options before turning to narcotics. There are other medications that can work depending on the severity of your pain. 
3. See recommended specialists. As the complications of diabetes accumulate, the list of doctors you'll need to see is going to get annoying at the very least. But you have to see them because they're specialists. They focus on just one aspect of medicine. They'll know about the latest treatments available to you.
4. Do not seek out narcotics first! Once you open that can of worms, you're in for a lot of needless drama. My fight to get off those absurdly high doses of opioids was one of the most difficult things I could do while simply sitting around. I was not addicted to them, but my body had become dependent on those high doses. (Where I exhibited addiction behavior was with cigarettes, which is a different story.) Overall, it was a pain to reduce my painkillers.
5. Take medications AS PRESCRIBED! Whatever the medication is, don't get creative. A common misconception is that "more equals faster." It does not. Not ever. Never forget that accidental overdoses are a thing that has claimed countless lives. (See numerous celebrity deaths for reference.)

That's all I have for today, folks. But you know what might be fun...? Putting up an unedited post. One that includes my every spelling and grammatical error. I don't know if I could pull that off. All of those little red lines beneath my mistakes would drive me up a wall!

And now... Place your bets! Can Rob get the picture of the beautiful, scantily clad young woman this time? You know he can't, but he'll keep trying. Let's see what today's photographic error is!

Well, we got close. It's her knee.

Saga of the Foot - The Aftermath

You're back! And it's time to see justice done! My literal flesh had been sacrificed to the negligence of a group of arrogant orthopedic surgeons, as well as a significant amount of my mental health. Through it all, my mind was locked on the idea that I was going to sue those doctors into non-existence. They crippled me even further with their inaction. My foot had to be worth millions! MILLIONS! 

As I started the healing process after surgery, I began the quest online for a lawyer who would take my case. They get a nice percentage of the settlement, so surely a case worth millions would be worth their time. As I found them, I would call them.

Well, my friends, I gave up after talking to at least a dozen different law offices. No one - and I mean NO ONE - was going to touch my case with a 10 foot pole. 

I'll start with the lesser of the two reasons. You see, I was already disabled when I lost my foot. Being on Social Security Disability meant that there was no loss of earned income. That meant that that side of any lawsuit would be worth exactly zero dollars.

The other reason...? I'm a diabetic. Any attorney working to defend against my lawsuit would argue that diabetics suffer amputations all the time and that there was no way of truly knowing the cause of my loss beyond my illness. One lawyer said, "I'm not saying that what you suffered wasn't catastrophic. I'm saying that it would be impossible to win against what is considered common knowledge." My diabetic neuropathy had advanced to the point of Charcot foot. Who's to say an amputation wasn't waiting just around the corner in a month or two?

Talk about a gut-punch. The steady stream of rejections was translated horribly by my severe recurrent depression. "I am literally worthless." Hells, I wasn't even worth the sum of my base elements! THAT, dear reader, is one hell of an insult.

Enter chronic insomnia. I would lie in bed, stewing over the fact that a pair of doctors were going to get away with causing a literal loss of limb for me. I would vacillate between nearly uncontrollable rage and a bottomless pit of despair. Sleep would only come when my eyes swelled shut from exhaustion. The doctor I was seeing at the time went with the old insomnia standby, Ambien. But I turned out to be one of those people whose brain was put into overdrive when taking it. Want to be amused? One of the side effects of the sleep medication known as Ambient is insomnia*. 

My current physician - bless him - recognized my need for something that would shut my brain OFF! Now I'm eventually going to discuss the uses of narcotics when addressing chronic pain, but I'm going to use this doctor and this prescription to exemplify communicating honestly with your doctor!

The prescription is Xanax. (It's generic name is too long to type.) It comes in 0.25, 0.5, 1.0, and 2.0 mg. doses. The pills are also scored, meaning that they have a line in the center that allows you to split them. Pills that don't have scoring should not be split! (Consult your physician or pharmacist if you have any questions about prescribed medications.) My PCP initially prescribed 60 tablets of the 1.0 mg. dose to be used twice a day as needed. This prescription would last me well over two months because... Well, I didn't really need that much.

During a visit with the doc, I told him that I was using half a tablet at night - only 0.5 mg. - and occasionally trying to split the halves into quarters for a 0.25 dose during the day. It's that second part that was a little wonky. Even with a pill-splitter, those quarter-tablets would be randomly sized. Maybe I was only getting 0.15 mg. in a daytime dose. Maybe it was 0.35 mg. I had no idea. Because this is a habit-forming narcotic, I didn't like that I was taking an unknown dose, regardless of how small.

As a result of our discussion, the prescription was reduced to 0.5 mg. tablets that I could easily split by hand down to 0.25 mg. should I need something during daylight hours. That quantity of 60 tablets tends to last 45 days or more.

If you are dishonest with your doctor or withhold information that's vital to your care, you could wind up with the wrong medications, improper doses, ineffective or damaging treatments, or worse. "Worse," in this case, equates to "death,"

Now before I go, I don't know if you noticed the * at the end of my Ambien tale. That's because it brought to mind something I ultimately found very funny. They've since removed it, but according to the insert for Humalog, one of the signs of severe hypoglycemia is DEATH. Death... was just a sign... of low blood sugar. This knowledge led me to suggest that if anyone ever ran across a corpse that they should try giving it a candy bar. There's that slim chance that that's all they needed to live again. 🤣

That's all there is, folks. No one paid the price for medical malpractice. My would-be lawsuit was rejected for the simple fact that I'm a diabetic. Which means, as per my usual luck, the light at the end of the tunnel for me was...

At least it's not an oncoming train, right?

Saga of the Foot - Part 6

Y'know what I forgot? The actual cause of the ceaseless fluid leak prior to my amputation. Well, once my foot was removed, it was sent off to a pathology lab, where it was subjected to several tests, and... I'm kidding. It was immediately sent as biohazardous waste to be incinerated. While it might have been interesting to know the cause, the point was moot. The foot had to go. The foot went. End of story.

But when the doctor told me the foot had been incinerated, I did joke that I'd changed my mind and wanted it reattached.

My recovery from the surgery was prolonged by a mystery. With there being absolutely no source, a blister formed on the underside of my residual limb. The picture I'm about to show you is post op, just before the staples were removed. You'll note there are plenty of stitches that would remain for another couple of weeks.

I've circled the blister for your

viewing pleasure.

Blisters are usually the result of something constantly rubbing the site or a severe burn. We didn't know it at the time, but this was a diabetic blister. Do you know what causes diabetic blisters? No, I'm actually asking you, just as I did with diabetic neuropathy. Because no one really knows; I was hoping maybe you had the answer. They appear on the extremities for no apparent reason, so that's one more thing to be vigilant about if you're not controlling your blood sugars.

Fun, right?

After three long months of post op healing, I was finally given clearance to get fitted for my first prosthetic. Off I went to the orthotics lab, where I was given... a limb shrinker! I wish I had a picture of the one I used, but I never took one. Don't fret, though, because I looked up a generic one for you!

One limb shrinker

shrinking a limb.

Maintenance of one's residual limb is important. Even after all the incisions from surgery have healed, there's going to be significant swelling. Despite the fact that your eyes can see it and your conscious mind acknowledges it, your body doesn't know that your foot is gone. It needs to be retrained to recognize that it doesn't need all of that extra blood, oxygen, and nutrients. And what better way to retrain it than with some Lycra to strangle your flesh?

For the first couple of weeks, I faithfully wore my limb shrinker day and night. Then I got annoyed. I wasn't sleeping through the night because I'd bend what was left of my leg in my sleep, causing the Lycra to bunch up at the knee, and it would pinch my skin painfully. In all honesty, I have enough reasons to be taking powerful painkillers. I was NOT going to add irritation from a leg shrinker to the list.

On my next visit to the prosthetist, I told him that I was wearing the shrinker for most of the day, but that there'd be no convincing me to wear it at night. Because of my stubbornness, my residual limb might not be small today, but I'm not overly concerned about that. When I get to remove a source of pain from my ever-growing list, I'm a happier camper.

A mold was made of my stump and I returned two weeks later for my first official fitting. This was it. I was getting my first new leg! Adjustments to the socket and the angle of the foot were made, and then, for the first time in six months, I WALKED! I was a little stiff and shaky at first, but the prosthetist was impressed at how quickly I was able to start taking regular steps. He said that 80% of new amputees tend to simply forget how to walk. Obviously, I hadn't. Although... After my first few hesitant steps, I stopped and did an imitation of Peter Boyle from Young Frankenstein, shouting the strangled line, "PUHHIN ON DA REEEZ!" (Movie trivia: No one was sure what the creature should say, so Peter Boyle improvised the line and comedy history was made!) The prosthetist thought it was hysterical.

My first month with my new leg was a pain in the tuchas. It was a struggle every day to get the pin on the leg cover to line up with the hole at the bottom of the socket.

The prosthetic as a whole.

The notched pin. It is NOT a screw.

The hole at the bottom of the socket.

Can you see why it might be a problem at first? Once the leg cover with the pin on the end was inside the socket, I could no longer see my target. Putting it on each day was a 5 to 10 minute ordeal. I commented once that I wished the socket was transparent, but the prosthetist said that they couldn't make the carbon fiber socket see-through.

Fiber. Carbon. Socket. You have no idea how much abuse this thing can take. Obviously you shouldn't try to damage your prosthetic, but someone experimented. She explains that it's the epoxy that eventually burns, not the carbon fiber. 

Aside from the obvious reason of why you shouldn't try to damage your detachable leg, since you kind of need it to walk, is the price. Gods above and below, THE PRICE! Being on Medicare, I get a lot of mail that starts off with, "This is not a bill." It's Medicare's friendly way of saying, "If you didn't have us, this is what your medical expenses would look like." Well, I got one of those for my leg, and the amount covered was about $5 shy of $8,000.00!!! I could have gotten a prosthetic CAR for less! For that kind of money, it should come with all sorts of James Bond-like extras. Like I could press a button and little wheels would pop out of the foot, and then I could just push along with my good foot. Or maybe a small refrigerated space to keep a cold drink. Or maybe a gun that comes out Robocop style. SOMETHING! Instead, all I get is next-to-impossible-to-destroy carbon fiber, advanced, lightweight alloys, and a foot engineered to simulate the natural gait of walking.

Jerks.

Having seen the price tag of my new leg, I went online to find out what the "black market price" was for it. Maybe I could sell my leg for a profit, tell insurance that someone stole my leg, and they'd get me a brand new one. Financial windfall, here I come! 

Follow me for more tips on how to defraud the government and wind up in jail!

The problem is that my prosthetic leg is worth $8,000 to me and ONLY me. Online, if you want a used prosthetic leg, you can get it for around $150 at the most. It won't fit anyone but the original owner, and it's alignment will only benefit them. In other words, a used prosthetic leg is worthless.

There was one other aspect of being an amputee that required an adjustment of conscious thought: socks. These are layers of Lycra that can be added to the leg covering to improve the socket's fit to your leg. There are all sorts of reasons why your residual limb might change size. Leg elevation, water retention, continued use of a limb shrinker. Gaps that form between the leg cover and the socket can cause pain, sores, and even calluses. To prevent these, "socks" can be slipped over the end of the leg cover. They come as one-ply, three-ply, and five-ply. If you're not catching on, think two-ply toilet paper. It's the thickness of the socks.

Seen here: one five-ply and one three-ply

sock on the end of my leg covering.

Here's the issue: I have to make sure the pin comes through the end of the sock. If I don't and force the pin into the socket, it gets jammed in place. Until I figure out a way to get it off, I'm then stuck with the leg attached. I had a couple of minor jams and one MAJOR. The major one required my to get into the shower and force soapy water into the leg covering so it would get slick enough inside to slip off me. Then someone whose hands haven't been decimated by diabetic neuropathy had to come help force the pin to release the sock-covered pin.

Fun times.

Well, quiet people, we're very near to the end of this saga. All I need to tell you now is the epilogue. About the massive lawsuit I brought against the doctors who didn't listen to my pleas for help when I made them, and their comeuppance for being the primary cause of the loss of my foot. More than the physical damage, there was the immeasurable psychological trauma of having a foot I'd lived with for over 51 years amputated. It's a light at the end of this nightmarish tunnel, right? See you next post!

Saga of the Foot - Part 5

Well, my commentless readers, this is it. The part where... I yell at you some more for remaining silent! Blogspot's analytics say SOMEONE is reading my posts, but no matter how many times I ask, no one comments. I'd like to know if I'm doing well or poorly.

Why, yes... As a matter of fact I AM rather needy. (Send hugs.)

That out of the way, we've reached the part where I lose a few pounds in just one hour. In terms of a weight loss program, I do not recommend amputation.

The first step was a visit to my Primary Care Physician - PCP - to be cleared for surgery. Between September 2011 and October 2018, I had 15 different surgeries, most of which were on my feet. (The vitrectomy and cataracts surgeries are in there somewhere.) Thus, having my PCP look under the hood, check the oil, and kick the tires was old hat by now.

It was as I was leaving his office that this very real exchange occurred. I love telling this story because it sets the tone of my public attitude about what happened to me. The nurse - a sweet, empathetic woman - was somewhat melancholy as I was leaving. "Well," she began, "I guess we'll see you... after."

To which I replied with an oddly cheery voice, "Yup. Next time you see me, I'll be a foot shorter."

She lost it, nearly coming to tears with laughter. Some people, however, are reluctant to laugh. They know I'm joking, but don't want to laugh at my loss. If I didn't want people to laugh, I wouldn't tell the story. And in case you're wondering, this is 100% true.

The basics of my BKA - Below the Knee Amputation - were simple enough. I'd be knocked out. They'd do a nerve block for my lower leg. They'd cut and cauterize what they needed to. Post op, I'd have to wear a brace for two weeks to prevent contracture. Contracture is when the muscles and tendons permanently tighten, causing a serious decrease in range of motion. If that happened, learning to walk again with a prosthetic would have been next to impossible.

I'm going to show you the brace, but the picture requires an explanation. You see, the best investment I've ever made in my entire life was the $1.07 I spent on a bamboo back scratcher at a dollar store. This thing's been a life-saver! Knowing I was going to be hospitalized for a while, I made sure to pack it with my other belongings. Combine the back scratcher with the brace and we wound up with the following picture and caption:

"Rob has already fallen victim to Medicare

cuts. His prosthesis is less than adequate."

Oh... That thing strapped higher up on the brace was to prevent it from chafing my other leg. Velcro somehow manages to make life easier and more difficult simultaneously.

The two weeks after the surgery are kind of blurred. I was, after all, on copious amounts of painkillers. But here are some of the highlights.

1. I learned a thing about amputations, or at least the style that I got. (Different situations require different procedures.) When they removed my foot, they cut my Achilles tendon, and then rolled it and the muscle up, "tacking" it in place on my severed bone. Mind you, I never asked what "tacking" entailed; for all I know, the doctor used a thumb tack to hold it in place.
2. I had two and a half to three hours of physical therapy a day. Every time I was told that if I performed one activity or another for so much time or covered a certain distance, I would score higher on my final evaluation. I took those as challenges. Looking back, I wish I'd done worse, but more on that later.
3. The young physical therapist that was nearly half my age and that I thought was absurdly pretty just had to be the one to assist me in taking my first post op shower. And wouldn't you know it, while waterproofing my residual limb with medical tape and plastic bags, I just had to discover how soft her hands were on my inner thigh! I think that may have been the very first and only time I was thankful for having E.D.
4. Making sure I could get off the floor if I took a fall. I initiated this exercise because I was aware of how alone I'd be at times. A fall was inevitable. Of course, I was lowered to the floor for this exercise. Knocking me over or letting me fall was apparently against hospital policy.
5. Being compared to the late Don Rickles. (Frank's story at the end of that clip is the best!) I feigned a lot of irritation over things that were beyond anyone's control, with reactions so over-the-top that it would get others laughing. I actually found the comparison flattering.
6. Because my amputation occurred right around Halloween, I suggested someone get me a stuffed toy shark so we could tear open its mouth and fit it around the end of my now-incomplete leg. 😁 Toy sharks of the appropriate size weren't available at the time. 
7. The first people to stare at me.

That last one was mostly amusing to myself. I was left at a hospital exit while someone brought a vehicle around to assess if I could get in and out of it. While I was waiting, a mother and her two kids came in. Without even realizing it, all three of them stared at me. With as much excitement as I could muster, I gasped and said, "My first starers!"

Confused, the mother asked, "What?"

I quite happily explained, "You're the first people to stare at me and my loss of limb! Big day for me!" She was immediately apologetic, which I cut off swiftly. "Please... If I was upset, I would have snapped at you and the kids. I'm trying to make light of it so my circumstances don't drive me insane." With a sigh of relief, they moved on while I was wheeled outside to get in and out of a car.

The hospital staff realized early on that I was stable enough to stand without assistance from someone else, so they turned off the alarms that would alert them if I tried to get out of bed unsupervised and a sign was taped to my door to ensure I wasn't interrupted if ever I stood to use the bedside urinal. Somehow, the sign got moved, resulting in...

I guess they were supposed to

knock on my head? 🤔

I said earlier, I wished I'd done more poorly in terms of working toward my final evaluation. The reason why is because I was under the impression that I'd receive a wheeled mobility device when discharged, be it a wheelchair or a knee scooter. But because I did so well during my final evaluation, I was given a bare-bones walker. The exhaustive output level that I'd achieved during physical therapy was now expected of me every day until I was fitted with a prosthetic. At age 51 (at that time), with diabetic neuropathy significantly affecting my hand and arm strength - something they somehow didn't include in their final assessment - and being overweight due to a number of factors that I won't get into now, there was no way I was going to be able to maintain that level of activity.

This is a knee scooter.

This is an average, run-of-the-mill

walker. No AC, no BOSE sound

system, no undercoating.

What they also failed to realize was that there was always someone around during my physical therapy. If I started to lose my balance, someone was there to make sure I stayed upright. When I returned home, the only person around would be my housemate, and he worked 40-ish hours a week. His dog and my cat didn't really count in terms of helping me around the house.

Also, that PT to make sure I could get off the floor if I fell...? Well, I needed it almost immediately.

I'd been home a whole three days and was alone, just me and the beasts, when I decided to get a drink from the kitchen. On the way, I noticed the mat under the dog's food bowl was slightly out of place, making it a potential trip hazard. I made the brilliant decision to use one of the legs of my walker to straighten it. Did I brace myself against the wall? NNNNNNOPE! I skipped that rather vital step in the plan and went right for adjusting the mat.

It all seemed to happen in slow motion. One moment, I was standing on my leg. The next, I was gradually tilting toward the floor. The less-than-tender embrace of gravity took over, hastening my descent. I reflexively threw out my leg so my foot could stop my fall. A foot that was no longer there. As though it was scripted, I landed directly on my stump.

There are countless movies in the world in which someone receives a catastrophic injury and simply stands there, screaming. No words. Just a primal scream of agony. Somewhere in my brain, I always thought that was silly. Normal people don't just stand around and scream. They shout invectives. They mentally lock on to something and curse it as the cause of their misfortune.

That's what I thought before I fell. After I fell, I accepted that an uncontrolled, incoherent scream was a part of reality. I lay on the floor, screaming at the top of my lungs for a couple of minutes. The dog, of course, wandered over to let me know she was there to assist in any way she could, which was not at all. Sitting in the doorway to my bedroom was my cat, looking at me as if to say, "Great play, Shakespeare. What're you gonna do for an encore?" 

I crawled to where I could use the kitchen counter to get back on my foot. Sobbing, I collected my drink and returned to my room, where I took a fistful of painkillers.

Okay, I did NOT take a fistful of painkillers. I may be dumb, but I ain't stupid. I remember taking the maximum prescribed dose, even though it was about an hour early. My thinking was that the last dose would be wearing off soon enough, and I really needed the next dose to be working when that happened. HOWEVER, despite the fact that I suffered no detrimental side effects, you should NEVER, EVER overlap doses like this! That's how accidental overdoses occur. 

Something you may or may not have noticed... I used both terms "residual limb" and "stump" to describe what was left of my leg. There are a number of words and phrases in the amputee lexicon. If ever you talk to an amputee, you might want to ask what their preferred label is. Most, like me, probably won't care, but it never hurts to check. 

Here's where I'll end today's post. Coming up... A limb shrinker, a blister, getting fitted for a prosthetic socket, my first prosthetic, fighting to get the dang thing on right, and walking for the first time in six months.

Saga of the Foot - Part 4

Wow. You came back, even after what I showed you last post? I commend you for your bravery. Unfortunately, it doesn't get better. Sorry about that. 🙁

And while I'm at it... WARNING! There will be more disturbing images of my foot in this post!

Okay... I was off to see a new wound care professional. When asked if I'd been treated previously for the wound, I said yes, but refused to give any information about "the school nurse." I wanted a completely fresh assessment of the wound without it being tainted by the doctor that had started giving me nightmares. And the new doctor's assessment brought a heightened set of old anxieties.

His theory was that a chronic infection had latched itself to the hardware in my foot. As it was explained to me, infections that became attached to hardware were next to impossible to cure. If that was the case, they could TRY to remove the hardware and any infected tissue, but the aftermath for someone with Charcot foot is that the interior of the foot would simply collapse. His advice...? Lose the foot and get a prosthetic. 

My very first second opinion opened with amputation as the recommended treatment plan.

However, he wasn't about to have me run off to have my foot removed. Instead, he set up a consultation with an affiliated orthopedic surgeon... who was on vacation for the rest of that week, of course.

I count the surgeon as my second second opinion. He used the words "cautiously optimistic" several times during my visit, meaning that he was hoping there'd be a chance I could keep the foot, but he didn't want to make promises he couldn't keep. What's more, he deemed my case so serious that he wanted me on the operating table THE NEXT DAY! 

There was a present waiting for me on the day of surgery: a nerve block. Once applied, I could feel absolutely nothing below my knee. I was gloriously pain free for that time! Mind you, they told me that it would only last for 12 hours, so when it didn't wear off after that, I panicked and thought they'd damaged the nerve. A few phone calls later, I learned the time limit was actually 40 hours and calmed down.

The results? Well, the surgeon cut away the entire lump on the underside of my foot. There's no picture, but I can make up for that with a description. I had a hole that was a perfect circle on my sole that was 2 inches in diameter. The inside looked like ground beef. And in the depths of the wound, the surgeon found... MRSA! That's the super bug I've described previously. The special specialist and the school nurse had all failed to go deep enough to find the infection. I was put on oral antibiotics for 21 days. Daily wound care nurses would continue. And with any luck, I would heal properly... unless the source of the MRSA was the hardware. If that was the case, this thing was never going to heal.

DRAMA ALERT! DRAMA ALERT! DRAMA ALERT!

In the weeks that followed this surgery, my life exploded. My ex planned to go to a gaming convention with friends. Her life became all about this event. A month before she was to go, she did something that finally made me realize that being with her was a monumental mistake. With this realization came a series of phone calls to have friends come rescue me from her. (Remember, no details about that nightmare relationship beyond how it affected my foot unless it's asked for.)

While I was coping with the twin disasters that were my feet, our apartment became such a catastrophic mess that she didn't even notice when I packed all of my belongings! Mind you, it took me the next 30 days to finish packing what few things I owned because of the giant hole in my foot. And it wasn't until the day before she left - with everything paid for and her solidly committed to going - that she finally asked if I'd be okay without her for a few days. 

Oh... There was one other thing that made my plan to leave her without advance warning acceptable in my eyes. She'd been telling me that she was going to leave her engagement ring behind because she "didn't want anything to happen to it." Translation: she was going to cheat on me and didn't want the ring around to remind her that she was supposed to be in a committed relationship. I took the ring with me when I left.

At a new location, I had to rush to find wound care. I got that taken care of with remarkable speed, leading to my third second opinion at yet another wound care clinic. They'd try to heal the wound, but they were a lot less optimistic. Their opinion was that it was probably best if I had the foot amputated and started the healing path in that regard.

Then came the podiatrist I had to see for basic foot maintenance. He was second opinion number four! He said that even if it healed, there was a better-than-average chance that it would happen all over again.

Finally, second opinion number five. I went to see a new orthopedic surgeon. By that time, I'd been trying to heal the crevasse in my foot for a year. Brace yourselves again. You'll get the picture of what it looked like at the start and what it looked like just before the amputation.

What it looked like at the beginning.

What it looked like a year later. And that

blurry, handsome devil in the background

is me. Try not to swoon.

Simply put, I wasn't healing. Not completely. If ever there was any progress made, it would be undone in short order. "Two steps forward, two steps back." It was a no-win proposition.

There was one good thing about this horrific scenario. I'd had a year to get used to the idea that I was going to lose the foot, which is a lot better than most people. I also had people around me with twisted senses of humor. So this is where the real jokes start to fly!

But they'll have to wait. That said, I've tortured you with two really grotesque pictures of my ex-foot. I know I've been teasing you with the beautiful, scantily clad young woman. Well, here she is!

Her smiling face, anyway.

Saga of the Foot - Part 3

I'm going to start this post with a WARNING! The image of my wound that I'm going to include in this post will be very disturbing and downright grotesque. You'll see the aforementioned swelling, macerated skin, and quite a bit of epithelial tissue. (Epithelial tissue forms the covering of all internal and external surfaces of your body, lines body cavities, and is the major tissue in glands. (Thank you, Google.)) 

Also, I've taken a half-dose of my antianxiety meds before I started writing this. I'll try to keep my rage from bubbling to the surface, but I won't promise it. Note: I only make promises I know I can keep, so when I say I'll try, that's the best I can do.

Picking up the story where we left off, the foot and ankle specialist scheduled me for emergency surgery two days after his last examination. To commemorate this event, our planetary system orchestrated a full solar eclipse. But I firmly believe it was arranged for the general populace, not just me.

This doctor, whom I refuse to name due to the possible perception of libel, even if what I say is 100% true, was no mere orthopedic surgeon. I refer to him as a foot and ankle specialist because that was all he worked on. He was what you might call a "special specialist." Knowing this, would you like to know what he found during the emergency exploratory surgery? Nothing. He couldn't figure it out. He GUESSED that the lubricant my body was supposed to use between the joints so they moved smoothly was being produced in excess because my body couldn't comprehend that many of the bones in my foot had been surgically fused together. Thus, he stitched me up and scheduled a follow-up visit at his office during the next work week.

On that next visit, which was a Tuesday, he noted three things.

1. I was healing.
2. I was still leaking the mystery fluid.
3. The surgical site was very swollen.

To address the swelling, he had his assistant put me in a full-contact cast. I don't know why this was done. I don't understand it as a treatment. When I explain to other doctors what was done, they stare at me in horrified disbelief and ask, "HE DID WHAT?!?" All I can do is shrug. There's the suggestion on various websites that using a cast can control swelling, but what shocks the other doctors is the fact that I was still ACTIVELY LEAKING FLUID OF AN UNKNOWN ORIGIN! 

The doctor saw me two days later, Thursday, to assess if the cast was controlling the swelling. He liked what he saw, so I was put into another cast and scheduled to return a full week later.

Up next...? Labor Day weekend of 2017! Yes, falling between those two fateful visits was a federal holiday. A weekend that was supposed to be filled with friends, family, barbeques, and the remembrance of those who literally gave their lives so people could work without an ongoing fear of death on the job. But mostly it's usually filled with people thinking, No work for three days! 

And I just had to ruin it. You see, the fiberglass cast I was put into was black in color. (It was the only color the office had.) That Sunday, not only could I feel the cast soften, but I was leaving black spots wherever my foot made contact with the floor. So I did as instructed: I called my doctor's office because something was wrong. I left a message with the on-call answering service that my cast had softened from the inside, and asked if I should go to the emergency room to have it assessed. One of my doctor's partners was on call that weekend, not my actual doctor, and she said that so long as there was no foul odor and I wasn't running a fever that I could wait until my follow-up visit on the upcoming Thursday.

Dear reader, I'm not a normal patient in many regards. Thanks to diabetic neuropathy, I have no surface sensation from my knees to my toes, which is what's expected with neuropathy. That said, I can STILL feel the soles of my feet. Well, I could. That's slowly vanishing, too. But at the time this story takes place, I felt plenty, and it was... gross. Seriously, it felt like I was walking around with my own personal swamp locked inside that cast.

When everyone returned to work on Tuesday morning, I called my doctor's office with a request. Could I come in an hour early and have the cast removed so I could then allow my foot to dry off? It was a surgical site, so I didn't think it could be washed and toweled dry. I just wanted it to air-dry. The answer, which I received the following day, was a "no." They were too busy, so there wouldn't be any open exam rooms for me to occupy for an hour.

So I waited for my Thursday appointment.

Until that appointment, this specialist would call me "The Poster Boy for Compliance." I followed doctor's orders to a T. I was told not to go to the ER on Sunday, so I didn't. I was told not to show up early for my doctor's appointment, so I didn't. And for my strict compliance, I wound up with...

Brace yourselves. This is where it gets ugly.

For my strict compliance, I wound up with this:

This is the wound exactly as it appeared on

the day the cast was removed.

Seeing is bad enough, but let me explain exactly what you're seeing. The "red meat" inside the open wound is the epithelial tissue I mentioned at the start of this post. The white, seemingly dead flesh around the edges is macerated skin. The skin further away from the wound is dry from the padding inside the cast, so the pinker skin closer to the hole is wet from the mystery fluid I was still leaking. This particular angle isn't that great, but there's also massive swelling all around the wound. (Don't worry. I'll have improved angles in a later post.)

I... was... PISSED!!! I strongly suspected that my doctor's partner was too busy enjoying the holiday weekend to really take into account my complaint about the cast softening from the inside out. I don't know who was involved in the discussion about me wanting time to air out my foot an hour before my scheduled appointment - a call that I made Tuesday and wasn't answered until Wednesday! - but obviously they didn't realize the severity of what I said. 

And now... Now the specialist went from treating me like one of his favorite patients to pariah. (For those that don't know that word. It means someone who is despised or rejected.) He was quick to refer me to a wound care specialist, and then did his best to wash his hands of me. 

Because I saw this wound care doctor at a different location, I was unaware that he was actually the third doctor of my surgeon's practice. And this guy was a real treat. I've offered to discuss the subject of good and bad doctors. This guy was a BAD doctor. 

Believe it or not, it's actually unusual for a wound like what I had to hurt, but it did. Something was very, very wrong. But when I asked him to do something about my pain, he refused. Utterly, completely, 100% refused. He said I should talk to my primary care physician. I argued that my primary wasn't treating the wound, and so wasn't responsible to treat the pain it was causing. And his response to my perfectly logical argument? "Well, I'm not prescribing anything, so your primary is your only other option." 

Let's set aside that aspect and get to the horror of the wound. It measure 3.5 cm (1.37 inches) long, 1.5 cm (0.59 inches) wide, and 4.0 cm (1.57 inches) deep. He cleaned up the wound as best he could, arranged for home care nurses to visit to change the dressing and to continuously assess the wound. And that was it.

Two days later, I had my first visit with the home nurse. The dressing applied at the wound clinic had already soaked through. Not blood. There was rarely any blood at all. It was always that mystery fluid. Due to the saturation of my bandages, the nurse visits quickly went from three times a week to daily, including weekends.

To clarify how much drainage was coming from my foot, the nurses started using something called OptiLock. This sterile dressing functioned like a diaper, absorbing fluid and turning it into a gel within its layers to lock it away. On most days, the OptiLock literally filled to bursting! This was during the daily dressing changes!

During my second visit with the wound doctor, the nurse removed something that was apparently sticking to the wound and I almost jumped through the ceiling. That brilliant specimen then asked, "That hurts?" I remained silent, but looked at him with an expression that said, "No, I yelp and flinch when something feels good." And the doctor still refused to address my pain.

My third visit to this jerk... This is where I finally lost my temper. I complained about the pain again and he refused to do anything about it again. But this time he countered with, "But we ARE treating the wound."

That's when I snapped. "CONGRATULATIONS. YOU'RE OFFICIALLY NO BETTER THAN A SCHOOL NURSE TREATING A BOO-BOO!" He actually had to leave the room and take a few deep breaths before returning to finish treating the wound. 

Things became so bad with this doctor that I started to dread my visits to his office. No joke, I had literal nightmares about having to see him. Making it worse was that he was the only wound care specialist in the area. The next nearest specialist was a 45-minute drive away.

What finally tipped me over the edge was something one of the home care nurses told me. My wound was being packed regularly with something called Dakin's solution. (Basically, it's bleach water. Buying this solution premixed is costly - about $17 minimum. Learning the exact ratios and mixing the distilled water and bleach yourself is much cheaper! Around $1.29 for the distilled water, about $1.79 for generic bleach. And since insurance wouldn't cover the Dakin's, guess what we did.) The nurse told me that the solution was great for fighting bacteria, but not so great for promoting fast healing. To quote her, "Our job is to show progress in your wound care. But that's not the case with the wound care center. The longer you have the wound, the more you have to see them, the more money they make."

Thus, on 27 October 2017, I traveled the 45 minutes to see a different wound care specialist.

That adventure, however, will have to wait until next post. For now, to make up for the gross foot pic, here's a kitty performing kata.

Master Kitty says, "Flow like water."

Saga of the Foot - Part 2

Are we having fun yet? How could we not with a story about serious illness, abject terror, and life-altering surgery? I mean, reading about it probably isn't a thrill-a-minute, but I'm pretty sure there'll never be a movie about this, so reading is all you have. Sorry.

Now... Where were we? Ah, yes. The grotesque slob that was my ex rushed me to the hospital because of the massive swelling (medically known as edema), intense pain, and "stuff" leaking from the sole of my foot.

The first thing they wanted to do was try to get a sample of whatever was causing the swelling to send off to the lab, along with the usual blood work. The ER doctor took what even I considered was a scary looking needle and tried to get get some of the fluid out of the abscess. Insulin dependency and needles go hand-in-hand, so me deeming it "scary" was saying something. (For the record, an abscess is a swollen  area filled with pus. While never officially saying what filled it was pus, it was always referenced as an abscess.) He obtained a little of the fluid and plenty of blood, making it visually impossible to guess what it was, but in the process he gave the lump an extremely dark bruise. For the remainder of my hospital stay, every time someone new came to examine the wound, I would have to explain that it was a bruise and not necrotic tissue. (Dead tissue.)

Yes, "the remainder of my hospital stay." I was admitted and put on a regimen of strong broad spectrum antibiotics. Doctors don't simply prescribe antibiotics willy-nilly. There are now meds that target specific bacteria and focus on specific areas of the body. They're not going to prescribe something that works on respiratory infections for urinary tract infections. Broad spectrum antibiotics are those that aren't tailored to something specific, but work everywhere and attack a wide variety of bacteria. They hoped to narrow down my specific needs with the culture taken with the giant needle. (A culture is a sample of tissue or fluid that is sent to the lab and grown in a Petri dish to see what kind of bacteria it is.) In the meantime, I was on three different IV antibiotics, all of them delivered over a full 24-hour span.

I was also subjected to an x-ray and a WBC (White Blood Cell) scan. This test involves them taking 57 gallons of blood from me... Okay, there's only about 1.5 gallons of blood in the human body, so 57 gallons is a slight exaggeration. They actually only took 50 milliliters, but it looks like they're trying to empty me out of blood. They sent the blood off to a radiology lab, where they separated the white blood cells, irradiated them, and finally injected the radioactive cells back into me. Then using medical mysticism and voodoo - I'M STILL NOT A DOCTOR! - they got pictures of where the white cells rushed to battle infection. Mind you, white blood cells perform their job throughout the body (as you'll soon see), but they were on the lookout for specifically concentrated gatherings. The abscess lit up like a light bulb, but the bones did not, meaning that the infection wasn't osteomyelitis. 

My WBC scan.

I know it's difficult to see, but you can just make out the shadows that are my feet in the above picture. The white spot is the aforementioned irradiated white blood cells focusing on the exact spot where the abscess was.

About the white blood cells working throughout the body... Think of it as regular maintenance. They'll be present, but their dispersal isn't concentrated enough to indicate infection. How do I know this? Because while I was filled with radioactive white blood cells, they also did a full body scan to make sure something wasn't hiding elsewhere. I took one look at the pictures of my torso and asked, "Why is my uterus lit up like that?" Mind you, there's no biological or medical reason why I might have a uterus, so my question got a lot of laughs... as intended. 😉 What I was calling "my uterus" was only vaguely shaped like a woman's reproductive organs. 

I fight the terror and darkness with humor when I can.

My stay lasted six days. During that time, we learned that my infection wasn't MRSA, but MRSE. MRSA is - you'll love this one - Methicillin-Resistant Staphylococcus Aureus. This is considered a "super bug" that requires heavy doses of antibiotics. MRSE is Methicillin-Resistant Staphylococcus Epiderminis, which is more easily treated. (Or so it was explained to me.) The fun thing about MRSA is that once you have it, you run the risk of it popping up again for the rest of your life, so the verdict of MRSE was something of a relief.

I was put on a specific antibiotic on my release and my doctor eventually prescribed physical therapy - PT - to reduce the ceaseless swelling after I had no apparent holes in me anymore. He had no idea what was going on inside me, but hoped PT would disperse whatever was gathering on the sole of my foot.

It hadn't occurred to me at that time that the cause of my infection might have been my ex. Not yet, anyway. But there was a better than average chance that her slovenly ways made our shared bed an infectious bacteria farm. (If you want to hear the details about her, you'll have to ask, as my relationship with her only loosely affected my diabetes up until this point.)

Four months after the bilateral foot surgery, with the swelling still present, but the exterior seemingly healed, I was drying my foot briskly with a towel after a shower when an absolutely miniscule callus - or so it appeared to my amateur eye - got caught on the towel and popped off. My foot immediately started leaking again. It was that clear "stuff" with no discernable scent.

Okay, I'm not a wound care specialist. (Insert my insistence that I'm not a doctor here.) That said, you should have the basics of wound care on hand at home for any wound that appears on your feet. Clean with soap and water. Disinfect with iodine. Apply some antibiotic ointment. (My preference is ointment and not cream because the former helps keep bandages from sticking to the wound.) Cover the wound with a sterile dressing, and then CALL YOUR DOCTOR! Better your doctor should know at the start that you have a small cut on your foot that you're treating with the basics than receive a panicked call from you later about the extremely painful, odd-smelling wound you never reported. If you have diabetic neuropathy, always check your feet at the end of the day! You may have hurt yourself without feeling it during the normal course of your day! NEVER, EVER pick at scabs or loose pieces of skin! NEVER, EVER file or sand down calluses! Leave the care of calluses and cutting of toe nails to your podiatrist! If the wound you have appears irritated, is warm/hot to the touch, and actually hurts when you make contact with it, and it is past your doctor's business hours, get to an emergency room! Infections can do serious damage very quickly if improperly treated.

After some quick first aid, my freshly leaking foot and I were taken to the ER. They did a CAT scan, also know as a CT scan. (No, they aren't looking for cats. No, they don't have a cat look you over. Stop that! It doesn't involve cats!) It's a quick and easy way to get a look at various tissues inside you. Lengthier and noisier would be an MRI, but those are done less during an ER visit. The scan showed another abscess, but my blood work all came back normal. No elevated white cell count, meaning that my body hadn't detected an infection. They packed the wound and told me to call my doctor the next day. (Packing a wound helps speed up healing and keep the wound healing evenly.)

Special side note: Packing the wound caused me quite a bit of pain. That was a little odd, considering that there was supposedly no infection present.

I called the foot and ankle specialist the next day, as instructed by the ER doctor. He wanted to see me right away. After a physical exam that left him mystified, he scheduled me for surgery two days later. He was determined to find the source of the fluid that was perpetually building up and leaking from me.

This surgery will mark the official beginning of the end for my left foot. Can diabetes be attributed to this loss? Partially. But from my point of view, a majority of the reason was medical malpractice, and you'll see why in my next post... because I have to stop here due to the level of anxiety this part of the story is producing. I'll get through it eventually, but that will likely require antianxiety meds. In an effort to make myself - and by association you - feel better, here's a picture of a giant kitty playing with a car.

Imagine having to clean this cat's litter box!