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!