Look, Honey. Another Disaster.

I have a completely different post all ready to go, but events from yesterday and today have prompted me to write about how damnably frustrating the complications of diabetes can be.

This tale actually starts about 12 days ago, when a friend took me to do some food shopping. It's easier to do by car, and I haven't driven since being declared disabled decades ago. While we were out, something caught my eye on the floor, and when I looked down, I discovered a cut near to where my foreleg meets my foot. No idea when I got it, but it looked angry.

Let me pause here and remind everyone that I have advanced diabetic neuropathy. That I didn't feel this wound when I got it wasn't a surprise. The wounds that I DO notice come from collisions where deeper nerves have registered the impact.

"Rob, you promised humor in your posts. This sounds pretty serious so far." You're right. So here's a moldy oldie. Q: If a one-L lama is a priest and a two-L llama is an animal, what's a three-L lllama? A: A really big fire. (Get it? A three alarm fire? Three fire stations show up to fight the... Never mind. I heard it back in junior high. Oh, sorry, "middle school" for you kids today.)

So my friend and I notice the wound, but we were almost done with my errands, so we finished up and he got me home. Once the groceries were put away, it was time to assess my wound. 

Quick! Change tense to make it extra confusing!

1. How does it look? The surrounding skin looks red and angry, but not blazing red. Due to the discoloration of my skin from countless wounds and scarring, it's sometimes difficult to make a visual assessment. If it's visibly red, it's getting infected.
2. Does it hurt? Now that I know it's there, I concentrate. If I can sense even a small bit of pain, it means that the infection is creeping its way deeper. On the scale of 1 to 10, with 1 being no pain whatsoever, I was at a 2.
3. Is it warm to the touch?* This one requires taking a bit of care if the wound is fresh. You really don't want to stick your fingers into an open wound. During this assessment, however, it had already scabbed over, so I didn't need to be as careful. DON'T EVER PICK AT A SCAB ON YOUR LEGS AND FEET! You'd only be inviting more bacteria into the wound. This one is a little tricky for me. My wounds often don't feel any warmer than the rest of my leg. But if I elevate my leg and allow the blood to flow properly, my wounds can wind up feeling very warn indeed.
4. If there's fluid leaking from the wound, what color is it? Clear fluid, like that which comes from a blister, isn't too worrying. White pus is an indicator that it's getting more seriously infected.
5. Is there swelling? This one's tough, especially if you're an older diabetic with any degree of water retention in your legs and feet. Your clearest indicator will be if the wound itself is raised. If you can't tell, simply move on.
6. Is there a foul odor? If you can smell the wound at all, things aren't good. So...
7. Check for a fever. Most hospitals define a fever as 100.5 F (38.06 C).

Depending on severity, any one of these things can require you to drop everything and head for the nearest hospital. But for me on that day, there was nothing that made me panic. Red, mildly painful...? Meh. I contacted my PCP through the patient portal with his office and reported the wound. The next day, an antibiotic was delivered. No muss. No fuss.

For the record, regardless of the severity, if you are concerned about the state of a new or new-ish wound, call your doctor if it's daytime, or head to the ER if it's night. Better to be a bit overly cautious than under-cautious.

I basically treat all of my wounds the same in terms of dressing them. If small enough, I'll use gauze with two adhesive edges. Even if it claims to ne "non-stick," I use some antibiotic ointment to prevent a scab from sticking to the dressing, because they'll sometimes do that regardless of the claims on the box.

But sometimes these dressings can be finicky. My skin is dry and flaky, so the edges of the gauze can start to lift up. My solution - and I really should stop doing this - is to apply a little medical tape to hold it down... which is exactly what I did on Sunday. When I went to change the dressing, the tape I'd used to hold it down ripped off a chunk of skin!

Diabetic blisters. I've mentioned them a couple of times. Their cause is unknown. They just show up to become a health hazard. The blisters that I develop start off in stealth mode. The area is flat, but with a little probing I can feel the pocket of fluid underneath. Because there'd been fluid between the layers of my skin, the tape ripped off the topmost layers on Monday.

I live alone. I don't even have a pet. But that doesn't stop me from vocalizing my frustrations. Not "verbalizing." No, that would require intelligible words. Instead, I start swearing like Fred Flintstone. Basically a lot of grumbling and growling.

Great. More holes in my flesh to worry about. Diabetes mellitus really is the gift that keeps on giving.

Which brings us to this morning. Time for a fresh dressing on all of the holes. And while inspecting the area around where I'd ripped off that patch of skin, I could feel more fluid underneath. The surface hadn't bubbled like a proper blister, so how was I to know that it would burst? And burst, it did! Just a copious jet of stuff exploding and dripping down into my sock.

This. This is a spectacular day. 

Now I have two separate areas of my lower leg with gauze over them, and I was smart enough to use an old ace bandage to hold everything in place... or so I hope. The problem with using an ace to hold the gauze down is that there's nothing holding the elastic in place. Thus, it can slip up, down, or even around my lower leg.

It wasn't all that long ago that I was ignorant of diabetic blisters. I wasn't affected by them, so there was no reason for me to know they even existed. Once they started, however, they wouldn't give up. Sometimes I get a few months reprieve, but they always come back.

What's my current status? I've called my doctor's office to request "the big guns." The area where the skin came off looks dark and ugly, and it's stinging quite a bit. I don't want to play any games with it, so I asked for a stronger antibiotic.

Meanwhile, if any of you are diabetics that aren't controlling your blood sugars, know that exciting nonsense like this awaits you. Take my words to heart, not Cookie Monster's.

But we do, Cookie. We really do.