Tuesday, June 24, 2014

Personal Trial: Leg Sores (Recovery)

Well it's been about 3 and a half weeks of recovery, since I went to and left the hospital.  The first two weeks were a little rough.  The leg part wasn't too bad but my left ankle swelled up more since the hospital.  It was pretty painful.  I had to keep my feet up to keep the pain at bay.  When I had to put them down to crutch to the bathroom or something I would have to sit on the edge of the bed for at least a half an hour to allow my blood circulation to run its course so the pain in my foot wouldn't be bad enough to where I could stand keeping it down for a crutch to the bathroom and back.  Finally after some new meds and elevation and ice the swelling went down and the pain eventually went away.  I missed two Sundays from church and I was so sad to be away from Primary for that long (I teach/do music with Primary kids ages 3-11 at church each week).  It was a long two weeks.  I felt so useless as all I could do was sit in bed or on the couch or sleep (which I needed for recovery, but still).  Adam has been such a sweetheart taking care of everything Eli needs and me.

After the swelling went down I found four small purple bumps around my ankle.  "Nooooooo!"  I called the dermatologist about it and I went in for them to see it and they told me to be careful and put my prescription ointment on it.  Well, the next day, wha-da-ya-know, I bumped it and it blistered.  It was different than the ones on my legs though.  It never popped, per say, but it ended up sort of slowly leaking out and left behind excess skin, which is now starting to peel off.  It's still healing but looks as though it will be a lot easier to manage than my legs (hooray!).

The ankle progression:

Monday, June 2

Saturday, June 7

Tuesday, June 10

Friday, June 13 - morning

Friday, June 13 - evening

Saturday, June 14

Sunday, June 15

 Monday, June 16

 Tuesday, June 24

So that's the ankle spiel.  As far as the legs, the dermatologists prescribed me some steroidal ointment to apply to the wounds twice a day along with some oral steroids in the form of Prednisone (boooo) as a joint decision with my GI doc.  I'm taking like 12 pills a day right now, boo.  In the name of health....  My Ulerative Colitis is finally getting under control, and the leg wounds are looking better.  They are trying to scab but the docs don't want them to.  When all this is done I'm going to have some nice scars.  I'm sure they would scar worse if they scabbed.  This is still going to take a long while to heal completely.  I go in tomorrow morning to see the dermatologists for another check up.  I'll be seeing them every few weeks for a while I guess.  In the mean time I'm taking lots of pills, cleaning my wounds once a day with water and ivory soap, changing the bandages twice a day, and being careful not to injure them further as that could make them worse.  And no soaking in water, which means no swimming.  :(  What a way to spend a hot summer in AZ!  But I'm happy to be walking.  :)

Some pictures of the "zombie bites" --

Monday, June 2

Monday, June 9

Monday, June 16

Monday, June 23

Thursday, June 5, 2014

Personal Trial: Leg Sores (Hospital Stay)

In the Oro Valley ER Friday night we were visited by two doctors, neither of whom had seen this kind of condition before.  The nurses did some tests (including blood work -- time #2) and the doctors must have done some research because he came back after a while and told me the diagnosis was Pyoderma Gangrenosum, a condition that had evolved from the Erythema Nodosum I was almost finished recovering from.  Ultimately the doctor sent me over to the University Medical Center since they have a dermatologist team there.  After a long time of waiting for them to get everything straightened out (paperwork, a room, etc.) we finally headed to UMC around 11pm.

We got checked in at UMC, answered lots of questions, they did some more tests...  The doctor wanted to clean the wounds and I cried, mostly from the anticipation of excruciating pain (also, he had just made me do the lay/sit/stand blood pressure check -- standing on my legs made them hurt already -- hello?!?).  He assured me that it wouldn't hurt, but he let me pour the saline on the first wound.  It didn't help that I wasn't so trusting of the doctors since the first one at the Oro Valley ER basically stuck his finger in my wound!  It hurt so bad, what the heck!!  Anyway.  It didn't hurt very much at all as they cleaned out the wounds, but I still was not happy with them.  The doctor went over the diagnosis of Pyoderma Gangrenosum again and told me that I would be visited by the rest of the med team in the morning and also that he would call the on-call dermatologist around 8:30am the next morning to see if and when they might be able to come take a look at my leg wounds.  He sounded unsure that a dermatologist would come in over the weekend since "there are no dermatology emergencies" (they kept saying that).  He also thought the dermatologist may want to get a biopsy of the sores.  The nurses and techs did more tests (including more blood work -- time #3), and finally just after 3am they all left us alone and we were able to go to sleep.

Everyone knows, however, that you can't get much sleep in hospitals.  Saturday morning the nurse woke me up at 5:15am and told me she needed a urine sample, and they took my blood pressure then as well.  Since my legs had been up for a while I needed help into the bathroom so she grabbed me a walker, that was nice to have for the remainder of our stay.  Also, I loved all the railings in the bathroom!  So nice.

Saturday was mostly a waiting game.  Adam and I were able to take lots of short naps, and the nurse/tech would come by every once in a while, around 2 hours or so.  8:30am came and went and we hadn't heard anything about whether or not the doctor got ahold of the dermatologist.  Around 9am the new med team for the day came in to pay me a visit.  It was just like in the movies or TV shows as the head doctor and about 5 or 6 students all piled into my room, each one rubbing their hands with sanitizer, and surrounded my bed.  The doctor said I would probably need more steroids to help with the healing, but that it was not infected even though there was redness around the wounds (my theory is that the redness was just from the leftover Erythema Nodosum -- there were no other signs of infection).  He said that a dermatologist would need to do a biopsy to confirm the diagnosis, but he wasn't sure if they would come in to do it over the weekend or if I would need to wait until Monday.  He also said that healing for this condition would take weeks or even months for a full recovery.  The students looked at my legs, asked me a few questions, and then they left.  At this point I still had no idea what the course of action was going to be once we left the hospital (or when we would even be able to leave).

We never did hear from anyone whether or not a dermatologist was going to come in that day to see me; they never even told us if anyone had been reached.  A little frustrating, but it ended up working out OK so no big deal.  Sometime after 2pm a couple of doctors came into our room and announced that they were the dermatologists.  HURRAY!!!  That was a huge relief!  They took a look at my wounds and confirmed that it was, as they suspected, a pretty obvious case of Pyoderma Gangrenosum.  They said that they see it a lot (which was a nice change from every other doctor I saw that weekend that had never seen anything like it).  They explained that any injury can make the condition worse so they advised me to be very careful as it heals, and also because of the ease of it worsening with injury they said that they did not want to do a biopsy.  They did, however, want to do a culture swab of the wounds.  This was one of the first things that the Oro Valley ER doctor did, when he hurt me!, so I told them that the doctor at OV did one and that we brought a whole package of info with us when we came to this hospital and that maybe that info was in there.  FINALLY someone agreed that they didn't have to "do their own" stupid tests and they checked the paperwork and thankfully that was enough.  The dermatologists explained again that healing would take some time, several weeks at least.  (No more dance for me for a while.)  And they said I will have some "nice" scars as a result of this.  They gave me course of care which was to clean the wounds each morning with running water and ivory soap, apply a steroidal ointment once in the morning and once at night, and apply an antibiotic ointment once in the middle of the day.  I was scheduled for a follow-up appointment the follow up Wednesday, when we would see if the course of care would remain the same or change depending on how my wounds were doing.

We spent the next few hours waiting for paperwork and prescriptions and finally I was wheeled out of there around 5:45pm.  Whew!  What a beginning to a weekend.

A condition like this sure is not ideal.  Especially with a husband and a son to take care of.  But it could be much worse.  I still feel very blessed.  Not only are we surrounded in proximity of miles and airwaves by so many loving and supportive family members and friends, but we are full of peace because of the love of our Savior, Jesus Christ.  Because He suffered for and bore the trial of all our sins, pains, afflictions, infirmities, and weaknesses, my joy is full because I know that life is still good and that this isn't the end result.  Because He died and rose again, I know I will too, and that my body will one day be free from all these bodily ills and imperfections.  And what a great blessing that my loving Heavenly Father has given me a body in the first place!
"For behold, this is my work and my glory—to bring to pass the immortality and eternal life of man." -- Moses 1:39

To be continued...

Wednesday, June 4, 2014

Personal Trial: Leg Sores (Back Story)

It all started in 2004 when I was diagnosed with Ulcerative Colitis, an intestinal disease that causes ulcers in the colon.  This condition also weakens the immune system since it distracts it into fighting one's own body instead of other real threats.  Since I was diagnosed I've mostly been in remission but have had a few flare ups over the years.  Some time last year I was bad and stopped taking my medication for no good reason, just got out of the habit and didn't get back in.  Needless to say it caused a flare up of the UC.  Since the beginning of the year, however, I've been very diligent in taking my daily medicine, although this did not get my condition back into remission.  I finally went to see my doctor (I was embarrassed that I had stopped taking my meds and caused this flare up, which is also a bad reason) and started taking more meds to help get the UC under control.

A few weeks ago I developed something called Erythema Nodosum, a condition on my lower legs that involves warm, red, tender bumps or nodules under the skin, which can make it become pretty painful to walk.  One of the ways it is brought about is by some other autoimmune condition -- like UC.  I have had a case of EN a few times before so I knew what was happening and was taking steroids to help get rid of it.  It was going away and all was fine until...

Last Sunday (May 25) I noticed I was developing some sores on top of the healing EN.  They were becoming increasingly painful.  They looked like blisters and were mostly light in color and I could see dark spots that looked like blood was hanging out there.  I had three -- one small one the size of a dime on my left leg, and on my right leg another small one the size of a dime along with a very large one the size of a quarter.  I was getting desperate and thought they needed to pop or something.  Wednesday late morning as I was walking into the kitchen I felt something liquid-feeling on my leg.  I looked down and the small sore on my right leg had popped all on its own.  I dabbed it with tissue until all the stuff came out, which was more than I expected.  The blood was dark red and it looked sort of creamy like there was puss mixed in as well, and it was really goopy, not runny.  An hour or less later as I sat on the couch, I moved my leg and the huge one the size of a quarter started draining.  I helped all the stuff out, which was A LOT -- it took a few minutes.  My leg was feeling better already!  The sore on my left leg opened and drained as well.  The drained and open sores kept bleeding though, which was a little concerning.  I just thought it would take a little time for them to clot or something and I would be on my way to recovery.  I covered them up with what we had on hand at home (a cut up diaper and ace bandages) and went to a meeting that night, and then re-bandaged them and went to bed.

I actually waited around all day Thursday because I don't have a primary care doctor and I don't like the doctor who is usually in the Quick Care.  So I wanted to wait until Friday to go in to see the doctor I like.  On Thursday when I changed the bandage to real gauze, an off brand of neosporin, and medical tape I noticed the sores were literally holes in my legs.  There were two where the large sore was and one where the small one was.  I didn't think much of it, covered them, and went on with the day.  Except that this is when the new pain started.  We didn't have crutches or anything so that night I actually sat on the floor and scooted to the bathroom because it hurt too much to walk.  :(

By the time Friday came around I was in more pain and had a really hard time walking.  Like I said, I scooted on the floor when I needed to get somewhere.  Adam had an appointment in the morning so he took Eli over to Grammy and Grandpa's and when he came back home he helped me get ready and we went off to the Quick Care.  We got there at about 11:20am and finally got in to see the doctor around 1pm.  I don't know what was going on back there, but there were only 2 or 3 people ahead of me.  Anyway, I showed the doctor pictures I had taken on my phone and he actually looked at the small sore on my left leg.  He had never seen something like this before, told me to get blood work done, prescribed me some pain medication, and told me to see a dermatologist to have them check it out and get it biopsied.  So we got the blood work done and went home.  I made an appointment with a dermatologist for Tuesday.  Then I finally took off the bandage on my right leg to change it, as it was obvious that it had bled quite a bit underneath.  What I found was a surprise -- there were now 3 holes instead of two where the large blister was.  I thought that was odd and took a picture of it, something I had been doing as this was progressing, and actually posted this one on Facebook.  I was curious to see what any medical people would have to say about it.  The overwhelming response from loving and concerned family and friends was to go to Urgent Care or the ER -- right now!

We packed Eli back up and took him back over to Grammy and Grandpa's and headed over to the Oro Valley Hospital ER (my brother said there is hardly ever a wait in that ER -- and he was right!).  We arrived at 6:30pm.  We walked up and walked in.

To be continued...

Some pictures for your viewing pleasure if you care to see this sort of thing.  If you have a weak stomach, skip it (seriously, it gets pretty gross).

1 day before drainage (27th)

Morning of drainage (28th)

Right after drainage (28th)

A couple hours after drainage (28th)

1 day after drainage (29th)

2 days after drainage (30th)