Last Friday at the Wound Care Center at Legacy Emanuel they dressed my wound with Silverdene, one 3x3 sterile pad, one 5x9 on top of it and then gauze roll and
tubigrips over the heel on top of everything.
After the second day the
Silverdene started to
burn real bad especially in infected areas around the wound to the point i could not sleep and dug mm deep "trenches" around the eschar. Tubigrips over two thick layers (one 5x9 thick pad, bandage) were cutting circulation in the dorsal
artery and caused serious pain (claudication) in downstream areas so i had to remove it. Improved after about 24-48 hours.
Bandages do not work well without tubigrips. I went outside one day and the bandage came undone so i replaced those with diabetics
socks two days ago. Not as tight as tubigrips, they were still cutting the circulation, promoting decreased blood flow and infection at wound site which started to spread in the entire leg all the way to my thighs.
Normally would have called and asked them for advice but there is something in the post visit note that discouraged me to do so. I remember during the visit i asked the doctor what type of tissues were affected or how deep was the wound and he said he does not know and asked him to do an MRI which he declined and sent me to X-ray to check for "bony erosion".
He also performed a quick (by ear) waveform test on 4 of the six major arteries of the feet using a small battery powered Doppler and found a borderline abnormality consistent with calcification which is not confirm by the ABI with digital waveform test done at Legacy Meridian days before.
X-ray came negative for that but and by using an ambiguous language they said i might have calcified vessels (which is not confirmed by the previous X-ray interpretation at the ER) and an MRI is recommended if there is "infection concern" so he ordered one.
I had several episodes in the past weeks (from different reasons, like exposure to cold) even more severe and i know it will take some time to re-set. Wound itself does not seem to have been affected, infection is in the areas around it. Looking at the pictures with progression of the wound in the past 10 days, the wound is progressing now at a rate similar to a non-diabetic laceration.
Tomorrow i have again an appointment at the Wound Care Clinic with dr. Davut Savaser (Turkish, Armenian, Jewish descendance by name) apparently of Seattle. Noting the semantic resemblance of his name with a recurrent name from the news.
Here is the picture with the wound since Jan 18 or several days after i discovered it (after i saw blood on the bedsheets). I have made some bad mistakes though, one was using hydrogen peroxide to disinfect a couple of days which extended the eschar.
Here is a picture with progression over the last 10 days.
Here are two pictures of the shoe that cause the erosion seen in the bottom of the pictures above. There is some sort of wrinkled cushion inside that is also pretty hard (as hard as the surface leather). There are the same type of wrinkles in other areas where i had blisters. However the erosion goes way up, and was promoted by a cut (or 2 cuts in the
shape of X) some time around December 23.
The other shoe has similar but smaller wrinkles. There is/was an X shaped couple of cuts on the right foot that are now almost healed.
Some existing neurophaty promoted numbness of my legs so i did not feel (most) anything. That leg was intermittently hurting in different places anyways (yes pain alternating with numbness). Also the contribution of the smoke coming from outside. Walking on a 3 mile loop around Legacy Meridian Park Hospital)
I always stuck my index finger inside when i put them on.
11:40 02-27 Picture taken from dr. office after partial debridement (pulling of "the pieces about to come out"). The nurse packed the wound
with per dr. choice.
12:55 BTW when i got at the hospital, there was vague smell in the air i could not identify but once inside by BP was 200/100 and would not go down with time (it went up by the end of the visit). But when i got out, i figured the reason. There was a pretty bad smell of tarr from a pavement work somewhere which clogged my nose, slowed my breath etc..
Also i know from experience that the smell of fresh asphalt is bad for wounds because it promotes bad (dark) bacteria.
