Wound History and Progression

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".

X-ray came negative for that but and using an ambigous 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.Savaser. 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.