Progress Report #9781
Still here. Still have two feet.
It's been a while since I last did a real update here about My Left Foot and its pet osteomyelitis infection of the heel bone. Wednesday 26 November 2014 (DW), actually.
So in mid-December, in the middle of Finals and Grading Week, I had my flurry of appointments from the Wound Clinic, Foot Surgeon and Infectious Diseases, plus my G.P. and going into January, my dentist and eye doctor -- both overdue because of scheduling issues with things like hospitalizations and stuff. (grin)
Overall the news was good. In fact, the good news was that for the first time, the foot surgeon trimmed some of the scar tissue from the main heel wound area and there was no collateral bleeding. Could the damn thing be actually healing? Hard to tell. Infectious Diseases showed me the spreadsheet of my bloodwork values going all the way back to when this crap started getting serious in May 2013. At this point, December, all my levels were in the acceptable ranges -- no sign of infection -- with one minor exception. Protein levels. Protein, needed for healing, has been low from the beginning, and when I was hospitalized they gave me some protein drinks to supplement. Wasn't off the charts low, so I agreed to add a hardboiled egg to my lunch.
Tough job. I love hardboiled eggs.
Wound Clinic and foot surgeon concerned that it may never heal over. But I am tolerating the antibiotic I've been on, so Infectious Diseases extended the Rx for ninety more days.
Also in December, I got a new AFO ankle foot orthotic. The first AFO was rated to last about a year, but after fifteen months, the joints were beginning to get loose. Alas, the superb guy who made the first one has moved on -- to Mary Free Bed? -- and the new guy is earnest. And helpful. As is, well since you are a large person and you're wearing the first AFO, let's make the new one tougher, helpful. In addition to a new mold reflecting the fact I was out of the hosptial, the plastic was thickened from 3/16" to 1/4".
Of course, he didn't tell me this and since I had no feeling in my foot, I went using the new AFO for a few days -- and found that I was getting a pressure mark and blood blister across the top of my foot. We tried it on and off through ConFusion in January. When I went back for a second adjustment, we realized that it was getting pinched. But they don't have a working shoe stretching machine. They don't have the tools to cut the top of the left shoe and sew in a gusset. And the special orthotic shoes they do sell? Don't go up to 10½ 6E or wider.
I've been waiting for the minor injury to go away. There's a cobbler in Grand Rapids who might make it work. Or there's a shoe store near 44th Street in G.R. who sells specialty sizes. Or I could try a size 11 6E shoe from New Balance and see if that gives me the extra room -- essentially buying a pair of shoes for one shoe.
Meanwhile, I am still using, you guessed it, the old AFO. Found that an Allen wrench can retighten the hinge screw, although that does nothing for the offset between top and bottom halves caused by the stressed joint.
The January visit to the Wound Clinic was more of the same. A mix of static and dynamic processes -- new small areas will open up or blood will pool somewhere and leak out. My theory has been that the original wound had two areas and a tunnel, and Holland Hospital connected the tunnel, plus the Strange Incidence of the Missing Hyrdraferra Blue (twice), whereby new exit wounds appeared as bits of dressing emerged after weeks or months -- whew -- so therefore there is some internal areas of damage that also have to fill or heal or do something. But the wound doesn't smell, it isn't hot. I have no fever -- after a brief day where it spiked slightly, I've been doing a morning temperature every day and, as per my usual, I am subnormal (96° to 97°F).
And now here in mid-February we are starting another round of Let's See Everyone. Although this time, they are scattered over a couple of weeks.
This Monday I had a repeat of the MRI I had in August (DW), also at Blodgett Hospital. Went by myself. I hoped to get one of the handicapped spaces nearest the door, not the least of which was because it was about zero with a biting wind. Alas, I was again in the third row on the far side. I mean, who puts HANDICAPPED parking spots on a grade? Really? You couldn't buy a level?
On my first MRI last year, I selected Led Zeppelin for the Pandora music feed over the noise cancelling headphones. In May I picked Queen. August, let's go for Blondie. You need something loud. This time I decided to go for Neil Diamond. Started with Sweet Caroline in concert, but a lot of Pandora's idea of Neil Diamond sounded like Simon and Garfunkel, including cuts from the Concert in Central Park, plus a little James Taylor. Actually, pretty anthem-like when you get down to it. But sometimes I wonder about the people who run MRIs. Telling me it'll be about twenty minutes, when the multiple scans actually total about an hour -- who are they kidding? This happened last time, too. I can read the countdown clock on the GE machine. (grin)
Wednesday it was the Foot Surgeon. And Stacey, the most cheerful aide in the world. We love her, but I imagine she would really irritate some people. Always happy, excited and no volume control. Fun.
Anyway, the great thing about having no feeling in my foot is that my surgeon can take a scalpel and really go to town on the debridement. Seemed to think that our theory that we're seeing underlying damage surfacing had some merit. AND she had the new MRI results. Compared to the August MRI on the same machine with the same camera -- there is no change in the bone. This is wonderful news, because if the infected area expanded during this period of the extended antibiotics, it would be trouble. Of course, it is far too much to expect the area to retrench, or at least not yet. But we may well be in that ten-year window that Infectious Diseases was talking about where I could survive with osteomyelitis without too much problems. Ten years might get someone the time to figure out how to replace a heel bone. (non-amputation-grin)
The other great thing about a foot surgeon is that she's fearless in aggressively trimming my left big toe nail, which probably as a result of getting jammed in the end of the shoe by that newer AFO, is ingrown. Kids, do NOT try trimming your nails that far on the inside edge at home. This is what we pay professionals for.
Wound Clinic will be at the end of the month -- Spectrum loves playing musical offices, so they are moving from the second floor to the third floor in the building across from Butterworth Hospital. Infectious Diseases won't be until St. Patrick's Day. But since I'm not teaching, it's not a problem.
Overall -- the progress is... nothing major happening.
Oh, and super good news. The Grievance we had to file with Priority Health over some Physical Therapy visits I had in 2014 past a thirty-visit-per-year limit we didn't know about, but are allowed under the GVSU plan, has been cleared. When I talked to the go-between at Priority this afternoon, Jennifer said it looked like the ~$3000 bill was paid. Yay.
Dr. Phil
It's been a while since I last did a real update here about My Left Foot and its pet osteomyelitis infection of the heel bone. Wednesday 26 November 2014 (DW), actually.
So in mid-December, in the middle of Finals and Grading Week, I had my flurry of appointments from the Wound Clinic, Foot Surgeon and Infectious Diseases, plus my G.P. and going into January, my dentist and eye doctor -- both overdue because of scheduling issues with things like hospitalizations and stuff. (grin)
Overall the news was good. In fact, the good news was that for the first time, the foot surgeon trimmed some of the scar tissue from the main heel wound area and there was no collateral bleeding. Could the damn thing be actually healing? Hard to tell. Infectious Diseases showed me the spreadsheet of my bloodwork values going all the way back to when this crap started getting serious in May 2013. At this point, December, all my levels were in the acceptable ranges -- no sign of infection -- with one minor exception. Protein levels. Protein, needed for healing, has been low from the beginning, and when I was hospitalized they gave me some protein drinks to supplement. Wasn't off the charts low, so I agreed to add a hardboiled egg to my lunch.
Tough job. I love hardboiled eggs.
Wound Clinic and foot surgeon concerned that it may never heal over. But I am tolerating the antibiotic I've been on, so Infectious Diseases extended the Rx for ninety more days.
Also in December, I got a new AFO ankle foot orthotic. The first AFO was rated to last about a year, but after fifteen months, the joints were beginning to get loose. Alas, the superb guy who made the first one has moved on -- to Mary Free Bed? -- and the new guy is earnest. And helpful. As is, well since you are a large person and you're wearing the first AFO, let's make the new one tougher, helpful. In addition to a new mold reflecting the fact I was out of the hosptial, the plastic was thickened from 3/16" to 1/4".
Of course, he didn't tell me this and since I had no feeling in my foot, I went using the new AFO for a few days -- and found that I was getting a pressure mark and blood blister across the top of my foot. We tried it on and off through ConFusion in January. When I went back for a second adjustment, we realized that it was getting pinched. But they don't have a working shoe stretching machine. They don't have the tools to cut the top of the left shoe and sew in a gusset. And the special orthotic shoes they do sell? Don't go up to 10½ 6E or wider.
I've been waiting for the minor injury to go away. There's a cobbler in Grand Rapids who might make it work. Or there's a shoe store near 44th Street in G.R. who sells specialty sizes. Or I could try a size 11 6E shoe from New Balance and see if that gives me the extra room -- essentially buying a pair of shoes for one shoe.
Meanwhile, I am still using, you guessed it, the old AFO. Found that an Allen wrench can retighten the hinge screw, although that does nothing for the offset between top and bottom halves caused by the stressed joint.
The January visit to the Wound Clinic was more of the same. A mix of static and dynamic processes -- new small areas will open up or blood will pool somewhere and leak out. My theory has been that the original wound had two areas and a tunnel, and Holland Hospital connected the tunnel, plus the Strange Incidence of the Missing Hyrdraferra Blue (twice), whereby new exit wounds appeared as bits of dressing emerged after weeks or months -- whew -- so therefore there is some internal areas of damage that also have to fill or heal or do something. But the wound doesn't smell, it isn't hot. I have no fever -- after a brief day where it spiked slightly, I've been doing a morning temperature every day and, as per my usual, I am subnormal (96° to 97°F).
And now here in mid-February we are starting another round of Let's See Everyone. Although this time, they are scattered over a couple of weeks.
This Monday I had a repeat of the MRI I had in August (DW), also at Blodgett Hospital. Went by myself. I hoped to get one of the handicapped spaces nearest the door, not the least of which was because it was about zero with a biting wind. Alas, I was again in the third row on the far side. I mean, who puts HANDICAPPED parking spots on a grade? Really? You couldn't buy a level?
On my first MRI last year, I selected Led Zeppelin for the Pandora music feed over the noise cancelling headphones. In May I picked Queen. August, let's go for Blondie. You need something loud. This time I decided to go for Neil Diamond. Started with Sweet Caroline in concert, but a lot of Pandora's idea of Neil Diamond sounded like Simon and Garfunkel, including cuts from the Concert in Central Park, plus a little James Taylor. Actually, pretty anthem-like when you get down to it. But sometimes I wonder about the people who run MRIs. Telling me it'll be about twenty minutes, when the multiple scans actually total about an hour -- who are they kidding? This happened last time, too. I can read the countdown clock on the GE machine. (grin)
Wednesday it was the Foot Surgeon. And Stacey, the most cheerful aide in the world. We love her, but I imagine she would really irritate some people. Always happy, excited and no volume control. Fun.
Anyway, the great thing about having no feeling in my foot is that my surgeon can take a scalpel and really go to town on the debridement. Seemed to think that our theory that we're seeing underlying damage surfacing had some merit. AND she had the new MRI results. Compared to the August MRI on the same machine with the same camera -- there is no change in the bone. This is wonderful news, because if the infected area expanded during this period of the extended antibiotics, it would be trouble. Of course, it is far too much to expect the area to retrench, or at least not yet. But we may well be in that ten-year window that Infectious Diseases was talking about where I could survive with osteomyelitis without too much problems. Ten years might get someone the time to figure out how to replace a heel bone. (non-amputation-grin)
The other great thing about a foot surgeon is that she's fearless in aggressively trimming my left big toe nail, which probably as a result of getting jammed in the end of the shoe by that newer AFO, is ingrown. Kids, do NOT try trimming your nails that far on the inside edge at home. This is what we pay professionals for.
Wound Clinic will be at the end of the month -- Spectrum loves playing musical offices, so they are moving from the second floor to the third floor in the building across from Butterworth Hospital. Infectious Diseases won't be until St. Patrick's Day. But since I'm not teaching, it's not a problem.
Overall -- the progress is... nothing major happening.
Oh, and super good news. The Grievance we had to file with Priority Health over some Physical Therapy visits I had in 2014 past a thirty-visit-per-year limit we didn't know about, but are allowed under the GVSU plan, has been cleared. When I talked to the go-between at Priority this afternoon, Jennifer said it looked like the ~$3000 bill was paid. Yay.
Dr. Phil
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