Leg Time

1st Peter 2:24:
Who His own self [meaning Christ] bore our sins in His own body on the cross, so that we, being dead to sin, should live righteously:  By His stripes you were healed.

Healed.  It is with joy and excitement and hope and thanksgiving that I speak that word.  Healed.

For years, I attacked my own body.  I kept it hidden from most of the world, but not from the doctors who worked so hard to help me heal from those attacks.  I received compassionate, skilled medical care; many who admit to self injury are not so fortunate.

But medicine and time can only heal so much.

My right leg has been hurt quite badly, many times.  A few years back, it caught up to me.  Requiring yet another set of sutures landed me in the hospital.  Hospitals are good places to go if you are sick.  Hospitals are also good places to go if one wishes to be exposed to a plethora of hurtful bacteria.  My leg got infected, and for the first time in my life, the medical care I received was sub-par.  It festered and deteriorated for months before I had the first of too many emergency procedures.  At that time, it was found that the years of injury had caused significant vascular impairment.  In other words, you can only wreck so many arteries (big and small) before your foot simply doesn't get enough blood.  Because of the circulation problems and the effects of stress on my immune system and the unfortunate combination of resistant bacteria, it has been a rocky road since then.  I have spent more days either in a walking boot or on crutches, than I have spent walking normally.  I've got very limited sensation.  Lasting muscle weakness.  Pain, all the time.  And when stuff happens - little stuff, like a scuff on my heal from the stairs or a scratch from one of the cats - it doesn't heal like it should.  It can't. 

Last fall, things cascaded downhill really quickly. 

I am proud to say, though, that I have not done anything to deliberately harm myself in any way since the beginning of 2010.  I've been taking care of my body; seeing it as a gift from God.  It has been a fight.  A difficult, frustrating fight that has been worth it every second of the way. 

But it is in my medical record that I used to hurt myself, deliberately.  Every time a professional has entered the picture to try to help with my leg, it has been assumed b y them that I am still doing things to hurt myself.  It's led to ineffective and unprofessional treatment.

I am now three months into a process of trying to heal the ulcers that broke through the surface of my skin graft and proceeded to worsen and deepen for weeks as wound care specialists treated me for infection.  Infection that isn't present.  And it has been three and a half weeks of daily (yes, every day) appointments with my family doctor.  Three and a half weeks of finally having someone acknowledge that this is not something within my control, and it is not something I have caused.  Three and a half weeks of compassion and the best medical care that my doctor and the nurses working with him can provide. 
And healing is happening.  All the fancy solutions and ointments have been abandoned in favor of simplicity.  Pain relief has been not only provided but encouraged.  Nobody is wasting time trying to place blame.  And the wound that physically should not be able to do so, is healing.  Rapidly and well.  Skin is growing where skin can't grow.  I am completely without signs of systemic infection, and there is also no evidence of bacterial colonization.  Some of the defects that were present even after reconstruction and grafting surgeries have been filled in with healthy tissue.

It is nothing short of amazing.  Even miraculous.

And instead of a future full of continuous appointments and frustration and pain, there is an end in sight.  The day is not so far off when I will be able to leave the clinic and know that I don't have to go back any time soon.  Don't get me wrong; my doctor and the nurses and even the receptionists are wonderful people.  People I care about, people who are uplifting and kind, who are the sort of people I would choose to spend time with simply for the sake of their company.  It's just that the daily appointments, the constant need for said appointments, and the amount of energy, time, and attention being devoted to me, feels suffocating.  I'm the sort of person that prefers to fly under the radar.  Solitude doesn't feel lonely to me - it feels peaceful.  There are times when I am not sure what I look forward to more - being healed or the simple reality of not needing and not receiving this sort of intervention every day. 

Eventually though, I will be well enough to just pack a bag and go stay with my dad and family without having to worry about making it to my next appointment.  Eventually, my time and energy will be put into something more, something better.  Eventually, I  won't require so much as an Advil or Tylenol for pain relief, let alone narcotics.  Eventually, I'll walk into that clinic on two feet with no crutches in my hands, and I will undergo the recommended yearly physical exam, and there won't be any problems.  I'll smile at the nice people and walk back out the door.

A Few Things.

First, Lizzie asked who died on the 28th... and I'm not sure what she's referring to?  Lizzie, if you read this and would leave a comment as to why you asked that, I'd be happy to answer.
Second... a leg update.
It hurts.  The tibial plateau (or at least the soft tissue over it) is very inflamed.  And red.  And brown.  And purple.  And bruised.  And there is a bruising all the way up and down my tibia.  It hurts like you wouldn't believe to walk on it.  Which makes no sense, because there's no infection.  No internal damage.  Unless the infection was there before... which I had been wondering about.

Today, my friend called my doctor, to inform him (the doctor) that my leg was really sore and swollen and red and warm.  The doctor gave me a serious lecture about going to the emergency room right away.  Because my leg cannot be messed around with.  At all.  Can't take that kind of risk.  Apparently, it's still... "fragile" and isn't remotely healed enough to be able to handle any further damage.  Or something.  I grudgingly concluded the phone call with "Yes, sir" in response to his demands that I go to the ER "right away" and not wait even an hour.

And then my friend approached with a very well known (and very excellent) surgeon in tow.  He (the surgeon) just happens to be a black belt where I take martial arts.  He checked my leg.  His expert diagnosis?  "That looks like it hurts."  Ya think?!  He proceeded to say that it's an inflammatory response that is sort of creating a negative loop - more inflammation, irritates the tissues that were previously infected and irritated (i.e. muscle compartments, periosteum on my tibia, venous structures, lymphatics... which causes more swelling and more irritation. 

He also said it was an exceptionally beautiful graft, and insisted I tell him the name of the surgeon who did it.  And then he said it looked like a shark bite.  Totally un-prompted, I promise.
That's funny.  Because when nosy people who I don't know ask what happened, I say "Shark bite."  And then they say "Really?"  And I smile and say "What do you think?"  I make it pretty clear with my tone that it's not really a shark bite, but that I also won't entertain any further questions.
We're attempting to install a motion alarm in our stairway and door alarms on our doors.  Right now.  It's 11:00 PM.  It's not going well. 
I wish it was Sunday.  On Sunday, my Pastor is taking part of the service to answer some very important questions for us.  I think we might get rebuked a little bit, but I really want and need to know the answers, so it's all good.
I'm rambling.  Because I'm tired.  And the hydroxyzine has kicked in.  Which means it's time for the Ambien and the lorazapam.  Yes... that's three meds.  As opposed to four.  And we're looking to wean off the lorazapam within the next month or two.

Heal the Wound...

Every once in a while, I write a post wherein I expose to you the things that I usually keep carefully covered up.  The things that are uncomfortable, unpopular... without beauty and without grace.  This is going to be one of those.  If you want to continue to look at me the same way you always have - stop reading here.  I'll resume "regular" posting soon.

If you are okay with maybe changing what you think of me, of my life... if you're okay with reality being different than you might think, keep going.

If you were sitting here in the room with me, you wouldn't see my legs.  They'd be covered.  My right hand would probably be covering my left arm.  I'd talk to you, look you in the eyes.  You'd see me smile, see my brows pull together with concern.  I'd listen to your every word, tell you I cared.  And I would care.  I'd do whatever I could to show you His love.  But you wouldn't see my legs.

Unless you were truly broken.

If your hope was gone, if your heart was shattered, if tears were streaming down your face.  I'd take your hand, look into your eyes.  I wouldn't look away.  I might shake, and my voice would get quiet.  I'd pull up the leg of my pants.

You'd look down, wondering what I was doing.  The ugly, red hole in my leg... the lines across my skin... the evidence of old wounds would be there for you to see.  Your face would register surprise.  Maybe repulsion, maybe curiosity.  You'd stare, for a few seconds, maybe minutes.  Silence, until your eyes shifted back to my face.

And then, I would tell you why the song that is playing right now means anything at all to me. 

I would tell you that my hope has been gone.  My heart shattered.  I've cried until I had no more tears.  I've stared silently at the darkness, afraid of the light.  I would take a deep breath.  I would tell you that time and again, the pain and the blood have flowed out of me.  That my own hands have been instruments of destruction.

I would look down, and you would too.  Together, we'd look at the scars.

And I would tell you why I have stopped wishing for God to take them away.  Each one is a silent witness, proclaiming this truth: He is enough.  He is there.  He is faithful.

I do not show them off.  I do not want the world to see them if I don't have a chance to explain.  I am ashamed of what I've done.  But I am not ashamed of Him.  I am not ashamed to say that out of the ashes left by burnt out hope, He is creating a masterpiece.  I cannot see it - it is not finished, and I am on the inside looking out. 

I am breathing.  My heart is beating.  My hands are warm, there is fire in my eyes, my back is strong.  And it is not because of anything I am or have or can do.  It is Him.

He has preserved me.  He will present me blameless.  He lifts my head, He washes the shame from my face.  In Him, there is freedom.  Life.  Liberty.  There is no condemnation.  No fear.

He is your hope.  He is the only thing that can hold the pieces of your heart together.  He is the One who never leaves, never fails, never ends.  His shoulders are broad - they can carry the weight of the world.  And He loves you.  He has redeemed you.  He knew you before you were born, and He knows every minute tomorrow holds. 

The hurt, the loss, the destruction I have known, are not visible.  You can't see them.  If you were here in this room, there wouldn't be any way for you to know about them.  Except for the scars.

They speak.

They might make you cry.  They might make you cringe.  They might make you wonder if I've ever known the pain that you're feeling now. 

They will show you dependence. 

If you were here, I would squeeze your hands, ask you to look at me.

I would tell you that you will fall, again and again.  That your heart might be broken anew.  That you will feel more pain.  And I would tell you that He will pick you up.  That He will hold you, and wash you, and purify you.  I would remind you that in Him, there is healing and fullness of joy. 

And after you left, I would be thankful for the scars.  Not for the pain.  Not for the wounds.  Not for the sorrow.  But for the healing.  For the truth.  For Him.  For you.

If you were here.

Stock in 3M

So I've been thinking... maybe my husband and I should support ourselves financially.  By taking out stock in 3M.  You know, the company that makes VetWrap.  I use a roll every day.  For my leg.  Speaking of leg... I think it's time I quit hiding it and post an update.

This is what it looks like all wrapped up the way it's supposed to be.  VetWrap comes in a lot of colors, by the way.  In case you were curious.  I use the VetWrap for the fact that it creates and maintains even tension.

Underneath the VetWrap, I have an ace bandage.  Not a regular one - one that is twice as long as normal.  It holds my foot in alignment, at least most of the time.  It would not be adequate without the VetWrap though.  The tension, if left as you see it below, would migrate and slip, and would fail to control the swelling or assist with circulation.

Underneath all that ace bandage, I have a hefty layer of 6-ply gauze.  I'm not actually oozing or bleeding or anything.  But the gauze is important.  I have learned how to carefully fold it so that it provides padding and also some protection in the instance of shearing pressure over the graft.  Plus, I can gob massive amounts of aquaphor underneath it, and keep everything soft and happy.

The final thing that stands between my leg and the world at large is Aquaphor.  Maybe I should take out stock in Beiersdorf Inc. (the makers of Eucerin and Aquaphor) too.  I use great gobs of it on my graft site every morning and night.  It is, according to the plastic surgeon, the most important thing I can do for the graft.  Keeping it soft helps to gain thickness, prevents it from splitting and causing major issues, and enables it to stretch a little if it is bruised, instead of breaking open.

Okay, this next one is the one that embarrasses me.  Please no mocking.  But also, please don't look away.  I'm not trying to engender sympathy, not trying to say "poor me."  I'm trying to say... be careful.  What you see below is the result of a relatively small self-inflicted cut on my shin.  It got infected.  The bacteria was resistant to treatment and ate away a LOT of flesh, including some important blood vessels and a nerve.  It also inflamed the lining on my tibia, which caused enough internal swelling to significantly damage the interior nerve.  I have no sensation below that ugly hole, short of some intermittent tingling that cannot be interrupted.  Irritating.  But, I am blessed.  The infection nearly took my life.  I am not only alive, but I can walk.  On my own leg.  It looks pretty stupid, but it is attached and mostly functional.  The surgeon was able to move around existing muscles to make up for the loss of one of my shin muscles.  That's why the graft looks so lumpy - the muscles are still settling into their final positions, and are bulking up a little unevenly.  I expect it to improve over time.

Anyway. for the curious, this is an update on how my leg is doing.  I have some big leg-related news pending right now... I will post when the time is right.  Meanwhile, I hope this answered your questions. 

I'm Alive.

It wasn't all that long ago that I wondered how long that would be true. The alive part, that is. I remember the surgeon coming, telling me that the VRE infection I had developed in January was still rampant. It grew both in my wound and blood cultures. For those of you unfamiliar with the abreviation, the VR portion stands for vancomyacin resistant. That means that they literally don't have anything left to treat it with. They were pumping me full of three kinds of antibiotics, plus the antihistamines and steroids required when giving me levaquin (I am allergic). Those would take care of some of the bacteria - the other kinds. But the VRE? The doctor said it was up to my own body.

God was merciful. I initially caught the infection along with four other kinds of bacteria. Most likely from someone who didn't wash his or her hands adequately before applying gloves and doing a dressing change while I was hospitalized. They told me then that there was nothing they could do about the infection. We all thought it had abated, until nearly three months later when my shin literally started rotting off.

God was merciful. In spite of the fact that the original wound was self inflicted, and in spite of the fact that I was falling apart in so very many ways, He saved my leg. And He saved my life.

I was thinking about this tonight in church, and Psalm 143 came to mind. I've got it below for you to read. It just seems... fitting.

O Lord, hear my prayer, listen to my cry for mercy;
in your faithfulness and righteousness come to my relief.
Do not bring your servant (me) into judgment,
for no one living is righteous before You.
The enemey pursues me, he crushes me to the ground;
he makes me dwell in darkness like those long dead.
So my spirit grows faint within me;
my heart within me is dismayed.
I remember the days of long ago;
I meditate on all your works and consider what your hands have done.
I spread out my hands to you;
my soul thirsts for you like a parched land.
Selah. (Which means meditate on this.)
Answer me quickly, O Lord;
my spirit fails.
Do not hide your face from me or I will be like those who go down to the pit.
Let the morning bring me word of your unfailing love,
for I have put my trust in you.
Show me the way I should go,
for to you I lift up my soul.
Rescue me from my enemies, O Lord, for I hid myself in You.
Teach me to do your will, for you are my God;
may your Spirit lead me on level ground.
For your name's sake, O Lord, preserve my life;
in your righteousness, bring me out of trouble.
In your unfailing love, silence my enemies;
destroy all my foes, for I am your servant.

An Un-Finished Product.

So, right now, my leg is almost a finished product. At least as far as my plastic surgeon is concerned. The graft has taken very well, and that's what his job was. He's proud of his work. And really, he did do a good job. The Hole, as I call it, is completely covered with skin/scar tissue.

But, and this is a big one... it's not finished. I am currently able to walk on it, but not very well. No proprioception (the ability to tell where it is at) and no feeling in most of it. Medically, there is nothing that can be done. According to medicine, I will always have The Hole, and it will always be super sensitive. I will always have a nerve deficit, and will be unable to regain a lot of the function that's been lost.

But there's something even bigger than that. I refer to Him as God. You know, the Creator of the universe? He amazes me with His love and His faithfulness. He is my provider. My healer. And with Him? Exceedingly above and beyond that which I could ask or even dare to imagine. That's what He'll do for me.

I can't honestly tell you what my leg will be like when He is done doing what He's doing. I don't know how much I'll feel, or what I will be able to do. I don't know if He will get rid of The Hole (He can, you know - He can do anything), or minimize it, or if it will always be as ugly as it is now.

But I DO know this: His mercy, shown to me in spite of the fact that I picked up the blade, I made the cuts, and I ignored His pleading voice... His mercy has left me standing. Do you get that? STANDING. I can stand up. I have two legs. Both of them work well enough that I can stand. And I can walk.

Today, I visited a friend who was working in the long-term care unit of a local hospital. The people there can't say what I can. Many of them will never walk again, this side of heaven. It wasn't all that long ago that I lay in a hospital bed, my leg feeling like it was on fire, and wondered if I'd still have two legs the next evening. It wasn't that long ago that a physician advised me I should be prepared, because a lot of the bacteria that grew in my wound culture was completely resistant to treatment. It wasn't that long ago that I quietly pleaded for my life. So in a way, I do get what those people are going through.

But in a much bigger way, I don't. The reality is, "The Worst Case" has already happened to them. For me, it was a future possibility. At times, I was told it was a future likelihood. But, I have received MERCY. I cannot complain. Yes, my leg is hard to use. Yes, my knee keeps getting wrenched because my foot floats to some some absurd angle mid-stride. Yes, I lay awake at night unable to sleep because my leg is covered in goosebumps and quivering and shaking and jerking.

But there's more. Because I can stand on my own two feet. I can walk down the long hallway of a rehab unit to visit a friend. I can get in my car and drive. My foot has a pulse despite significant arterial damage. My skin graft took, the first try. 100% of it. I stood in front of a Martial Arts class last Thursday, and taught. Next week, I'll stand in front of a group of women and endeavor to give to them what's been given to me.

I'm not ready, yet, to share what is left of my leg. It isn't pretty. It isn't completely healed. I still have a huge red rectangle where the doctor took skin for the graft. I still have to have it wrapped all of the time, to try and prevent swelling. But you know what? I am ready to share that my God has preserved my leg. I still have it. It is still useful. And, despite so many emotions saying otherwise, so am I.

So am I.

Really Short.

So tonight's post is going to be really short. I want to write about connections - and will do so soon. I also want to finish out my series on the love of God.

But right now, I am under the influence of some strong medication, and do not want to risk posting something crazy, so I'll stick to just a general update. My leg is healing - during the dressing change on Thursday, we saw PINK SKIN underneath the sewn-on dressing. Actually, it's stapled on. But whatever. The doc has sewn a dressing over the donor site, some yellow mesh-type stuff. And over the graft site, he stapled some sort of peforated clear stuff that reminds me of plastic. It's great, because it means that dressing changes aren't ripping away newly grown in and healthy tissue.

As for pain, it comes in spurts. Tonight, there's lots of it. Last night, there wasn't. When it gets really sore, my entire leg gets covered in goosebumps, but no other body parts do. It's wierd. I still have a gigantic dressing/cast - a half cast wrapped on with large quantities of cotton batting to keep things soft and comfy. Still allowed only 20 minutes below waist level every two hours. Still no weight bearing or moving the joints above or below the graft. Starting to itch something fierce, meaning healing is definitely underway (as if the PINK SKIN underneath the dressing wasn't enough).

Saw the fertility doc yesterday. No, we're not doing treatments right now. Yes, we're looking at surgery again to address some adhesions. Yes, we will evenetually try another round of treatment. Yes, we're aware that now is not the best time to do so. So's the doc. We're all on the same page.
Yesterday, I ALSO saw my counselor. Have I mentioned that he is literally an answer to prayer? A God-fearing, God-LOVING, experienced therapist who knows what I need and how to get me there. It's one of those things that has been making a huge difference in my journey toward "healthy and whole."
For tonight, that's all folks.

Update. Graft Is Good.

Saw my graft site today. It looks really good. The skin is pink (full of holes, too). The edges have all adhered properly, everything looks as good as possible. I didn't realize that there would be STAPLES in my leg, but... I'll get used to it and there's only a few. I also didn't realize how much the donor site was going to hurt without the wound V.A.C. on.

So I made a choice today to spend another day or two here, receiving some I.V. pain meds and anti-inflammatories. Feels a little selfish and a lot wimpy. However... that's what I've chosen.

I also found out today that it will be a minimum of 3 weeks before I can begin any weight bearing on my leg at all. For now, it is allowed to be below heart level for a total of 20 minutes every 2 hours. If you think about it... I can go to the bathroom and that's about it.

But all in all, things are doing well. That's all for tonight - I'm off to watch a movie as I fall asleep.

Last Day?

This could very well be my last day here in the hospital. That would be fantastic, you know. I'm not sure what will happen tomorrow, though. I may go home to resume all activity, or maybe I'll go home for more bed rest. If it's the bed rest thing, I'm going to stay in the same place I spent my high school years, simply because everything is on one floor. Or maybe I'll stay here on total bed rest still. Or stay, but with "bathroom privileges." Really no idea.

Today has been a rough one as far as feeling just... crummy. I ache everywhere - all my muscles and joints. My head is pounding, stomach rolling. Foot has gone completely numb to the touch, but still feels constant pins and needles. Donor site is super sore - had to rip the bandage away so it isn't getting brushed, and even then... my skin twitches and it almost makes me yelp.

Yes, I used the word yelp.

Have been being a jerk today as far as company goes - haven't wanted any. A friend who works here stopped in, and it was good to see her, but... over all, I want to be alone. Completely left to my own devices and quiet and peace.

I have to figure out supper, and to be honest... I think I just want oatmeal and strawberries and yogurt and bacon. Not a typical "supper" but it's about the only thing that doesn't turn my stomach at the mere thought of eating it.

There is also that hot fudge and marshmallow sundae down the hall in the freezer for me. But that's not "healing food," it's just yummy.

The nurse just came in and did a "mental health assessment." She doesn't seem to know what to do with the answers I gave her (honest answers). Is it really that unusual for a patient to come in with PTSD and also be in the middle of some serious depression?? Here's to hoping she doesn't page some random on-call person for me to talk to. Blech - who really wants a stranger to talk to, ya know?

Prayer requests today - I don't want to stay here any longer than absolutely necessary. I don't want these aches and sweats and chills and new pain and new numbness to mean anything actually bad. That this is just a normal healing progression. Otherwise, I'll check back in tomorrow and let you all know the verdict - home, here, what can I do, all that jazz.

It's a Heaven Day Today

Today is post-op day 3. That means that the day after tomorrow, I may get to go home. Which would be fantastic.

However, having spent the last five months fighting to get this thing healed up, I am not going to argue with anything the surgeon says or recommends.
For the most part, the care I have received here has been phenomenal. The therapist who leads my DBT group stopped by to give me the homework from the group I missed. The psych. nurse who assists with that group came down today and spent nearly an hour - it was actually quite helpful.
My psychiatrist has been in at least twice every day, making sure that as my body gets all wonky from the surgery, the psych meds are adjusted as needed. Have had a few nurses and/or nurse's aids who are rather bitter that my "bed rest" does not involve a catheter or bedpan. Not sure why - it's less work for them this way, and it's definitely less traumatic for me. If the surgeon had not agreed to the modification, the psychiatrist would have prescribed some pretty serious sedatives.

Plus there's the whole laptop that's been supplied for my use. And the fact that some friends have allowed me to borrow some of their movies.
I guess I don't really have anything else to update you with. The wrappings (half-cast and LOTS of padding) won't come off until Sunday, and we won't know if the graft took, or how well it took, until then. Can't say when I'll be home, because nobody knows.

But I do know that when I get there, my house will be amazingly clean. My wonderful aunt Barb came over today, and she worked hard (very hard, from what I hear) to make my homecoming easier and safer. Extremely grateful.
My grampa's sweet, dear sister Hazel has stepped into eternity to join that cloud of witnesses. Those of us still here will miss her, but truth is, she's never been better than she is now. Today is her heaven day.
Specific prayer requests - rapid regrowth of skin at the donor site, and rapid growth at the graft site. Less of the pins and needles sensation, less itching. And it'd be great if the really persistent and very uncomfortable aching in my tibia were to ease up a bit.
So, that's all I've got for tonight.

Day 2. Or 3. Depends how you view it.

Had my surgery early Tuesday afternoon.

There were no complications. The doctor wasn't able to do as much reconstructing as he wanted, but that is okay. He got the skin graft in place, put the biggest splint/bandage on my leg that I have ever seen, and is very optimistic that the graft will take.

I'm hooked up to a hospital grade Slurpee now, which is a pity. I miss my little one.

This bed rest thing... there are people who do this for months at a time and they stay sane. I don't get that. I suppose maybe if I were actually miserable, it wouldn't be such a bad thing, but the truth is, they've got my pain under control and I feel pretty great.

Fortunately, they do supply us with laptops to use. So I can tell you all in real time that I am doing well. Just ordered a late lunch (like 4 hours late - whoops). Will be taking a nap sometime shortly thereafter, unless the pigeons outside provide me with adequate entertainment. We shall see...

Scheduled Post #1

Today was the Big Day. As written on my pre-op orders, my surgeon performed, on "the lower right extremity," a "deep structure, muscular, and vascular reconstruction followed by a partial-thickness skin graft." I would imagine that right about now, I am in my hospital room either asleep or wishing I was. I'm receiving some pretty heavy duty antibiotics to fight the three bacteria that grew out in very large quantities on the last culture, and have formed obvious colonies in my wound. I've got a couple big whitish-yellow ones, and a couple big greenish ones. Or I should say, I had those. The surgeon removed them.

I can honestly say that while I doubt the next few weeks will be all that enjoyable, I am quite convinced that it is the right decision.

I'm not proud, but the wound was self-inflicted a long time ago. Toward the middle of January, actually. We are now pushing the middle of May. That's five months spent trying to deal with one stupid cut. I'm going to tell you a little bit more about it, just because I want to write it out for my own sake. And maybe some of you will read it and get the guts to stand up for yourself more effectively than I did.

The cut was deep - one of the deeper ones I've ever made. My bone was exposed, a muscle cut through nearly all the way, and an artery severed completely. My husband came home and found me with that and several other cuts, sitting on the floor in a daze. He called 911 - I think I asked him to. I had lost a lot of blood, and was scared. Very scared.

The nearest emergency room happens to be one we don't prefer, but when one calls 911, one loses the option to choose. Fortunately, they allowed me to call my regular physician to come in and do the repairs. He did an excellent job - I was able to walk when he was finished, despite the muscle damage.

I was admitted to the psychiatric unit of a different hospital. While there, nurses changed the dressing on my leg daily. After about a week, I noticed that one cut did not look quite right. I pointed it out to the nurse, and she assured me it looked fine. I know my body pretty well, and knew it didn't look "fine," but I let it go. The next day, it looked even more "off." I pointed it out again, with my husband present. She said that all wounds heal differently and it looked fine to her. The next day, the same thing. 12 days after the original injury, the sutures were removed. The wound looked swollen, was hot, and just a tiny bit pink. But I had no fever and there was no visible pus. I insisted, again with my husband and two nurses present, that it felt very much infected and asked that they please have a physician look at the wound. The nurse practitioner barely pressed on one end and the whole thing split, revealing the infection I had told them was present.

It took a month for the wound to close. Most of that month, I was in the psychiatric unit. I was accused of wound tampering and told that I was the reason for the infection. Cultures grew out bacteria normally found in fecal material, as well as some found in dirt, and some found exclusively in certain species of pet birds. In other words, the infection came from someone who just didn't do a good job of washing his or her hands.

After the scar was fully formed, my leg would frequently swell and get hot just below it. I was assured that that meant nothing. No problem. When yellow fluid began draining from the corner of that scar and from several others, I was told again that it was normal fluid and there was no issue. I let it go. Again.

Nearly a month passed, with constant drainage, swelling, and pain. I was assured by physicians (not mine - he was not yet cleared to see patients following a horrid accident) that it was fine. Told I was being a hypochondriac. My chart was noted that I was suspected to be a Munchhausen's patient. (Munchhausen's is a disease where patients make themselves sick in order to get attention from doctors. For the the record, I loathe having to go to the doctor. For anything.)

I woke up one morning with a leg that was grossly swollen, red, and hot. I had a fever, ached from head to toe, and couldn't stand even the brush of my pant leg against my leg. I emailed my doctor, and waited for the clinic to open. I was given a 2:30 appointment. When we got there, the doctor let us know that a surgeon was on his way over to look at it. Two hours later, I was wheeled into surgery and the abscess was drained. A wide, eye-shaped hole was left that went all the way down to the bone and muscle, to allow all of the "fluid" to drain. Wet-to-dry dressings were applied, that I changed out twice each day. After two weeks of no visible healing happening at all, the surgeon decided he'd order a wound V.A.C. Meanwhile, I noticed that there were little black spots forming inside the wound, around the edges mostly. He assured me that these were just dried spots of blood.

And then the whole thing turned black. As if someone had dumped tar into the wound. And the black started to spread. The surgeon took two days to believe me over the phone, and I came in a day early to get the wound V.A.C. put on. He was shocked to see that it really was black. Rather than do anything, though, he applied the V.A.C. (henceforth referred to as Slurpy) over the top of the eschar. He said he believed it would take care of itself.

Four days later, when I went back in for the dressing change, the necrosis and infection had spread dramatically. Went in the next morning for yet another operation, and stayed in the hospital for 6 days. The day I went home, the doctor applied a special dressing that contained silver. He said that would help kill off any micro-organisms. It started to sting and burn as soon as it was applied, and within two hours, I was in nearly unbearable pain. The doctor did not believe me, said that it was normal for it to burn a little. A nurse brought up Munchhausen's yet again. I asked to either be transferred or released so I could seek a second opinion.

By the next morning when I saw a physician in a wound clinic at a different facility, the reaction between my body and the silver had enlarged the hole in my leg considerably. I was in absolute agony. I was angry, tired, and barely able to think. The dressing was removed, taking with it all of the granulation tissue that had formed during my 6 days in the hospital, as well as the facia over one of my muscles. Fortunately, the exposed nerve stayed intact. The nurse dumped saline into the wound, over and over. Each time, it briefly stung but the agony lessened. By the time she was done, it felt just like it should - sore, a bit of stinging, some aching... nothing even remotely unbearable. The wound doctor looked at the wound and photographed it. Noted that my tibia was exposed. Noted that there were areas of necrosis that went deep into one of the muscles. Noted the exposed nerve. Noted the end of a vein that had been severed by the last surgery. And then referred me to a plastic surgeon.

He took more photographs, looked at the wound more. Talked to me about the fact that he was pretty sure the wound would not heal without significant intervention. Scraped away some colonies of bacteria. Burned away a bit of necrosis. Flushed everything out with saline. Put Slurpy back on, with a normal slurpy sponge. And scheduled today's reconstruction and skin grafts.

The point here? If you know, and I mean absolutely know something is wrong in your body, don't let a doctor or nurse blow it off. I did, and here I sit five months later, waiting to have major surgery and praying that everything can be achieved in one operation. I am on narcotics, and have been for the last three months. I have three types of bacteria that are not antibiotic resistant, and yet continue to colonize the gaping hole in my leg. And if that first nurse, the one who said all wounds heal differently, had listened... well, I wouldn't be in this situation at all. Had it been treated correctly way back in January, all of this would have been avoided.

Speak up folks, and be loud.

But That's So Selfish (Plus a Leg Update)

Forgive me if I include a very brief leg update for the curious: Still scheduled to be admitted the morning of May 11th, will go home 5-7 days later. The psuedomonas turned out to be susceptible to Cipro, so I'm taking very high doses of that and Augmentin up until that morning. A "colony" of bacteria was removed by the nurse today, which will be cultured and verified as something that either Cipro or Augmentin will kill. Slurpy's working well. Pain is decreasing. There are several small eschars (areas of hard, dead tissue) and several obvious colonies of bacteria, but over all, the wound is looking better than it has since the original surgery. Talked to the doctor about some concerns I have related to the PTSD. The result? He understood. I will have a private room. I will not be catheterized and I will not be required to use a bedpan. Over all, a very productive day.

Okay. Now that that's over with, the meat of this post.

Selfishness. Defined by Webster's as either "concerned excessively or exclusively with oneself: seeking or concentrating on one's own advantage, pleasure, or well-being without regard for others" or "arising from concern with one's own welfare or advantage in disregard of others." Certainly not a trait most of us want attributed to ourselves. In fact, I don't know that I've ever met someone who said to me, "I wish I could be just a little more selfish."

I have noticed that many people, myself included, seem to say "yes" to almost any request made of them. I want to give. I want to help. I want to be selfless. If it benefits someone else, I am all for it. Even if it hurts me. I have always used Galatians 5:13 & 14 to justify myself in this attitude. I've convinced myself that i have to "do it all" because... well, because that's the unselfish thing to do. Look at those verses with me for just a moment, will you?

It is absolutely clear that God has called you to a free life. Just make sure that you don't use this freedom as an excuse to do whatever you want to do and destroy your freedom. Rather, use your freedom to serve one another in love; that's how freedom grows. For everything we know about God's Word is summed up in a single sentence: Love others as you love yourself. That's an act of true freedom. (taken from the Message Bible)

I could use this passage to try to convince you that we should do everything others ask. After all it says "serve one another in love." Right? We should serve others. In love. Because that's what we're told to do.

Let me ask you something though. Have you ever been SO busy that you cannot remember what it is you are supposed to do next? Maybe not. Have you promised someone that you'd be there for them, only to walk away with the sinking realization that you have another equally important commitment? I think that sometimes in our efforts to serve God, to love our neighbors, we fall terribly short. Not for lack of willingness. Not for lack of "yes" answers. But because we don't say no. We get so wrapped up in doing, going, and helping, that our own lives start to fall apart.

Look at Luke 6:41 & 42

"Why do you notice the little piece of dust in your friend's eye, but you don't notice the big piece of wood in your own eye? How can you say to your friend, 'Friend, let me take that little piece of dust out of your eye' when you cannot see that big piece of wood in your own eye?! You hypocrite! First, take the wood out of your own eye. Then you will see clearly to take the dust out of your friend's eye.

I always looked at that passage as sort of applying to them. You know, those other people who sit in church with you. But you know what? It's talking to me. The reason I didn't think it was? Well... I am pretty sure I would notice if I got a big piece of wood in my eye. Even if it was metaphorical, like getting entrenched in sin. Or failing to meet my commitments. Or failing to manage my finances. Becoming unsubmissive to my husband. Wouldn't I?

Maybe. If I had time to pay attention to that sort of thing. You know, in between all of the loving my neighbor that I have to do.

Face it. We cannot obey the commandment set forth in Galatians if we don't take heed to what's written here in Luke. Maybe that's why Luke comes first in the Bible? We absolutely, positively must take heed to ourselves. We have to take care of ourselves before we can take care of anything or anyone else. There is no way we can be of any earthly use if we are falling apart.

I am a very good example of this one. I got so caught up in wanting to "be better" and help people that I didn't even notice myself slipping back into the very dangerous, very scary habit of self mutilation. The mess I made is still being cleaned up (see the note at the top of this entry). And right now? I just need to let myself take care of me. I can't take care of others, can't see past my own mountain to help them. And that hurts. But truth doesn't always feel good going down - sometimes, it's bitter, like medicine. Right now, my truth is that I can't really do much for anybody else. I hate it. Loathe it. Want to deny or ignore it. Or both. But I can't. I have to heed it, or I'll wind up with not just a big stick in my eye, but an entire log jamb. And that would certainly help my neighbor, right? Well... maybe not so much.

A little bit further in Luke, it we see what exactly it was that Christ came to do. We are called to be Christians, or Christ-Like. So maybe we ought to read what He did, so we know what we ought to be doing. Read Luke 19:10 with me:

The Son of Man (Christ Jesus) came to find lost people and save them.

Well, that's simple. If we're to love people, and be like Christ, we should be out finding lost people and saving them.

I will be honest. Right now, I feel selfish. I am not out finding lost people and saving them. I am barely getting through my days, battling a systemic infection, fighting to keep my leg, looking at my 3rd urgent surgery in so many weeks. Praying that this one the last - the surgeon isn't sure it will be.

Am I a bad Christian for this? Am I failing? I've stepped back from some of the "helps" things that I usually do. I spend less time now "reaching out." I am asking others to help me. I am trying to force myself to let them. Everything in me is screaming out "THIS IS SO SELFISH."

But then I read this in Matthew. Matthew comes before Luke the way we arrange our Bibles, but this account is after the commandment to love, and after we see what Jesus came to do.

Read Matthew 14, verses 22 and 23:

As soon as the meal was finished, He (Jesus) insisted that the disciples get in the boat and go on ahead to the other side while He dismissed the people. When the crowd dispersed, He climbed the mountainside so He could be by Himself and pray. He stayed there alone, late into the night.

So. There you have it. Jesus, who was perfect, drew away for a time. He spent time alone. He prayed, and He didn't do it for just a little while. He did it late into the night. He didn't just happen to find Himself alone, either. He sent everyone away. He took care of Himself. I don't believe that He would have been able to do what He did if He didn't take this time, alone. This time to be restored and refreshed and rebuilt.

And so, while my flesh screams "SELFISH SELFISH WOMAN" my Spirit whispers, "Wisdom. This is wisdom."

Think about it... can you find a way to apply any of this to your own life? If so, please leave me a comment. I'd love to hear from you.

Update. Again.

So, you may remember that just over a week ago, I posted a link to this picture (as well as several that were a little more graphic):

Well, the surgeon I was seeing at the time (Dr. T.) was not impressed. He felt that despite several negative swab cultures, there was clearly a "creeping infection" in my skin. He said the only thing to do was to remove the dying flesh, as well as a a "fair margin" of healthy tissue, and then keep me in the hospital until he was certain things were healing. I had the surgery on Wednesday. I was warned by the anesthesiologist that evening that the "defect" was a lot bigger than Dr. T. and I had discussed. I was thankful for the warning - the next day during dressing change, I was shocked to see a hole twice as big as discussed.

I stayed in the hospital until the following Monday, recieving intravenous Timentin. I was discharged grudgingly when I requested that I either be transferred or released to seek a second opinion. A special sponge containing silver was applied with my wound V.A.C. and I proceded to have an allergic reaction to it. A LOT of diphenhydramine (Benadryl) later, I had my appointment in a wound clinic with an infectious disease specialist. He and his nurses spent nearly an hour picking bits of the sponge out of my leg, and then photographed the remaining defect. Sadly, the sponge enlarged it quite a bit. They reapplied the wound vac and set me up to see Dr. B. in plastic surgery the very next morning.

He took one look at the wound, had more photographs taken, and began talking about reconstruction and skin grafts. His nurse was pretty careful when applying the wound vac. You'll notice in the picture below that the wound is surrounded by something yellow and leathery looking. This is called DuoDerm. It's applied right up to the edges of the wound in order to prevent any damage to healthy skin. You'll also see some wound peeking out from underneath the sponge. That's fine - the general idea is to create an overall vaccum, and the sponge doesn't necessarily have to cover the whole wound to do so.

Unfortunately, the defect now covers a large percentage of my lower leg, as you can see in the picture below. Underneath the sponge, there is bone, muscle, a nerve, and several vessles exposed. There are some new areas of necrosis, one of which involves an abcess-type lesion in one of my shin muscles. Dr. B. has reapplied the wound V.A.C.

Because of the generalized swelling and infection, I have to keep my leg wrapped fairly tightly to promote healing to whatever extent possible. The more granulation tissue (healthy regrowth) my body can produce between now and the day I have my surgery, the better things will go.

As for the V.A.C. - it takes the yellow and green and red fluids from the wound, and sucks it at a constant negative pressure into a tube. This tube runs up my leg and out the top of my pants.

My V.A.C., which is named Slurpy, then makes all sorts of strange sounds (constantly, but especially when all else is still and quiet).

Lastly, the fluids are deposited into a canister containing a gel packet. This keeps things from sloshing around while I walk. I wear Slurpy in a pouch over my shoulder, sort of like a purse. Which I hate (purses, not Slurpy).

I am currently at home. Surgery is scheduled for Tuesday, May 11th. I will get a call tomorrow to let me know whether or not I need to come in prior to my surgery date for premedication. The latest cultures of my wound have shown a particularly resistant strain of pseudomonas. Dr. B. has to go back to the infectious disease specialists to find out if they think that IV meds during and after the surgery will be sufficient, or if they think I should come in early for IV meds.

The day of surgery, Dr. B will reconstruct many of the deeper structures in my lower leg, some of which were damaged years ago. Then the skin graft will be placed, the appropriate dressing and sponge applied to both the graft site and the donor site, connected to Slurpy, and I will wake up. I will be in the hospital for a minimum of 5 days, with the potential for significantly more given the persistent signs of systemic infection. Blood cultures were finally drawn yesterday, so the results of those should be available before surgery.

I guess that's it for my update. As always, I appreciate your prayers and well wishes. This is a battle I don't like fighting. Don't want to fight anymore, but I have to keep going. No other choice. So today, just like most days, I am entirely dependent on Christ for my strength.

Prayer Request (Again)

So I'm asking that you pray for me. There is some necrosis in the new wound, showed up this AM and has spread since. Also an area of obvious infection despite the IV antibiotics. Now my knee is becoming increasingly painful and is starting to swell. Temperature is going up in spite of the fact that I am surrounded by ice. Please pray that these negative processes cease and my leg begins to heal. If it looks worse in the morning, I will be requesting a transfer to a larger and more advanced facility.

Absent and Accounted For

After the surgeon saw my leg this morning (no pictures this time - suffice to say the hole is approximately 11x8 inches and definitely shows signs of infection - he said i need surgery asap.

I go in tomorrow morning at 7:00 AM. He is concerned, and feels very, very badly for having not responded to my previous requests to do something more drastic as things were going rapidly south. But he has promised that I will keep my leg, and he has a plan set in motion to help me heal.

I will be staying in the hospital for a while - until he is completely satisfied that my leg is actually healing and is healthy. I don't know if that means a couple days or a couple weeks. Regardless, I have printed off a LOT of coloring pages, have packed my notebook, journal, Bible (most important thing to pack), and ways of coloring to keep me busy while I lay there in a hospital bed.

Your prayers and support are appreciated. I will have my phone, so will be able to update via twitter, so you can always watch my sidebar for updates.

The Good, The Bad, and the Ugly

>So, Slurpy is good. Yes, I said Slurpy. I have named my V.A.C. unit. It makes the most inappropriate slurping sounds, and generally when all else is silent. So Slurpy it is. It's been great not to have to deal with the dressing changes, and to not have to smell the infection. It's also nice that all of the yuck that comes from the wound is being sucked into an air-tight container and I don't have to do anything with it other than turn it in to the nurse at my next appiontment.

That's the good - Slurpy is working out well. Chugging along at a continuous negative pressure of 175mmHg, with high intensity. It is helping to control the pain (although right at the moment, I am up instead of napping due to pain).

Now for the bad. The eschar hasn't receded or anything - still black, still hard, still leathery. Worse yet, I had to do a change of dressing (add more) on Friday night because even more tissue had died. And today, I'm looking at possibly doing again. I wasn't supposed to have to do anything at all with it until I saw the doctor on Tuesday.

The ugly? I think I'm looking at surgery, again. So much more flesh has died. And there's a lot that looks like it will die soon - it's red, raw, peeling, hard, hot, and mottled with white and yellow.

But the best? My God has promised me something. He said that by the stripes of Jesus, I have been healed. I have no fear. I know this will resolve. I know that my leg will heal. That I will continue to have two fully intact and fully functional lower limbs.

For those of you who have a certain... unusual curiosity (like myself) here are links to a couple photos of the way my leg looks today:

This one gives you an idea of how much of my leg is impacted by this.

This one gives you an idea of how... icky... it looks.

You'll notice that there are red lines around the wound - those lines are where the living tissue meets the dead tissue. It's bright red there and extremely sensitive. And that's all I've got to say about my leg today.

The Surgeon Says...

So, as some of you may know, I've been on the phone with a man who is not my husband an awful lot lately. His name is Dr. T, and he is my surgeon. I struggled for two days to convince him to see me, because my leg wound was turning black. He kept saying it was fine, that it wasn't really black. Actually, my description yesterday was "the middle is black, and the skin radiating out from the edges is mottled yellow and green and brown and black."

I've got a picture of what I was trying to describe. It's a bit... graphic. So if you're squeamish, do not click on the link below.

Click here to see what my leg looked like on April 20th

However, after my husband saw what it looked like, he called the surgeon himself and got me an appointment. Went in, had to wait 45 minutes, and the surgeon came in. He looked at it and I promise, he did a double take. He apparently really didn't think it was actually black. He thought that we were seeing blood clots or something of the sort. No, not so much.

He scraped away at the tissue he described as "dead" and then scraped some more. Then he got giddy, and called it a word I can't remember. And then the bomb got dropped - it was actually my fault. The cutting I did in January (haven't done any since before the last time I was hospitalized, by the way) has really hindered my superficial blood supply. The wound he made to treat the previous tissue death, inadvertently removed the blood supply for much of the surrounding skin/tissue as well.

Because of that, the skin, and the tissue beneath, has died. It looks gross. Smells worse than it looks. And it creeps me out. He said it's okay - that it will be self-limiting and should be about done progressing. On Friday, his plan is to keep me wide awake, use only a local anesthetic, and remove the tissue that has died. Time for a little baring of my soul, so to speak... that absolutely, thoroughly terrifies me. So if you pray for me, please, PLEASE pray for peace as I go in Friday morning. Once all of the dead tissue is removed, he will be putting a wound vac on. I haven't researched this yet, so if anybody has had one, or knows much about them, please share.

After all his scraping and carrying on, I don't think my leg looks any better at all. I think it looks worse, to be honest. But here is what it looks like today. Again, if you are squeamish, do NOT click the link below.

Click here to see what my leg looked like on April 21st

So, that's my update for those of you (and there have been quite a few) who have asked how my leg is.