WOW.

So I actually DO have a reason for having neglected this blog so thoroughly.

Starting mid-September, my leg (the one that had the graft in May of 2010) started hurting more than usual, and getting more warm and swollen.  I had xrays and blood tests and even a bone scan.  Nothing indicated an infection of the bone, but nothing was entirely "normal" either.  We were in the middle of investigating possible causes, while I fought increasing pain.  The following bullet list is a short summary of what transpired after the bone scan.

• Sunday, 10/30/2011
  At some point before this, I acquired a small, innocuous looking scratch on my graft, close to the edge that is stuck to the front of my tibia.  It didn't hurt, didn't look infected, didn't cause a fever... and I have no idea where or when or how I got it, because I can't FEEL the skin where the graft is.  Not sharp pain, that is.  I can feel pressure, sure, and heat, but no sharp sensations.  On Sunday, Derek and I noted and commented on the scratch and what appeared to be a bruise beneath it.  Just a little pink, and a little warm.  I already had an appointment scheduled for Monday, to discuss pain control options.

• Monday, 10/31/2011
  By Monday morning, my shin was huge and hot and red, I felt like I'd been run over by a Mac Truck, I had a fever, and was genuinely sick.  Sick enough that after drawing cultures and other labs, my doctor tucked me into an ambulance and sent me away to the City.  By this point, every breath made my leg feel like it was being smashed.  I was in tears, shaking and sweating.  I will pause here to say this:  Whoever decided that paramedics can start IV's and administer Fentanyl at their discretion... they are something along the lines of "hero" to me.
  
  We got to the Hospital, and I was taken straight to a room.  NO ER, no triage, nothing.  Just up to a room.  More cultures were drawn, another IV line was started, and a circle was drawn on my leg marking the edges of the red, swollen, hot skin.  I was then sent for an X-Ray, which I assumed would come back normal - the last one had.  But no, it did NOT.  It showed fluid and air building up in the deeper tissues, indicative of a fast-moving infection.
  
  Then I met my surgeon, Dr. J.  I had him and his resident assigned to me, another surgeon, Dr. A, as well as Dr. M, Dr. C, Dr. M and Dr. F, plus their interns.  It was a herd.  I wish it could have all been done by just one person.  Less intrusive that way.
  
  7:30 that night I was in surgery.  The operation went fast.  They didn't have to remove anything terribly important, and left the incision (about 6 inches long) open and packed.  I woke up in recover at about 9:00 and I swear, I had NEVER been so miserable in my life.  My temp was up over 104, I was pouring sweat, covered in goosebumps, shivering so hard it was more like convulsions, crying so hard, throwing up, and my leg felt like a combination of fire and being crushed, more intensely than I could comprehend.  It was almost midnight before I was in good enough shape to see my hubby.  They said I was septic, and that's why I was so miserable.  I had a great night nurse who kept my double room just for me, and took care of me so well.  Next morning my roommate arrived and I could. not. do. it.
  
  I don't like PTSD.  I don't like that an other's simple presence when I'm not feeling well or perceive that I am vulnerable, is enough to send me into full-on flashbacks and panic attacks and terror and my brain goes into lock down mode.  There is no reasoning to make it stop, there's no gentle tones or persuasive words.  I spazz out in a world-class manner.  So my good ol' nurse got me moved to a private room in a different unit.  The staff THERE were great too.

• Tuesday, 11/1/2011Tuesday morning, I found out that I was now on Vancomyacin, Rocephin, merepenem, and flagyl.  And I got my PCA pump.  Oh that wonderful device with the stupid nose flap.  Hospital brought me in a laptop to use... mostly it just sat there playing music or shows off of Hulu.    That afternoon, I went back into surgery for more debridement and dressing change.  Late that night, I was taken to a procedure room and sedated for a dressing change.

• Wednesday, 11/2/2011 I continued to complain of pain on the inside of my shin bone - not where the abscess was.  And in my ankle.  It kept getting dismissed.  Temp was staying mostly normal.  They told us the organism was susceptible to the meds I was getting (e. Coli - and NO, I don't know how anyone gets e. coli in their leg, but apparently it's not as far fetched as I thought).  I pointed out a second area of possible infection.  They agreed.
  
  They wanted to unpack, debride, use pressurized water to cleans, and then repack my wound.  And I flipped again.  NO WAY.  Not with me awake!!!  They ran around and around with me about it, until Dr. J finally asked what the real problem was.  I explained the flashback it was conjuring.  And from then forward, it was sleep-city.

• Thursday, 11/3/2011 Thursday morning, I went to a procedure room and was given conscious sedation for my dressing change.  I kept complaining about the area near my tibia that hurt, so they ordered an ultrasound to look for free fluid... and boy howdy, did they find it.  Nice little abscess under the skin but mostly fluid buildup around the bone.  The took me to the OR, knocked me out completely, did a needle aspiration on the new abscess and tried to get the deeper fluid, and then aggressively cleaned the initial incision and performed a delayed closure.  They left a lot of drain tubing in place.

• Friday, 11/4/2011 Was still on the Fentanyl PCA.  Dr. M wanted me to go home... I knew I wasn't ready.  Dr. F, from infectious disease made a plan with my husband - I would go 24 hours with IV fluids but all meds would be oral, unless things escalated, before I would be allowed home.  Surgery liked the plan, but said we should wait till Sunday, so they could pull the drain before I left.  So we left THAT as our plan.

• Saturday, 11/5/2011 1/2 of the drain was removed.  I was taught how to do my own dressing changes, shown what to watch for.  There was some iffy blood work, but they decided it was contaminated by skin, not by actual blood-borne pathogens.  I was off the PCA.  Miserable, but off the pump and ready to go.

• Sunday, 11/6/2011 Sunday, they pulled the rest of the drain, said what to watch for, how to care for things.  At that time, a secondary abscess just medial of my tibia was noted.  It was felt to be small enough that antibiotics alone would address the problem.  After much waiting around, I got to LEAVE.  To go to MY HOME.

• Monday, 11/7/2011 I did my dressing change as ordered - I even filmed it for documentation. The rest of the day, I spent sleeping.

• Tuesday, 11/8/2011
  Because I was uncomfortable waiting a week to see my surgeon for a recheck, my family doc agreed to take a look.  He did so, and called the surgeon.  They had me go NPO immediately in preparation for seeing the surgeon on Wednesday.
  
  Unfortunately, that night, I took a shower.  My first since the surgery.  They had finally given permission and it felt SO SOOO GOOD.  A sponge bath just can't even compare.  About 7:50 PM I was all relaxed and sleepy and fell asleep on the couch.  I woke up screaming at the TOP of my lungs at 8:05.  My head was the WORST pain I can imagine.  Searing and pressure and throbbing with my heart beat and made worse by sound and light and trying to lay flat and turning my head or moving or coughing or talking.I was screaming too much to call 911, and my husband was at work.  They got there though.  I rode lights and sirens (and lots of IV meds pushed and some crazy EKG monitors - finally a nicely documented run of SVT). 
  
  Doctors started talking meningitis, encephalitis, and big scary bad words.
  
  They still don't know what caused it.  Spinal fluid came back indicative of SOMETHING, but non-specific.  CT didn't show any large abnormalities.  So I got me a room with a room mate and the pain and the PTSD fed off each other until they ended up moving me up to the cardio floor, into the only private room left in the hospital. 
  
  They had me on Vanc, Rocephin, and Merepenim.  They switched the Rocephin to Timentin, and the merepenim to Erdepenim.  They also added in Acyclovir.  I had to have two lines again, because the meds couldn't mix together outside the body.

• Wednesday, 11/9/2011
  Finally, things under control enough that I SLEPT.  And SLEPT.  And then SLEPT some more.

• Thursday, 11/10/2011 Home sweet home.

• Wednesday, 11/16/2011 Recheck with the surgeon.  He informed me I needed my secondary abscess drained.  He recommended a standard I&D, under anesthesia.  I consented, and planned for Thursday to be a nightmare.

• Thursday, 11/17/2011 So much for a nightmare.  The day went well.  Operation was really fast and smooth, recovery was smooth, they are hopeful that maybe this could be my last trip to the OR for this problem.
   
• The weekend went well, but the defect was growing worse.  And today, my surgeon has prescribed honey.  Like from bees.  That's what I put in the wound.  I thought he was crazy.  But it turns out it's more widely known than I thought.

So THAT, is where I've been.  If folks have an interest, I'll put together a picture tour similar to what I did with my hand for you all that time.  But right now?  I am going to SLEEP.

Chronology of an Owie

In pictures, here is what my hand has done over the last three weeks.  This is all the result of having blood drawn from one of the veins in my hand for a routine test.  It formed a clot and for whatever reason, the clot didn't dissolve.  Over time, the bacteria introduced by the blood draw multiplied and formed an abcess inside the vein.  They then spread to surrounding tissue, including my skin.  Officially, it is septic thrombophlebitis.  The two pictures that are NOT of my hand mark the start of each hospitalization.  One showing the three IV bags and PCA meds I had, one showing the goofiness of my doctor and his and my mutual friend. 

The pictures are low quality because they are all from my cell phone.

This post is brought to you in response to some requests I've gotten.

Wow.

Sorry to have left you all hanging.

I stayed home from the hospital for ALMOST 36 hours.  Almost.

When I was readmitted, my temp had gone from 96.8 when I was discharged to 103.9 when I showed up back in the emergency room.  Seven degrees doesn't matter much in weather but inside a human body, it's a really big deal.  Hot stuff. 

Okay, that was across the lame line.  But it made you either smirk or groan, right?

Reality is, I first mentioned my hand to a nurse at the end of December.  I had the fertility doctor check it on January 5th.

I made my first trip to urgent care on January 12th.  No labs were drawn and the only advice was "use lots of heat.  If it weren't for your leg, I'd say this wasn't infected at all.  But it looks similar to how that did, so I'm going to prescribe this particular antibiotic for you for seven days."  I dutifully soaked my hand many times a day, making sure to move it and use it and get it good and toasty.

Nine days later, on the 21st, I was back in the ER with a temp of 100.9 (normally run 96.5-96.8) and my hand looked... rough.  Bad.  Not so good.  Swollen and red and pretty sore.  I had thought I was getting the flu Wednesday night (24 hours after the last dose of antibiotics), and it proceeded to worsen along with the appearance of my hand.  That doctor said that since the first course of antibiotics worked so well (It did?  Really?  How'd I miss that?) he thought I must be one of those "rare people where seven days isn't long enough" and he was going to prescribe the exact same medicine, at the exact same dose, but this time for ten days.  He said that if the heat helped, I should continue it but it didn't really matter.

My husband and I both felt very uncomfortable with the hasty exam (more just a glance than actual exam), the lack of blood work, and the lack of follow up.  Especially since at that point my hand was acting exactly the same as my leg did last year - and the doctor was acting exactly the same as the doctors did last year.  We kept insisting we were uncomfortable and the doctor got more and more irritated, until he finally offered a referral to the wound clinic.  We knew that the 48 hours until I'd be able to see them (if seen immediately) could see things go south really quickly, but at least we also knew that the wound clinic is home to a bunch of very smart, talented, experienced infectious disease doctors and surgeons.

Wound clinic called Monday morning, offering me an appointment less than 30 minutes later.  It's a 40 minute trip in this weather, minimum.  I asked for a later appointment and was put off until the next afternoon.  That night, I did not sleep.  I used heat, I tried ice, I tried compression, I took Advil, I took Zofran, I took Vicodin 7.5 (two of them).  I finally fell asleep at 7:30 A.M.  I slept until noon, and when I woke up I knew I would be admitted.  For what started out as a simple skin infection of the hand, and even Friday night, could have been handled on an outpatient basis if it had been done correctly.  But now my hand was so swollen that it looked fake.  The skin was shiny and tight and deep, dark red.  It was very hot to touch, and I could no longer move my pinkie, ring, or middle fingers.  The pinkie and outside edge of the ring finger were numb.  And I felt generally sick.  Achy, sweats, chills, fever jumping between 99 and 102.9, unable to keep anything down.  I packed some books and clean underwear and socks and a stocking cap along with my favorite pillow, and off I went to the wound clinic.  My appointment was at 2 PM, my blood was drawn and x-rays taken by 2:30, husband got there at 3:00 just in time to watch the orthopedics consult jab an insanely large, thick needle into my hand in an effort to "aspirate" the pus.  By 4:00 I was getting settled into my room and waiting for IV therapy to come get things started.  After five days of high-dose Rocephin and Vancomyacin, with a Fentanyl PCA pump and frequent IV Zofran, I was sent home with Bactrim, Vicodin, Zofran, and Neurontin for the pain in my now-damaged nerves.  I'd been seen by infectious disease, orthopedics, plain internal medicine, neurology, OT and PT, an intensivist, and about a million interns and 500,000 residents. 

I was thrilled to be going home.  Finally, healing and doing well.

I lasted from Saturday afternoon until Monday morning.

When I was readmitted, my hand was blowing back up, I now had no sensation or reflexes below the wrist in my ulnar nerve and limited sensation and reflexes in the others, and my temperature went from 101 when we left home to 103.9 when the admitting nurse took my temperature. 

More Vancomyacin and Rocephin, more Vicodin ans Neurontin, more days on the Fentanyl PCA pump, More Zofran, more doctors, and an operation to remove the abscessed vein (yes, apparently a not-quite-sterile blood draw can lead to the development of not only phlebitis and cellulitis, but also abscesses inside of your veins) and the necrotic (i.e. dead) tissue that was around it, and I was sent home.  After finding out that the infection I was fighting was directly linked with human saliva.  Eeeeewwww.  There is only one person who could have introduced the germs, and that is the technician who drew my blood in December when all of this started.  I was actually asked this past week, by one of the infectious disease doctors, if this infection was self-inflicted.  Um... no flipping way. Besides, how would I have done it?  "Excuse me, Ms. Lab Tech person, before you stab my hand with that needle, would you mind letting me lick it first?"  Seems unlikely.

Now here I am, halfway through February and two months out from the original offending blood draw, and I am struggling hard to stay out of the hospital.  Three admissions might just send me over the deep end.  Well, not so much the admissions... it's the need for the admissions and the fact that this can all be traced to one person and the fact that we aren't ever going to even be apologized to for any of it, plus the fact that I have long-term, likely permanent, damage and loss of function in a previously healthy hand.

I know, I'll let go of the anger and sadness, and I will learn ways of making my hand do what I need it to do, but right now, tonight, I am so very ticked.

Leg Update.

Have had a few people wondering how my leg is doing... so I thought I'd post an update.  I am 5.5 months post-op, and almost 33% of the way through the "active healing" phase.

The graft is doing well, after I split it open a while back.  Other than the scars from that, it looks pretty good.  It's turning colors, and is closer to the color of my regular skin.  There's something going on with one of the muscles in the front of my shin - it hasn't functioned since I bruised and split things. 

Yes, I bumped the contrast a little on this, so you could see the outlines of the muscles.  See that big gap in my shin?  That's not supposed to be there.

It's hard to sit idly by as adhesions form between the graft and the muscle facia, since I know eventually they'll tear free.  Surgeon sais absolutely no efforts are to be made to stretch or break them until after that 18 months, though, so... I watch.  The medial edge of the graft is adhered to my periosteum.  THAT part of it actually really hurts.  Very sensitive to the touch, very uncomfortable if it gets pulled on.

But over all, I am thrilled with how well it is doing.  It is healing, I have TWO functional legs, I am alive.

And as a friend said the other day... it's starting to look like a leg again.  :)

Das Boot.

This is a leg update, just in case you want to quit reading now. 

It's been REALLY sore the last week or so - I think from nerves regenerating.  Or something.  I've been getting some spots of superficial sensation back, but the spatial awareness isn't there at all yet.  Tibial plateau is still very sore and bruises randomly (and often), but I haven't had a fever in over a month.  I've been working out and for the most part, tolerating it pretty well.  By working out I mean doing Martial Arts and pushing as I do.  But over all, in spite of the soreness, I feel like it's been doing really well.

Today, I put some things into a cave for a friend.  Heavy things.  That I was dragging in a big blue toy bucket with one hand, while I used the other hand to hold a rope and walk backwards down a VERY muddy incline.  A very steep, very muddy incline.  And then I climbed up for a second load.  And then climbed up to untie a rope to use down in the cave.  And then climbed out again.  And then built a fire (I'm an excellent fire builder).  At some point, either in dealing with the cave or in breaking up wood for the fire, there was an impact to the back edge of my graft.  It didn't hurt - I never felt it happen.  But now there's a nasty bruise underneath the graft, the muscle compartment is rock-hard, and the skin graft is split in a few places.

SO... I'll be backing off on the physical exercise for a week or two, and wearing BOOT again until the swelling goes down and the muscle softens back up.  It's frustrating, but... it will be okay.

**I am editing this to add a picture?  Why?  Because you guys asked for it.  I'll leave it small for those of you who might be a bit... squeamish.  But this is what it looks like if you happen to have a skin graft wrapped halfway around your leg, and you subsequently happen to bang it into... something.

Are you sure??

On July 23rd, as you may remember, I had surgery.  To "treat" endometriosis.  There was a complication this time - the first time ever - that rendered my bladder defunct.  Or something similar.  Regardless, for 48 hours, it took a lot of work and pain and fluid to get my bladder to give up any of its contents.  ANY of it.  Never mind emptying.  That was entirely out of the question.  I literally begged the nurses to get the doctor to let me go home.  They did.  Not sure how, but they did.  Doctor called the next morning, and was unhappy with the fact that things were not working yet.  I was unhappy too - do you have any idea how much an overly-filled bladder hurts??

Sunday morning, I could barely move, it was so full and so sore.  I didn't really think three hours would make much difference in the grand scheme of bladder-life, so I sent my husband to church.  Asked him to have our Pastor wear a prayer-cloth and bring it home for me.  When my husband got home, I took the cloth, tucked it in my waist band and went back to sleep.  I did so with the expectation that I would wake up and have him take me to the hospital.  Very faith-filled thoughts, huh?

Regardless, I woke up two hours later and my bladder let loose.  It felt amazing.  As in I cannot begin to describe the relief.  I'm not sure how much fluid it takes to change the level of water in a toilette that much.  I do know that when I left the hospital, my final bladder scan showed about 1200 ml's of urine (the max in a healthy bladder is supposed to be between 200 and 600).  They didn't tell us this - I looked it up in my on-line health record.  I also know that there is no way it ever dropped below that.  The tiny amounts I could squeeze out were barely a drop in the bucket. 

All of that... and then the "miraculous urination."  And even with that... I hurt.  Really hurt.  My bladder, which is functioning at half-thickness in many locations after as much endo as could be removed, was.  My uterus, which was stuck to things and covered in endo.  My ovaries, which had worked their way into my peritoneum (abdominal lining) again.  My intestines.  Stomach.  Liver.  These are the things I can distinctly feel.

Why?  Why do we do this instead of choosing to remove my reproductive organs and hit the remaining endo with chemotherapy?  Which could actually let me live the rest of my life with much less pain?  Why are we trying to figure out a way to pay for expensive "reproductive assistance" this winter?  Why do I want to go through the pain that will be involved in conception, the discomfort of pregnancy, hours of labor... when adoption is right there in front of us?  Why am I not terrified of the possibility of my heart going completely nuts while pregnant?  (My chart, by the way, states that I have SVT and AV-Nodal Re-entrant Tachycardia.  Both.  Listed as separate problems.  I guess they still haven't really made up their minds).  Or of scar tissue impeding delivery and requiring a c-section?

A good friend asked this today.  Part of my answer isn't really fit to share here on this blog.  But part of it is.  The part that says... I want the opportunity to be part of that kind of miracle.  The miracle that takes two microscopic pieces of two totally separate people, and out of that, an entirely new person grows.  The miracle that places a soul and a spirit inside that body.  I want to hear the screaming that heralds new life - new life that came from within my womb.  I want to grow impatient, large, and clumsy while this new life grows inside of me.  I want to do this thing, this amazing, entirely unique, miraculous, unparalleled thing that is called giving birth.  I want to add life to this planet I live on.  To contribute.

And this is all just the reasons I want to actually give birth.  There are so many other reasons to be a parent.  Which is a separate post and, at least in my heart, a separate dream.  I mean, yes, giving birth does have a tendency to lead to parenthood... but parenthood can be reached without the birth part.  Well, at least without me doing the birth part. 

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.

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...

Real Post

So, this is really me, in real-time. Not much to report... just stuck here in bed until Sunday. I can get up (with someone holding my leg so it stays above my hips) to go to the bathroom, and that's about it. trying to stay occupied.

Surgery went well, no arterial graft or rpair as he couldn't locate anything to really work with. Muscle fixed/reconstructed, skin graft in place. Giant (I mean GIANT) dressing and a half-cast (splint) that goes from my toes to half way up my thigh.

Struggling big time with some emotional things. My psychiatrist came in today to talk about that, which was good. Doing a bit of changing with my meds.

I have 2 funtional iv ports, wich rocks.

And now I have company. So goof bye.