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Joining the herd

The PolyBlog
April 25 2021

As of today, we have completed 1/6 of our household steps towards vaccinated immunity. With the recent drop in age for the AZ vaccine, my GP’s office had sent out a broadcast email to patients over 40 to say “Come and get it!”, like ringing a dinner bell. But my profile isn’t completely typical, so after reading a bunch of stuff online, I reached out to my GP to check on whether the AZ vaccine was right for me and that my curation had been correct.

Efficacy concerns

Generally speaking, of course, the recommendation is to go with availability over efficacy rates. Currently, the Pfizer and Moderna vaccines are about rated to 90-95% efficacy, while AZ was down at 70%. Those are the initial efficacy rates against contraction, but all three of course are almost 100% effective against serious illness leading to hospitalization or death. In other words, even if you get sick after that initial efficacy number, your second number is generally 100%.

So what’s the issue?

I’m on the cusp of pre-diabetic / diabetic. When the three available vaccines were tested, they had very few people in the sample group with diabetes, and when they did, they usually weren’t separated out between Type 2 (controlled with lifestyle or medication) or Type 1 (requiring insulin shots). I would be near to the Type 2 category.

For the results they DO have, the numbers drop for efficacy — anywhere from 15-25% lower than that of the general population. Again, though, that’s the efficacy rate against contraction. Very few of the studies reported had reliable reporting on the secondary efficacy, but it LOOKED like 100%.

Yet you can only get one vaccine type, and I was reasonably sure I was good to go with the AZ one, but as I said, I wanted to be sure. I booked my appointment and then reached out to the GP for a quick consult before getting it.

My questions broke down into three steps:

a. As a near type 2 patient, was there anything that suggested I should wait for Pfizer over AZ? Was there anything with my health that said “wait”? As expected, and as hoped, she confirmed that the second efficacy number is close to 100% still for AZ for diabetics, and thus, yes, availability is more important than initial efficacy.

b. My household has an atypical profile with all three of us in the house having higher-risk profiles individually. Did that change anything in the calculation? I was mostly worried that I could still contract it with the lower rate and transmit it to them. But “some” immunity faster is still better than efficacy rates, as expected and hoped. It might even strengthen the rationale, although it is a double-edged sword, of course.

c. The last question was one I found no information about anywhere…some disease profiles suggest that the person should NOT wait 4m for the second dose but should get it sooner rather than later. Certain auto-immune diseases for example are being recommended to get Dose #2 as soon as possible. While AZ is being rolled out for dose #1 now, and the second in 4m, I wanted to know if anything in my personal or household profile changed that calculation. Put bluntly, if I could get Dose #1 of AZ now but Dose #2 wasn’t available for 4m, but I could wait a month for Pfizer but get 2 doses a couple of weeks apart, then waiting might get me “completed” for dose #2 faster. Diabetes didn’t seem an obvious candidate to avoid the waiting period, but as I said, you can only get one dose. I didn’t want to find out after the fact that I should have gone another route.

In the end, I was all clear. I was expecting to be, sure, but I did want to be sure. It’s too important to rely on Dr. Google for this one.

The shot

I confess, I don’t often think of it as a shot. Sure, I say “flu shot” like everyone else, and my “COVID shot”, but I would never use it as a verb. A couple of friends posted about being shot and I was like, “Huh?”. Because for me, it is very clearly a stabbing. 🙂

I booked the appointment through my GP’s online site and was relatively shocked to see that they had Sunday appointments available. I didn’t click as soon as I got the first notice, I wanted to check a few things, but I was able to book on Thursday for Sunday’s schedule. Pretty quick overall.

I arrived, parked in the lot next door (free on weekends!), and entered the hospital (the clinic is in the first floor of a LT care facility). A security person directed me to a COVID screening form, a receptionist checked me in and gave me a new mask, a nice escort took me to an available nurse in one of the examining rooms, and it was on like Donkey Kong.

Cathy, the nurse, did a simple run-through of who I was, checked my contact info so I could get receipts and follow-up notifications, screened me for a bunch of Qs again about reactions or likely reactions to a vaccine, confirmed a few details about the vaccine itself (where I was like, huh? Oh right, yes, she should tell me what she’s injecting, I suppose). Small needle, go to the waiting room for 15 minutes.

While I was in the waiting room, I got the notification from the scheduling portal for my second dose. They also told me orally that it was assuming they got the vaccine then, and nothing changes to either move it up or back. It’s an administrative booking, basically, more of a reservation than any guarantee that they’ll have a dose available then or that it will take that long.

I killed my 15m and left. About 30m after I got my shot, the Ministry of Health sent me a confirmation email as my immunization record.

My mental / emotional reaction

I said to Andrea and Jacob that I might cry when I got it. So much stress, and here’s a small light at the end of the tunnel. And as I walked towards the hospital, I did feel quite emotional. All the way through it? Nada. Just process.

When I left the building, I let the experience flow into me, and while I felt like I *could* react more for a release, I wasn’t feeling like I needed it. I was fine. Ho hum even.

I found it a bit odd, actually. I wanted to ring a bell, smash a pinata, get doused in confetti, have someone solemnly say, “I now pronounce you vaccinated”.

But ten minutes after I left, I was back in my ongoing mindset. The NY Times had a great article this past week about the new term for those who are stuck between normalcy and not-quite-depression — it’s called languishing. And it almost precisely captures what I have been feeling for the last two months as I recovered from my leg wound and rebuilding my website.

Now that I’m done the rebuild, I feel almost out of sorts. There’s no fanfare for finishing THAT either. I feel like there should be a reward for myself, some milestone to celebrate somehow, and yet here is perhaps one of the biggest milestones of the last 14m, and I was already past it and thinking, “Hmm, what’s for dinner?”.

Right up until Andrea hugged me at home. Then I lost it. I could probably lose it again right now, while I am writing this, if I let myself. The built-up energy, the tension in my heart and mind. Yet it isn’t honestly about me, not really. Sure, I’m scared like everyone else, and with my health, there’s a good chance that long-term ventilator use would not end well if I was hospitalized.

But my biggest worry is about Jacob and Andrea. I am their biggest vector. Jacob has almost no other vectors BESIDES me, actually. And the thought of my getting sick and exposing them, or leaving them without my support, is scary AF.

The journey isn’t over

Earlier today, I received my feed from GoComics.com and I loved the post by Tim Campbell (here). In the comic, it shows a person running a race and crossing under a banner held up by two vaccine needles. The caption reads, “Keep Going. This is not a finish line.”.

And it’s not, in oh so many ways. But let’s cut it to two.

First, the obvious one, just because I have a single dose, or even if I had a double dose, I still have to keep social distancing and wearing a mask. It doesn’t change my life until we get closer to herd immunity.

Second, the bigger issue? It’s one dose of six that my household needs. I need another dose of course. Plus Andrea is consulting with one of her doctors on her best way forward, similar to my discussion above. In the meantime, she’ll take whoever offers her an appointment first, and she’s registered multiple places. With 2 doses needed for her.

But Jacob is turning 12 in May, and probably by the fall / early winter, there will be options for people down to the age of 12. I chatted with him recently about how he feels about it, and while he has no strong views about the vaccine or not, the abstract doesn’t really resonate with him vs. the practical issues of going to school or being virtual. The bigger issue for him is that he doesn’t like needles. I told him he needs to get comfortable with the idea because I don’t know of too many reasons we wouldn’t do the vaccine for him if it’s generally available. 🙂 Maybe he can race his cousins although a couple of them might have a leg up, having a doc for a mom. 🙂

So where does that leave me? A tad bit more hopeful than I was this morning. I’m still languishing.

But I’m at least languishing with a small hole in my left arm. I’ve taken my step towards joining the herd.

Posted in Health and Spiritualism | Tagged Covid, health, mental health, vaccine | Leave a reply

The end of wound care (with warning)

The PolyBlog
April 24 2021

For those who are friends with me on FaceBook, you’ll know that since mid-January, I’ve had an ongoing issue with one of my legs. An open wound that wasn’t healing. It’s a long, torturous saga, and I’ve been torn (literally, hah!) about how to talk about it in a way that makes sense to other people, because it wasn’t a “small thing”. In many ways, it likely seems like it. And it started that way. But I didn’t want to share ugly photos on FB that people would see and immediately say, “Ewwww, why would share THAT? That’s gross!”. Because it IS gross in some places.

So this is the big warning — some of the photos are raw portrayals of the actual wound. Not exactly “bloody” or gory, but not something you want to view before dinner or share with Grandma. If you don’t want to risk seeing that, DON’T SCROLL FURTHER.

Let’s start with a bit of simple context

I’m overweight. And pre-diabetic (depending on my latest A1C numbers, sometimes I am closer or not at all). Regardless, big, diabetic-ish, and as per both, I have problems with liquid pooling in my legs. They swell, and then I sleep, they drain, it starts again. Gravity is not my friend in these things, or many others for that matter.

I have scars on both legs on my shins. A well-spent youth, shall we say. Nothing scary, nothing worrisome, just old childhood scars. On my right leg, it’s a bit more of an issue than the left, but that’s through usage.

If I go to block a soccer ball, or catch a closing door, or some wood slides and is going to bang against my leg, it is ALWAYS my right leg that goes forward. Almost NEVER my left. Right at the exact same height on my right leg is where I catch the dishwasher if it’s open and I move too close too it as I go around, or the corner of the car door if I have my hands full and trying to use my body to close it. Over the last few years, some of the scars have swelled up at times. Or at least I thought that was what was happening. They’d swell, like a blister, and go away or pop and leak water, heal, all good. It happens, it’s annoying, but generally no biggie.

Over the last year though, I’ve done way less walking around than I used to when I was commuting to work, so the swelling is a bit worse, and at the time of the “incident”, my right leg had a couple of blisters. I thought it was just the scars, but in retrospect, it was PROBABLY blisters / leg ulcers due to veinous insufficiency (the fluid doesn’t drain as well as it used to, and if you don’t move around as much / walk as much, then the calf muscle doesn’t get around to pumping it back up).

So what was the “incident” and why do I keep referring to it that way? Because it was really innocuous. Benign. Simple. It wasn’t a trauma, no war injury. I am not exactly sure of the date because it WAS so minor. Late October / early November, I guess.

I was going to bed late one night, it was dark in the bedroom, and as I went by a laundry basket on the floor, I caught my shin on the edge of the rim. It hurt, sure, but it wasn’t OMG, I’M GOING TO DIE or anything. It was “nothing”. I did an intake of breath, cursed under it, and went to bed.

When I woke up in the morning, I realized I’d actually broken the skin. It tore the “blister” and a bunch of water leaked out. So I had a bit of blood, and a spoonful of water or so probably, but well, not much more than a 100 other scratches you would get in the garden.

It was no big deal.

Until it was “something”

Fast forward to January, it had more or less healed, didn’t really think much about it. A couple more times it leaked in November and December, but well, there was no blood. I’d clean it up, have a shower, get on with my day. I wasn’t really worried about it, it was just annoying.

But in the third week of January, it started to hurt. The blister also seemed bigger. But it didn’t seem like a major cause for concern. I took a photo just so I could see it better.

Pre infection - Jan 18

It didn’t scream “giant problem about to take over your life”, but it was sore, maybe infected, so I called my GP. Of course, it’s a pandemic, so going to a GP isn’t my idea of a good time if I can avoid it, but saying the words “potential infection” moved me to the top of the list. By the time I saw them that week, it had, umm, progressed and was clearly now infected.

Infection - Jan 21 Last appt - Jan 22

(the first photo is taken upside down from above, and the lighting is off, it wasn’t that red, but the infection part is relatively clear). I did 10d of antibiotics, plus they cleaned and dressed it, and then the GP referred me to the Local Health Integration Network for ongoing wound care. They deal with a lot of post-surgical follow-up so people don’t have to go to hospitals to do it, they have multiple companies and offices all over the city, and wonders of wonders, one just two blocks from my house. Awesome.

Round 1 of wound care

So I started wound care. Basically what this means is that they would see me every two days. I would go in, and we’d start with some general COVID screening questions (a light screening since many of the patients coming in ARE running fevers, so they have to see more “is this normal fever or something else?” and really mostly seeing if anything changed in the last two days). I wouldn’t say it felt as “formally safe” as going to places like massage therapists or chiro or even a hospital where you have to fill out a full form everytime, but they run fairly efficiently, so I never waited more than a minute or so in the waiting room to go in, where it was just me and the nurse in a repeatedly sterilized room.

For wound care, they remove all the old bandages and stuff, check to see how much drainage there was and what colour, they clean the wound with saline, and then start “debriding it” which scrapes off any of the dead skin that is preventing / blocking healing. Yep, that sounds about as much fun as it is. Anyway, after it’s clean and debrided, they put a layer of “something” to fight infection / draw stuff out of the wound, a layer of bandage to capture any drainage, and then a layer of compression to force any liquid out of the leg and improve healing.

Given my weight and diabetes, and the original ulcer-like blistering, all tied to the swelling of fluids, I was in compression for the right leg. Note that you can use custom wraps, put a compression “tube” on, use generic over-the-counter compression socks, or get custom-fitted compression socks. I call them geezer gaiters/garters, but all four options are rated by pressure in “mm of mercury” similar to blood pressure.

The rating for commercial over-the-counter stuff is often 10-20 mmHg, and I had tried those once before back in about 2016 or so. I didn’t find them terribly useful, didn’t seem to do anything, and since they were also hot, scratchy and uncomfortable, I only lasted a few weeks before ditching them. This time around, it wasn’t optional.

It also has to be “uniform” to promote healing, and the best way to do that is a custom wrap. Like a mummy up to the knee. So every two days, they’d give me a new anti-infection layer, a bandage layer and a compression layer. The tension of the wrap establishes the level of compression, and therapeutic use is generally 20-40, with a good starting point of 20-30 mmHg. So that’s what we did.

Every two days, regardless of the day of the week, I would go over and get everything changed. The first two weeks went well enough, a bit of pain here and there, but the antibiotics seemed to work, compression was going okay, I was working on longer-term custom socks (I’ll come back to that in a minute). Things were progressing.

After two weeks, it looked like this:

20d later - Feb 8

Really, I was only having three issues. The first was easy — going every two days and doing the debriding was a little irksome. But no real choice, and oddly enough, I think the regular human contact was probably a good thing in retrospect. Second — showering was REALLY annoying. You can’t take the wrap and bandages off, so I had to get a little shower bag thingie to cover my lower leg while I showered. Not very satisfying, but no biggie.

But the third issue was my mental health. I can manage my health well enough for my physical stuff, being obese and diabetic-ish. It’s taken its toll over the years, but I make progress when I do what I’m supposed to do, and I don’t when I don’t. Not the happiest of subjects for me, not a great success story, but I know all aspects of it. Yet here was something I couldn’t avoid/control/manage.

I suck at chronic physical pain. I can handle stress, emotional stuff, intellectual blowouts, I know how to adapt, manage, evade, control, etc. But physical? It’s my weakest area. And I’ve always known that. It’s my greatest fear about getting old, or even falling now and injuring a knee. This wasn’t my knee, so I could still walk around, but I have to wear compression socks generally for the rest of my life. Which I’m going to be embarrassed to do, for example, at a resort or at the cottage. So will I be able to be out in public in shorts? I already tend to wear a t-shirt in swimming (a rash guard for avoiding sunburn, hah!) but how am I going to be with compression socks on? Will I do what I expect I’m likely to do and just wear pants until I’m about to go in the water and come out, put on the socks, and then cover everything up? Adjusting to the new reality messed with my head for a few weeks. Yeah, I knew I’d get there mentally, but it messed me up for awhile.

But the rest of it? Relatively manageable.

Okay, I had ONE setback

Most of what was going on was simple adjustments. We tried wrapping to “this” height or “that height”, one felt better than another. Standard adjustments. But I did have one BIG setback.

I mentioned there were 3 layers — anti-infection layer, bandage layer, and a compression layer. We started off with using a silver nitrate type layer for the anti-infection layer. It’s essentially a mesh layer with silver in it that helps fight and draw out infection. Here’s an example from later in my treatment plan of what it looks like going on:

Silver nitrate worked well - April 3

It worked well for me, generally, but after about a week, the one nurse thought the drainage pattern was a bit sub-optimal, so we tried a new tool. It’s an iodine base layer. It goes on like a layer of cloth, all dry, but as the leg warms it up, it turns to a bit of a paste. She felt it might work well on my leg and draw out more infection. There’s no “single” way to fight this stuff, they adapt their choice of tools to how the wound looks, and in her view, it was asking for the iodine layer.

Setback -- the iodine layer - Jan 29

Now I’ll tell you, we also adjusted the compression that night from 20-30 to 30-40. To help the leg heal faster by draining fluid that attracts trouble, like infection. Great, right?

I had everything done mid-afternoon and shortly after supper, my leg was SCREAMING at me. Really really painful. Up until that point, on a scale of 1-10, the first week it was maybe a 3-4. Occasionally, if I sat too long without raising my leg, I’d get a twinge that would go to 3-4 too. But overall, maybe a 1-2. Nothing to write home about.

By 6:30? My leg was a really irritating 5-6. I had no idea what was going on, and the only thing I could figure out was that the new compression increase was too much. I couldn’t take it. So, despite the fact I’m not SUPPOSED to do this, I had to take it off. Instant relief. It dropped to about a 2-3 again. Still a bit sore, but manageable. And I wasn’t jumping every few minutes. Whew.

Until about 9:00 p.m. When it started again. I was going crazy, it was like someone was constantly stabbing me with a pin. Fine for about 30s and then another stab. Two minutes, settling down, okay, then stab, stab, stab. WTF?

I had to see what was going on. So I took the bandage off with Andrea’s help and the wound looked like the photo above with the goop on it. It was stinging so much, I had no choice, I had to wash it off. It stopped screaming again, and stayed that way. Sore, sure, but easily manageable with Tylenol or just putting up with it.

So we switched back to the silver nitrate the next day AND figured out that I needed backup bandages at home in case I ran into another problem. I had simple stuff, but nothing that would work well for wound care.

The next couple of weeks were, umm, iterative. 🙂 We would adjust something here or there, make it more comfortable, address my latest pain point so to speak, but it was, overall, progressing.

Time for discharge?

About 6 weeks after we had done everything, I was nearing the end of my time. Basically they don’t do anything if you’re no longer “leaking” i.e. “no discharge from the wound = discharge from wound care”. I was feeling good, able to move around a bit better perhaps too, etc. We took a drive out to the Carp Library to pick up some telescopes for a project I’m working on, I was carrying one out to the car, and I fell.

I was going through the door, my boots kind of rubbed against each other, the little buckles caught on each other, almost like I had tied my shoe laces together, and I went down. Hard. Right on my right shin.

I was freaking out mentally. No, no, no, no, no, this CANNOT be happening. I’m DONE. No, no, no. On top of it, I fell on cement that was covered in that ice melting stuff, the crystals, and it was eating into my knee. Yep, I had ripped part of the pant leg, gashed my leg, drawn blood, and I had potential ice crystal crap on it. Fudgicles was NOT the word that came to mind.

I did realize something though. The compression wrap on my leg? It acted like a shinguard. I had felt NOTHING below the knee. It was intact, no issues at all. It had even protected the knee a bit by absorbing the fall. We finished up, and then I drove home, limped into the house, and had Andrea check the leg. It was not great looking, but very superficial wounds, we thought. I called the wound care people, I went in the next day, no damage. Simple abrasion, very shallow, we’d monitor it, but no setback.

I wanted to cry in relief.

A week later, I was good to go.

Ready for discharge - March 7

It would take a while to heal, and I was having “dry skin issues”, but I was good to go. No more drainage, no more wound care. I was officially discharged.

Woohoo!

Not so fast there, chief

That night, I’m at home, and I notice that my sock is a bit wet. WTF? Why is my SOCK wet? Oh, there’s a small area at the bottom inside of the wound area that is still leaking. Okay, call them the next day, I’m back in wound care until that spot closes. No biggie, this happens all the time. I skipped over mentioning that not too long before we got to week 6, I was changed over to every 3 days instead of every 2, normal for pre-discharge. Anyway, I was back in.

But it was minor, so they don’t even want to see me. I can do it myself at home and come back in a week. They give me a small nitrate for the infection layer, just in case, AND, just for fun, this exciting new bandage.

Dun, dun, dun, I call it the spider bandage.

It’s basically a large bun-like bandage, about 3 inches in diameter, you put it over the area, and then it has about 8 little strips of adhesive going off it like spider legs to adhere it to the leg. All good, easy to work with, I’m fine.

Andrea helps me with wound care after 2d and we switch out the old spider bandage with the new one. She even has to do the saline cleaning, no debriding thank goodness, but we’re good. Takes a bit longer the first time, but it’s easier for her to do it than for me to try. It stings a bit when we take off the old bandage, but well, it’s a bandage. It doesn’t kill me or anything, maybe a little more painful than a bandaid, but it’s 8 strips.

Day 3-4 go okay, it’s a bit sorer than I was expecting, but okay, fine. Another change of bandage, a bit more pain, but I appreciate the help, and I don’t have to go out. All good.

Day 7 is the next change, and well, it doesn’t go as well. It’s sore removing the bandage and my leg is inflamed. It is red, it hurts, and as my GP calls it later, visually striking.

Houston, we have a terrible, terrible problem

I go into wound care, and it is clear I’m in pain AND the wound has gone drastically in the wrong direction. It isn’t clear to me at first how or why, but something is seriously off. The main nurse looks at it, asks what we were doing, asks what was on it, realizes it was the spider bandage and says, “Oh.”

We give the other nurse the benefit of the doubt that my leg has reacted to the adhesive. In fact, fast-forwarding to the end of my diagnostics, what actually happened was that the choice of bandage meant that the adhesive strips were on relatively “new” skin next to the wound. It hadn’t fully healed. So when we took off the bandage, it basically tore the new skin off with it. We work with the “one or the other” possibility for a few weeks, and I’m not chasing blame, just diagnosis as we did with the iodine (“Okay, that doesn’t work for you!”) but eventually one of the doctors tells me it is / was not a reaction to the adhesive, it is very clearly skin tears.

Okay, I’ve held off long enough. This is the scary photo.

Angry and painful - March 18

The good news is that my primary area in the middle is unaffected, but now I have two NEW wounds either side of it. FFS.

And yes, it is painful AF. I am DEFINITELY not discharged, in fact, I’m back not only to square one, but in fact we’ve also past that point and regressed further. I’m now worse off than when I started. There is only one small saving grace.

The new “wounds” are NOT like the previous ones which were deep. These are, relatively speaking, superficial. Sure, I now know what it means for someone to tear a strip off me (hence my original joke at the top about tearing), but well, it might not be as long. I hope.

Nevertheless, the wound care people heavily advise me to go see my GP. Obviously. Which I do. The on-call doctor covering is a long-time GP that I love, not my doctor but he fills in when she’s on vacation, and he did indeed sum it up well. “Well, that certainly is visually striking.”

(Our cousin and friends are doctors who concurred that it was better to be visually striking than medically interesting at least.)

He looks at it, assesses it, confirms continued wound care, and turns me over to the nurse who is new and also covering for the regular nurse. She is a bit older, and practiced nursing in her home country before immigrating to Canada, very nice. But she doesn’t listen to me very well. I don’t know if it’s her bedside manner or a language barrier.

For example, when we were removing the bandages, we got to the bandage layer, which regrettably has had some drainage and thus is stuck to my leg. I’m at week 8 of wound care, and I know that the best way to get it off is with saline to soak it to let it “release”. Which I tell her, she confirms, and then proceeds to rip the bandage off in three strips. Like removing a bandaid, as they say. EXCEPT I’M THERE BECAUSE I HAVE NO F***ING SKIN because the bandages already took it off. I visibly react in pain. “Oh did that hurt?”. Okay, deep breaths.

We get through everything, we go to do the close out, so she cleans and dresses the wound. She doesn’t have silver nitrate (or more accurately, doesn’t know where this office keeps it), so she does a basic bandage which will be fine until the next day with real wound care. But she uses this liquid to clean the wound. I forget the name now, but when it goes on, it practically burns. It is really stinging. She then takes a cloth and proceeds to quickly WIPE DOWN MY LEG AREA OVER THE WOUND. I just about jack-knifed off the table. OMFG. If I wasn’t almost passing out, I would have been screaming at her. I did, in fact, scream a little when she did it. And she suddenly realized that I am in fact in pain and she’s about to get murdered, as she switched to being very careful after that. I got the name of the liquid so that we won’t ever use it again in my wound care, and when I told the wound care people, they were like, “Are you crazy? You can’t use that on a wound. It’s a debriding agent. It probably took off more skin!”. Yeah, so there’s that.

They wanted me to report her, not for punishment but as a learning opportunity, and I thought about it but I’d moved on. Then one of the nurses there called to follow up and I said, “soooo, while we’re on the phone, who do I report this too?” Not for blame, just to let her know, never do that again. They reported it to the nursing manager who did, apparently, use it as a teaching moment.

Whatever. I’m focused on wound care.

Starting to heal - March 28

Wait, I haven’t been to the ER yet, have I?

I’m set up, wound care fixes me the next day, I’m all good. I’m moving forward.

Until the Saturday morning. I wake up, and my leg is SCREAMING at me. A 5-6 level, WTF? Why? What’s going on? It’s been hurting a bit all week, actually, but that’s just normal stuff I think. I do have a MAJOR LEG WOUND after all. It isn’t a paper cut.

But Saturday morning? It’s screaming. If I am vertical longer than about 30s, it starts hurting. If I elevate it, it’s more normal.

Now, of course, all the way through this journey, I’ve been asking, “So what if…” this or that happens, what do I do?

One of the things to watch for is sudden intense pain or spreading pain that might indicate blood clotting. Well, here I am, with very intense pain. I don’t know that I need the ER, but, well, it’s Saturday. And the wound care people said, “If you’re in pain, go to the ER.”. Okay, off I go.

I go in mid-afternoon, finally see someone around 6:30, and then doctor around 7:30. Dr. Carter is his name. Very good, imo, although mostly I spend time evaluating pediatric people, not docs for adults! Anyway, he agrees that it is very visually striking, no signs of infection, but he wants to run a blood test to see if there’s any chance of blood clotting. He warns me that the test often gives a false positive in the sense that a negative result rules out 2-3 things, but a lack of a negative result only means they can’t rule it out, not that it’s positive. If it comes back “non-negative”, then I’ll need an ultrasound.

Great, I love phlebotomy as a practice. (Not). But it goes well, all done. And 20m later he’s back — I’m negative, none of the problems we tested for are what’s going on. No signs of clotting or anything else.

But here’s the thing. I’ve been in the ER for about 4.5h at this point, with a lot of pacing since I couldn’t put my leg up. Which means I used my calf muscles to get the fluid moving out of my leg, and the pain is almost gone too. I can go home, since there’s not much else to do, but I don’t have any real “resolution”.

However, he is concerned about who’s driving my wound-care bus. When I tell him me, he says, “No, I mean someone with a medical degree.”. I had to admit, well, almost nobody. Sure I saw Doctor #1 back in January, Doctor #2 by phone in late February for another round of antibiotics), nurses for ten weeks, and doctor #3 the day before, but well, I guess my main GP was following all of it (which she was, I shouldn’t imply she wasn’t, I just mean I didn’t meet with her because of timing).

None of which was sufficient, and in his view too, it was dragging on. He referred me to the soft tissue clinic at the hospital, and they gave me an appointment for 2w out. In the meantime, I would continue with wound care.

I went home, we adjusted my wound care to go only with the silver nitrates that worked, the 20-30 compression that worked, and a new wrapping technique for the bandage layer that covered more area with less slippage and no tape anywhere on my skin. Okay, 2w and we’d see what happens.

The ER was so much fun the first time

Fast-forward 6 days to Good Friday and I went to bed really late on Thursday night, planning to sleep in. I was digging deep to move my website recover along, and it was about 3:30/4:00 a.m. when I crashed. Normally that would mean sleeping until about 10:30 or so, but at 8:30, I was wide awake with my leg SCREAMING at me again. I was hitting about a 6-7 this time on the 10 point scale, it wasn’t going away, AND on top of it, I couldn’t get it to stop even my elevating my leg. I’d raise it, turn it on the pillow and 30s later, back screaming. No good positions at all anywhere. The only thing that helped was walking.

So off to the ER again. I confess, I debated not going the first time. I mean, let’s be real. What were they going to do? It’s a leg wound; I’m not dying. Better pain meds? It didn’t seem like it was worth it. But I got the blood test done and was referred to the soft tissue clinic. I hadn’t seen them yet, that would be another week, but I had felt that the first visit was worth the 4.5 hours.

And yet here I was again, with no explanation. I took the compression off, no change; I took the bandage off, no change. We had used the best infection layer, the best bandage technique, the best compression. WTF????

So off I went again. The pain went down with all the walking, and after 5h, I saw the doctor. This one was not as, umm, useful. I described it more as what I originally expected. Nothing they COULD do. So she recommended cognitive pain management, although I don’t mean that in a technical sense. I just mean it was more “suck it up buttercup”.

She didn’t think it looked infected, but honestly she was already half-way out the door to talk to some other patient, I guess, with a real problem. She gave me a prescription for antibiotics in case it was infected (up to me to decide in a few days) and a prescription for a topical steroid to reduce inflammation (also up to me to decide if I wanted to use it).

Now I could play Health Gambling. Here are the rules of the game:

  • If you have an infection, then you should take the antibiotics;
  • If you have inflammation, you should use the cream;
  • If you only have inflammation, but guess wrong, the antibiotics will do NOTHING to help the inflammation;
  • If you have infection, but guess wrong, the cream will cause the infection to go CRAZY and get way worse.

Up to me to decide. Great. Where’s that wound care bus driver the first ER doctor wanted?

I talk it over with the wound care nurses after the weekend, and we all agree that it is probably safest to take the antibiotics to eliminate the chance, and then when it’s done, use the cream. Fine. I’m good to go. I have a plan.

Probably the wrong plan

So when I picked up my antibiotics, the pharmacist asked me about the prescription. Because the Rx was for 2x a day. Except that antibiotic is normally ordered for 4x a day. I confirmed she had indeed very clearly said 2x a day, so I went with it. He said it was possible, just unusual, but okay.

Took it for 4.5 days and then went to the soft tissue clinic. I had photos of the whole journey, and this is what my leg looked like at the time.

Just after soft tissue clinic - April 11

The clinic doctor was very clear and immediate with his diagnosis. THIS WAS THE BUS DRIVER WE WERE LOOKING FOR!

So, here’s the run-down:

  • Yes to everything about compression for the long-term except the level. The wound care nurse was pushing me to go for 30-40, he said 20-30 was working, and sufficient based on my left leg, all good;
  • The original problem probably could have been prevented with better initial cleaning, ongoing moisturizing, and compression throughout;
  • The secondary trauma was very clearly skin tears from a bad choice of bandage, not a reaction to the adhesive;
  • No signs of infection and I should stop the prescription immediately AND it should have been four times per day, the 2x was doing nothing but suppressing stuff;
  • I could stop wound care because there was no longer any sign of discharge (the bandage was clear after two days and he poked the wound a LOT, the only one who has oddly enough); and,
  • I had a skin inflammation that did need cream but the original prescription was not a great choice for this (and I hadn’t started it anyway), so he gave me a brand new one (the same one the wound care nurse recommended).

All of which we did in about 10 minutes (albeit it took longer with the resident initially).

Wow, now THAT’s a bus driver who knows the route!

Newly discharged

I went back to the soft tissue clinic today for my two week follow-up. Over the last two weeks, I’ve basically done three things.

First, I’ve used the cream. I was supposed to do it twice a day, 12h apart, but because my sleep schedule has been messed up, it was more like 3x every 2 days. Anyway, it was working.

Second, I’ve been wearing my new custom-fit compression socks, and I’m okay with them. My brain has already adjusted to them for the most part, and since wearing them is no more embarrassing then walking around fat, F*** the universe if they don’t like them if I’m wearing shorts. At least they are reasonably close to my own flesh colour. I’ve also been wearing an extra liner on my right leg just to stop any fabric from rubbing against the wound, and it doesn’t hurt that it adds another 10mmHg to the compression regimen. I’m also a little bit optimistic about the fabric. It is fairly durable, and I’m hoping it will prevent some of those past scratches in the first place when I inevitably bang my leg again.

But you know what else I’ve been doing? Showering.

That is so huge, you have no idea. Since I’m wearing just socks, and have no wraps to protect, I can just have a normal every day shower, no baggie / cast cover on my leg required. It feels like heaven. Sure, I can’t “rub” it with the towel for fear of scraping skin off, but a regular shower? That’s worth it’s weight in gold.

Discharged - April 22/23

The final photo above shows fewer wound issues, reduced swelling, and reduced inflammation. It will still take time for all of it to heal, but I don’t have to use the cream anymore unless I notice something later.

Which leaves me with a healed leg, some good ongoing treatment solutions, some renewed impetus for other health stuff for the future, and regrettably, a small lingering mystery.

What caused the pain to spike which sent me to the ER twice? I have a theory, and it holds up enough to be viable, but no way to know for sure. Both times, I was off work that day. Why is that relevant? Because it means I was up late the night before.

I just averaged an extra 40h a week for six weeks rebuilding my website, and on the Friday night before the first ER visit, I was up to almost three or so. For the second visit for Good Friday? I was up to almost 4 the night before.

Which means I put in two really long days while sitting at my computer for REALLY long periods of time without a lot of movement around to do other things, they weren’t generally days I had wound care so wasn’t out for that, and then at night, I spent almost 7 hours straight at my desk. Without raising my leg or moving around. Because I was “in the zone”.

If I’m right, that being too sedentary the day before led to the pain the next morning, I need to remember that gravity isn’t my friend and to set alarms to move around more.

In the meantime, start the jukebox…”Freedom’s just another word for…” being discharged.

I just need to keep my squirrels under control too. Because every bump on my leg makes me think it’s another potential ulcer and the bus stops at my front door every trip. What I do need to focus on is moisturizing. My feet and legs are REALLY dry right now. I couldn’t handle would care on my own, but this? I think I can manage this one.

Posted in Health and Spiritualism | Tagged health, leg, wound | Leave a reply

Two steps forward, one step back

The PolyBlog
February 13 2021

I’ve posted already about trying to wrap my head around likely wearing compression socks for the rest of my life, etc., but quite frankly, I’m doing more “compartmentalization” of it than anything. I need to get through wound care first.

On the positive side, things seem to have “clarified” as to what was going on with the leg. As I mentioned previously, the area that is affected is an area with a bunch of scars from when I was a kid. Whenever I skinned my knee or scraped a shin, it was likely that leg. I lead with it, I protect the rest of my body with it, I fall more on that one than not. So it got dinged pretty well. One time dirtbiking, I smacked it pretty well with a foot peg on an ATV, and it was a giant black bruise for about a month. Probably should have had that looked at, but didn’t. Shake it off, just a flesh wound, right?

And now, as an adult, my streak continues. If I ding it, it is likely in the same spot. I hit it with the dishwasher door, my car door, or, a few months ago, the side of a laundry basket in the dark. No biggie, except, well, over the last few years with my weight and pre-diabetes stuff, I have swelling in my legs ergo more water, and that area has blistered. I thought it was just blistering on the scars, but now that things have healed mostly, you can see that it is around the scars, certainly, and in the area, most definitely, but in addition to the scars, I have simple blisters here and there. They fill with water, I catch them on something, they break, they leak, they dry out, they annoy me for a few weeks, they heal, the cycle starts again. Except this last time, I scraped a pretty big area and they didn’t heal very well. Partly the excess water, partly my age, partly that I’m not doing as regular a routine for early morning showering and scrubbing for personal hygiene as when I actually ever left the house. Not egregiously so, just not as regularly. Often because my sleep was screwed up, I was up late, I overslept, rushing to start work, no time some mornings for proper cleanse. Slam, bam, rinse you, ma’am? I dunno, there’s probably a rhyme there somewhere. Regardless, call it some form of leg ulcer, and move on.

And this time it got infected. Wound care and compression has helped heal it, and seeing the benefits of the wound care has shown me that this thing was NEVER going to heal on its own. Even without the infection, I’ve had proper care on it with compression for 3 weeks and there is still a small area that is “open”. But it’s working. One giant leap forward, right?

Plus, while I compartmentalized the future for compression socks, I finally got my doctor’s office to forward a prescription for custom-fit socks after two weeks of calling in order for me to now go on Tuesday to get them. Yay. Okay, not really “yay”, just “tick”, it’s moving forward. And I do have a tube compression on the left leg that is removable, which is nice to give me a break at night.

But if progress comes on one front, I normally see backsliding somewhere else. And in this case, it’s not that far away. I took antibiotics for 10d, seemed to fix me up, but this past week, my wound has been a bit sorer than normal. It’s covered, so I can’t monitor it daily, only every 3d, and on Monday they removed a bunch of dead skin around it, so not surprising that when they were done, it was quite red and annoyed. On Thursday, that redness seemed even more pronounced and a bit “wider”. The nurse marked the edges of it with a pen to see if it goes any further by Sunday (my next wound care treatment), but she felt it was a tad warmer than the rest of the area, so I took pics (as I do every visit), and forwarded a series of 6 photos to my family doctor. I then had a phone appointment this afternoon with a resident in the clinic and it was great. She agreed it was prudent to continue the antibiotics just in case, and although I’ve been on them before, it seems like a prudent risk. I don’t know that I would do the same ones again anytime soon, as I’m risking resistance, but once more into the fray. So I have antibiotics for another 14d. If I get flushed, nauseated, pain, shivers, etc. in the next 48h before the antibiotics take hold, I have to go to the ER. Fun times.

Two steps forward, one step back.

Which also means that I’m self-conscious now. Almost like memes about COVID. Wait, I have to watch for shivers? Well, I’m cold right now, what does that mean? Or my wound is giving me a sharp pain right now, what does that mean? Generally, it means I’m sitting in a cold basement AND I need to stretch my leg again that has been in the same position for an hour. Doofus. I’m supposed to stay vigilant, not paranoid.

On the other hand, Jacob and I binge-watched Captain American, Captain Marvel, and Iron Man 2 today, plus started a medium-sized Lego project, so it was a good day overall. Close two compartments, open another, onward!

Posted in Experiences | Tagged health, mental | Leave a reply

Articles I Like: The Pandemic Is Resetting Casual Friendships – The Atlantic

The PolyBlog
February 9 2021

A friend shared an article this week from the Atlantic written by Amanda Mull (The Pandemic Is Resetting Casual Friendships – The Atlantic) about the impact of the pandemic on social ties. The content isn’t revolutionary, cutting-edge, or original, but I really like the way she explains the breakdown. In essence, she uses the standard sociological explanations of people having different types of friendships, acquaintances, etc. radiating out from your “self” and talks about the tier 3 and beyond links that have been severed due to the isolation.

Tier 1 is your immediate social network and would normally include your family and best friends. In short, the ones that you likely included in your “bubble” or “pod”.

Tier 2 is your expanded network of friends, family and all your immediate coworkers. Some people put coworkers in Tier 1 since you see them every day, but one thing the pandemic has made clear is how those coworkers are different from people who are in your pod.

While Tier 1 is still restrictive, it mostly remains “in-person”. People you still see and interact with in-person, albeit in different ways. Tier 2, by contrast, has almost entirely gone digital with Zoom calls. Everyone knows about the impacts on those groups, it’s very clear, no big surprises left there.

Tier 3, by contrast, is the “extended” friends who might not even be considered “friends” in some cases, merely people who are regular acquaintances with whom you are friendly (the “weak ties” of social interactions in your normal in-person day to day life). Mull uses the example of a social group she used to see regularly at a bar to watch football games with, but lots of people have these groups. Trivia friends. Hobby or association friends. Another example from the article is the barista who knows your favorite drink and has it ready for you when you get to the counter. The little added touch that someone a bit distant socially says, “I see you”.

While Mull calls them “casual friends”, I often think of them as almost transactional friendships. For me, some of my best examples coalesce around food service.

When I was away at university out West, and living in residence, we had a small crew who regularly ate together. As we would go through the dining line, we would occasionally chat with the cashiers. We didn’t know them well, but if we were about to line up, we would often move to the line up of the one we knew, if she was working. For me, it was a bit of comfort too. The sense of familiarity. Our conversations never even progressed to names. We just said “hello”, or maybe if the line wasn’t too rushed, maybe we’d talk about the weather, or plans for the weekend. Idle chatter.

Later when I was living out of residence during the summer, and working full-time while most of my school friends had moved back home, I found dinner time a bit lonely. I didn’t want to go home, I wanted a bit of social interaction, and I would frequently go to a local family restaurant where there were about 30 tables, and a small set of waitresses, five or six regulars. While I liked all of them, I would frequently choose to sit in a specific section of one of the waitresses. Sometimes I would even ask to sit in Kat’s section. I didn’t know her well, it was just that we would normally chat for 2-3 minutes while I was ordering. Sometimes it was about law school — her father taught at the university, and she was thinking about trying for it, but she wasn’t sure if it was what she wanted to do. Sometimes it was about books, as I usually had one with me for reading. Or the weather, whatever. I suspect too that her coworkers likely teased her about me, because I would request her section. They likely assumed, incorrectly, that I had a romantic interest in her. I didn’t, I just liked interacting with her. I found her refreshingly lively when I was feeling a bit lonely. One night, our conversation seemed to have a different edge to it, almost like she was leading it somewhere. Since I’m generally dense about women, any thoughts I had at the time were likely to have been erroneous but there seemed to be a different feel to the conversation, including four or five directed comments that seemed to lead to her telling me what time she got off work. I suspected, but had no way of knowing, if she was hinting I should ask her out, which I did not do. Ironically, I would have been happy to have gone for a drink or something as a friend, just to get to know her better, but I wasn’t in a mental place to be dating anyone, if even that was what she was suggesting, if she was suggesting anything at all. I also know the limitations of friendships that start the way they did.

Amanda Mull’s article, though, suggested she does go deeper with her interactions:

Of the dozens of fellow fans and bar employees I’d greet with a hug on a normal fall Saturday, I follow only a handful of them on social media; for most of the others, I know only their first name, if that. But many comforted me through mutual, bone-deep disappointment, or sprayed champagne at me in exhilaration.

I did not, of course, ever greet the serving staff with a hug. Nor was I greeted by the regulars in the bar with a round of “Norm!” when I entered Cheers. And yet, I have had a similar “Cheers” experience of sorts, of being the regular barfly.

When I was still in the office, I would frequently stop by the restaurant downstairs multiple times a week for lunch. Some of that is laziness in that I don’t like heating up leftovers at work, but I do like hot lunches, and some of it is that I like the comfort of people being around without having to interact with them very much.

For work, I would go in, sit at the small bar with about 8 other rotating regulars, and eat my lunch. Usually I was also reading something, news or a book, or working on something from my website sometimes. The “buzz” around me was soothing, like being part of something without being part of something. It’s the same experience most people get in going to a coffee shop. There are people around but you don’t have to interact with them if you don’t want to do so. And if you do, well, most of them will quickly move away from you. 🙂

Anyway, back to work. For my regular visits, I would see 2-3 regulars fairly often, enough that I got to know their names and generally where they work. One is an IT guy named Chris, another was a lawyer. There were others, but they never said much. I’ve had regular conversations with Chris over, say, a five year period. I don’t know his last name, and outside of knowing he’s into Star Trek, most of our conversations were mostly superficial. If he died, I wouldn’t go to his funeral, I didn’t know him that well, but it would make me sad, and I would miss him.

For the workers, there were 2-3 who always had a friendly smile, a warm welcome, maybe an extra dose of fries when something in the kitchen was taking too long. They’d refill my drink faster, they’d stop by to chat, they check in on me. Friendly, sure, and attentive.

But, again, there are two giant factors in those interactions.

First and foremost, and going back to the example out west of the waitress who may or may not of been suggesting I ask her out, the entire relationship is, well, fake. She (and it is often a she) is literally paid to be nice to customers. Is she nicer to me than someone else? Maybe, or maybe she likes bigger tips, or it’s just because I’m low maintenance as a customer. I don’t make inappropriate comments, I don’t freak out if she forgets my drink, I’m not pissed if the kitchen is taking longer than normal. I don’t go for drama, and I don’t create drama. In, eat, get out. I want the noise and buzz around me, not a problem.

Second, and perhaps equally important, there is nothing invested in the relationship. Its nature, aside from being transactional, is also superficial. Who is going to get angsty about a passing comment about the weather? Like most people in casual situations, you don’t openly start conversations with strangers about income, politics or religion. And if there’s a drunk sitting next to you at the bar, they tend to shut up if you ignore them enough. So they are “problem-free” friendships because, generally-speaking, you don’t interact deeply enough for anyone to HAVE a problem.

And yet…

Even if I discount commerce-based friendships as real friendships, I miss them. I stopped in to work back in June to pick some gear up, and top of my list for the visit was to swing by the restaurant to see what was going on. I remember back in March, just as we were debating what was going to happen, the one waitress was asking what we thought would happen. And I said quite openly that I thought we were going to get sent home, and likely for an extended period.

Which of course was devastating news for her. She worked in a restaurant that mainly served people who worked in the building. If the building closed down, she would have no customers; no customers, no work; no work, no hours; no hours, no pay. The restaurant was still open in June, but there were no serving staff, they were let go long before then. It was the owner and a cook, that was it. And I wonder how she’s doing.

When I visited Victoria a couple of years after I was in Ottawa, just back for a visit, I made a special point of going back to the restaurant just to see who was still there. I knew nobody who was working, and it made me sad. More than a lack of connection at the university, more than the loss of friends who had all moved away, I was saddened by the thought that these “fake” commerce-based friends were gone. The sense of comfort of eating there was also gone. It was just food.

While I wish the article delineated between different types of those friendships, I feel the burn of the rest of the losses.

I miss a few coworkers from around work, not ones who are in the same team, but who are part of the broader work environment. Most of them were of the type where if we ran into each other in the hallway, we would stop, step off to the side for a few minutes and just chew the fat for a few minutes. Nothing deep, just catching up on each other’s lives. People who I don’t feel that I know well enough to follow on Facebook unless we were both accidentally on the same friend’s comments list. That would be a step too far, too regular of contact, too personal. True work-only friends. The ones who I will no longer see when I retire, unless I bump into them in a department store.

And I say this even though I’m an analytical introvert. I miss that social connection, however casual it might have been. I don’t necessarily need it at work, it could be through a community group, or a restaurant, or a coffee shop. Maybe an outing for breakfast with other retired people from work (a group I would like to join one day).

But I feel it. And felt it. I would regularly wander around the floor, just going for a walk to stretch my legs and get out of my cubicle. Experts would call it networking, but it wasn’t really intended that way. I would just wander. A DG or two that I knew, I would stop by and say hi. Maybe chat for 5m, just catch up. A director or four or five that I know, one in particular that I’m thinking of who I used to see once a month or so in his office at the end of a day. Just quickly catching up, nothing big. He retired last fall, and I don’t really have a connection to keep interacting with him. Facebook or a Zoom call would be “too personal”, too intrusive. We were drop-by friends, like chatting with a neighbour while walking to the mailbox. Okay, maybe a little more than that, but still, a somewhat contextual or transactional friendship.

And the article is right. We can’t replace those Tier 3 connections with simple digital options. We’ve boosted the FB connections, we have found some communities online, but generally speaking, we haven’t replaced those moments of personal connectivity that was part of our day. Sure, maybe you COULD phone them, but it would be weird to do so, for both of you. It’s why many people lament the loss of church — that WAS their community of Tier 2 and 3 connections, separate from the spiritual component.

I also think sometimes it is the biggest threat to people following isolation protocols and rules. When Tier 1 and 2 are insufficient, people crave Tier 3. Or without Tier 3, they need more Tier 1 and 2 to compensate, and suddenly you have large family get-togethers. Not because they’re disrespecting the rules, but because they feel the need and it helps them rationalize their choices.

Either way, I like the way the article explains it and how it made me think about more things today.

Posted in Learning and Ideas | Tagged friends, health, ideas | Leave a reply

Wound care and failed states in Africa

The PolyBlog
February 8 2021

So last week was a mixed bag for my wound care. On Monday, my legs were itching like crazy, so I took off my compression bandages at lunch just before I had my appointment, had a full shower, and went to my appointment. My wound-care nurse was NOT happy with me. Literally, it was off for about 20 minutes, and in her view, was long enough to completely undo all the compression up to that point. Hence my brain being kicked around that this is my new normal and I’ll never be able to take them off for life. Not completely rational, perhaps, but there it is.

On Wednesday, we changed the bandages, things were looking really good for my small wound / gash on my left leg (we started treating it just in case it got worse), and we increased the compression on my right leg from 20-30 units to 30-40 units of compression. Basically? We used a wrap that squeezes the leg more when it contracts. The goal was to see if I could tolerate it.

I couldn’t. By that night, it had to come off, my leg just hurt too much with the higher compression on. So on Thursday, I called the clinic to see if I could get in. But I never heard back (they’re not sure what happened with the message as they never got it nor is that usual, even though I was coming in Friday anyway, and they felt I should have got a call…me too, to be honest). So on Friday, with only one wrap still on my good leg, I attempted the infamous “shower with garbage bag over it” technique that didn’t work worth a damn. The top seemed pretty sealed, but alas, no, when I got out, there was water pooled in the bag and my toes were soaked. Ergo, if water comes in from above, and reaches my toes, you can bet everything in between was soaked. I cut it all off so I could get the leg dry, and had it rebandaged at my appointment. It was a new nurse, and she didn’t beat me up about having removed it Thursday or Friday, all par for the course, and I was in a pretty subdued “life sucks” mood anyway, so I was likely giving off a “don’t crap on me” vibe.

On the positive side, things were still progressing, the left leg looked healed so no need for any more wound care on that, not really, just the compression bandage. And the right leg? There was still one small area that needed to still close, but the rest was “closed” with new skin having formed. From looking down on the wound from above, i.e., upside-down, the wound looked like a map of Africa and Niger was still an open wound, Algeria and Chad were states in transition, and the rest of the continent was poised for recovery. I had no idea what was happening in a little area near Madagascar, but then again, nobody ever does.

The big news? I could move to three-day care instead of every other day. So Monday, Thursday and then, exciting isn’t it? Valentine’s Day. Maybe I’ll show my leg some love, although after each appointment of scraping and peeling off dead skin or scabs, I already have the red roses covered. My wounds always look very angry with me.

Today was my new appointment, so in I went. The Rx from the doctor’s office for custom socks has still not arrived, so I had to call again. Not a giant deal, but it delays again my referral to the place that will actually do the custom socks in time so that when the wound care is over, I can just use them at home. I phoned around town to try to get proper cast covers for my bandages so I can shower more easily (we used them before for Jacob when he was doing serial casting) but ended up having to buy them online from Amazon. I ordered two, one for each leg, and they’ll be here tomorrow. Great! But then my appointment removed the bandages from my left leg entirely and so now I only need one for my right leg. Grrr…She gave me a tube sock to cover the left leg for now, open-toed, but still doing basic compression (around 10-15 units, over-the-counter grade). And my right leg? Niger is still a war zone, but Algeria and Chad show signs of transitioning to recovery. The Northern coast experienced Tropical Storm Tweezers today to get rid of skin that failed to grow, and that was a new level of fun. My wound showed me the redness of its love again.

So, definite progress, at least physically. Mentally? Not so much.

I’m coming to grips with it a bit, but we were out on the weekend as Andrea wanted to go tobogganing at our friend’s place in Manotick. They even got to try out this Finnish kick-sled that looked like a bit of fun to try. But I couldn’t do any of it. I can’t afford to fall, for one thing, or even bang my leg on something. Plus, I’m wearing bandages that make it hard to even get my regular boots on while having a thin cover on my toes (i.e. VERY cold), and I can’t even put my big warm boots on with the wraps still on. So I had to drop Jacob and Andrea, and go do something else for an hour.

When I’ve missed out on some activity in the past, even if it was semi-health related, there was always a combined “failsafe” for my mental side that the reasons were either at least partly choice (I was choosing for mental health reasons, for example, knowing I COULD do it but it was a bad idea to push myself that way right then) or temporary (my knee was sore from something else, or my back was out and needed chiro), and often a result of having done something else earlier in the week.

This time? It’s not temporary, it’s not choice, and it’s not a result of some trade-off of another activity earlier in the week. Just as with my stupid decision last summer to jump off a dock and almost permanently injure my calves and knees, there’s a degree of disability here that prevents me from doing what I want to do. I really wanted to try the kick-sled. Ironically, I didn’t even have to address the question if I was too heavy for it or might damage it, because it wasn’t even an option to consider, not while protecting my leg from future damage.

I’d like to think that I’ve worked too hard already, although that wording doesn’t feel right. It’s not hard work, it is just time and energy devoted to having my legs wrapped and then sitting. So it is more like I’ve invested too much time in the current healing process to risk a new injury that will set me back.

What will I think a month from now? Will I have some basic compression socks that look okay and I’ll think it’s no big deal? Will I adjust to it like my CPAP machine where I was thinking, “Okay, for the rest of my life, this is my nighttime”? But I know it helps, so I use it every night, no big deal. I’m better with it than without, most of the time. I do, still, occasionally sleep downstairs or take a nap without it. In the right position, I can sleep just fine without it, albeit not sustainably. So I take a break. But if I go to the cottage even for a weekend? I take the machine. I know I’ll sleep like crap without it in another bed. I do the work because the benefits are immediate and I can see them.

Will the benefits of compression socks motivate me somehow? Will I embrace it the same way? Or perhaps it is something that I’ll simply tolerate because I have no choice. Time will tell.

In the meantime, I’m down to one leg wrapped and I can take the sock off my left leg tonight. Progress of a sort.

Posted in Pondside Planner | Tagged health | Leave a reply

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