The end of wound care (with warning)
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.
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.
(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:
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:
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.
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.
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.
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.
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.
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.
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!
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.
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.