Nuthin' going on

As can be seen my ulcer hasn't really changed over the last month. It doesn't hurt so much, just a little bit when i'm taking a shower or changing the bandages. My meds haven't changed. The only thing I've done different is to increase my daily exercise. For exercise I spend about 40 min to an hour walking around my neighborhood or the park.

Ouch

Although my ulcer appears more 'clean' than it has in the past, the actual pain level has been raised. I have been averaging one pill for pain a day, something I have not needed to do for over a year.

After I shower, I keep the wound covered with a Telfa and some gauze. Also evident is the edema that has returned to a small degree. The discoloration is actually scar tissue.

3mm deep

I had a conversation with the doc from Boston. It seems what I need to get done can be completed here in NYC. He has since spoken to my doctors (dermatologist and oncologist) and everybody seems to be on the same page.

Whenever I need to get a refill on a prescription from my dermatologist, I have to go and get my situation reviewed. This includes him saying 'its getting better' or 'its getting worse', a swab of the ulcer to check for infection(s), a measurement and my blood pressure checked. As the pic illustrates, my ulcer hasn't expanded much over the last few months but it has 'deepened'. The pic does a lousy job showing the ulcer's depth. The nurse said it was '3 millimeters deep'. I can't imagine it was too accurate because of the method employed but I can say that at 3mm or whatever, it fuggin hurts. I have some pain pills that i take from time to time just to deal with it. It feels like a super heated wire wrapped around my ankle or a chunk of glass under the skin. When it hurts really bad i can't get anything done. So, i just pop a pill and wait for it to 'go away'.

The new meds that I am supposed to take promise to heal up this leg and allow me to get off the prednisone. We shall see..

flare ups

As I continue to take a smaller dosage of Prednisone, my pyoderma is struggling to return. After a shower a few days ago i noticed that some of my skin 'came off'. this area has been healed up for almost a year. There isn't much I can do. I have put some Neosporin on it and am hoping for the best.

Ho Hum

Its been over a year since my diagnosis of having Multiple Myeloma. Although the amount of cancer in my system is small, it seems it was enough to trigger this Pyoderma.

My ulcer seems to have calmed down a little but unfortunately expanded a tad too. As the pic illustrates the skin surrounding the ulcer seems to just be disappearing. And it is, like slowly burning newsprint.

My Rx hasn't been changed and I have not been in contact with the specialist in Boston yet. I have left a few messages and even spoke to an assistant but have yet received a call. I'm not sure how they stay in business up there..

Boston?

It seems my dermatologist wants me to see a specialist in Boston. When I moved to NYC from Kansas City, I began to be spoiled by having everything within a $15 cab ride. After living here for over ten years I have been conditioned to think 'if it isn't here who needs it'. The only exception I have come up with so far has been Wal-Mart (I know that $5 bucks for a bottle of store brand aspirin is NOT normal).

Now it seems my condition will send me seeking treatment or advice in Boston. They want me to to some type of treatment that will heal up my leg and get me off of the prednisone. My dosage has been reduced which is why some of the ulcer has returned. As one can see the sore has become 'bumpy' and red. The bumps are very soft and 'spongy', not really a source of pain. However the general area is painful, stinging, especially during a shower. This stinging has also awoken me from sleep. I pop a few Tylenol and go back to sleep or at least try to.

I didn't sign up for this bullshit but it seems I'm stuck with it..

Stinging returns

Part of my usual routine is that after I shower I let my leg 'dry out'. Prior to bandaging my leg for the day I cover my ulcer with a topical steroid. If still damp, the steroid lotion wont stick to my skin. I noticed the other day that while i was watching TV waiting for my leg to dry, I began to sense a sting. Over the last few days it has become more so.

unfortunately this pic show that I have some flare ups coming in around the lower edge. This stings. The next time I go to the dermatologist, I'm sure I'll be getting a shot.

A cut on my sore

I'm not sure what I did but I developed a bloody knick, as seen in the pic. I was sitting at my PC doing some work and I noticed that my bandage was red. When this happens I automatically think I'm having a bleed-out. But it wasn't coming past my bandage. A genuine bleed-out would have been trickling down my foot and all over the floor, not a good thing.

After I took the bandages off, I saw that it was only a small thing. I cleaned it with peroxide and applied fresh bandages. No problems since.

I am always paranoid of having a bleed-out while at work or meeting with a client. My suits and stuff are all hand made. I think its important to dress the part, in my case banking. It would be imposable to 'look the part' if I had a river of blood sloshing on my shoe. So far this hasn't happened. It would really suck if it did..

clearing up but a bit of a pain

After a few weeks of the Ultravate and Neosporin the majority of the 'yellow gunk' that was capping my ulcer has gone away. This is an advancement in the 'healing process' but is actually painful, a slight stinging pain.

My Prednisone has been reduced to a 40/0/30 regimen. So I am kinda happy about that. I spent a few days in the pool this week so I wrapped my leg with an Ace bandage, covering my dressing. I'm sure without the Ace, the dressing would have slipped off. Not a good thing.

Power of the Ultravate

For what seems like no reason at all my ulcer started to heal while using Ultravate (cream). For a few months it seemed like I had reached a plateau. Things started healing again with no change in medication. Not sure why..

My dermatologist told me to soak the area with hydrogen peroxide to help remove some of the yellowish gunk. To accomplish this, I put some gauze over the area and soak it with peroxide, letting it set for about ten minutes. It does a good job loosening things up.

Strange advance

After a few months of really no progress and for no reason, my ulcer has begun to shrink and 'dry out'. After changing my gauze, I could see some 'fluid loss' from the ulcer. It was slight but noticeable. Recently I have not seen any 'residue' on my gauze upon removal. Its stone dry. The only thing that I have done different recently is get some sun. I live a few blocks from Central Park (NYC) and I actually got a little 'sun burned', very rare for me. So, other than time under the sun and the drinking of Gatorade, my routine hasn't changed.

I am still taking 40mg of Prednisone every other day. And applying Neosporin and Ultravate to the ulcer.

Still hanging around..

Although I am happy about reducing my Prednisone intake, I have noticed some 'give back' in some of the gains I have experienced. I had hoped that my Prednisone regimen would be over by now but no such luck. Sometimes after a shower portions of the 'white cap' of this ulcer is washed away revealing ordinary sore tissue. I'm not sure why it is there but always comes back after its removal, so something is going on.

Bleed Out

It would seem that I have another skin infection on my lower leg. I had just gotten out of the shower and was dressing when I noticed blood on my bedroom floor. My first thought believe it or not was that someone had broken into my home and was bleeding. However I quickly noticed that it was spraying onto the floor at that very moment, obviously from my leg. And so it was. Painless and without sensation I had 'sprung a leak'. It reminded me of a squirt gun but a constant flow. The amount of blood I lost in that quick moment was unbelievable. I wrapped a t-shirt around my ankle and made an effort about an hour later to bandage it up with gauze and such. When the shirt was removed the squirting started again. The pic shows the gauze used and shirt ruined. I had to cut the bandages off because I had so much tape holding the gauze in place.

After a day and after my shower I removed the dressing and it seems the squirting problem has healed up. I have a MD appointment today so I expect to get another med..

No pain, slight gain

My current reduced regimen of 40mg on and 0mg off (days) has had surprisingly little effect on my ulcer. It does seem to be coming back albeit slowly. The last time i saw my dermatologist he gave me a few shots of cortisone to the area, causing some bloody areas that healed up quickly. These ruddy spots are a result of the needle marks almost two weeks ago. After I shower, I will often leave the area uncovered for a few hrs, drying it out. There is little or no pain.

reduction

I am starting to eliminate taking any Prednisone every other day, 40mg on and 0mg off. As the pic(s) illustrate, some of the ulcer has returned, albeit in a much more mild form. When I shower, I apply Hibiclens (that strange expensive soap in the aqua blue bottle) to the area. It doesn't hurt at all and I know the area is as clean as can be expected. i don't rub or scrub the area because it would cause some bleeding. Its as if my skin is thin, easily damaged.

sleepy days

It may look painful but it doesn't hurt at all. The surrounding shiny skin is all scar tissue. The prednisone and/or the zoloft is making me really sleepy. Some days I feel as though i could sleep all day. Its difficult getting things done or staying on a schedule of any kind when its being interrupted by constant naps.

I do have a really comfy bed and I am a lazy ass but its much more than this. After a good sleep I'll be up for about an hour or so and then I need a nap, probably 2 or 3 hours.

Rx

Every once in a while I get an odd prescription, usually for some type of ointment that is very expensive, $100-$200+ a tube. I also get a coupon of sorts from my Dr's office that allows me to have this medicine with or without insurance being used for about $20 bucks. Its obviously a promotion by the pharmacy maker but i'm not so sure why. A 90% off coupon in kind of a big deal.

edema is back, sort of

After a few months of being on Prednisone my leg is still effected by Pyoderma. My doc seems really pleased by the progress even though a plateau has been reached and even a little progress surrendered. My Prednisone has been lowered to 30mg a day which makes me happy but also a little nervous. The side effects of taking Prednisone really suck but the drug really works.

It seems I am supposed to go onto a new treatment in the following months. I'm not sure what it is or what its called but I'll find out soon enough.

This pic may seem a bit 'rough' but my leg is pretty healed up. I have been experiencing a lot of 'weeping' or fluid sheeting from a very localized spot. It looked like i was springing a leak! My doc said it was 'edema fluid'. I had to change my dressing about every three hours as opposed to about every 12+ hrs. Using absorbent dressings as opposed to the Telfas removed some of the tissue on my pyoderma ulcer, hence the reason it looks so red and banged up. It doesn't hurt except for a small stinging once in a while. Not a big deal..

Vitamins

As a going concern i have always taken a multivitamin and always a chewable. I simply cant swallow pills. When I was a kid my dad would scream at me because I wouldn't/couldn't swallow a medication. Well I am past 40 now and I still can't swallow pills. Oh, well..

When I first moved to NYC, fall 1997, my first job was at the Vitamin shoppe. It's still there, 23rd & Park. I worked there for about eight months. The pay sucked but I got an education on supplements. Most of the employees were students but a few were actually doctors (MDs) from other countries unable to practice medicine because they lacked the completion of programs and/or licences that are required to work in the US. I would say that 90% of the supplements that are sold are complete nonsense. And most of the vitamins/etc that you will find at CVS, Duane Reade, Wallgreens and etc are garbage. Oddly though, Wal-Mart carries some of the better brands. As a rule i never scrimp on shoes, bedding or vitamins/drugs.

I was asked by my doctor to add some vitamin D to my daily regimen. The Carlson gems have Omega-3 so i went with that..

Addl pics..

As the weeks roll on and I am taking this lower dose of Prednisone my ulcer seems to be slowly creeping back. I have been using a topical ointment, Ultravate (0.05%). It looks and feels like ordinary Neosporin but it actually does a good job of taming 'hot spots' that erupt on my skin. I just apply a small amount to the affected area twice a day and after a day or two any redness or soreness is gone.

As the pic illustrates, my leg is mostly covered by a scar. The damage to my skin was enough to ruin the hairs on my leg. My legs were generally hairy, nothing crazy, but still 'hairy'. It seems the follicles were removed when my skin was covered by this scar.

A few pics..

Progress as it is..

Here are two different pics of my leg from the other day. The photo effects were added to show what is still an 'ulcer' and what is actually a scar. I have some serious scaring on my leg. Other than ruining my possible career as a runway model for Vilebrequin, it doesn't bother me at all.

My Prednisone has been reduced to 40mg/day and I should be totally off it in the week(s) ahead. It seems my body has been generating the basic side effects of using Prednisone; acne, bulkiness in arms, neck and back, and 'moon face'. My face has gotten chubby. Its as if I am turning Korean!

As I have stated in the past, i have been diagnosed with Multiple Myeloma, cancer of the white blood cells, not a good thing. I'm at a very early 'stage 1', so early that no treatment will be begun until some point in the future, probably a year or so. My 'numbers' are confirmed but very very low. The new drug that i am supposed to take next week is supposed to help treat my Pyoderma but not interfere with any future cancer treatment options.

Progress

Using a little photoshop type magic I have isolated the areas that are still ulcerated. Everything else is healed scar tissue. This is really no pain anymore but it does sting during a shower.

High Blood Pressure

My pressure is usually about 125/75. Since i've been taking the prednisone it has made my blood pressure really rise. because of this situation I have also been taking Lisinopril, 20mg/day. Even taking the blood pressure pill, I seem to still suffer from high pressure. i will prob increase the dosage or move on to another medication.

If you need to watch your blood pressure, this Omron machine is great. One button operation and easy to fit into luggage. I got it on Amazon.com for about $50 bucks. Heck of a deal..

Hair regrowth?

It seems that one of the side effects of Prednisone is hair growth. I noticed about a month ago while shaving that I had hair or stubble on the side of my head, the temple area. I never had hair there before.

Also, as the picture illustrates, I have had some hair loss as I've aged but some of it has grown back. After every shower I comb my hair back so I really am familiar with my hairline. The hairs on my temple are small white hairs, tiny. They have grown much larger and turned black. I'm sure when I stop taking the prednisone all of these hairs will fall out...

January progress

This pic was taken a few days ago. I have been reduced on the prednisone to 50mg a day. Due to this reduction some of the ulcer has returned. The left part of my leg is the part that hurts the most. It really stings.

The pinkish area may appear ulcerated but is in fact scar tissue. It seems that I will have this scar for freeking ever. Well at least until the cancer gets me.

Neosporin

I've been reduced to taking 50mg of Prednisone and using some ointments on what ulcer remains on my leg. The Prednisone I've been taking for about three months and it has cause some side effects, acne on my chest, puffyness around my face and eyes. I don't want to take it anymore but am forced to. Without it my leg will no doubt flare up again. I don't want to go through that painful nonsense again.

Living in NYC sucks if you are trying to save money. Neosporin (1oz) costs about $10 per a tube, CVS brand $8 bucks. Wal-Mart sells a box of two 1oz tubes for $4 bucks! The problem is that all the hippies, commies and econ flunkies refuse to let Wal-Marts exist in Manhattan. For some reason K-Mart is fine though? Anyway whenever I come back to the city, I always try to hit a Wal-Mart before coming back. One can save a fortune.