Edema

My right leg/foot has always been free of any nonsense that I have experienced over the last few years. Without any warning my right foot and leg has exhibited edema, not a good thing. Everything has occurred on my LEFT foot/leg. The thought of "it" spreading to my other leg/foot makes me sick.

My Prednisone was increased last week(120mg/day) in an effort to 'heal up' my ulcer. My face is getting so chubby, a side effect, I joke that I'm turning Korean. Again, NOT a good thing.

Nerve

As can be seen, edema has returned by a small amount. The lower part of the ulcer a short 'french fry' line can be seen. I think it's a nerve because if it is touched or pressed a bolt of pain shoots down my ankle into my foot. This explosion of pain is so great I simply can't put it into words. If you can imagine lightning in a bottle but instead in your foot, you'll get the idea. Thankfully this doesn't happen often.

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.

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..

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..

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.

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.

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.

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.

A few steps forward and one back..

I have been on the Prednisone for a few weeks. My original dosage was 140mg a day and is currently 60mg a day. I have experienced a few side effects such as acne on my neck and forehead and a 'puffyness' around my eyes and face. Also sleepyness of fatigue. When i started taking the prednisone i couldn't sleep. A few hours every few days seemed to be enough. however getting off the drug, reducing my dosage, I have been very sleepy through out my day. After a three hour nap I'll wake up and sit at my computer and then fall asleep in my chair after about 30 minutes. And I'll be napping for about an hour or so before I groggily awaken.

My leg has healed about 85%. The Prednisone has worked out really well for me. However, as my dosage has been reduced, the Pyoderma has returned on two small areas. These areas never really healed but the progress has stopped and actually gone backwards, not a good thing.

Aesop fable ideas

This thing is healing up that much is for sure. Its actually a tad strange slowly realizing that this is gonna' become a really large scar on my leg. In this bizzare patchwork of pink, red and what could be best described as 'gunk' there are areas of healed skin. I wish this would heal faster but everything seems to be running on its own schedule or clock speed. I'm just here for the ride. I take my meds, keep the leg clean and dry and hope for the best.

Before I started my treatment it was very difficult and a real pain in the ass to walk around, get things done, daily activity stuff. Presently I find incredable pleasure in walking the neighborhood, going nowhere in particular, listening to my ipod. I hate sitting around the apartment all day doing nothing except reading, watching TV and 'scratching my balls'. A lazy weekend is great but being forced into it for a few months isn't.

Anyway, i'm trying to come up with some kind unbelivable story to go with my unbelivable scar. Lazer accident in college? Chemical spill at the farm? Road rash? Giant mutant jellyfish attack?

Slow progress

Let there be no doubt that the Prednisone is an effective drug but it is going to take some real time, months in fact, to get my leg healed up. Its hard to actually tell but many spots on the top are actually healed but scared. My dermatologist explained to me that they may be 'scaring to significant scaring'. Oh, well there goes my calf/shin modeling career. I didn't care how bad the scars are gonna turn out. I just want this thing out of my life.

My dermatologist has bumped my dosage back up 20mg/day. So, I'm taking 120mg/day again. 100mg wasn't enough. I was developing new sores and old ones were coming back. Screw that!
It seems my dosage is so high that my immune system is being damped out so I am to also take an powerful antibiotic, Bactrim. People with HIV take this drug to prevent sores, opportunistic infections and death. great..

So my immune system is so fucked up that it is attacking healthy tissue so it needed to be toned down to a level that opens me up to opportunistic bugs that I may come into contact with hence forcing me to take yet another drug that is to do the task my immune system seems not willing or able to undertake.

ugh..!

As I have had my intake of Prednisone reduced the Pyoderma's flareup has slowly crept back onto my leg. Last week the entire wound was smooth around the edges. This morning it looks like a pizza crust around the outside portion. These flared up areas are a source of pain. I find myself taking Tylenol throughout most of the day. I hate taking pills but the discomfort at times is simply unbearable.

The edema is still mostly gone which has afforded me the opportunity to walk around my neighborhood. I went to the park this afternoon (Carl Schurz) and just walked around the UES with a cup of coffee in my hand. Simple but something I wouldn't have been comfortable enough to undertake a few weeks ago due to the pain and the edema.