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.

Closeup detail

Although some of the area looks sore, it isn't. The patches around the side are actually healed. For some reason the higher area of my leg is healing first and the lower part is 'taking it time'.

This odd patchy 'gunk' on my leg doesn't come off at all, even in the shower. It would be too painfull to have the shower directly hit my leg but to have water run down my side or leg doesn't sting so much. It wasn't more than a month or so ago that to endure the stinging pain of a shower was almost unbearable. I like most people love taking a refreshing hot shower. I even got a Speakman! But alas, even the sensation of warm water involved serious stinging, like hot salty oil.

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.

Backtracking

Since I have been on the Prednisone my Pyoderma has cleared up a lot. However my doc has me reducing the dosage over the last week by about 40mg to 100mg a day. Although this seems high, it may not be a high enough dosage. I have noticed, since the dosage reduction, that some of the edges have flared up again. These flareups are a source of stinging pain.

The arrow is pointing to a totally new flareup. It stings and casually bleeds.

Clean up

This picture taken October 13th illustrates by what degree the edges have smoothed out and healed up. I have been using the Telfa bandages along with Mupirocin ointment. It really stings for about fifteen minutes or so after its application but it is effective.

The top part of my Pyoderma looks a bit rough and a sporting a darker red color. This is actually an effect of my bandages sliding off and exposing the higher leg, resulting in some scabbing.

Although it still looks awful the amount of pain and discomfort I had been experiencing has been greatly reduced. At times I feel a single sharpish stinging but its brief and often muted by a few Tylenol.

Slow going

If you think this looks bad, trust me, it fuggin hurts too! At times it feels like a pan of hot grease was poured on my leg, resulting in a shallow but highly stinging pain.

This picture is actually of my lower leg after a good deal of 'cleaning up' and a reduction of swelling and edema after almost two weeks on Prednisone.

The Prednisone has been good for me and my situation, experience of only slight side effects, like insomnia.

A step forward a big step back

I have been on Prednisone for eight days and the results are stunning. The Edema and swelling has almost completely disappeared. The Ulcer is slowly healing and its production of 'yellow fluid' has been very much reduced.

It seems that I was diagnosed with Multiple Myeloma, a blood cancer. So, as my leg heals and I gain full use of it again, I am discussing treatments for my newly diagnosed cancer.

Prednisone has a lot of side effects but I haven't experienced much except sleeplessness.

After two days of treatment

When I awake in the morning I usually find that my foot is at it largest for the day. I have no idea why. This morning and even last night I noticed that the swelling or edema had subsided. Although the Pyoderma hurts like a bitch, the edema was always a source of annoyance. I've had a whole closet of shoes that were unwearable because my left foot couldn't fit or it was too much of a squeeze. I've experienced a tight pair of pants after a weekend of heavy drinking and 'feeding' but a tight shoe?

Treatment II

Its amazing these Prednisone pills. I've only taken it for two days and changes are already apparent. The puffiness or inflammation has toned down a notch or two. And the amount of wetness, that annoying yellowish fluid that my Pyoderma weeps out, has gone down. The other day I had to change my bandages every three or four hours tops because of all this damn fluid. Today I changed a set of bandages after six hours of use and they could have been worn a while longer.

I can hardly wait to see the progress after a few weeks on Prednisone.

Pyoderma growth

Pyoderma can expand at a furious pace which is detailed here. The only thing I can be thankful for is that I have only one Pyoderma ulcer although large and its located in an area I can care for myself. If this was on my back I'd need to get a nurse or if it was on my face I'd be in the hospital.

And yes it fucking hurts as bad as it looks..

Treatment

I've started taking Prednisone, six pills a day. It has a big list of possible side effects. So far I haven't had anything as far as a side effect except maybe a little light headed. I don't plan going anywhere so it shouldn't be an issue.

routine

When I first developed this Pyoderma I experienced a lot of bleeding. As the weeks have dragged on and my lesion has expanded the bleeding has virtually disappeared. I am of course happy about this. Not bleeding is a good thing, I would say. But what has also occurred is the progression of the pyoderma's sheeting or fluid production. I used to change my dressing every six hours or so, but due to so much moisture/wetness being produced, I can't put it off for that long.

My doctor said it was 'edema fluid', whatever the heck that is.. All I know is that because of this 'fluid', I am forced to change my bandages about every three hours.

Due to this fluid situation, I find myself using 'Curity cover sponges' by Kendall (Tyco healthcare). They are super absorbent yet won't stick to my pyoderma. And they are pretty cheap too.

exciting tape..!

Although I am not allergic to latex, I seem to have a reaction to adhesives used on some tapes.

When I had a needle in my hand during my colonoscopy, it was kept secure with a few strips of tape. It took a day or two to get the sticky residue off the back of my hand. And It began to itch, really itch. I scratched my hand for days, making my skin red and puffy in the process.

This 'micropore' tape works great for me. It keeps bandages secure yet its easy to remove. The hair on my leg isn't ganked during tape removal which is a plus.

..custom kitchen, deliveries..

The costs associated with Pyoderma can add up really fast. I live in NYC and the items that I need can't be purchased at Duane Reade or Walgreens. I find myself going to a medical supply store to get the things that I need. The type, size and quantity of what ever I need can usually be found here.

To save money I purchase most of my supplies from online merchants. The price differences can be unbelievable, even more so since I'm forced to pay 'NYC prices'. For example, the Telfa pads that use are about $24 a box at the local spot but less than $13 online. I figure that I go through $35 worth of supplies a week. This is represented by gauze, tapes, wraps, nonstick pads, saline wash and etc. This of course doesn't include any medications that I may be taking.

At the docs

Sitting on the table at my doctor's office. I was expecting to get an injection of something but didn't get anything. The doc is going to put me on a regimen of steroids. I hope they work out..

Ouch

This Pyoderma ulcer on my leg doesn't seem to want to quit growing. I am supposed to start taking some type of steroids orally to help fight this lesion, but I have another test to complete and they don't want me taking anything until after the next exam is completed.

I remember when the bandages covered the entire ulcer but it has continued to expand. The most effective way to measure the extent of growth or expansion is to compare pictures and to note the increasing amounts of gauze or dressings required to dress the area.

Odd side effect

The mixture that I had to consume to clean out my colon prior to my colonoscopy had an effect on the edema in my leg/foot. I was surprised by the edema loss enough to take a picture of it.

I have no idea why this happened but if it happened to me I'm sure its a common occurrence..

Afterwards..

So I had my colonoscopy and oddly enough everything was 'normal'. I was expecting to have Colitis or Crohn's, but in fact had nothing.

The Anesthesiologist hooked me up to a heart monitor and put a needle in my hand. She said that I wasn't going to be 'put out' but would be sleepy during the procedure. It seems when the anesthesiologist said 'sleepy' what she meant was knocked out because I don't remember a thing until i was asked to 'wake up'.

I felt groggy for the next few hours. I went home drank some water and Gatorade and fell asleep for about nine hours.

The next morning I found two sticky pads on my chest. These things were used to hook me up to the heart monitor the day before. One was actually difficult to remove pulling some of my chest hairs out in the process. The only pain I felt throughout the whole procedure..