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..

Getting ready

Before one gets a colonoscopy it takes a day to prepare the system for examination. This means eating no foods all day except drinks, soda, coffee, tea until midnight. After midnight nothing can be consumed not even water.

In addition to this liquid diet I had to drink two liters of a 'cleansing drink'. It basically gives you diarrhea for the next twelve hours. And be prepared because this stuff works. It wont win any taste awards but its weak lemon-lime taste wasn't so awful.

Do's and dont's..

Pyoderma is often associated with Inflammatory bowel disease (IBD) which is generally seperated between the severe type, Crohn's and not as severe, ulcerative colitis. Because of this I'm having a colonoscopy next week.

The picture is of a list of all the things i can consume and the things i can't the day prior to examination day. I had a laugh because the secretary took a few minutes underlining everything and adding notes. I guess she thought I looked like a retard or something.

I also have to drink some type of mixture the day prior in an effort to clean the colon as much as possible. He apologized for having me drink this stuff because its supposed taste awful.

My strange cat

He wont eat fish, shrimp, hamburger, chicken or any of the other 'break offs' I have offered him over the years.

If a taco chip is offered, he munches away..

Cool thingy

I went to the 'imaging center' to get some X rays of my bones and I noticed this little robot thing sitting behind me. When I put my hand under the spout, it squirted out some hand sanitizer. It had a pleasant unique spearmint scent.

Since H1N1 and various flu varieties are floating around, I find myself too often washing my hands. And of course since I have Pyoderma, a constant open wound, a perfect entrance for any and all airborne illnesses, I must be vigilant with my hygiene.

Its called a 'Germstar' sanitizer. I found a merchant online that sells a 'starter kit' for about $130. It may seem like a lot to pay for a hand sanitizer but I thought it was that cool.

That ain't juice

My doc wanted me to complete another urine test. Instead of just filling a little cup, I was instructed to collect my urine over a 24hr period. This requires me to keep my collection in the refrigerator as I collect it and deliver it to the testing center.

One that healed up

This picture is shows a lot of details. Two of the arrows are pointing to the puffy bands that surround my Pyoderma. These bands are the source of most of the pain. Between these two rings there appears to be a gap of healthy unaffected skin. I have no idea why or how this healthy skin remains but it would probably help answer questions about Pyoderma's existence.

The small dark spot with an arrow is actually an original Pyoderma boil that never really grew. It was there for about two weeks and then it just started to heal on its own. I would occasionally put Neosporin on it but that was it.

As of now the black spot is gone. I just have a small scar. Why did this Pyoderma boil heal while the other two continued to grow?

Maintenance

I go through a lot of tape and bandages on a daily basis just trying to keep my Pyoderma clean and dry. Its an uphill battle. My Pyoderma is constantly weeping or seeping fluid, interstitial fluid. I had first been using a medical tape that appeared like thick scotch tape. After a few uses it began to peel away bits of my skin as well. I switched to paper and cloth (Durapore by 3M) tape and these worked well except for the occasional yanked hair or two.

The roll above is a product call Coban tape. It doesn't stick to anything except itself. It can be reused as long as it is clean and it usually does a good job staying in place. It will even stay secure while in the shower. Its kinda pricey, about $5 a roll but again finding it for sale online is easy and more cheap, about$3 each.

I seem to prefer using the Coban tape for my upper calf and Durapore cloth tape near my ankle.

Hippocrates

After all of the tests have been done my situation has been narrowed down to two possible situations which are common for people experiencing Pyoderma, Inflammatory Bowel Disease (IBD) or Leukemia. I have been flagged for some above average items that are common but could point to Leukemia but my money would be on the IBD. I used to have the symptoms about two years ago. I thought I was becoming lactose intolerant. I have a father and niece that are both very intolerant to dairy. I chalked it up as one of those things due to getting older. I don't have any of the symptoms of IBD currently but I was told that I didn't have to prior to developing Pyoderma.

If one has IBD or Crohn's disease, Pyoderma development is a possibility. From the readings I have done on Pyoderma it appears that persons that suffer from Crohn's develop the most stubborn or recalcitrant Pyoderma.

Ring of fire

This picture illustrates the thick band or ring that forms around Pyoderma. Strips or strings of dead tissue can be seen around the edges. I have never intentionally removed dead tissue. I usually leave it alone and it just comes off when bandages are removed or maybe while in the shower.

These swollen rings will exist for about a week then they disappear. The center area of the wound doesn't really change. Most of the changes happen on the outer edges.

It really hurts too

These Pictures were taken at the same time. They illustrate the slow process of gently removing absorption pads. I use these when I go outdoors. Its common that the pads are bloodied after wearing them for about 7+ hours. My wound may only bleed in one or two areas but because the pads are absorbent they will soak up the blood although slight for hours. After a few hours of this it may appear that the entire wound is bleeding but as the right picture illustrates my wound has two small spots of bleeding.

The puffiness around the edges are well illustrated and are actually the Pyoderma expanding. These puffy ridges produce extreme constant pain. The lower center doesn't produce the constant pain of the ridges but at times I feel a sharp stinging. Sharp enough to make me twitch out of a chair. These wide puffy ridges will last about a week and then they will settle down, the puffiness and a lot of the pain disappears. The Pyoderma will remain unchanged for about five days and then this puffy ridge will reappear in another region of the wound and it expands some more..

Edema

As the picture illustrates I have edema in my left leg. It only effects up to but below my knee. It doesn't especially hurt to have edema but it can be a pain dealing with having it. I wear a size 12.5 shoe and many of my loafers I can't wear because my left foot won't fit. I have a pair of Trask loafers, super comfy and well made but my left food bulges out of it. So, I find myself wearing sandals most of the time.

Also because of the edema I am forced to sleep sitting up. If I sleep laying down, like one usually does, when I get out of bed my leg begins to burn. It feels like my leg is on fire. It takes about ten minutes for this pain to subside but it is so intense that I choose to sleep sitting up or sleep with my left foot on the floor. I have purchased a 'bed wedge', a foam cushion, that would allow me to sleep sitting up. I haven't received it yet so I can't supply any details.

Mystery

At times and for reasons I don't understand my Pyoderma will bleed, from around the edges. It doesn't feel anymore painful than usual but it just bleeds. This picture was taken after a nap.

Also as one can see in the picture its important to have a good work space where the bandages can be removed and new ones applied. For me this means my living room. My bed is too far off the floor and my bathroom is too small. I of course use a towel to protect my rugs from any spills or stains. Blood in a carpet/rug can be impossible to clean out.