New to the scene.

Considering the large amount of steroids I'm taking every day its amazing I managed to have a new flare up just below my knee. This area started to flare up about six weeks ago but my dermatologist hit it with a needle before it could become anything serious. So, I thought. It's come back. And boy was it fast. It went from small purple bump to actual hole in about three days. This pic was taken prior to going back to the dermatologist for additional shots. I hate having to deal with this Pyoderma bullshit. One of the few things I'm content about is that everything is located in one area, my leg. This would suck if it was on my face or my privates. How would one live a normal life with no skin on their face?

Well huh..

The dermatologist was surprised by how much the ulcer has healed over the last month. It all looks the same to me but there seems to have been some real progress. The increase in the Prednisone might be the reason. Its slow going. The only thing I'm doing different lately is soaking my leg in the tub for about 30min a few times a week. I have spent so much time avoiding water and contact in general on the ulcer It's kinda' odd having it submerged in water. It feels good, no pain. I just drizzle on some Hibiclens and read while my leg soaks. The goal is to just help clean up the ulcer in general. I am always making the effort to keep things clean and dry.

My apt bathroom is too small for a Jacuzzi bath but it would be great in a situation like this.

Tendersorb

The leg pad that I'm using is made by Kendall, a 5"x9" variation of the Tendersorb. These things work really well. I call these my "leg diapers". A few pieces of tape and a fresh pad takes about two minutes to change up. If this is something you might need you should get them online. I pay about $8 for a box of 36. A heck of a deal. My local NYC store would probably want $25 for the same thing, so shop around.

Exudate

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Little change

Not much has changed over the last few weeks. I went to see a surgeon that specialized in ulcers. He took a few pics with his phone and said that it was "interesting" but he offered nothing new. I'm so fucking happy that my condition was "interesting". It was waste of my afternoon.

The edema leakage issue slowed down for a few days last week but has since started up again. I've tried to note some change in diet or meds but nothing different was done. Its a real problem because I have to change the bandages after a few hrs because they are soaked. This makes things tricky when going to the office.

Clean but still mean

Any stinging I may have felt over the last few weeks has pretty much gone away. As the pic illustrates, the ulcer hasn't healed much at all considering the increase of Prednisone. I'm getting some bad side effects, bloating, weight gain, moon face, all the good ones. It really sucks.

The pic also shows some dead tissue that seems to be hanging around waiting for debridement. The best way to gently clean the area is using a soaked paper towel and warm water with some hydrogen peroxide. This mixture is almost painless and gently eats away dead tissues or dried blood with ease. After a 20 minute soaking the ulcer is almost squeaky clean.

Stings

These pictures show were things are at with my pyoderma. My 'chubby leg' looks like a sausage because of the Edema, that comes and goes. The B&W picture is just to show the area where it really stung. It has since gone away. The extra dab of neosporin did the trick i guess.
My increased Prednisone dosage should be having a much better effect than what I'm seeing now. When i first used it over two years ago it was like a magic bullet. The results were immediate and dramatic. Its not the case anymore. I'm not sure what my options will be if this new 'Prednisone push' is a dud. This fuking thing on my leg is making my life difficult.

Vitamins and stuff

My regimen of supplements has grown a tad. The 'D' was suggested by my dermatologist. The 'B1' was suggested by my Oncologist. I am on a treatment for cancer and the B1 is supposed help avoid neuropathy. So far so good. The Iron I only take occasionally. The brands are of my own choosing. They may cost a bit more, especially the Carlson, but they are the best.

Carlson makes the best fish oil pills. They are clean, non-offensive tasting and offer a wide variety. I worked at a health food store for almost a year, twelve years ago. so It was like getting a free education on supplements. Some fish oil pills taste truly awful, sweaty dumpster oil tasting! A neutral tasting pill taken with a bite of food should do the trick for those easily offended by 'fish pills'.

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.

Complications

Although I've been taking a higher dosage of Prednisone than usual, my ulcer has been getting bigger. The dark red edges sting. For an unknown reason my ulcer 'weeps', produces edema fluid in unmanageable amounts. It has happened in the past for a day or so and then stops, all for no reason.

Well, its been in 'weep' mode for about a week. When I sit at my computer at home, I do it with my foot on a towel. After a two hours its soaked! This prevents me from going to my office. I'm lucky that I'm able to work from home, but I don't like working from home. I have interns that I'm supposed to be helping out, not an easy thing to do from home. My dermatologist wants to raise my prednisone to a high level again, temporarily, just to heal things up.

Adjustments

I have been taking a higher amount of Pednisone the last few weeks. After a few days of 30mg/day its obvious that this dosage is insufficient. The front of my leg is unchanged. The back however has various developments, arrested only by a dose of prednisone.

In the shower I make an effort to keep my leg clean with hibiclens. Great stuff but it stains! Things look really bad after I shower which seems odd but, it is what it is.

Current suck-ness

For whatever reason my leg has begun to go the edema route again. I have raised my Prednisone dosage after last weeks flareup and have seen immediate results. The original ulcer in the front has simply stopped healing and is taking on a bizarre shape due to the edema in the surrounding area.

Flare ups

After being on a Prednisone regimen of 40/0/40 for about six months, I had a flare up. I must have forgotten to take my dosage because the day after my skipped day I could feel that my calf was getting 'thick' with edema. I didn't think much of it until I noticed the multiple hot spots on the back area of my calf. The back of my calf has been totally free of any pyoderma until just recently. All flare ups are preceded by 24+ hrs of edema. I'm currently taking 40mg of prednisone a day, perhaps more if needed, to stamp this nonsense down.

A new one.

After months of what could be best described as 'dormant', the front of my shin hasn't changed at all. No progress and no 'falling back'. That is until last week. My ankle was sore, it looked swollen. After a few days the false boil showed itself. As one can see, my anke is still showing signs of edema and the new ulcer or eruption is about the size of a dime.

I am taking a battery of meds so I'm surprised that this thing showed up. Surprised and worried, actually..

Slight progress

As the weeks wear on my ulcer shows the slightest of improvements. My ulcer doesn't even sting anymore. An odd thing going on is this little 'node' that has popped up. It doesn't hurt and it is easily pressed down. It isn't hard but in fact soft almost sponge like. In the past I have had these node type things before, they just disappeared after a few weeks. This one has decided to hang on.

Not much changed

After a little more than a month on my new meds I don't feel different but my leg seems to have cleared up a tad. I'm not sure why the pic has a bluish hue. Its some odd effect from my camera. The actual level of pain or discomfort has gone down by a modest amount. In months past if I got my ulcer wet in the shower it would hurt or sting. Now there is only a slight sting.

I usually bandage my ulcer about twice a day with fresh gauze and ointment. For some odd reason over the last few weeks my ulcer has been 'leaking' clear fluid, edema fluid. This was a real problem a year ago before I started taking the steroids and my leg and ankle were visibly enlarged. Currently my leg doesn't seem enlarged at all, so this edema fluid is odd. I could lay the blame on my new medication but this mysterious edema leakage has happened in the past as well. It begins and ends within a week or so for no rhyme or reason. Its obvious when this is occurring because when I change my dressing its usually bone dry. During an edema spell my Telfas are soaked and even the gauze is damp. I expect this to end within a week or so, again with no explanation.

Spring is almost here..

On my last visit, my dermatologist was pleased with how 'clean' my ulcer was and the lack of a 'ridge line', something very common with Pyoderma. Because of the nice weather i find myself walking around more just for the heck of it, exercise and such. I'm not sure this has any effect on my ulcer. I doubt it.

The nerve pain I have been experiencing the last few months has been reduced by a satisfactory amount. I'm not sure how or why but it just progressed that way. The sharp nerve pain i would feel every time I bathed seems to be a thing of the past. I would love to have this healed up by summer, so that i could wear shorts or swim without wearing an Ace bandage. I fear that may be wishful thinking or a delusion of grandeur.

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.

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.