Almost There, But With New Baggage

The wound care doctor has pronounced my surgical wound almost completely healed.  With the pronouncement, unfortunately, comes a spate of new issues.

Issue #1:  Testosterone, again.  A normal range for a male my age is 110 to 575 ng/dL on the bioavailability scale, according to my doctor.  Mine has been in the 70s.  (This is a change from what I'd posted earlier, due to a discussion with my doctor at an appointment this morning.  He says it's a logarithmic scale with not much difference between the 30s and the 70s, so I still wasn't off by a significant amount.)  No idea how long this has been going on.  My primary care specialist put me on shots yet again, although this time every other week instead of weekly.  My pain care doctor almost fell out of his chair when he heard the (old) number.  His response was to start weaning me off of the Methadone pain medicine, moving me from 5mg three times a day to 5mg two times a day.

Issues #2 and #3:  Headaches and irritability.  I have been hit by what might be migranes several times a day for the past three days.  These correspond with the end of a testosterone injection cycle, and probably have something to do with the reduced Methadone dosing..  I'm getting my T-level checked again tomorrow (2013/05/01) and should know something by the end of the week.

The last time I had shots my levels screamed past the 575 ng/dL level (new number), to something like 1280.  We only did the shots because the (insert trademarked medicine name here - you've seen the ads) actually lowered my levels.

Issue #4:  Heartburn.  No, not me, my wife.  She's suffered with it for almost all of her life, and for some reason it's coming back hard after mellowing out for a while.  It interfered with what should have been a 100% memorable trip to The Salt Lick in Driftwood on Sunday.  Still, 99 44/100% isn't too bad. ^_^

Anyway, all these issues have combined to make the past few days mostly absolutely horrible, not only for me but for my wife, who is putting up with all of my problems somehow (no idea how - a lesser woman would have run away screaming by now).  She's also got her own issue mentioned earlier, plus that of a certain somewhat-invasive yet standard medical test for which she began a week of prep yesterday.

It's a big, hairy furball of a mess.  Still, we're fighting through it, hopefully together.  I just wish the headaches and the heartburn would go away.

Case Closing, I Hope

The wound care doctor has managed finally to get my surgical wound on my outer left ankle to heal to the point where I can get it wet, wear socks, and do my normal stuff without help from my wife (she is rejoicing, yes).  He went to using a "long acting" collagen with a  different dressing.  I still had to keep it dry during showers, but I didn't need a re-wrap afterwards.  I'm still experiencing pain to the touch above it - something I will explain to my Pain Management doctor when I see him this morning - and I'm still taking Methadone 3 times a day to keep it and all of the other pain under control, be it from the fractures or from other arthritic conditions.  Two more appointments and I should be done with the wound care.

That allows me to approach other problems not caused by the fall.  First up will be my left knee, which I screwed up badly in a bicycle accident in the early 80s.  I won't bore you with the details - suffice it to say that I had the knee scoped back when arthroscopic surgery was still relatively new, and the doctor who performed it was not much of a specialist.  I've got arthritis, bone spurs, damage behind the patella, and other aches & pains that I've lived with since the operation.  To this day I can't kneel, even with a pillow.  I'd say that makes it an extremely good candidate for surgery.

Even that won't be the end of it.  I've got arthritis in my right knee with bone-on-bone on the medial side, and I can't lean or kneel on it either.  I need to fix this, get the rest of the hardware implants removed from my right foot, and see if something can be done about the arthritic symptoms I've had in the lower spinal vertebrae.

Next update will hopefully be a continuation of what happened to get my ankles into the shape they're in right now.  We shall see.

Limping Ahead A Bit

Here's where we stand (or sit) at the moment.  All of the hardware has been removed from my left ankle.  That ankle hurt the worst, despite other treatments.  It took two operations, since the doctor didn't want to have to haul out the hammer and chisel to pull out certain screws.  He also didn't want to remove a syndesmosis that had developed over a ligament.  The hammer and chisel were removed during the second operation that happened in late 2012.

Since then, I've had hell getting one of the incision wounds to heal.  (The first person to use the word "diabetic" in a response is going to get hit over the head with a very large and ripe banana.  My A1C is 5.1 and my fasting glucose is 84, so I'm in "diabetic remission.")  Removal operation #2 required incisions on both sides of my ankle, so the ortho doc went in through my already existing scars.  I don't know what he did wrong, but I don't like it.

The scar on the inside area (the medial area? Correct me if I'm wrong) eventually closed up with fibrous material and a nastier scar.  The scar on the outside area (lateral?) has never closed up.  The ortho doc had no idea why it wasn't healing, and I damn near scared my primary care physician to death when I showed it to him during an appointment for a different malady.

I was referred to a specialist in foot wounds in December 2012.  He has since poked, scraped, suction bagged, and medicated the outer wound site, with no joy.  The latest thing he tried involved a "procedure" of some sort which was close to an operation, but not exactly - I was heavily sedated, but not knocked out.  During the procedure, he did a curettage which scraped out all of the fibrous (fibrous == bad) material.  He later told me that it extended all the way down to the bone.  He sent samples from the procedure for infection testing, but no word on those yet.

After the Big Dig (left outer ankle version), he injected a newly approved fluid which he said contained placental and amniotic fluid material.  He told me that it was "sort of" a T-cell injection, and believe it or not, it's working!

Or at least, it was.

So, here I sit, almost 7 months after the second hardware removal, still having to have my wife irrigate, pour collagen flakes into and then bandage my left foot since the wound is in an area I can't reach.  The good news is that I've grown a lot of granular "beefy" material (doctor's words, not mine), which is a sign that the wound is healing.  The bad news is that it seems to me like it has hit a plateau.

I have another appointment with him on Monday.  Watch this space for updates.