The Sharkbite
2005-05-26, 2:14 p.m.

Day 277 Re-start

Started relating the story of how I messed up my leg. Got to 3 pages (single spaced, normal margins) in Word when I decided it should probably be possible to tell hit all the salient points in under 500 words.

Here goes.

Tent camping with the family in Old Forge NY, Labor Day weekend, 1999. Out last full day there, we went to a water park (Water Safari). Had a blast. Noticed a lump on my right shin. Dime sized, peaked at � inch tall, maybe. Hurt. Might have banged my leg on the speed ride, or any of the other rides in the park. Didn�t think much of it. Started a fever that night. Flu in September? It happens. Didn�t think much of it.

Next morning, my leg hurt pretty bad. Was generally swollen and red from the knee down. The original lump was more pronounced and a bit bigger. Wife & kids had to pack up camp for the most part. I was pretty useless. Hurt to walk. I think I may have helped put stuff in the cars, if they brought it to me. Was saving up my mojo to drive as we had both cars there and the kids were as yet too young to drive.

Uneventful 4 hour drive home. Yes, all in New York state. Took ibuprofen before we left camp. Helped bring my fever down temporarily. Wife & kids got the cars unloaded, I collapsed on the couch. C brought me a thermometer. My temp? 104. Call doctor. Doctor says �Get thee to the ER, now�. C takes me to the ER, boys get to camp out at home (14 & 15 at the time. No problem) ER doctor plugs in saline IV�s, antibiotic, ibuprofen. Get x-rays. Doctors look, poke, prod. Nothing in the x-rays. They pronounce �It�s cellulitis�. General infection of the derma of unexplained origins. Give me a prescription for antibiotics. Ask me to stay overnight. I decline � wanting my own bed after a long weekend of sleeping bags.

Got a week off work. Pain lessened. Redness seemed to decrease but not totally disappear. Ran out of antibiotic. Called my doc, got a refill. 2 days later, it burst open. Leaking yellow goo all over my nice white socks. Call doctor next morning, describe what I see � including the dime sized black spot. Doctor says �Get thee to this surgeon, now�

Surgeon tries to debride in one of his treatment rooms. This does not go well. I get admitted to the hospital and put on a waiting list for an OR. Apparently, I am bordering on having gangrene in my leg. The antibiotic I was on wasn�t really being all that effective on what ever the bug was in my leg. Kept it from spreading real fast, but didn�t kill it. The massive doses of ibuprofen & Tylenol kept the fever down and relieved some of the pain, but really masked the carnage that was happening.

After surgery (which actually happened the day after I was admitted), I had a crater in my right shin roughly the size of a hockey puck, but not quite as thick. This is a 3� x � � crater. The surgeon thought it had a realistic chance of healing on it�s own, without having to do a skin graft. It would require daily dressing changes, visits from a home care nurse, and another 2 weeks of work during the beginning of the process. No more surgery? I was willing to give it a go. This decision happens in mid September of �99.

Did all the nurse visits (great bunch of folks there), dressing changes and culturing of patience. You ever pulled dried gauze out of wound when the intent is to deliberately tear out any scab that may be forming? Every day for 4 months? Takes lots of pain killers. Especially when you have to do it yourself. That was a condition of my getting home care nurses, being able to change my own dressings. I did it every time but the very first time. It hurt. Even after taking vicodin an hour before changing. Started to get used to it a bit, and developed better techniques, but it always hurt. Kinda sucked really.

Anyhow � after 4 months of this, I was getting tired of being patient. Granulation tissue had grown in to pretty much fill the crater. There was about a � inch rim of self generated skin/scar tissue around the edge, but it seemed to have stopped filling in. That left an unhealed patch about 2� tall and 1.5� wide pretty much centered on my shin.

In December, I asked the surgeon if this was at a point where we could consider doing a skin graft. He told me it had been ready for grafting for a while, but he didn�t mention it as long as I was willing to let it heal on it�s own. I thought that was pretty cool. A surgeon opting for the non-surgical treatment. There was another motivation to doing the graft soon too. We were headed to Florida for Christmas. Because I was leaving the state for an extended period, my home care nurse visits would be stopped. This was kinda critical as I was getting all my supplies through them, 100% covered by insurance. Sterile saline, gauze, tape, pads, gloves, all that stuff gets expensive fast. The nurses were kind enough to set me up with as much stuff as they could, including some really neat bandages I could wear in the water. But all that stuff eventually ran out and I had to buy my own.

Then I got the graft done at the end of Jan. �00. Outpatient style. Pretty neat. took a patch of skin from my right hip and planted it onto my right shin. Interesting process. Was about 2 weeks when the initial bandages came off. About 75% of the graft took on the first try. The surgeon (same one all along) seemed pretty pleased, so I was too. The remaining unfinished areas filled in on their own in about 2 � months. Finally, in April of �00 the surgeon pronounced me �as good as it�s going to get� and didn�t ask me to schedule a new visit. I was kinda bummed really. He�s a good doctor, and I always enjoyed my visits with him. Well, except for that first one, the debriding in his treatment room. Although I understand he�s fixed the dents I left in the walls.

Never did figure out what caused this whole thing. The lump visible the first week or so never showed any signs of bite marks or puncture wounds. The surgeon did get a culture when he first opened the site up. The bacteria that turned up in the culture was a rather obscure bug, but one that is normally found on your skin. It just isn�t usually a pathogen. Also turn out it is not affected by the antibiotic I was on. That�s why it was able to do so much damage.

But it�s all fixed now. Besides remembering how much it all hurt, all I really have to show for it is a scar on my shin that looks rather like a shark bite. Which is usually how I start out explaining how I got it. Then I back it down to the usual �maybe a spider bite, maybe nothing at all� because I still don�t now for sure how it started.

C�s Dad (B) is headed down to her brothers place for a few days. Nice to get a break. It�s difficult to not lose ones temper with him. Really need patience, but it�s a whole different breed of patience than I�m used to cultivating.

With B gone, C�s gonna bust loose tonight. I guarantee she�s passed out on the couch snoring by 9pm, having had no dinner and generally making an ass of herself from 6pm on. That�s another kind of patience I apparently need to develop too. Haven�t been to an Al Anon meeting since that first one. Timing just sucks lately. With the kids home and B visiting, evenings just aren�t as free and easy as they used to be. Heck, I haven�t even made it to my favorite aerobics class in 3 weeks. Tonight might be a good time to go, with B gone and all, but I know there is no diner planned, C�s gonna be shit faced, the kids will be hungry but with out a plan, and I�d like to get the lawn mowed during this break in the rain. So scratch one more Al Anon get together.

Better get back to work.
277 days down. My temper coming up.

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