Feet (again) SFW Pics

We have been waiting for my new antibiotics regimen to take effect before scheduling the next MRI to measure the state of the bone infection. While waiting, the gangrene cap on my right foot has started to detach. It's like a toddler loosing a tooth - first it moves a little, then it wiggles, then it flops around, then it falls off. Last night mine finally came off. Unfortunately it left some of my toe bone exposed. That needs to be treated right away - either graft on some skin or cut off some of the bone to close it up. Neither of those make much sense if we are going to amputate the toe in just a few weeks. So I need to do the MRI now to see if the infection has continued to spread. If not, we stitch up the one toe; if it has spread we are going to amputate them to remove all the infected bone. 

The Gross Foot Picture Reduction Act of 2015 is now in effect.

Workload

It has been tough first week, each day a bit harder then the last. I'm still struggling with a low energy level, partly due to liver and kidney function problems and partly due to the amount of antibiotics im taking to control the bone infection in my feet. I'm really looking forward to getting off the antibiotcs to see how it impacts this problem. Until then I will endeavor to preserver.

Major Milestone: Back to work

Today I started my new full-time job for a mid-size video product company in San Jose. It's quite an adjustment after many years of consulting. Unfortunately after 15 months of hospitalization and recovery, getting the consulting business going again proved too difficult. After falling off the face of the earth it's hard to get back on peoples radar. I also want to get back into a social environment where I can interact with others and work as a team. I kind of miss that. So I'm back at a 9-5 (at least) and working hard to get up to speed. It's nice to be back. I'll admit there was a long time when I feared this day would never come. I'm glad it's finally here.

Stratocaster modding

I decided to change the look of my Stratocaster by replacing the white pick guard and other plastic bits with black. My guitar is Lake Placid Blue (LPB) in color which is a common for Fender instruments and is almost always paired with white or ivory plastic. I saw a LPB Telecaster with black plastic at a shop a few weeks ago and thought it looked really good.

Installing the new parts was a little harder than I thought because I had to remove the guitar's neck to reinstall the pick guard. Here are the before, during and after pics. I think it looks a little "meaner" now. I still need to set the pickup hight and find matching black knobs and switch tip but the hard work is done.

Custom Shop Stratocaster as delivered

During Installation

New plastic bits and strings installed

Heavy Lifting

We got a small sandbox for Jackson. That "small" sandbox took over 400lbs of sand to fill. Filling was the hardest thing I've done in a very long time. 

How I feel better about my toes

Whenever I feel bad about my feet -- which I'll admit has been quite a bit recently. I found a sure-fire way to feel better. Simply google "gangrene toe images" or check out this site and look at the pictures.

Update

Here's what they look like now. #3 toes on both feet still show
remaining signs of gangrene. They look pretty gross.

Regular readers will remember that I'm still fighting an infection in the bones of my toes and feet caused by gangrene of my toes. The gangrene was caused by the use of vasopressors while I was sick. Vasopressors are a class of drugs that are given to increase blood pressure. The condition is called Symmetrical Peripheral Gangrene (SPG) which caused the flesh of my toes to die.

I've been on powerful antibiotics - first IV, then orally - for more than 9 months. All the while the infection has slowly spread, now involving metatarsal bones (foot bones) in addition to the phalanges (toe bones). It's becoming obvious that removing the infected area of those bones is the only way to stop the infection.

Unfortunately, that means removing all my remaining toes on both feet. Mechanically the human foot needs at least three toes to effectively distribute weight while walking. If you have to remove more than thee toes the remaining toes become overloaded and will develop sores and ulcers. My podiatrist is recommending removing the remaining 8 toes and one of the metatarsal bones.

Obviously this is not what we expected and is hugely disappointing. I thought I was well on my way to recovery and done with surgery and hospital stays.  

There is one glimmer of hope -- we are adding another even more powerful antibiotic to my current one in hopes of stemming the infection. To be frank, I don't think my doctors hold much hope, but for me this is the last chance. We will do another MRI in a couple of months to see if this new regimen works -- if not we will schedule surgery immediately after. Surgery will be two procedures, one for each foot spaced about 2 months apart, each followed by physical therapy session.

Hospital room 3206

There are few things worse than being in Hospital. I know, I spent last week there. It’s not really the Hospital that is so bad, it’s being sick enough to get there. I know, I spent last week there too. Another unexplained bout of nausea and vomiting started early Monday morning. I held out for a couple of hours, hoping it would pass. It did not. It was a classic CVS flare, intense nausea and vomiting every 15 minutes - endlessly.

Once I got to the ER, I gave the staff a bit of a scare - apparently my new compromised cardiac function looks like a heart attack on an EKG. Things got pretty exciting as they assumed the worst and started treatment. Luckily my Cardiologist was working the ER at the time and waved them off, explaining my condition and history.

As the vomiting continued throughout the day I was admitted late in the afternoon. It took 72 hours for the flare to finally subside and the vomiting to stop. Like last time Reglan (Metaclopromide) was the most successful treatment. I’m not sure what happened - Phenergan used to work really well for me but has basically lost it’s effectiveness in the last couple of years.

On Thursday I took a “Gastric Emptying” test. It involves eating a egg-salad sandwich laced with Barium and laying under an X-ray machine for a couple of hours while it passed through my stomach. I fell asleep after the first hour so it all passed pretty quickly.   

As is typical, this CVS flare has been followed by severe night sweats, soaking my night

clothes and bedding multiple times each night. Based on past experience it gonna last a few weeks. Speaking of experience, I realized I've been dealing with this for nearly 25 years. That is a long time.

One of the toughest parts of any Hospital stay for me is getting an IV. I’ve always been a difficult stick and this time was no different. I think I had 6 different IV locations between the back of my hand to my elbow joint on both arms. Even when they get one started, it seems to stop working within a day or two. Infiltration they call it when when the IV leaks and my arm swells like a sausage. It happened twice this time.

The other tough part of Hospital stays is the lack of sleep — Starting at about 5am the work cycle starts. First comes the 5am blood draw. 2-3 vials each time. Then the 6am blood pressure check and first medication cycle. At 7:30 it's breakfast delivery and at 9am another BP check — you get the idea. The cycle continues until the last BP check at midnight. All this activity doesn’t leave much time for solid sleep.

I left Hospital Friday night about 7 and slept most of the weekend away. I’m starting to feel stronger now — I took a walk with Kathy and Jax today and felt tired but good. So now it’s all follow-up appointments with my Gastroenterologist, GP and Cardiologist. One down and two to go...

Jackson photos

The Truth

I've worked to keep these posts positive, focusing on achieving goals and milestones. The truth is that somedays it really hard to be positive. Today is one of those days. Things ARE getting better, I'm a little stronger and little less tired most days, I can walk and ride my bike, but the truth is that I am a long way from "recovered".  I may not be "sick" anymore but I certainly not "well".

I still struggle daily with pain, sometimes so bad I can hardly get out of bed. And even after all the physical therapy I still struggle to lift my arms over my head or carry anything even slightly heavy. I have some pretty serious nerve damage in both my feet and legs that causes a mixture of hot pain and numbness. I still get light headed when I stand too fast and sometimes struggle with balance a bit when I walk. I still can't even look at my feet without feeling a deep sense of sadness and loss.

Next month will mark the anniversary of getting sick and I'm not sure how to deal with it. On one hand I'd like to celebrate simply being alive, on the other hand, I don't feel like it's really over yet.  I know I'll never be the same as I was before, I just wish I knew what I will be.