Fresh Mud

(There are some photos, with appropriate warnings, at the end of this entry.)

I started using a wheelchair on and off from around the age of 17 years until, eventually, I had to use it full-time; I made the conscious decision to stop walking on my 30th birthday, in 2003, and a consequence of this was that my feet would swell slightly due to the lack of use and movement. A couple of years later I started to develop some rough skin on my right ankle and, when I noticed this, I realised that I had stopped being able to roll over easily in bed and so was sleeping on my side all through the night. At some point I started to get quite severe pain at the site of the rough skin and, on one occasion, my partner had to fetch pain medication from A&E in the middle of the night. A couple of weeks after that, the skin on my ankle broke producing a small but very sore area: it wasn’t much of an issue until one day I realised that the break seemed to be growing. My GP referred me to a specialist and he determined that the wound had been infected with a bug named pseudomonas. He prescribed me with some painkillers (tramadol), anti-inflammatories (diclofenac), and ascorbic acid, also known as vitamin C. He also arranged for a district nurse to visit every three or four days to clean and dress the wound.

I tried, as much as I could, to keep my foot elevated but, in hindsight, I could have tried much harder! Over the next few months, with the district nurses cleaning and redressing it every few days, the wound, or ulcer, grew and grew. Eventually, the specialist decided that I needed a spell in hospital and wanted to send me immediately; unfortunately, that was the 22nd of December and I, not wanting to ruin my partner’s Christmas, refused. Therefore, he gave me strict instructions to only put my foot down “when absolutely necessary” and I would be admitted Boxing Day instead. Whilst in hospital, the only time my leg wasn’t elevated was whilst I used the toilet; also, it was regularly bathed in a warm purple liquid that I seem to recall was potassium permanganate (but don’t quote me on that!). After three weeks, the pain had all subsided and the ulcer had dried up somewhat.

After being discharged, the district nurses continued to visit and dress the ulcer, and they were amazed at the change. Each time they came there was a little bit of new skin growing over what was once a gaping wound, and, eventually, they no longer needed to visit; whilst I was glad that was the case, I did miss them as they were, every single one, wonderful people.

I only saw the specialist one more time and he said, “Our work is done. Have a nice life and, in the nicest possible way, I never want to see you again!”

After nearly 12 months of taking tramadol daily, my next challenge was to wean myself off it which, if I am completely honest, was an absolute bloody nightmare. Long story short: I suffered around three days of sleepless nights, cold sweats, and mild shakes to be rid of the addiction no-one warned me about; I write about it in-depth on my old blog.

I took several dozen photos, at first for my own records, and then at the request of the district nurses. Here are just six to represent the ulcer’s progression – please note the description/warning with each one.

15 Jun 2005 – rough skin, no gore;
21 Jul 2005 – broken skin, mild gore;
10 Oct 2005 – broken skin, severe gore;
26 Dec 2005 – broken skin, severe gore;
18 Jan 2006 – broken skin, gore;
7 Apr 2006 – scarred skin, no gore.