July 31, 2012

Frankentoe

Georgia hates me.  I'm truly starting to believe this.  Only instead of my house whispering violently at me to "Get Out!" like the Amityville Horror house, it's the entire state of Georgia telling me.  It's now been exactly two years since I moved here, and in that time I have worn a cast for the first time ever, broken two bones (one of them in multiple places), had my toe cut into on 3 different occasions because of improper nail healing, had appendicitis and still can't find a hairdresser with whom I am completely satisfied.  Now I realize that one could argue the appendicitis was just coincidental, as were the breaks--or the result of my now being 47 and clumsy.  Still, it seems that the coincidences are stacking up, and not in my favor.

No doubt everyone is getting tired of hearing about my Frankentoe, and heaven knows I'm getting tired of talking my tarsal tribulations, but I'm gonna just sit here and vent a little more anyway.  Shortly after the most recent procedure with Dr. Knickknacks a month ago (today), I went to visit the girlie in NY.  My instructions were to soak the foot at least once a day in a tub of Epsom salts and betadine, hose it down after soaking with peroxide, then let the toe "air out" for an hour or so before wrapping it back up.  No antibiotics were prescribed, which I thought odd.  But I'm not a doctor, so what do I know?

Because there was nothing to soak my foot in short of cooking pots in the kitchenette, which I didn't think future residents would particularly appreciate, we went in search of a suitable substitute at CVS and found a medium-sized blue tub of the kind one might fill with drinks for a party.  After taking off my bandages back at the hotel, we discovered that my toe was now an attractive lobster red, as though I had sunburned it in the extreme.  It was inflamed and angry-looking, and exceptionally tender to the touch.  As in "breathe on it and I'll scream" tender.  Soaking it was an excruciating enterprise, even in lukewarm water, made worse only by the air hitting it afterwards.  Frankentoe was less problematic when wrapped up in sterile dressings and Polysporin, but I still suffered from sudden twinges of serious pain during the visit, for which I'd have to stop what I was doing or saying at that moment till the pain passed.  It made the visit interesting, though I did my best to downplay it so as not to ruin my limited time with the girlie.

This picture doesn't do the red justice, but you'll get the idea.  Yay, grody toe!!

I arrived back home on Monday, nearly a week after the procedure, after an arduous hobble through Atlanta's enormous airport and the endless parking lot to retrieve my vehicle, which resembled nothing so much as a big metal box of hellfire from sitting for days in the sweltering heat.  I sat down for my daily soak, only to notice that my toe was as red as ever.  Now I realize that having someone whack into one's flesh with a tiny machete is gonna piss off the surrounding flesh, but it still seemed unrealistic that no healing would have yet occurred.  The skin around my flame-red toe was beginning to peel, just like almost every sunburn I've ever had.  I was still getting painful twinges periodically.  It finally occurred to me that if it was like a sunburn, maybe I should try using Aloe Vera on it, which I did--annoyed that I hadn't thought of it sooner.  The aloe did help deaden the pain enough to make it tolerable, fortunately.

I became convinced that Dr. Knickknacks had been overly enthusiastic with the freeze spray and given me frostbite, or at least a significant freezer burn.  Nothing else made sense.  As a result, I renamed Dr. Knick "Frostbite Frank."  (Because I like alliteration.  I'm cool like that.)

By the time the second week was almost over, my toe had finally faded from Torched Redhead to a violently purplish-pink to a moderate fushcia.  At last I could touch it and dress it without gritting my teeth, just in time for my follow up visit to Frostbite Frank (FF).  I dutifully went to FF's office and removed the dressing.  He looked at it, observed that the corner was not yet closed up, then jammed a Q-tip aggessively inside the hole, making me buck a good foot off the table.  He looked at the Q-tip and then proclaimed me free of infection.  Thanks, FF...I appreciate doctors who assault open wounds without first warning me.  I told him my freezer burn theory and he insisted that he'd have had to spray me for an hour with the spray for that to have happened.  But then he would say that.

Instead, FF decided that what I actually had was "contact dermatitis,"  which I seriously doubted.  I've had contact dermatitis--hello, adhesive allergic reactions!--and this didn't look remotely the same.  I've also never had dermatitis PEEL, much less extensively.  FF clarified, saying it meant that I'd had an allergic reaction to the Neosporin I was using.  Except I wasn't using Neosporin, genius...I never do because it always makes my skin burn.  I used Polysporin instead, which has always helped and which has never given me a reaction--never mind the fact that it was only put on the open wound...which was the only part getting better.  Then he tried to tell me that I'd had a reaction to the Betadine I was supposed to soak in and put on the wound when I dressed my toe.  Again, genius, I don't think so...if that were true, then why is the red ONLY on the top of my toe and not covering my entire foot, which also soaked in the Betadine wash?  Logic fail, FF.  FAIL.  His next attempt at stifling me was to suggest that I had not been letting enough "air" get to the toe.  Except I was following YOUR directions, dude.  When he'd finished blowing me off, he re-wrapped the toe and sent me on my way with instructions to continue with the Epsom soak, but to discontinue the antibiotic cream and Betadine and to come back in two more weeks to make sure the hole had closed.

I spent much of the rest of that afternoon stuck in traffic because of an accident on a highway near me, after which I ran a couple of errands, grabbed dinner and then went to my choral rehearsal.  After practice, I went home and refilled my basin to soak my toe.  When I took off the dressing, I discovered that, once again, my toe was bright red.   Once again, it was swollen and excruciating to the touch.  It became clear to me that even on the remote chance I did have contact dermatitis, I'd gotten it from FF's office, presumably from his supposedly sterile dressing.  The fact that Frankentoe experienced a crimson tide directly after two visits to FF could hardly be coincidental.  The excruciating twinges (and by "twinge" I mean "flaming red-hot poker shoved directly under my cuticle") began again and I spent most of the rest of the evening in tears.  In between episodes, I researched dermatitis.  I still wasn't convinced that I had it.  The hubs agreed to go to the store, even though it was late, to get me some non-expired cortisone cream on the off-chance I did have dermatitis, happy to be able to help in some small way.

It's Baaaaaaack!

Much of the third week was spent like the first week after the procedure:  endless foot soaks, angry flesh, and intermittent pain.  By the beginning of the next weekend I was starting to see pus coming out of the corner, so I knew that it was infected again, regardless of what FF had said.  I almost went to see my hero FMD over the weekend, but I didn't want to keep being a whiny pain and decided to give the toe and FF the benefit of the doubt.  By Monday, it was just getting worse, so I called to see if FMD was available.  Naturally, he wasn't--I'd blown my chance.  So I called FF's office instead, only to find out that he was out of town all week.  Great.  His nurse/receptionist agreed after hearing me out to email him, however, and see if he would call in an antibiotic.  Which he eventually did.  I ran over to Walgreens that evening to pick up a Z-Pak.  Um, okaaaaaay.  My immediate reaction was that "FMD wouldn't have given me a Z-pak..."  Z-paks are traditionally used more for respiratory illnesses.  I've had more than a few for bronchitis and/or sinusitis, for which they work brilliantly.  But a poisoned toe?  Yeah, not so much...because my toe doesn't have a sinus infection, doncha know...

Still, I dutifully took the Z-pak, which did exactly nothing for most of the first three days.  When I take it for colds, I see results within 24 hours.  I'm just sayin'.  By the 4th and 5th days, Frankentoe finally seemed to be improving, or at least sucking marginally less.  The second I finished taking the antibiotics, however, Frankentoe got worse and started spewing pus again.  Awesome.

Saturday I called the local urgent care to see if FMD was on duty, which he was.  Before I could talk myself back out of it, I drove over to see him.  I told the receptionist I was willing to wait for him specifically, since he'd already dealt with my toe issues previously.  She didn't answer.  I asked if she'd heard me.  She got a little testy, then I pointed out she hadn't answered, so I didn't know.  "Sorry."  Sure you are.  Eventually I got called back, explained everything to the nurse, and waited for FMD.  Who did not arrive.  I apologized to the perfectly nice doctor who did come in, saying I wanted FMD who was already familiar with the problem.  He was totally cool with it and left to get him.

FMD came in, looked at my toe, listened to my tale of woe, and pretty much immediately said "It looks like a staph infection."  But because he is AWESOME and, you know, actually intelligent, he did not assume he knew everything or that I was an idiot who knew nothing (like certain podiatrists I could name), and decided to do something shocking--he took a CULTURE of the infection to determine exactly what kind it was so it could be properly medicated.  Of course this meant I had to be cut yet again, but for FMD, I'll do just about anything.  I seriously want to have his little doctor babies.  He is the MAN.

FMD whipped out the freeze spray, but concentrated it in a short blast directly to the afflicted corner so he could avoid the the ravaged, three-times peeled already toe top.  He cut into the corner to release any impacted pus and to swab it for a culture.  It was highly uncomfortable and painful in spite of the spray, but I put on my big girl panties and handled it.  He gave me a prescription for Doxycycline (used in the treatment of bacterial infections including chlamydia and syphillis, so I won't have to worry about those little problems for a while) and told me to start taking it immediately and that someone should call me, probably on Monday, with the lab results and let me know if we needed to change medications or not.  Then he sent the nurse back in to hose out my toe with saline and put a fresh, non-staph-laden dressing on it.

This--THIS--made sense to me.  A staph infection.  THAT was logical.  THAT explained all my symptoms.  The prescribed medication also seemed appropriate to the situation.  Why should competent doctoring be so elusive for me down here??  More importantly, why must FMD insist on working at the urgent care instead of becoming my personal physician?  And in spite of it all, he has character.  He refused to comment on FF's ineptitude or anything regarding him, though he did raise his eyebrows sky high when he asked if FF had given me any antibiotics and I said "no."  Eloquent commentary, that.

Within 24 hours of starting the doxycycline, my toe was already starting to do better.  And, as promised, someone from the clinic called me yesterday morning to let me know that I had indeed tested positive for staph and should just finish taking all the doxycycline.  Of course, I was also told to keep my appointment with FF today so he'd "know what was going on."  Yeah, that's not gonna happen.  I called yesterday and had a lovely chat with FF's machine, on which I mumbled lame excuses about why I couldn't keep the appointment and how I would call later to reschedule.  Which I won't.  There's no way in hell I'm going back to that office while I have an open wound (if ever), because I am 99% sure that's where I got the staph infection in the first place.  Staph infection from the staff.  Yeah, not happening.

Today I've had my 6th dose of probably 10-days worth of doxycycline, and my toe, for the first time in a month, is starting to look like an actual toe.  The furious fuschia and malevolent pink have faded to the pale pink of healing new skin and the hole in the corner of my toe where the nail root was removed is already closing up.  My cuticle no longer sits 1/8 of an inch off the nail bed.  I can again bend my toe.  The peeling has mostly stopped, other than leftover dying skin.  All of this happened in just three days.  THREE DAYS.

Yay, FMD!!  I will keep you supplied in snickerdoodles for LIFE!

What should have taken maybe a week to be mostly healed has taken a month, and would likely never have healed because of FF's refusal to take me seriously or, you know, diagnose me correctly.  However, assuming he did his original job correctly and effectively killed the relevant section of damaged nail root so it will stop hanging every time it tries to grow back out, I'll consider this a win.  A dubious win, but a win nonetheless.  And maybe, just maybe, by the end of summer--some 15 months after my toe was first broken--I can finally stop messing about with said toe.  Walking would be nice.  I'd like to be able to walk and wear real shoes again.  I think I've worn real shoes exactly three times in the last 14 months.

It would be nice to talk about something other than what I've damaged lately and why Georgia is trying to reject me like a botched organ transplant.  Sigh.

EDITED TO ADD:

Interestingly, I was just looking at my discharge sheet from FMD last night and discovered that my official diagnosis was for "Paronychia (pare-o-nik-ee-uh)."  So of course I had to look it up on the magic Google last night and, wouldn't you know, it described my symptoms exactly.  And there were pictures that looked just like my toe.  Isn't it funny how one so-called doctor can stare at my foot and be completely oblivious to the severity of an infection, instead offering me load after load of bullshit explanations for the toe's condition while another can merely glance at the same toe and nail the diagnosis even before lab results for the culture come back?  Or that one of my friends, who is an ER nurse, didn't even read this post and was instantly freaking out just because of the first picture that posted with it?  Because it turns out, you see, that when the red extends past the cuticle line, it means that the infection is creeping well into your injured digit, far past any pus-filled abcesses.  Which is, ya know, SERIOUS.

Did I mention I won't be going back to Dr. Effed-Up-My-Toe ever again?  Yeah, that's a no-brainer.

Meanwhile, a week later, the toe is doing much better and mostly looks like a toe again, albeit with an oddly-dented nail (yet another souvenir of Dr. Dumbass' ministrations).  It is still more pink than it probably should be, but then it has 3-4 layers of skin to finish re-growing.  There is a bit of nail apparently growing out of the nail bed, though, and I can only hope that it is a truncated version which will grow smoothly out and that the corner of the root is indeed dead and not destined to hang yet again.  Because if it does, I will be seriously pissed.  I really do NOT want to have to go through this all over again.  Heck, I'm pretty much over the daily salt soaks for over a month...the idea of having someone hack into my poor toe for a 4th time is less than attractive.

Still, for now at least, my toe is healing nicely from its many trials.  Fingers crossed things stay that way.  Even in Georgia it would be awkward to wear flip-flops all winter.  Again.

2 comments:

  1. Oh my! I am glad you found someone to help you. Those infections are nothing to joke about and you could have lost afoot, or worse. Glad you are feeling a bit better.

    ReplyDelete
    Replies
    1. Thanks--it's been quite the journey, needless to say.

      Delete