Wednesday, October 12, 2016

Ulcers and Tissue Death

When I came out of my back surgery in November 2015, my parents noticed that I had two puncture wounds on my left ankle.  I didn’t have them before I went in for surgery so we know that I got them while in the operating room.  We’re thinking that either my ankle was bumped or that the O.R. team tried to put an IV there.  We didn’t think much of it and expected them to heal.  But unfortunately they didn’t heal, instead they grew together and eventually became an open sore. 

I found a wound doctor in Layton that I started seeing the beginning of March.  A lot of different things were tried to get this ulcer to heal.  I had many forms of collagen put in, a snap vac that put negative pressure on it to help divide the cells faster, and my blood was drawn and then put into a machine and eventually formed into a clot that was then put on the wound.  All of these attempts didn’t work.  It just seemed to get deeper, which was pretty frustrating.  In May I was put into a walking cast in hopes that it would stabilize my foot and keep my ankle from moving so that the ulcer would have a chance to heal.  My foot was checked a few days after the first cast was put on.  It seemed to be working and I was put back into a cast, this time not having my foot checked for a week.  It was pretty hard walking with the cast because my balance was still off from everything that I had already gone through. 

My parents went to Hawaii for twelve days, a day after I got my second cast, to help my sister, who was having her third child.  Since I had only been home from the hospital for a few weeks my parents felt it would be best if I stayed with my grandparents while they were gone.  My grandma took me to my appointment to get my cast off and check my foot.  I wasn’t prepared for the news that would come.

After the cast was taken off, my grandma looked at my foot and noticed that I had a bruise on the bottom of my foot.  I had her take a picture of it since I really couldn’t see it.  I figured it was just a bruise and that it would eventually go away.  My doctor came in and looked at my foot.  What looked like a bruise wasn’t a bruise.  I was told that somehow the blood flow had stopped in that area and killed the tissue.  The doctor proceeded to cut away the dead tissue and sent it off to have it analyzed.  It didn’t bleed when he started cutting and I couldn’t feel a thing, which surprised my grandma.  I lost the feeling in my foot a year ago after everything started, so not having feeling in my foot has been good and bad.  My doctor told me that when I came back in a couple of days that they would do a test to check the circulation in my foot.  I was then told that I could not walk and needed to be in a wheelchair.  I couldn’t believe this had happened especially while my parents were gone.  Thankfully I still had a wheelchair at my house from the last time I was in it.  We picked it up and then drove back to my grandparents’ house where I called my parents to let them know what had happened. 
A couple of days after my initial doctor’s appointment I went back in to have the test to see how much circulation is in my foot.  I was told that if it was low then I would need to see a vascular surgeon.  During the test, which took ten to fifteen minutes, I just kept hoping and praying that the numbers would be high.  The test came back showing that I only have 20% blood flow in my foot.  That’s really not good, it should be a lot higher.  I was very disappointed and didn’t know what was going to happen.  I didn’t know if my foot would heal with that poor of circulation.  My doctor went and called a vascular surgeon that he knows, explained my situation, and then immediately sent me over to see the vascular surgeon.  I saw the vascular surgeon who did another test on me and then asked me about my medical history.  He couldn’t believe that someone so young had so many health problems.  He set up a CT angiogram for that Friday where the vessels from my heart down would be looked at.  He believed that I had some sort of vasculitis.  I had the angiogram done and it showed that the vessels in my legs are narrow and some have aneurysms in them.

It took a few days, but once I processed everything, I couldn’t believe this had happened to me.  I wasn’t happy and didn’t understand why Heavenly Father was going to make me go through this again.  I was very upset with Heavenly Father and my faith started to waver.  This was the second time I ended up in a wheelchair because of pressure sores since I was 10 years old.  I didn’t want to go through the emotional pain again.  I became very self-conscious about being in a wheelchair when I was ten because of what people said and how they acted around me.  That hasn’t changed.  I dreaded people seeing me in a wheelchair because of my self-consciousness.  I didn’t want to be looked down on or judged.  I didn’t even want family to see me in my new situation because I was scared and felt vulnerable, which is really stupid but it’s how I felt.  The first Sunday I was in a wheelchair it was my stake conference, and since I was able to watch it online I told my grandparents that I wasn’t going to go to church with them.  In reality I could have watched my stake conference and gone to church with my grandparents but I was so scared and didn’t want anybody, including my aunt, uncle, and cousins seeing me.   I know I’m loved by them and it wouldn’t have been a big deal but like I said, I was scared. 

My brother and his family came up to my grandparents’ house for dinner that Sunday night which helped.  My grandma knew that I was feeling down and that having my brother and his family over would help me.  I was nervous about how my nephews would react to seeing me in a wheelchair.  They didn’t care and showed me more love and acceptance then I could ever imagine.  They helped boost my spirit that night. 

Even though I‘m in a wheelchair I still try to be as independent as possible.  Because of past experiences I have a hard time letting people help me.  I don’t want to feel like I’m a burden so I tend to just do things myself, even if it’s difficult for me. 

A week after receiving this devastating news I started hyperbaric treatments.  I was told that I would start out doing twenty treatments to see if it was working, if it was I would continue with the treatments.  During hyperbaric treatments you lay on a gurney and are sealed into a pressurized chamber where you can either sleep or watch movies.  Hyperbaric treatments is where you breathe in oxygen that is three times higher than normal oxygen.  Having more oxygen in the blood helps in wound healing.  I would go to hyperbarics five days a week for about two hours each day. 

A couple of weeks after I started hyperbaric treatments a new sore developed on my fourth toe.  When this new sore was discovered I was pretty upset.  I kept feeling like things were getting worse, not better.  Around the second week in June I had a wound vac put on the sores on my ankle and bottom of my foot.  A wound vac is a machine that you wear 24/7 that is like a vacuum and puts negative pressure on the wounds.  A piece of foam is put over the sores and then taped down with a special kind of tape so there is a good seal.  With so much negative pressure being put on the sores it will suck up the drainage into a canister.  The negative pressure is supposed to help the cells divide faster and help the wound heal.  I had the wound vac on for two months, having the dressing changed twice a week.  When I had the dressing changed I was able to see how much or how little progress the wound had made during the week.  I believe that it did its job and helped the wound on the bottom of my foot get smaller.  I didn’t really notice it doing a whole lot for my ankle sore.
 
In the middle of July as my wound doctor was checking the wound on the bottom of my foot, he noticed that the capsule covering the joint of my pinky toe was exposed and had slipped.  I was sent to see a podiatrist down in Salt Lake.  As I saw this doctor I was told that I needed to have a graft that contained shark cartilage and cow collagen put in the wound.  This procedure would have to be done in the operating room and would have to be done that week.  The doctor told me that if I didn’t have this done then the tendon would die and the death would move into my bone and I would need my toe amputated.  I had the surgery on Friday, July 15, 2016.  It was a very simple surgery and I didn’t have a lot of pain from it.  After a few weeks this graft did what it was supposed to do and covered the open capsule with granulated tissue that would then start to fill in with skin.  This graft helped my ankle sore and the sore on the bottom of my foot make significant progress. The sores started coming to the surface and shrinking.   

Toward the end of August my wound doctor decided that I would benefit from an epidermal graft.  This is where a machine is placed on the thigh, it heats up the skin and forms tiny blisters.  The blisters are then sliced off and put on the sores.  The blisters are supposed to help promote skin growth.  It takes anywhere from two to six weeks to see results from this type of graft.  For me it took about four plus weeks to see significant improvement. 

Finally at the end of September the sore on my ankle healed.  It had been so stubborn for so long I didn’t know if it would actually heal.  I was very excited when I saw that it was healed and saw that the sore on the bottom of my foot only had a small sliver left before it was fully healed.  I was anxious to stop hyperbaric treatments but knew I couldn’t until I was fully healed.  One week later, the beginning of October, the sore on the bottom of my foot was healed.  I was so excited because the doctors weren’t sure if it would heal or not.  I was finally able to stop hyperbaric treatments after having 79 of them. 

Being stuck in a wheelchair and not being able to walk because of the sores has been very hard on me.  There have been many times when the emotional pain has been too much and almost paralyzing.  I have been so scared of what people think when they see me, that I find myself making excuses to avoid certain situations.    I have tried to tell myself that it doesn’t matter what people think of me, all that matters is what Heavenly Father thinks of me and what I think of myself.  Unfortunately I can’t always convince myself of this. 

 When the emotional pain gets to be too much I don’t always feel like I can talk to others about what I’m feeling, so I just hold it in until I am alone.  There have been many nights where I have literally cried myself to sleep because the emotional pain is too much and I can’t keep it in anymore.  During these times I have prayed for strength to make it through another day.  It’s been amazing to see and feel the strength that Heavenly Father has blessed me with to go through another day and then another.  I don’t think I would have been able to make it as far as I have without the help from a loving Heavenly Father. 


My journey is not over yet and I know there are more challenges ahead of me, but with help I will overcome them.  A lot of the fears that I have haven’t subsided and still haunt me on a daily basis.  But I am confident that everything will work out how it is supposed to as long as I keep my faith strong and trust in my Heavenly Father’s plan for me.