I was able to make a couple of changes with respect to my medical care that I am really happy about. First off, I got a second opinion on my wound. The doc I saw was a breath of fresh air compared to what I have been dealing with. Granted that I made a 60 mile trip to see this doc, but I was really happy with what he had to say, so I transferred care to him.
First thing he said to me was really heartening: no Unna Boot. Because I don't have any vascular insufficiency it is not appropriate for me to wear one. Second, he had me ditch the Frankenstein shoe as it is actually making things worse rather than better as far as pressure on my heel. Rather, he prescribed a different shoe, one with an open back and a more forward heel strike. I suspect it will make a difference, provided the insurance provider approves it, but that's another story. He also prescribed different topical medication - a compound of BactroBan and Sentyl (I hope I spelled them correctly), which are a bit on the old school side, but they have a proven track record with wounds like mine. He also told me that the Silver Gel has a time window of about 4 weeks that it is effective in, and after that I'm forced to deal with the law of diminishing returns in that is becomes totally non-effective by then. So all it really was doing was keeping the wound bed moist but not having and effect on the bacteria.
He also remarked that the area around the wound was reddened and really warm to touch compared to the rest of my foot. This may be simple inflammation, but because when he'd seen this in the past there was infection associated with it. So, I'm back on anti-biotics. This time I'm taking Bactrim as it was one the sensitivities that came back on the last culture I had taken. Ciprofloxacin is now right out and a member of my allergies list due the the adverse reaction I had a few weeks ago when I took it. So far, I don't seem to be having any dificulty with the Bactrim, which I'm quite happy about, and more importantly, my pain level is lower than it has been since this all started.
I think I'm finally on the right road. Now all I have to do is get the Ortho guy to sign off on letting me do PT....
First thing he said to me was really heartening: no Unna Boot. Because I don't have any vascular insufficiency it is not appropriate for me to wear one. Second, he had me ditch the Frankenstein shoe as it is actually making things worse rather than better as far as pressure on my heel. Rather, he prescribed a different shoe, one with an open back and a more forward heel strike. I suspect it will make a difference, provided the insurance provider approves it, but that's another story. He also prescribed different topical medication - a compound of BactroBan and Sentyl (I hope I spelled them correctly), which are a bit on the old school side, but they have a proven track record with wounds like mine. He also told me that the Silver Gel has a time window of about 4 weeks that it is effective in, and after that I'm forced to deal with the law of diminishing returns in that is becomes totally non-effective by then. So all it really was doing was keeping the wound bed moist but not having and effect on the bacteria.
He also remarked that the area around the wound was reddened and really warm to touch compared to the rest of my foot. This may be simple inflammation, but because when he'd seen this in the past there was infection associated with it. So, I'm back on anti-biotics. This time I'm taking Bactrim as it was one the sensitivities that came back on the last culture I had taken. Ciprofloxacin is now right out and a member of my allergies list due the the adverse reaction I had a few weeks ago when I took it. So far, I don't seem to be having any dificulty with the Bactrim, which I'm quite happy about, and more importantly, my pain level is lower than it has been since this all started.
I think I'm finally on the right road. Now all I have to do is get the Ortho guy to sign off on letting me do PT....
3 comments:
Walt,
I hope this doc works out fine. Can you imagine the people that cannot change physicians and wind up with an amputation? Great Post!
Alex ~D~
http://theapocalypsepapers.blogspot.com
Sounds like it was worth the trip! Hope everything starts to get better!
Sounds like the new doc spoke a lot of common-sense. Sometimes a second opinion is very valuable.
I hope the heel responds quickly to the change in treatment ........
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