LATE NIGHT REALITY CHECK

Posted at 3:48am

Well, this week is getting off to an auspicious start.

Over the past ten days or so, my right big toe and its joint have been painful in a familiar arthritic/gout way, so I asked the center's doctor to prescribe me Colchisine to alleviate the pain. It brought the pain down by a good margin but it continued to be painful, so I assumed the Colchisine needed more time to really do its job.

But tonight I could not sleep, so I got up, did some tidying around the apartment, and went outside to dump a bag of trash for morning pickup. When I came back inside I again readied for bed, and for some reason I gave my toe a once-over. The skin on its underside was swollen and it gave like a balloon when pinched between two fingers, and what at first looked to be dirt was in actuality the pad of the toe being dark from what appeared to be a large blood blister. (I had showered an hour earlier, so my feet were squeaky clean.) Upon close examination, it did indeed appear to be an infected blood blister, so my mind shifted into "taking care of medical business" calm mode, and I gathered the implements of pro-level care that I have here at home, items provided by my podiatrist for just such situations.

I cleaned the swollen area with alcohol and a surgical towel, then I hit the surface with Betadine solution (the brown fluid that's applied to sterilize skin ahead of surgery). I then opened a fresh Number 10 surgical blade, pinched a section of the stretched skin, and made the tiniest of nicks, barely a pin prick. Even that slight opening caused a thick, pressurized spurt of dark, thick, likely infected blood, which continued for a bit as I applied pressure all around the area, and along with the blood a semi-solid chunk of what looked to be infected material was expressed from the incision. Once that was cleaned away and the the toe fully drained, I opened the incision further, freeing the loose balloon-like section of skin and trimming it away to reveal healthy pink toe flesh beneath, swabbing it with sterilizing fluid the whole while. Once that area was opened up and no more blood/crud flowed, I did a bit more cosmetic trimming of dead skin, some of which was connected to a now-useless hardened callus, so in a few minutes the toe, though raw, was clean and healthy-looking, so I again applied Betadine, swabbed the area again with a surgical gauze square, and then applied a layer of medi-honey, as I had been instructed to do when battling the issues I'd had with the toe in previous months. Once the hoey was packed firmly into the raw area, I covered it with a gauze square and tightly wrapped the toe with a stretchable surgical bandage that tightly takes on the form of whatever it's wrapped around and holds the shape until whenever I change the dressing.

All of that took perhaps fifteen minutes for cleanliness and precision care. My podiatrist taught me well.

I get picked up for dialysis in around five hours, so I will now attempt a few hours of sleep. Once I arrive at the center I will call my podiatrist's office and see if he is available to see me later this afternoon, post-dialysis. His usual hours at the office near me are on Thursdays, but he's a resident at Presbyterian-Methodist, which is also close by, so I hope to catch him. If he's not available, I will hightail it to the urgent care, just nine blocks down 5th Avenue, between 7th and 8th Streets, and let them check me out and give me a professional cleaning and dressing. I will also request a prescription for a strong antibiotic and I will follow whatever care instructions they give me. After that, we shall see what transpires next.

I'm concerned about this because I would prefer not to lose my remaining big toe but, to my admittedly untrained eye, it looks like I spotted and dealt with the current issue before it got too far along and went out of hand. That said, I await the word of a qualified medical professional before I fully relax. But having already been through the amputation of one great toe, I am not fearful if it should come to that again. I certainly hope not, but I am ready to do whatever it takes to keep the remaining big piggy.

Very much in "medical taking care of business" mode right now, and I will maintain that state of mind and focus until I see a professional this afternoon. I hope to be attended to in a little less than 12 hours.