Folks, once again, I am in the hospital. This time, I’m in for a painful infection in the big toe of my left foot. The backstory is too long to post here on the main page, and if you’ve been following my posts on Facebook and elsewhere, you already know it. In the event you don’t, you can read my post, called The Ballad of Big Toe.

Here’s my situation as of Thursday, July 29th, 2021:

This morning was pretty normal, as far as a stay in a Long-Term Acute Care (LTAC) hospital can be. My wife showed up early, and we resumed the “Sorry!” Partnership tournament. (Note: she would go on to trounce me 3-0 during the day.) Late in the morning, we were paid a visit by my case manager, a physical therapist, a nurse, and a wound care nurse, together at one time. They discussed my case with my wife and me, giving me a tentative release date of August 14th. I’m hoping I’ll be out earlier than that, but you never know, especially with the way this cellulitis has progressed.

Shortly after noon, my son and his wife arrived. My son had his new viola case with him. Quite impressive, it was – unless I’m mistaken, it was built out of blue fiberglass and fashioned like a sturdy cello case, with latches all over the place. He’s quite proud of it, and I believe his wife (a violinist with a regular-style, more expensive case) is a tad bit jealous. Anyway, they stayed for a couple of hours and made life more enjoyable.

Late in the afternoon, I developed a bit of a problem in my left arm, just below my PICC line. A rather startling lump formed on the right side of the inner crook of my left elbow. The timing of it is rather suspect, because it formed as I was receiving my last IV of antibiotics (at least, I noticed it as the IV line was being disconnected from my PICC line). The lump is about an inch-and-a-half long by three-quarters-of-an-inch wide, and I think it sits right above a blood vessel. The night nurse looked at it and decided to give my case doctor a call: he ordered a venous ultrasound for tomorrow to find out what’s going on inside.

You know, just for once I wish something would act the way it’s supposed to with this hospital stay. Just once.

After dealing with an affliction of spots and blisters for almost a month now, today, on this last day of 2020, I finally have a diagnosis! I saw the dermatologist this afternoon, and he pronounced that I have a case of Henoch-Schönlein purpura, which is a rare form of vasculitis.

Some of the peculiarities of Henoch-Schönlein purpura, or HSP:

• It affects children more often than adults.
• When it affects adults, it is more severe.
• It can cause pain in the joints and the abdomen.
• It can result in kidney damage in a small percentage of cases.
• It usually resolves on its own, but not without several bouts of purpura (spots/blisters).

My next step, according to the dermatologist, is to pay a kidney specialist a visit. He wants to make sure I haven’t suffered any kidney damage from my attacks. If I haven’t, then I’m to stop taking the Torsemide diuretic that I’ve been taking to get rid of the edema/swelling in my legs. Also, I’ve been given a steroid cream to apply to my red spots to help make them go away quicker.

At least I have an idea of what this stuff is now. Time to get to work on fixing it.

It’s not very often that I get to use the phrase, “Boy, howdy!” in a serious post, but this is one of those occasions. Boy, howdy, has December 2020 been strange, health-wise!

And rather disgusting as well. Just wait until you see the Gallery, if you dare.

Now, for the story. Things started off around Monday the 7th, when I noticed a “fuzzy” spot on the third toe of my right foot. These are usually bad news, since they tend to lead toward outbreaks of osteomyelitis (bone infection). I resolved to call my podiatrist the next day.

The next day, I checked my toe and was shocked by what I found. The “fuzzy” spot had quite literally exploded like a piece of popcorn. I couldn’t get in to see the podiatrist the same day, but I did get in the next day (Wednesday the 9th).

During the delay, I started developing small, itchy spots on my lower right leg. A bit of background: I was already on a blood thinner (Xarelto) due to a suspected blood clot somewhere in my system that might have been causing severe edema/swelling in my lower legs and feet. Now, understand that the itchy spots were extremely itchy. I succumbed to evil temptation and scratched them. They eventually blistered up, badly, prior to me seeing the podiatrist.

Come time to see the podiatrist, and my right lower leg and the aforementioned toe are looking terrible. He puts me on two antibiotics and tells me to come back Friday, saying that he gives my toe a 50/50 chance of being saved. He has no idea what the spots are.

Friday, I’m back in the podiatrist’s office. My spots are black and draining (especially one huge one above my heel), my toe hasn’t improved, and my edema is in runaway mode. The podiatrist fears osteomyelitis plus some strange infection, but he has no idea about the edema. He sends me to an emergency room for admission to the hospital. They do admit me, begin running tests, and place me on super-strong antibiotics.

Saturday, the podiatrist partially amputates my toe. I later learn that I did have osteomyelitis in the tip – he described the tip bone as “soft as putty” – and that the flesh around the bone was infected with MRSA. He assures me that he got all infected material when he did the amputation. However, I’m still on super-strong antibiotics for the draining spots. I do run a slight fever, which is extremely odd because I never run fevers. Ever. I’ve also still got the edema, which by now has spread to my hands.

One day, as I’m sitting with my wife after lunch (thank the maker they allowed visitors), I noticed a couple of new spots on an arm. I scanned my extremities. There weren’t just a couple of new spots, there were a lot of new spots. Both arms, both legs, and both sides of my groin – all were covered in new red spots. Once I got the doctors to pay attention (they weren’t the best), they flew into action. They’d ruled out a blood clot as the cause of the edema, so they stopped my Xarelto. They switched one of my two super-strong antibiotics to something else. They ran more blood tests. Eventually, they started punting me off from one doctor to the next, none of which knew the cause of my symptoms. They finally took me off of all antibiotics, just in case I was having a reaction to one of them.

After a week in the hospital, they discharged me with instructions to go and see a dermatologist, which I have done. He took a couple of punch biopsies of the spots on my right thigh and told me to come back on New Year’s Eve. However, a few days later, my hands swelled up to the point where I couldn’t make a fist and my fingers bruised, with the fingertips turning a mottled red. I had to see another doctor ASAP.

The first doctor available was an associate of my primary care physician. My wife and I went through the whole story with him. He was left sufficiently shocked. He ordered a brace of blood tests, the results of which are slowly trickling in. So far, everything has been normal, save for the fact that the tests show I had a staph infection while in the hospital according to him. We’re still awaiting the results of several other tests, though. He put me on Amoxicillin for a possible nasal infection, but took me off of it when my spots came roaring back to life. Maybe there’s a connection.

For now, I’m being seen by a home health nurse three times a week. They’ve got my right leg wrapped up from my toes to my knee. I’ve got to make sure I stay on top of my pain medicine, otherwise my leg starts burning on me. Also, I can make something resembling a fist now, which means I can type once again, hence this blog entry.

If you are really curious and have a strong stomach, now’s the time to go over to the Gallery and have a look at the proof of what I say. My wife has been busy documenting this to the best of her abilities, and she’s come up with a few doozies. I do warn you, if you click on the link I will provide, you will be hit in the face with some nasty imagery.

Ready? Click here and let’s begin.

First, the good news. It looks like I won’t be needing to see a Wound Care specialist for the blister. After a couple of weeks of bleeding and draining, it suddenly decided to heal. I have practically no trace of it left. Hoorah!

Now, the bad news, and it is indeed bad. If you’ll recall, I’ve been fighting edema/swelling in both legs and ankles for months now. My primary care doctor ordered an ultrasound of my legs, which came back negative for blood clots, DVTs, or other problems. He also ordered a blood test called a “D-dimer” test, which is supposed to check for evidence of a blood clot. A normal person’s numerical value on this test would be below 0.50. My value was 4.08, which my doctor called, “very high.” He immediately ordered me a prescription for 20 mg of Xarelto (a blood thinner) and is going to set me up for a CT scan of my chest, since that’s where any blood clot will likely be.

Fortunately, I have something working in my favor. Back in December of 2009, I had a “Greenfield Filter” (pictured on this page) implanted into my inferior vena cava. This was done to prevent blood clots from traveling from my broken ankles to my heart and lungs at the time (long story). Who knows – it may be doing its job as I write this.

Needless to say, this whole situation is scaring the daylights out of me. I’ll admit that I’ve upped the dose on my anti-anxiety medication in response. It’s helping a bit, but mostly it’s making me sleepy. I’m combating that with a Diet Mountain Dew and the soundtrack to The Mandalorian, Season 1, Chapter 1. Remarkably effective.

Anyway, I won’t have any further information until after the CT scan. Wish me luck.