It’s been a while, but there hasn’t been much to talk about on any given day. Mostly just several wound care appointments where the doctor is liking the progress the hole is making. It’s still ugly and nasty, but it doesn’t look like an effect from a bad zombie movie anymore.
The night I went to the ER, the surrounding tissue was grayish red, and the hole looked like something had taken a big bite out of me and it had gotten infected. Now the immediate surrounding area is ugly scar tissue, but it’s just scar tissue, not rotting meat. I have skin growing back in places, the hole is much shallower, and it’s getting smaller. The doctor and nurses are all commenting on how much things have improved. Not sure if I’ll be getting plastic surgery or not, but it hasn’t come up. I’ll take that as a good sign.
I finally had the vein procedure they’d mentioned back in April. That was fun and a half. The issue is that the vein in my upper thigh is supposed to be 3-4mm. Mine was 14mm. The average human aorta is 15-20mm. I did not realize this until Stacie mentioned this to our neighbor, an ER nurse. She was kind of horrified at the size of my vein, and Stacie just shrugged and told her “you’ve met him. Does he strike you as the type that does anything halfway?”
When the vein gets that loose, the valves stop working. When the valves stop working, the blood doesn’t flow back uphill and pools in the lower leg instead of circulating like it should. Poor circulation leads to all kinds of fun stuff, including problems with wounds healing. Hence the abscesses and ulcers I’ve been getting in my leg for the last few years.
Luckily, you have two sets of veins in your legs. The big one I was having issues with, and a bunch of smaller ones. Either set is enough to handle things, and if you need a bypass, they typically harvest some of these smaller veins to do it. If they have to plug the big one, the smaller veins are sufficient, especially if they aren’t themselves completely screwed.
Had the consultation in July, and they explained not just the procedure they’d be doing to me, but also how much progress they had made in treating this condition.
I was supposed to have the older version of this procedure done in 2012 or thereabouts, but it was far more invasive. The old version involved cutting your inner thigh wide open, ripping out the vein, and plugging all the tributaries. And you’re off your feet for weeks or months while everything heals, and you have a huge, ugly scar. The scar I don’t care about, but being out of work for that long would have left me homeless back then. So I never had it done.
The new version is called “radio frequency ablation.” Basically they insert a probe into your vein and hit it with radio waves to cauterize it from the inside. It cooks the meat, causes clotting and scarring, and over the course of the next couple weeks it scars (ideally) completely shut. Recovery time was described as “I schedule the surgery for Friday so the patient has all week to recover. I don’t foresee you missing work Monday, and if you do it will just be Monday.” Right on. Plus the procedure is so relatively minor they don’t even knock you out for it, just give you a valium and some local numbing stuff.
The next day I’m trying to figure out how to describe this to my bosses, since I knew they’d ask. Aaaand I realized something. I build robots. Robot school covers a lot of interesting stuff so you understand how everything works. Since so many sensors are EM-based, you get a nice overview of the electromagnetic spectrum. That’s when I realized what “radio frequencies” cauterize meat. Gorram microwaves. They were fixin’ to microwave me from the inside out. With at least part of the process all the way up so the emitter was an inch or two from my gear.
When I mentioned this to Stacie, her response was “well, as long as they don’t end up like corn nuts…”
The people at work had two reactions. Initially, it was just blind acceptance. I have had so much bizarre and horrific medical stuff go on over the last few years that they all just nodded and essentially took it as “microwaving you from the inside out, eh? That’s got to suck.” Then it switched to seeing the hilarity inherent in me getting my package microwaved.
So I got that done 26 August. Fun. And. A. Half.
Short version: lying on the table wearing nothing but a gown, doctor holding my package out of the way while he’s running the probe up the vein in my inner thigh from the knee up. And giving me a numbing injection every 30mm. So about ten of the damn things, including one right in the crease. That got real old real fast. Then the microwaving began. Two sets of microwavings at each of eight places running back down to my knee. There was nothing to that part – if it hadn’t been for the ‘50s B-movie mad science noises coming from the machine I wouldn’t have even known.
Then while I was lurching and staggering back down the hall to the OR prep room so I could get dressed again, the doctor headed out to let Stacie know how it went. He would not tell her they had briefly lost me on the table but it was OK because I’m too angry to die. He did tell her I tried to get him to though.
Had to have a venous ultrasound a few days after the procedure. One of the main potential complications of this procedure is a deep vein thrombosis. With my leg issues, I’m not taking any chances. Ultrasound results came back a few days later and said there was no deep vein thrombosis, and the backflow was greatly reduced. Not completely sealed, but definitely a major improvement. Looking online seems to say it only works 100% about a third of the time, though, so I can’t complain too much about these results.
The only real side effect after the weekend was the pain from the upper leg wraps. They do not stay put for very long and roll down, and when they start to roll down they dig in. Anyone who has worn pantyhose, stockings, or compression socks will know exactly what I’m talking about. For a couple/few weeks, the microwaved area felt cooked and leathery. To be blunt, it felt like someone had implanted a cooked bratwurst under the skin of my inner thigh. It literally felt like a tube of cooked meat. That’s shrinking a bit, so now it’s more like a lump of cooked meat instead of a sausage.
A month later, it seems to have worked. I’m walking better and the color of my leg has improved so much Stacie accused me of stealing someone else’s foot because mine is back to the right color again instead of the ugly reddish purple it and most of my lower leg has been for the last few years. On a bad day, my leg would turn an ugly purple from the knee down. Now my foot turns kind of reddish after a long day and that’s it. It also isn’t swelling nearly as much, and when Stacie started poking and prodding my foot and leg, she said she wasn’t leaving dents anymore. That’s helping with the walking and it seems to be helping the giant hole in my leg heal over.
The wound care team seemed pretty amazed at the changes too. They commented on how much better everything looked, didn’t say anything about the test results, etc. Then they started asking a bunch of horrific questions along the lines of “did this, that, and the other thing happen? No? Oh good. That happens sometimes.
I had an appointment with my regular doctor on Friday, and while I was seeing her for unrelated reasons (mostly diabetes and preventive) I made sure to wear my sweatpants that day. So when she asked about wound care I told her I could show her if she wanted. Her reaction to just the part of my lower leg that sticks out above the bandages was “oh my god. It hasn’t looked that good since last year!” I thought her eyes were going to pop out of her head. Then when I took the bandages off she squatted down to get a really good look and kept going on and on about how good the wounds looked, how much shallower they were, the color of the meat around them, the lack of infection, everything. She also said the part just below my knee had decreased in diameter by a third; it used to swell up really bad from the circulation issues and now it doesn’t.
So I’ll call that a success on several fronts.
There has been one weird side effect though. When I lie down, the blood in my foot and lower leg flows back up and I can feel it as a warm flow. It used to be a major sensation in my inner thigh. Two days after the procedure, I noticed the same sensation, but much smaller and in three different places on the front of my leg, and sometimes a bigger one on my forward inner thigh, but not the same part of my inner thigh as it used to be. I looked at a diagram of the leg veins, and it looks like these weird new sensations are the flow rerouting through the secondary veins. So yeah, not going to complain too hard about this.