There are only three very small places left on the top of the foot. Just about the ONLY place there is swelling anymore is the toes and the front half of the foot. The graft site seems to be expanding to fit more of the contour of the leg. He's been doing a lot of walking and the muscle is no longer so atrophied, but building. The seams of the graft are just beautiful and completely healed. The variations in color are mellowing out and it's looking more normal. The girls aren't taking any chances, though, and are strictly sticking to protocol to get these last few places totally healed up. Again, the slow spot seems to be over the tendon on top that seemed to take longer than any other area to cover with granulation. Because of all the time he's spent lying down with the foot elevated, he has done a lot of flexing and rolling his ankle so it doesn't become stiff and any more arthritic than it is. He has a very good range of motion in the ankle, the nurses were quite but to get the top large spot completely healed, he needs to lay off that for a little bit. No signs anywhere of problems or infection. What used to take nearly an hour to accomplish in a visit now can be done in 20 minutes or less. As of Thursday he has been off all prescription pain meds completely for two weeks and is not going back, no small feat considering the months that Dilaudid flowed through him in large amounts.
I have remarked many times that this has been as difficult mentally and emotionally as it has been physically. It was important to him to get off the pain meds. His father was a narcotic pill popper and he's done everything he can to not be anything like his family. There hasn't been alcohol for over 10 years anywhere near him, and to have had the pain pills this long bothered him. He did go through withdrawal, but focused on what he was accomplishing instead of berating himself that "I'm no better than my father." To him this was a very personal challenge for that reason, but it also meant closing the door on one more aspect related to this battle with nec/fac. He had an appointment with his regular doctor today and instead of the milk chocolate he's been eating to help with the withdrawal, the doctor instead said he'd rather it be dark chocolate for several reasons. It won't mess so much with his blood sugar, lots of antioxidants, and because of the sharpness of the taste you're less likely to eat as much of it. Duly noted, getting some tomorrow.
I showed the doctor the photo below and he was blown away by how well Mike has healed. "To have gone through what you've gone through, being almost 50 and Type 1 diabetic since 1988, once we get this testosterone back up, you will be like a kid again." He was very proud of how well Mike's done.
However, the visit today was not entirely a happy one. In December 2011 he was found to have VERY low testosterone. We were doing injections every three weeks up until August 1 when this all started. He was doing better and after the nec/fac, his doctor took him off all of the testosterone. This has obviously been a physically difficult time but the last blood test a week ago revealed that his testosterone was now in very dangerously low levels. With the pain meds gone, I now can see the effects of low T on a man and it's heartbreaking. Depression. Lack of initiative. Exhaustion. Weight gain. But the doc wasn't willing to prescribe anything until he'd done a prostate exam.
Do not think for a minute that I didn't run with this. Because I did. :o) After years of heading off to an annual exam and hearing, "Smile big!" for the mammogram and all sorts of lewd remarks about the exam table and stirrups, karma came back to bite him square on the behind. And I had fun with it. Ali and I left the exam room after the initial checkup and on the way out the door, I called to Dr. Kuzma, "Be gentle with him. And give him a 15 second cuddle when you're done." Karma. They both blushed.
So, the plethora of meds are gone, now it's only insulin, diuretic, potassium, and the testosterone cream. I marvel at how each piece has fallen in place and it only happened because we followed every instruction to the letter and looked to God for everything. We have lived in such a state of panic and urgency for so long that we now both agree on one thing: Boring is GOOD.
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