Jato

Adversity forges iron into the finest steel.

Rawhide Part 3

Nearly healed

It has been more than 5 weeks since I first noticed a skin issue that looked suspiciously like a skin infection. Two rounds of antibiotics cleared much of the condition, but this Monday my skin was still quite red on the distal end on my residual limb, far too irritated looking for me to run.

I researched various skin problems and this sure seemed like cellulitis with an added measure of folliculitis. Given what further complications could arise from these conditions, I decided I must see a dermatologist. My family physician's office gave me a referral and I was able to see the Dr. Allison Morrison on Tuesday. Her office is across the street from where I work, also very close to Dr. Ohlson's office as well. (I should note I also called Dr.Ohlson's office; he was out of town but called in to say I should see Dr. Morrison too.)

At this point my leg is better but still bright red. Dr. Morrison says my diagnosis from my family doctor was cellulitis, but at this point she is not as certain. Skin issues are common with amputees, having their limbs housed in dark, insulated prostheses that are perfect breeding grounds for numerous critters looking for a meal.

Dr. Morrison prescribed clindamycin, and suggested testing a smaller area with hydrocortisone to calm down the inflammation. I was also told when cleaning my leg to use cool water. By Friday the redness had turned to a healthier pink, and my residual looks good enough now that I can resume running.

*******

It would be difficult to impossible to know for sure what caused this infection, but there is one thing that stands out. In the past I had used A&D ointment to provide the lubrication and protection between my skin and the polyethylene liner. Outside of some heat rashes and skin pinching that were largely resolved, I had not had any abrasions or other significant issues until I changed to mineral oil. This was done because the A&D was clogging my vacuum pump at times, rendering it inoperative.

When I was told to use mineral oil I was not sure which product to choose. I did ask for recommendations but did not receive any specific answer. I did see there was such a thing as medical grade mineral oil, along with the usual items you can buy at any drugstore. Since I was only looking at this from a lubrication point of view, I bought a couple of brands and began using it.

A couple of months after this switch I was treated for a skin infection that was quickly cleared up, so I didn't fret over it. However, with this next problem I began looking seriously to all things I had control over and what had changed, and using the mineral oil seemed more and more like the culprit. I have no idea how sterile the oil is, and being cheap, would be surprised if it was of high purity.

I had visited ProCare the previous weekend and was told to go back to A&D, that whatever problems were causing the clogged pump would be addressed. An additional filter should help trap excess ointment that passes through the system. Also I know I do not have to use as much ointment as I did in the past so that should help too. For whatever reason, I do seem to be sweating less in my liner. When I have been able to run, I haven't passed large amounts of fluid through my pump. We'll see how it does later this summer when my mileage comes back up.

My NO2 injection tank, a.k.a. new filter

*******

For the second time this year I will restart my running toward my goal of running Boston. Week before last I learned I would have a deferment for running Boston in 2013. My good friend and amp running compadre/mentor Kelly Luckett called me after Boston this year to let me know this news, but suggested I get it confirmed since we had conflicting information from the race website. I called the BAA and got official word to which I was overjoyed.

Given this latest setback I would have 8 weeks to go from 0 to a marathon. With my recent knee surgery, I really did not want to push it so soon, but I am determined to make it to the starting line in Hopkinton next year. Not unlike my belief that I had to run the Charleston marathon despite many setbacks up to and during that race, I have to be at Boston next year. Few things can stop me but those things in my control will be handled.

And starting today, June 23, 2012, I begin training for Boston. Again. Determined. 

It is a good day to run.

Rawhide Part 2

After 10 days on an antibiotic my skin is looking much better, though not quite fully healed. I haven't run the past week since I didn't want to irritate the skin further and possibly extend my recovery time. I had thought it would have healed quicker than this, but staring at it does not seem to expedite the process.

The dark and always sweaty running prosthesis is an enhanced breeding ground for fungus and, no doubt, other wee microbes who love to feast on opportunity's hide. As I've mentioned, I am religious about cleaning my prosthetic wares, but I will be even more vigilant from here on out. There is a good article on this topic here.

I bought a bucket large enough to soak both of my liners in a bleach solution, and will clean them even more diligently with antibacterial soaps, hydrogen peroxide, and rubbing alcohol. Also at night I will use an athlete's foot spray on the residual. Now isn't that ironic, getting athletes foot where I have no foot at all? Cute, running gods, and well played indeed.

The Ugly - June 1, 2012

The Almost Good To Go

*******

I still do not know if I will have to requalify for Boston, I will be checking on that next week again and see if someone will be kind enough to talk to me. If not, I have about 11 weeks until my next marathon, once again being woefully unprepared for a race. It will be a slow one and I only plan to get my rusting carcass across the finish line in one piece without further injury.

There are promises to be kept and I mean to keep them.

Rawhide Part One

Skin infection on residual

A couple of weeks before Memorial Day weekend I noticed a red spot forming along the incision line on the front of my residual. I am very conscientious about keeping my liners clean, using antibacterial soap, and immediately attending to any skin issues like the occasional pinched skin break. This wasn't an abrasion, so I knew I had to be careful.

"Good good good lookin' out our back door" (S&L Photography)

We had been to Devil's Fork State Park where Jennifer had grabbed a great deal for a villa by staying up to midnight earlier in the year to snag it. We had a restful weekend, and did a little hiking at Oconee Station to Station Cove Falls. It was rather warm though not yet as hot as will be in another month. With my new walking prosthesis and the Renegade AT foot, I was enjoying the ease I could traverse the hills and uneven ground. With my old arthritic ankle, I could have not done this without a great deal of pain if at all; now I look for roots and rocks to walk over it because it does not hurt anymore. I never get tired of doing this!

Station Cove Falls (S&L Photography)

Anyhow I was sweating in my liner, not unusual and less than I have in the past, but still not the best environment for what was already starting on my skin. Despite applying a topical antibiotic to the spot, it continued to get bigger, and more red spots radiated from it. Follicultis? When we got home I noted things were degenerating, and was able to see my MD on Tuesday afternoon. He treated my previous infection with an antibiotic that quickly cleared it up; this time he used a different one that I began that evening.

I continued to run, not wanting to lose the microscopic fitness gains I have made since my knee surgery. This is obviously slowing the healing process so I am taking time off until the infection clears up. I'm also looking into changing my cleaning protocol, sterilizing my liners more often, and asking my amp running friends what they do to help prevent the problem from occurring in the first place. I don't want this to become a chronic condition or worse.

It is couch surfing season again, something I have done through my surgeries and other bumps in the road on this new running journey. I am hoping to heal in the next week as we have a race on June 14 at Charles Towne Landing. This is a Thursday evening event I choose because it could serve as a tempo run for me, since my racing speed, such as it is, will not return for many more months. With a few more workouts I should be able to run without someone mistaking me for a static park display.

Come to think of it, I ran my middle-aged PR at this location many years ago...it will be a nice reunion with the old me there, to see how far we have come and how far we will go. A little older, a little slower, but more thankful than ever, that...I...can...still...fly.

Red wing and all.

*******

Update: One of my CPs believe this may be fungal so some athlete's foot type medication may clear it up and be an excellent preventative.