Saturday, June 23, 2012

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.

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