As some of you may know, I am currently suffering with a foot ulcer.
For those of you who didn’t know this, here’s the short version of events: I used to sleep on my right side every night; an area of dry, hard skin built up on the outside of my right foot because of the pressure; I started to get severe pain in my foot at night; the district nurse gave me some cream to clear up the skin; the pain got worse; the area of (now soft) skin broke out into a wound; the pain got worse. Since then I’ve been visited by the nurses almost every day for bandage changes and cream applications and have seen a specialist - a very nice man named Mr. Downing - twice. They’ve done arterial scans, ultra-sound thingymibobs and other tests and seem to have come to the conclusion that it was simply down to pressure, i.e. sleeping on it night after night after night.
Whilst I’m not particularly happy about having this ulcer, I am quite glad that it isn’t (so far!) as bad as it could be - compare how it looks now (warning: it’s not a nice picture!) to some of the pictures found using Google image search (double warning: they’re really not nice pictures!).
As a result of all this I’m currently taking a few pills to cope mainly with the pain - I’ve had a couple of courses of anti-biotics, but none recently. For pain relief I was started on co-codemol, but this proved to be insufficient to ensure me comfort or any kind of decent sleep, so they stepped me up to tramadol. Now, these babies did the job and they don’t give me the constipation that the co-codemol did. They do, however, have other side effects like making me dopey (more than usual …) and causing me to drop off to sleep several times a day. Unfortunately, whilst they gave me relief during the day, I could only take 400mg/8 capsules in any 24 hour period and this simply wasn’t enough to get me through the day and the night, so I was also given amitriptyline to take just before going to bed and while these certainly do the job of allowing to sleep, they also make it more difficult than usual to wake up in the mornings. I’m also taking diclofenac with my meals which, I’m told, is an anti-inflammatory and will also help ease the pain a little.
The point of this entry is … ?
As you can imagine, with all these pain killers and anti-inflammatories I’m not feeling normal (for want of a better word) - my senses are dulled, my reactions are slow and my brain just isn’t working how it should. I’m still me, but it feels like I’m under a heavy blanket and I can’t lift it off of me. So yesterday I tried a bit of an experiment: I didn’t take any tablets. At all.
When I got up at 11.30am (after N, my personal assistant, let me have a lie-in) I was still under the influence of the previous night’s amitriptyline, i.e. I felt only a small amount of pain in my foot. As I usually take my first dose of tramadol with my breakfast, half an hours worth of discomfort is the most I ever experience.
After about two hours of no pills, my foot was throbbing big time - if I moved it only slightly it complained bitterly: sharp intakes of breath ensued and I had to hold the tears. I discovered a while ago the if I put my foot flat on the floor and put pressure on the ball of my foot (i.e. as if I was leaning forward) then the pain was eased somewhat - unfortunately, as I spend almost all of my waking hours in my powerchair (which is too high for me to reach the floor when I’m in it), the only place I can do this is when I’m sat on the toilet, and getting to the toilet from my chair and vice-versa caused me even more pain due to the movement and shuffling I do when using my hoist.
So, after about three hours of no pills, I decided I couldn’t take it anymore and took a single tramadol (i.e. 50mg). About half an hour later (around 3 o’clock) the pain had eased a bit but was still enough to make me cry. I gritted my teeth and bore it for another four hours and then I took two more tramadol capsules and half an hour later the pain eased some more and was now quite bearable - on a usual day the pain would be almost non-existant by then. At 11 o’clock at night, I took two more tramadol capsules (making that day’s intake 250mg instead of the usual 400mg) and I also popped in an amitriptyline. I climbed into bed (which takes me about 25 minutes and requires N to lift my right leg - the bandaged one - up onto the bed), got comfy and drifted off. Unfortunately, I woke up at around 4 o’clock in the morning with the pain I used to get before I started taking the pills way back in May/June time - because I hadn’t taken my full dosage during the day, the amount I had taken obviously hadn’t been enough to build up my body’s resistance to make it through the night. I lay awake gritting my teeth for what seemed like three or four hours before dropping back off, but it turned out to be less than an hour and a half (N had woken at 5.30am and I was back asleep by then).
So, whilst I enjoyed having a clear head and not wanting to go to sleep all the time from not taking my pills, the pain and discomfort I got was too much to bear. Though it pains me to say it, feeling dopey and drowsy is by far the lesser of the two evils as far as I’m concerned.
I’m sure there are many of you out there who experience worse than I’m going through at the moment and I have the utmost respect for each and everyone of you for having the strength to cope with it in whichever way you choose.
At the moment I’m weak and desperately need pills and support to get through it - fortunately, thanks to my doctor (Dr. Williams), the nurses (Chris, Joyce, Karen, Kate, Linda and Liz), N and family and friends I seem to have a never ending supply of both.
Thanks for reading.