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It still hurts  13

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.


Hi Timmargh! Sorry to hear and read about all the pain a nd soreness that you are experiencing, I feel bad for you. Hope the pain a nd suffering dies down and you feel better soon. Never forget that all your blogpals are never too far away for a chat on each other’s weblogs and we all will give each other words of comfort and support! We all experience different forms of pain don’t we, but you’re right that we all cope. I know things right now seem unbearable for you but if you think hard, I am sure things will prove to be better. It’s good that N is there for you and I am sure that she is taking away some of the pain by comforting you! Bye for now sweetie! See you soon, Katie xxx - Katie Fraser

Thanks, Katie. You always bring a smile to my face. :^) - Timmargh

After reading that, I really do honestly hope that your foot impediment will clear soon to let you live more comfortably. Have the doctors said when the sore will eventually clear? - gamesfreak (Daniel Harper)

" Have the doctors said when the sore will eventually clear?" They said it will eventually, but it’ll be a few months at least yet. I need to have my foot raised as often as possible to allow the swelling to go down a bit, but unfortunately I can’t do it for more than about 45 minutes as my leg goes numb. - Timmargh

Oh Tim, pressure sores suck! Since this one crossed over to ulcer stage I can’t actually relate (managed to catch mine just before this each time) but I can only imagine the pain. I know that before they break the skin that massage is recommended, to help with the blood-flow they say, but I always find this so excruciating! and am not sure if it would even be possible with an open sore. I can relate to the meds, dopey, constipated, out-of-sorts. I also went cold-turkey off heavy duty pain meds once and was glad of it, but in my case the pain meds just weren’t working, only giving me terrible side-effects. Sounds like your experiment with the meds at least proved that in this case the side-effects are worth bearing since the pain relief is so necessary. Best of luck with this; I only wish that there were something that I could do! Keep smiling, and just think how good you will feel when the sore is gone! - gimpy mumpy

Ooh blimey! I know how you feel abut raising your leg Tim! I had to raise my leg when I broke my femur as a kid and when the doctors and my dad tried to put me in a bath I screamed the place down! My leg went numb too so I know how that feels! - Katie Fraser

Sadly that was the cause of all my bad problems and left me with a walking disability and a slight limp! - Katie Fraser

Tim, I don’t know why I didn’t think to suggest this earlier and I hope as fellow crip and fellow victim of everybody telling you how their aunt’s cousin’s best-friend cured themselves of your ailment by wearing a cow pat on their head, you will forgive me for doing so. Gingko-biloba. I have bad circulation which means my feet, hands, nose etc get icy cold in the winter. Gingko-biloba really alleviates this, it really has improved my circulation. May be useful to try some to speed up the healing process as I understand ulcers and circulation are related. Do check they don’t interact with anything else of course. Might be worth a try. Just a suggestion. Otherwise best wishes for a speedy recovery. - The Goldfish

You’re not one to to seek/allow sympathy, I know, but it’s damn frustrating (as a mate) to read of the pain and frustration you’re in and not be able to do something to help sort the problem!! It’s good to hear that you will be better in months though, and that reading from a previous comment, you can probably prevent this happening again. I’m now psyching myself up to have a look at the pictures. Chin up mate, Peru says hi too. - tugger

Hiya! I’m Nicola from Ouch! One of the many it seems, so to distinguish, my Ouch! name is KD_Djonma. I’m sorry to hear about your foot! Be carefull with the tramadol; they’re nasty things and very addictive. I think I’ve got a pressure sore starting on my right foot, I keep moisturising the area, but the skin is definitely messed up. Ahh well, it’s not an open sore yet, so it should be ok! Make sure you take care of your foot and I hope it gets better soon! Nicola - Nicola

Thanks for all the kind words, ladies and gentlemen - it’s nice to know you’re all gritting your teeth for me! Goldfish: I’ll look into ‘gingko-biloba’ - thanks for the pointer. Tugger: no worries, mate. Have fun looking at the pics and send my love back to Peru for me. Nicola: thanks for stopping by. My doctor has warned me about the tramadol being addictive and that’s partly the reason why I tried going without them for a while. I’m not an addictive person by nature (I can take or leave smoking, drinking etc.) so hopefully I’ll be okay. I hope yours doesn’t turn into something like I’ve got - call the doctor in soon and don’t leave it too late like I did! :^) - Timmargh

Don’t forget your nutrition in this though… those sores will need protein to help heal, and try to avoid excessive sugar and yeast as they encourage bacterial growth. Also if you are a smoker, try and cut down/stop if possible as smoking causes the veins to narrow which deprives the wound bed of oxygen. This also delays healing as it kills of all the new little cells are that trying to grow. - jayne

Thanks for the advice, Jayne. My foot is fully healed now (I’m writing a full account of it at the moment) and the district nurses talked to me about my diet - I was and still am taking cod liver oil, multi-vitamins with extra vitamin C and have increased my vegetable and fruit intake. I always ate fruit but had never been a vegetable lover, but I hold my nose and swallow them down! I’ve never been a smoker, though. Look at my halo: 0:^) - Timmargh