Soo, Wacko Jacko is dead.

[Toogoofy317]

I don't think that wound is able to press together. It is beginning to look more like an ulcer than an actual laceration. Are you using sterile water and such to clean this wound? A dressing is your best shot as soon as it gets wet change it out with a new one and make sure it is bandaged lightly. Some dermagraft would be nice but $1500 a treatment is steep but vs the alternative! Also, nicotine isn't doing your body a damn bit of good because it is a vasoconstrictor!

SPC I've actually had alot of experience dealing with wound management. Worked at MD Anderson Cancer center  in surgical oncology for a year and you should see the wounds people get from chemo and such. My worst experience however was a women that had Chron's disese (yes she ended up on the oncology floor in the VIP room for some reason) and she had an intestinal fistula that managed its way to attach to the skin. It abcessed and when it got really bad ruptured. She literally had feces squirting out of her abdomen with bleeding as well. Ever smell a GI bleed? Even though ORMC is a Level 1 trauma center all ICU beds were full at the time so I had a 12 hour shift of trying to keep that wound clean and suctioning feces. A couple of times the smell go to me despite huffing alcohol pads and rubbing vicks vapo rub under my nose and was heaving in her bathroom! I took a shower before I left work and then a two hour shower after work the smell permeated those scrubs and had to be disposed of. My roommate never forgave me for that nights wonderful smell!

Mary

[yamahonkawazuki]

OYE that had tosuck , yeah last tiem at ER was rediagnosed fom cellulitis to an ulcer. or maybe misdiagnosed fomr day 1 idk anymore 4 days out fomr antis now. i guess well see where it goes

[wladziu]

Good god im worthless. i threadjack a michael jackson thread and end up talking about  my wounds. i am soo sorry.

Stop it, Giggles.



Just got a chance to see the picture on something other than my phone.  Pretty advanced.  Is it oozing, yet? 
How did that start, anyway?  Is it a venous ulcer; did it just develop on it's own?  Or some sort of trauma?  No need for a big story or anything - venous ulcers can benefit from compression bandages to promote circulation. 

20 days of Keflex and sulfa?  Looks like you might have antibiotic-resistant staph.  Running a fever?  General lousy feeling/tired? 
You need to go back and have them give you another course of something else, since I take it you're allergic to penicillin/shellfish. 
Skin grafts are all well and good, but it's not gonna be completely necessary until you're approaching toxic shock.  (And, you might be getting close.)



You've got a pretty good size colony of something growing in your leg, basically.  It's slowed the healing to a virtual stop, and now it's feeding on you.  Especially with those curled edges and all that redness.  It should have been close to closing by now.  You've got clotting, and that's good.  But, the colony's gotten under the skin, and there's the problem.  Gotta kill it from the inside out, without opening it up anymore.  Keep slapping on some of your favorite bacitracin/neomycin/polymyxin complex (aka Neosporin) (since staph is gram-positive) and changing the bandage often. 
You need to take that leg more seriously.  Stop being a baby and start annoying the crap out of your doctor.  And stop crying about medical insurance.  You chose to live without it.  I'm telling you for your own good; that thing's not going away on it's own.  Keep skipping out, and you're gonna need to be admitted.  And, no doc's gonna be nice enough to treat it for free - there's thousands and thousands out there already trying the same thing.  Why do you think crackheads die early? 

[yamahonkawazuki]

actually lad, the lib governor of the state of tn, decided i dont need it anymore, and can not ever have it back

[wladziu]

I see. 


I'm interested in learning more about that. 

If I knew more, I'd help more.  But, I can't.  All I can do is "play doctor" over the internet, and give pretty limited advice.  Find a cheap clinic where the immigrant workers go, and bug the sh!t out of them.  Problem is, they'll try to treat you as cheaply and quickly as possible.  So, educate yourself on the problem and don't be afraid to argue with them to get treated better. 


It's the way the world works, unfortunately. 
You can be poor and smart, or rich and stupid, but don't be poor and stupid. 


And, for Pete's sake, wash your hands before and after you touch that leg.  EVERY TIME!  Keep that thing clean!  Soap's not good enough (it mostly just works as a mechanical lubricant, to help physically scrub away the bacteria).  First, wash it in betadine, then wash with alcohol to keep the stains off.  Betadine will stain your clothes, but it keeps bacteria away much longer than just washing in alcohol.  Don't use hydrogen peroxide, because it will eat away the clotting that you DO have. 
Then, slap some Neosporin on there, then wash your hands with the same alcohol.  THEN put on a NEW sterile bandage.  Costs more than just pulling up your sock, but it's called "taking care of yourself".   
Do it a few times a day, at least twice.  To cut cost on bandages, use a sterile pad with a reusable wrap.  A big box of 2x2's should be only a few bucks.  Just use enough to completely cover it, two deep. 
That, along with the RIGHT antibiotics, should get you healed up before you need to be admitted for IV antibiotics and Mr. 10-Blade.  Ask Mary how much THAT costs. 







Not trying to talk down to you (this isn't your fault), but I hope you see that being the "tough guy" doesn't land you hot women or big trophies.  Just a fat, red colony of staphylococcus aureus. 

[yamahonkawazuki]

i hear ya lad, hell, have had no energy for last week or so , general crappiness. can get into health clinic in 3 weeks. will er if it gets worse [/threadjack]

[wladziu]

No, no.  It's already "worse". 

You've got a staph colony feasting on your flesh, and it's migrated through your blood stream and lymphatic system enough to affect your behavior.  Feel the lymph node in your groin, I'll bet it's swollen or at least sore.  You need to attack this thing.  Your body chemistry's out of whack from fighting this thing, and your immune system is pretty much overwhelmed.  Look how much you're apologizing and crap, lately. 

Antibiotics don't just kill the "bad" microbes, they also kill the "good" ones.  The ones that keep opportunistics at bay.  It's why women often get yeast infections after taking antibiotics. 
Now, what do you think's gonna happen, given your weak-@ss immune system? 

And, it's not a matter of simply keeping clean or not working very hard.  There's more bacteria on your little toe right now than sand on your favorite beach.  Half your poop, by weight, is bacteria.  It's just a matter of time until one single microbe (and that's all it takes) to make another little home.
Look at those little red spots next to your wound.  That's uncirculated, clotted blood.  See how it's inside the red field surrounding your wound?  The staph that's inside that red field looooooves blood.  More food= more microbes, more microbes = more itching and broken blood vessels = more microbes.  See where I'm going? 



I'm telling you, that leg looks like twice-baked diarrhea.  When it gets those red spots and curled edges... you're done.  Next thing to expect is oozing yellow fluid and then stinky cheese smell.  The longer you wait from now, the more you're gonna end up paying.  Expect exponential movement of the decimal point. 

[wladziu]

And tell your doc you wanna start taking an anti-histamine.  Maybe it'll get you out of this freaking depression you're in. 


Don't take it just from my advice, though.  I don't know enough, yet. 

[yamahonkawazuki]

heh lovely how can i get relief for this back ?  ive threadjacked more than my share. answer via pm if you wish

[yamahonkawazuki]

I see. 


I'm interested in learning more about that. 

If I knew more, I'd help more.  But, I can't.  All I can do is "play doctor" over the internet, and give pretty limited advice.  Find a cheap clinic where the immigrant workers go, and bug the sh!t out of them.  Problem is, they'll try to treat you as cheaply and quickly as possible.  So, educate yourself on the problem and don't be afraid to argue with them to get treated better. 


It's the way the world works, unfortunately. 
You can be poor and smart, or rich and stupid, but don't be poor and stupid. 


And, for Pete's sake, wash your hands before and after you touch that leg.  EVERY TIME!  Keep that thing clean!  Soap's not good enough (it mostly just works as a mechanical lubricant, to help physically scrub away the bacteria).  First, wash it in betadine, then wash with alcohol to keep the stains off.  Betadine will stain your clothes, but it keeps bacteria away much longer than just washing in alcohol.  Don't use hydrogen peroxide, because it will eat away the clotting that you DO have. 
Then, slap some Neosporin on there, then wash your hands with the same alcohol.  THEN put on a NEW sterile bandage.  Costs more than just pulling up your sock, but it's called "taking care of yourself".   
Do it a few times a day, at least twice.  To cut cost on bandages, use a sterile pad with a reusable wrap.  A big box of 2x2's should be only a few bucks.  Just use enough to completely cover it, two deep. 
That, along with the RIGHT antibiotics, should get you healed up before you need to be admitted for IV antibiotics and Mr. 10-Blade.  Ask Mary how much THAT costs. 







Not trying to talk down to you (this isn't your fault), but I hope you see that being the "tough guy" doesn't land you hot women or big trophies.  Just a fat, red colony of staphylococcus aureus. 

Called tenncare ( Horribly mismanaged from the beginning) they cut out many enrolees, to qualify, have to be female with children) draw a check for anythign, or have in teh past, have cancer, or any and all of hte above.  the cover tn they replacved it with is no better than what im using now. literally NO better.

[Toogoofy317]

Dr. Tom Kim, the founder of the Free Medical Clinic of America, and a group of patients, community leaders and other members of the medical community have joined together to open free medical clinics across East Tennessee later this year under the banner of Clinic of Hope USA.  The first clinic run by the non-profit group is planned for Oak Ridge in either late July or early August and Dr. Kim will begin seeing patients at Methodist Medical Center once a week until a clinic can be opened at First United Methodist Church.  We will let you know the particulars when the opening date draws closer.

http://www.ramusa.org/expeditions/schedule.htm

It also seems that interfaith does not require you to be a knox county resident. I would call and explain the situation. Try to get a hold of this Dr. Kim and explain the situation. You only get as far as you put into it. Or go back to the ED or an urgent care clinic.

[wladziu]

I see.

Wish I could give you direction on it, but I know surprisingly little about that sort of thing.  The best I CAN tell you, though, is that it wouldn't be unacceptable to receive help from any of your loved ones (if they're willing and able).  It's always a last resort sort of thing, but you're pretty much there, man.  
I know everyone's family situation is different (please, don't fill me in), but pride goeth before the fall.  


Keep drinking though, and not a soul will help you.  "Pain management" or not.
If I knew you in person, I probably wouldn't be giving you the limited advice I am now, just based on that.  




Wracking my brain on your situation... and looking at your pain management problem and finding a doctor to treat you... I want to say that you should go to the health department in person.  Bring a coworker or an older (respectable) family member or your boss (probably the best, if he has time), and find a social worker.  Do NOT leave the office until you've reached some sort of plan of action.  It's THEIR JOB to find ways of dealing with cases such as yourself that slip through the cracks in the bureaucracy.  
They don't do a good job of it, because they're not paid well.  Pay them a shaZam!-ton of respect, and it MAY work well for you.
That's all I've got, and I seriously wish I could do more.
Other than that, like I said, just try to find an el cheapo clinic with a crappy waiting room.  Don't be afraid to tell the doc that you can't afford the high-end antibiotics.  They get kick-backs for prescribing certain things, but it doesn't mean it'll work better.  If it's $80 a course, then tell him you simply won't take it - to find you another.  Nothing with a brand name.  You want generic stuff that you can buy from Walmart.  

That course of action with the drugs is better used BEFORE infections get so advanced, so take my advice with a grain of salt.  I AM just a pre-med.  





And, about your back:
Like I said, try to find a DO.  If he can't help you, or doesn't want to refer you to a chiropractor, then I'm not certain what else you could do.
I don't remember exactly what your back problem is, but many people do have lingering nerve damage.  
Shouldn't be debilitating, but I don't know what the problem is.  









But, telling people you're turning to alcohol (and actually doing it)...  uh-unh.  No soup for you.

[yamahonkawazuki]

got declined by interfaith not being a knox county res. . that aside i CAN change my dl addy to a number on dawson hollow road powell tn ( friends home i visit regularly. They okayed it. not fraud either. it is i guess youd call it a secondary residence. i stay there occasionally. liek you do at bills.  helping out and stuff. so legit. yeah dr kim heard about this as well. THANK YOU mary. still luv ya. this was the info i was looking for  

[wladziu]

Oh, Mary posted at the same time as me!

That's a bad @ss program!  It's gonna be packed quickly, if it's not already.  Get an appointment NOW, without waiting for the opening date.  Talk to the entire chain of command on it, until you get a positive answer.  Tell them you have an open skin ulcer at an advanced stage of infection, nearing gangrenous.  If they say they'll call you back, talk to their boss.  Bug the ABSOLUTE sh!t out of them.  


Sure, tell them about your back and stuff.  But, if you drop the hint that you're slurping a DROP of alcohol for it - you're done.  No pain meds for you.  
Looking for pain meds is counter-productive, anyway.  I'd be in someone's office refusing to leave until it's fixed, if it were me.  If that means the disability office, ultimately, then so be it.  Hell, they might even be able to find you treatment, to get you off their dime.  

[yamahonkawazuki]

ehh narcs id rather not have. i " obtain them" like i did tonight. pain was intense while at work. not avoidable sorry    gota work off of them tomorrow. am out and cannot go back cause  money is tight. so i have monday off though  except for 4 hours of getting that victory running. im being lazy

[wladziu]

Giggles, stop telling us things like "I took narcotics while working around heavy machinery".  


It hurts my heart-muscle. 

[yamahonkawazuki]

Negatory on that. on heavy machinery for me. was somethign i did at home. not while at work. and have given up on the drinkage as well.  teh relief is worthless imho. can only legally work at home cannot use at work for obvious reasons. . teh health dept will NOT refer anyone to a pm doc. because the doc has the option of narcs. this HD does NOT prescribe narcs. and will NOT refer anyoen to a place that does. ( signs posted to this effect.) i get my insulin prescription here. if it werent for that id be out of htere. BUT so far i guess one could say im satisfied. even filled my anti prescription for me. but usually a 3 week minimum wait for an appointment. emergency or not 3 weeks. i could rant on that but its not worth it tbh. theyve got rules to abide by. set by whom id rather not know.

[wladziu]

No, no, you're not satisfied. 

You want proper treatment, and they're obviously not providing it.  Pain management aside, more problems exist.  You need to find a new doc, and you need one NOW.

You've got an open, infected wound on your leg, and they told you to come back in 20 days.  Strike one.  5 days is too long.
Predictable, severely debilitating back pain without a proper course of treatment, strike two.
Leaving you feeling like you need to turn to narcotics, strike three. 

Get into the free clinic for your leg, then b!tch your way through the HD until you find someone that listens.  Or find an el cheapo and educate yourself.  That's about all you've got, unless you wanna be an full-on alkie by Christmas. 





And, you're right on the appointment times. 
There's also a rule called "duty to act", and another against abandonment.  Wait, no... it's law.  Federal law supersedes local mandate, last time I checked (business law, fall semester, 08).  And, in 3 weeks, you're gonna be frog-pube close to losing half your d@mn leg.  So, whip that bad boy out at a HD registered nurse and just BREATHE the word "abandonment". 
Mary knows what I'm talking about. 
I'd still do the free clinic thing, though, if it's close enough. 

[wladziu]

That being said - you'd still have to pay for it.  Which is why I'd get into the free clinic. 




Whatever.  I'm done for now.  Fill me in with new developments.  And pictures!

[yamahonkawazuki]

copy that on all the above. will call monday and get he ball rolling on the clinic link mary provided. thank you. like i said earlier been looking for info on that for ages it seems  to both yall