I’m not particularly thrilled that my blog is all about my bad leg but as it currently dominates my life and friends and customers keep asking how I am doing this is the easiest way to keep them posted.

We left the wonky leg looking much better last Tuesday immediately prior to it being placed in the next round of compression bandages and feeling a lot more confident it was getting better as the improvement in three weeks was remarkable.

In the background I had been on a course of antibiotics, the fifth since this kicked off, which finished on Easter Saturday and would have been working their way out of my system by the good news Tuesday.

By Friday it had all gone horribly wrong! My leg was bleeding and that was sticking to the dressing. The pain had gone from not hurting on Wednesday to can’t bear to stand on it by Friday.  Initially, I was blaming the nurse that did the dressing as only a few are trained to do it and this was different (we do have a league table -the others are all amused that the boss is bottom of the table). I phoned to try and get an appointment that day (stop laughing) but was told to cope and they’d see me first thing on Monday.

Annie & I get a rating as we had to reassemble it all on Saturday using recycled components!

When I took the dressing off it was clear it wasn’t just crap dressing but that the infection was back with some force. By the end of Saturday the other leg was joining in.

Its fair to say I was pretty despondent that such good progress had been wiped out.

This morning was bedlam at the surgery. I had two appointments on different floors that overlapped. In the end I was in one room having Tanya doing the dressing done whilst the nurse for my INR test, Jade, nipped into stab me for that plus the duty doctor, Dr Forrest, was called into see my leg.

The despondency has turned back towards a bit of optimism tempered by my leg still hurting like hell for the moment. There was an immediate restart of the anti-biotics, a swab taken to check they’re the right ones, and advice as to which of the GP’s its best to see to talk about longer terms treatment. Even then at that point I was thinking, “yeah, I bet that’s three weeks on Thursday at the earliest.” Then Tanya played a blinder, bypassed the receptionists and booked it for 11:15 tomorrow. There’s a reason she’s top of the league table!

Hopefully, we’ll be on course for improvement again.  The nurses that do this compression bandaging have additional training. Rachel, in particular, its her specialisation and set up the original compression care plan.

There is a bit of conflict between the nurses and doctors at this point. The wound care and compression treatment can increase the risk of the infection as, basically, its squeezing the bad stuff out of the leg. The treatment plan indicates that a longer term course of a mild antibiotic may be warranted to stop this happening. Trouble is the nurses have to get the Dr’s to sign the prescription and they’ve all had the memo about antibiotic resistance without the specialist knowledge that in this case mandates it and won’t sign the chit.

I’d argue that six courses of flucloxacillin does more for compromising antibiotic immunity than a long low dose of a milder one.

Rachel failed but Sharron last Wednesday got somewhere and sent me a message to make an appointment to see a Doctor to discuss.  The trouble with that is that, like many, you can end up with a random doctor. Our surgery has 20 Drs and 3 sites. I’ve never seen the one that is my nominated doctor.

The other slight advantage of this mornings medical mobbing was that Duty Doc Carolyn was able to say “you’re best seeing Dr Vanessa for this issue” and Tanya made an appointment bypassing the receptionists.  [should add that the receptionists are generally very good but are up against it with too many people for too few appointments]

My earlier blog posts at the beginning of the month referred to Hopalong and the limitations of that for the then upcoming York Model Railway Exhibition. Now that the show is over and I’ve had another visit to the coven an update is warranted [and because its good news]

I’ll report on the modelling aspect of York show in due course but I had a great time. After the leg pain misery of the last three months causing me to miss both Narrow Gauge North and a Ffestiniog Railway thing I should have attended getting to the show for all three days, meeting and chatting to folk was a real tonic.

Whilst there was an element of “its 3.5miles from home, if I can’t make it to this one I really am screwed” but I am really grateful to Adrian & Phil for making sure I got there and helping with the things I couldn’t manage. All three of us actually got some modelling do as well.

Just to recap. This wonky leg has been acting up since before Christmas and the treatment was for a long while grin and bear it and stick a new dressing on it. At the beginning of April I started a new regime of treatment that was initially very painful as it consisted of my leg being bound in tight compression dressings.

In this form my wonky leg is bound from my toes to knee. It applies constant pressure to the skin and forces blood to the surface to facilitate healing. Each Wednesday its applied I’m in it until Tuesday night when I take it off and have a long soak in the bath before its done again the next morning.

Flag Delta – navigating with difficulty

I was walking with a stick as I needed it initially. I now use it sometimes if going somewhere crowded as much for the fact it advertises  “Keep clear of me; I am manoeuvring with difficulty.” As the bound leg, wearing the only shoe I own that fits over the bandages doesn’t always go the direction intended!

As well as the ulcer all the surrounding skin has been damaged and its all be leaking into the dressings. My initial thoughts as to why they wanted me to take it all off at home was so they couldn’t hear me scream as the dressings pulled all the scabbing off the wounds. There as also an issue that by the weekend the wounds were getting a bit smelly to the extent I was wishing that I had longer legs!

The lot I took off last night, the third lot, came off without the screaming but it all still looked a bit horrible prior to a good soak and a scrub before it was covered up for the night.

All the photos I take of it seem odd as the leg appears upside down from my perspective so I got Nurse Sharron to take a picture. The results are excellent, the main ulcer is virtually gone, the secondary one (doesn’t really show in the before pic) is also nearly gone, the rest of the skin surface is mending and the whole leg doesn’t look anything like as inflamed.

I am now in week 4 of the compression but there is progress and I can see an end to this plus a discussion has started about ongoing practicalities for carrying on with life and stopping this happening again.

York Model Railway Exhibition.   [A dose of realism].

This weekend is our local show. Its also one of the largest and a fixture in the exhibition calendar. For years now I have had a stand doing modelmaking demo with a bit of sales thrown in.  Its evolved over the years to now have a standard spot [stand 116] on the top floor forming a narrow gauge enclave with the 7mm Narrow Gauge Association and the 009 Society.

There are now three of us making an exhibition of ourselves over the weekend, Adrian Gray, Phil Traxson and myself. Its turned into a bit of a social event for us and a chance for a good gossip with the visitors.

In the past the stand & display has filled the back of a Volvo estate and has taken several trips with trolleys by to able bodied people to shift it in and out.

The dose of Realism?

If you’ve read the previous two posts you’ll know about my wonky leg. I’m typing this just back from todays visit to the coven of nurses to have the compression dressings changed.

I’ll spare you the gory views of the leg but this is the dressing whilst its clean and fresh. Things to note:-

• I can’t get a sock on
• I have only one pair of shoes that fit.
• Jeans don’t fit
• Can’t walk far or for long

So the dose of realism is that our stand this year will be a minimalistic affair with just a bit of a display and three of use drinking tea, chatting and doing a bit of modelling. Sales may just amount to a couple of magazines.

I usually cart all my soldering and metalworking kit along to the show causing disruption in the workshop before and after the event.

This year to  keep things light and easily portable I have this box of bubble wrap and am thinking this will be a chance to do something different whilst also getting a model done that customers have seemed determined to keep me too busy to get built.

Now I do have a vested interest in this model as I am custodian of its prototype and have supplied quite a lot of detail for the design of the kit.

It also fulfils the need for a quickly available loco for the garden railway for those quick opportunities for a play without the faff of getting a steam engine out.

Well, this wasn’t in my plan for Friday!

On the one hand its a complete pain in the leg whilst on the other its something different and possibly progress in the right direction.

This whole leg saga kicked off 30 years ago (see previous post) but this outbreak started in December and has been bloody agony throughout. All the nurses at our Doctors, (The Coven) have been brilliant but they’re not specialist wound nurses, some of them are just HCA’s so can only do the basics and then have to seek guidance for more difficult stuff.  

Once upon  a time it would have involved at referral to the lymphedema clinic at York District Hospital, as I was about 12 years ago in a previous outbreak. It was a “world leading” department and my referral resulted in probably the longest trouble free period. Someone decided they didn’t need it and closed it down.

N0w the process is that they refer the wound online to a tissue viability specialist who seems to pick things off a list with a pin to try, so far to no avail. Back in my late teens & early twenties meeting so many nurses was a dream night out but the problem now is one of consistency as you can see a different one each visit so they can’t tell if its changed since the last time the dressing was changed until one of the rising stars took a picture on her phone (well done Sarah, don’t ever loose your phone, your photo gallery must be pretty gruesome). That made me think that should be a pretty standard thing to do so I have been photographing my leg each time the dressings are changed.

Another problem is that they have their set ideas and each of them has a slightly different view and sometimes I can be telling them about the previous dressing/treatment/outbreak/cure and they’re clearly not listening. I’ve been telling them for weeks that its n0t the ulcer that hurts but all the breaks in the skin around it caused by the dressings and constant compression but they’re not listening and are just in ulcer car mode. There seems to be no recognition that the person with the most experience of my bad leg and the treatments is me!  I told one that this September is the 30th anniversary of wonky leg to the response, “I’m only 21”.

Progress in the right direction? Yesterday I saw a new member of the coven albeit only on alternate Fridays and it was a bit of a revelation. Rachel is a wound care specialist nurse who just deals with things like my wonky leg. I spent an hour with her discussing and creating a care plan and it was a revelation.

• Initial Care & dressing
• Next stage care
• Maintenance
• Prevention

The first thing is to get it healing and she has changed every aspect of the stuff in contact with my skin. The second is to really turn the screws on the compression. This has two functions, one is to squeeze the muck out of my compromised circulation and the second is to force blood to the surface to do the healing. In the past when I have had this (twice) its been done thigh to toe and is totally impractical and didn’t last very long. It depended on which of the three nurses who could apply it did it. With the worst it was round my ankles like Nora Batty’s stockings in less than a day. This lot is staying in place and despite it being uncomfortable and a bit painful its a lot better than the full leg version. I might not be able to get my shoes on or some narrower trousers but I can at least bend at the knee.

If this works it will be followed by something the maintain the improvement along with, hopefully, some preventative drug therapy and then a longer term regime to stop it happening again.

What I have on now is  supposedly two layer full strength compression. Actually works out at 7 layers. There’s dressings on the wounds, (silver bearing stuff – stings like fcuk), none stick mesh, absorbent pads, sort of cotton wool padding/bandage, layer one of tight compression bandage wound one direction, layer two compression (a sort of plaster on a roll & sticky) wound the other way and finally yellow line tubular bandage.

Each of the compression layers are calibrated to apply 20 somethings of force (can’t remember the units she used, not PSI).

It wasn’t uncomfortable at first but it’s designed to tighten and it’s starting to ache now.