Friday, August 2, 2013
Saturday, July 20, 2013
Spam THIS!
Even while worsened eyesight and the latest leg crisis combine with other responsibilities to keep me away from my writing, including this blog, the international spammers have kept passing but constant attention to the blog. Real readers wouldn’t notice, because most of my actions have been to delete the link spam posted as comments.
The spam is obvious to me on so many levels. I’m not pounded soft by the empty and insincere compliments to how well written an article is or how I must be an authority on "this topic." I’m not taken in by compliments to the appearance or layout and do not feel the need to give free coaching to people asking what software I use to create the blog. I’m not even going to address the people who post with the advice that the blog needs "more" pictures. This is a blog by and mostly for blind people.
Most of the link spam is posted anonymously. It makes me think back to an online conversation I had with fellow writer Brandon Bell when he was being harassed by someone posting anonymously to his blog. There have been a couple friends or readers who posted legitimately, and I do not want to limit them. I also believe that limited comments in any way can inadvertently lay a foundation for censorship. No one has to agree with me, we just need to disagree respectfully.
Censorship opposition aside, the idea of this blog is to force myself to communicate the experiences of vision loss and diabetes and the other problems that arise. Most of the questions friends and acquaintances have but feel impolite to ask can be answered here. Judging from search engine hits, many other people have gotten useful information among these posts. It’s not a commercial site. If I am not even trying to make money off of it, I see no reason to allow people across the world to post a pasted comments on my blog along with who knows how many other, just so they can end with a link to their commercial sites that hawk things like trick teas, rascally raspberries, gimmicks for overall weight loss or specific weight gain solely to the penis, supplements and non-American approved drugs, cosmetics, prostitution, and the worst among others, boner pills. Do these assholes really think I will allow boner pill links when I have maintained the most frequent label tag as "Cialis = Blindness"?
The spam filters here work very well, and what garbage they do miss, I am quick to delete.
The spam is obvious to me on so many levels. I’m not pounded soft by the empty and insincere compliments to how well written an article is or how I must be an authority on "this topic." I’m not taken in by compliments to the appearance or layout and do not feel the need to give free coaching to people asking what software I use to create the blog. I’m not even going to address the people who post with the advice that the blog needs "more" pictures. This is a blog by and mostly for blind people.
Most of the link spam is posted anonymously. It makes me think back to an online conversation I had with fellow writer Brandon Bell when he was being harassed by someone posting anonymously to his blog. There have been a couple friends or readers who posted legitimately, and I do not want to limit them. I also believe that limited comments in any way can inadvertently lay a foundation for censorship. No one has to agree with me, we just need to disagree respectfully.
Censorship opposition aside, the idea of this blog is to force myself to communicate the experiences of vision loss and diabetes and the other problems that arise. Most of the questions friends and acquaintances have but feel impolite to ask can be answered here. Judging from search engine hits, many other people have gotten useful information among these posts. It’s not a commercial site. If I am not even trying to make money off of it, I see no reason to allow people across the world to post a pasted comments on my blog along with who knows how many other, just so they can end with a link to their commercial sites that hawk things like trick teas, rascally raspberries, gimmicks for overall weight loss or specific weight gain solely to the penis, supplements and non-American approved drugs, cosmetics, prostitution, and the worst among others, boner pills. Do these assholes really think I will allow boner pill links when I have maintained the most frequent label tag as "Cialis = Blindness"?
The spam filters here work very well, and what garbage they do miss, I am quick to delete.
Saturday, July 6, 2013
Feelings of Abandonment
I have not abandoned this blog, despite the lack of a new post since April. (Forthcoming case in point, no sooner did I write that one line on June 4th when I was distracted away and unable to get back.)
Now it’s July 6th and I believe I can finish a hasty missive.
2013 has left me with an overwhelming sense of loss. On top of reduced capabilities and an attrition of friends, over the time since the eye problems began, I started the year with poor feelings for having sold my car. I can accept the inability to drive more than no longer owning a vehicle.
As the year progressed, I had an eye procedure that brought complication and less result than anyone had hoped. My father passed away, I noticed that the Crow boot-bound leg is losing muscle mass and even routine things took more effort. Even further reduced exertion was more than I found I could handle. I’ve had to give up more, especially when "over" exertion inflamed the tendon in my leg, which re-triggered the Charcot Foot inflammation and ended up ulcerating the ankle. The hole was larger than a silver dollar. More than three months later, it’s about the size of a penny or nickel.
I suffered the worsened by moving prized possessions to a venue for their sale. Despite the pride in ownership, this stuff is heavy and bulky and useless to a blind guy. Removal became critical because the fact that my apartment–in a house I own–is no longer livable for me, even before the reduced eyesight and worsened leg. There’s 34 steps between the street and my apartment; 48 between the street and my bedroom. It’s hard enough getting in the house empty handed. Groceries are outright burdensome.
The eyesight, particularly effects of and adjustment to changes in light, is worse. This limits everything, including functional computer time. Work on fiction projects has stagnated as much as the blog while I try to close out responsibilities and roll with the changes.
Things are looking less bleak. My guardian angels may be masochists, but they are on the job!
Now it’s July 6th and I believe I can finish a hasty missive.
2013 has left me with an overwhelming sense of loss. On top of reduced capabilities and an attrition of friends, over the time since the eye problems began, I started the year with poor feelings for having sold my car. I can accept the inability to drive more than no longer owning a vehicle.
As the year progressed, I had an eye procedure that brought complication and less result than anyone had hoped. My father passed away, I noticed that the Crow boot-bound leg is losing muscle mass and even routine things took more effort. Even further reduced exertion was more than I found I could handle. I’ve had to give up more, especially when "over" exertion inflamed the tendon in my leg, which re-triggered the Charcot Foot inflammation and ended up ulcerating the ankle. The hole was larger than a silver dollar. More than three months later, it’s about the size of a penny or nickel.
I suffered the worsened by moving prized possessions to a venue for their sale. Despite the pride in ownership, this stuff is heavy and bulky and useless to a blind guy. Removal became critical because the fact that my apartment–in a house I own–is no longer livable for me, even before the reduced eyesight and worsened leg. There’s 34 steps between the street and my apartment; 48 between the street and my bedroom. It’s hard enough getting in the house empty handed. Groceries are outright burdensome.
The eyesight, particularly effects of and adjustment to changes in light, is worse. This limits everything, including functional computer time. Work on fiction projects has stagnated as much as the blog while I try to close out responsibilities and roll with the changes.
Things are looking less bleak. My guardian angels may be masochists, but they are on the job!
Friday, April 26, 2013
Circling Charcot
My resurgence of Charcot "Sharko" Foot makes it a good time to go over the condition, especially as one of the biggest threats of the condition is that it is rare enough that doctors can easily make it worse. To the cost of the patient’s limb.
Charcot Foot these days is almost an exclusive diabetic condition characterized by sudden and often "inexplicable" swelling of the foot. The foot will often "run a fever" and can be seven degrees Celsius warmer than the non-afflicted foot. The condition is most often painless to the patient.
Usually, the Charcot Foot is triggered by a break or fracture among the bones of the foot. With reduced circulation and/or nerve damage, the diabetic does not feel the break and continues to use the foot as normal. The swelling is the body’s way of protecting itself.
The unintentional risk posed by doctors is that the attending physician will not recognize or know of the condition. Often, the doctor will probe the swelling to test for bacterial or viral infection within the foot. In doing so, the doctor may introduce surface skin bacteria inside the foot and cause a sever infection that can jeopardize the limb. The patient should neither allow biopsy nor any type of mechanical reduction of the swelling. About half the patients who allow those thing quickly lose the foot.
Treatment for the Charcot relies on treatment for the underlying cause. X-rays and MRI’s are often necessary to determine the damage location and extent. Staying off the afflicted foot as much as possible will be necessary. The bones must heal properly. If they do not, they can separate further, mal-forming the foot permanently and risk ulceration of the foot. To be bluntly graphic, ulceration of the foot is when the bones poke through the skin from the inside out. The risk of infection during an ulceration is high, and the diabetic patient may not be able to feel it happening.
As usual with me, everything was slightly unusual. I developed Charcot Foot not because of a broken bone, but by tendon damage in my toe self inflicted by a hard kick. I had an inept foot doctor who prematurely declared the Charcot had passed Phase One and did not take into consideration that I was on eye-dropped prednisone for an eye surgery. The Charcot Foot renewed with a vengeance, and the swelling further reduced circulation. With further impeded circulation, nutrients including high levels of calcium and deficient Vitamin D could not reach the center of the ankle. The central bones collapsed, permanent damage that put me in a Crow Boot.
Overuse re-triggered the Charcot Foot recently by re-inflaming the tendon. When the foot swelled, the Crow Boot no longer fit correctly and the ankle bones that are twisted and misshapen ulcerated through the side of the ankle.
The tendon will ever be likely to re-inflame while a broken bone would likely have mended. The crushed ankle cannot mend. I have to be diligent, and my situation of not being able to feel much pain in the ankle combined with an inability to see things wrong with the foot makes that even more of an effort.
Charcot Foot these days is almost an exclusive diabetic condition characterized by sudden and often "inexplicable" swelling of the foot. The foot will often "run a fever" and can be seven degrees Celsius warmer than the non-afflicted foot. The condition is most often painless to the patient.
Usually, the Charcot Foot is triggered by a break or fracture among the bones of the foot. With reduced circulation and/or nerve damage, the diabetic does not feel the break and continues to use the foot as normal. The swelling is the body’s way of protecting itself.
The unintentional risk posed by doctors is that the attending physician will not recognize or know of the condition. Often, the doctor will probe the swelling to test for bacterial or viral infection within the foot. In doing so, the doctor may introduce surface skin bacteria inside the foot and cause a sever infection that can jeopardize the limb. The patient should neither allow biopsy nor any type of mechanical reduction of the swelling. About half the patients who allow those thing quickly lose the foot.
Treatment for the Charcot relies on treatment for the underlying cause. X-rays and MRI’s are often necessary to determine the damage location and extent. Staying off the afflicted foot as much as possible will be necessary. The bones must heal properly. If they do not, they can separate further, mal-forming the foot permanently and risk ulceration of the foot. To be bluntly graphic, ulceration of the foot is when the bones poke through the skin from the inside out. The risk of infection during an ulceration is high, and the diabetic patient may not be able to feel it happening.
As usual with me, everything was slightly unusual. I developed Charcot Foot not because of a broken bone, but by tendon damage in my toe self inflicted by a hard kick. I had an inept foot doctor who prematurely declared the Charcot had passed Phase One and did not take into consideration that I was on eye-dropped prednisone for an eye surgery. The Charcot Foot renewed with a vengeance, and the swelling further reduced circulation. With further impeded circulation, nutrients including high levels of calcium and deficient Vitamin D could not reach the center of the ankle. The central bones collapsed, permanent damage that put me in a Crow Boot.
Overuse re-triggered the Charcot Foot recently by re-inflaming the tendon. When the foot swelled, the Crow Boot no longer fit correctly and the ankle bones that are twisted and misshapen ulcerated through the side of the ankle.
The tendon will ever be likely to re-inflame while a broken bone would likely have mended. The crushed ankle cannot mend. I have to be diligent, and my situation of not being able to feel much pain in the ankle combined with an inability to see things wrong with the foot makes that even more of an effort.
Wednesday, April 24, 2013
Insensitive
Long story short on the latest malady:
I over-exerted from the third week of March through the first week of April, with a steady increase in activity. This caused no immediate strain, but inflamed the bad tendon, which inflamed the Charcot Foot, which caused the ulceration of my ankle. The open wound is typically encased in a Crow Boot, which is a tight, foam-lined brace that supports the permanently I have to wear the Crow Boot at all times or risk further ankle collapse whenever I put weight on the right leg. The Crow Boot can be very warm on the leg, and a symptom of Charcot Foot itself is temperature of the foot that can be seven degrees Celsius above the rest of the body.
This forms the ideal conditions for bacterial growth, dark and warm and moist. The problem getting so bad so fast is not a sign that I am a bad diabetic who does not take care of himself. It is a matter that I am a diabetic with nerve damage who could not feel the break in the skin on the foot. I am a blind diabetic who could not see the break in the foot, or blood on a dark sock.
Two things made me aware of the problem. The first was a lingering smell. I wondered what the bad smell was in the kitchen. I noticed it in another room. I thought the cat box in the bathroom had a funky odor. When I went to bed that night, the smell from the removed boot was overpowering. I happened to notice that the sock was wet, but not in a uniformly sweaty way. I touched what is normally a rough, dry area of skin and squished my finger in a wet hole.
I called a tenant who helps me out a lot. He came over and we cleaned things up. He found my emergency pack of antibiotics and I started those.
By specific criteria, he agreed with my decision not to go to an emergency room that night, but to get in contact with my regular foot doctor in the morning. This decision was not for financial reasons, but logistical ones. The truth is, Charcot Foot is not all that common and many doctors will not recognize it. Many, in the course of good and reasonable treatment, will do things that will increase the risk of Charcot Foot leading to amputation. I felt safer going to my doc–Thomas Mancini of North Providence–rather than to someone who I could only hope would not make things worse. I’ve been there and done that.
Dr. Mancini saw me that day. He cut away some dead tissue and was surprised by the amount of bleeding. Nerve damage is not the same thing as circulation problems. He prescribed Augmentin, a powerful antibiotic. I am making a concentrated effort to stay off the leg and keep the boot off when I can so the wound can breathe. I did catch the problem soon enough that the infection had not reached bone or flooded my system. The antibiotics knock me out a bit, but do not bother my stomach. I will be staying on them (and off the leg as much as possible) until the wound is healed up.
This may sound odd from a blind limpy guy, but I am lucky.
I over-exerted from the third week of March through the first week of April, with a steady increase in activity. This caused no immediate strain, but inflamed the bad tendon, which inflamed the Charcot Foot, which caused the ulceration of my ankle. The open wound is typically encased in a Crow Boot, which is a tight, foam-lined brace that supports the permanently I have to wear the Crow Boot at all times or risk further ankle collapse whenever I put weight on the right leg. The Crow Boot can be very warm on the leg, and a symptom of Charcot Foot itself is temperature of the foot that can be seven degrees Celsius above the rest of the body.
This forms the ideal conditions for bacterial growth, dark and warm and moist. The problem getting so bad so fast is not a sign that I am a bad diabetic who does not take care of himself. It is a matter that I am a diabetic with nerve damage who could not feel the break in the skin on the foot. I am a blind diabetic who could not see the break in the foot, or blood on a dark sock.
Two things made me aware of the problem. The first was a lingering smell. I wondered what the bad smell was in the kitchen. I noticed it in another room. I thought the cat box in the bathroom had a funky odor. When I went to bed that night, the smell from the removed boot was overpowering. I happened to notice that the sock was wet, but not in a uniformly sweaty way. I touched what is normally a rough, dry area of skin and squished my finger in a wet hole.
I called a tenant who helps me out a lot. He came over and we cleaned things up. He found my emergency pack of antibiotics and I started those.
By specific criteria, he agreed with my decision not to go to an emergency room that night, but to get in contact with my regular foot doctor in the morning. This decision was not for financial reasons, but logistical ones. The truth is, Charcot Foot is not all that common and many doctors will not recognize it. Many, in the course of good and reasonable treatment, will do things that will increase the risk of Charcot Foot leading to amputation. I felt safer going to my doc–Thomas Mancini of North Providence–rather than to someone who I could only hope would not make things worse. I’ve been there and done that.
Dr. Mancini saw me that day. He cut away some dead tissue and was surprised by the amount of bleeding. Nerve damage is not the same thing as circulation problems. He prescribed Augmentin, a powerful antibiotic. I am making a concentrated effort to stay off the leg and keep the boot off when I can so the wound can breathe. I did catch the problem soon enough that the infection had not reached bone or flooded my system. The antibiotics knock me out a bit, but do not bother my stomach. I will be staying on them (and off the leg as much as possible) until the wound is healed up.
This may sound odd from a blind limpy guy, but I am lucky.
Monday, April 22, 2013
Life and Limb
Yes, the blog’s been neglected this month. So has everything else. The new hole in my ankle is my excuse and my valid reason.
The Charcot Foot has relapsed with new complications. People who have read the older posts about the Charcot development may remember that I did not get Charcot Foot in a normal way. It is an esoteric diabetic thing, but normally stems from unfelt breaks or fractures in the foot. Mine resulted from tendon damage. During a "second" stage of Phase One, my circulation reduced During that time when nutrients could not find effective delivery to my swollen foot, the central bones of my ankle collapsed and a minor toe problem gangrened inside of three days. Luckily, somehow I did not have any part of the foot or toe amputated, although some meat was shaved off of the big toe. I’ve been in a Crow Boot since to reinforce the structural weakness of my ankle.
I am now a patient of podiatrist Thomas Mancini, who has offices in North Providence and East Greenwich Rhode Island. Doctor Mancini did great by me in every way. Instead of rehashing the bad things involved in last year’s mess, I’ll refer newer readers to the label for "Sturdy Hospital" and an old post titled "Doctor Dumbass."
So what went wrong this time? I over-exerted. I had to be a little more active with some things through the final weeks of March. That bothered the leg tendon in the thigh somewhat. Just having to walk to the adjoining building from my apartment is some 75 stairs each way. Having to make that walk so many times took more out of me than "it should."
April started with a project of moving things out of the house and setting up for sales in a booth at an antique co op. I arranged to hire an old friend ahead of time, a big brawny guy who can handle moving 40 boxes better than a limpy gimpy blind guy can. The fault in that plan was in hiring someone without a job. This friend has not outgrown his lazy streak since we’d had more exposure to each other. He called on the appointed day with supposed willingness but plenty of work-aversion ideas and theories. I went to the back up plans, which required more direct effort of me and did not get the entire project done in one day. It’s still not finished.
The efforts inflamed the tendon from toe to groin. This re-triggered the Charcot Foot. The foot swelled. Being trapped in a fitted brace that was now too tight, the collapsed ankle bone ulcerated the inside of the ankle against the boot. The Crow Boot is tight and warm, an ideal environment for bacterial growth.
My roommate was away that week. I can neither see nor really feel a problem on that lower leg. I realized it was infected by the smell.
Infection on that leg is literal risk to life and limb. Unchecked, an infection can flood my entire body pretty quickly, or it can root into local bones and necessitate removal of those bones and the part of the leg they form.
The Charcot Foot has relapsed with new complications. People who have read the older posts about the Charcot development may remember that I did not get Charcot Foot in a normal way. It is an esoteric diabetic thing, but normally stems from unfelt breaks or fractures in the foot. Mine resulted from tendon damage. During a "second" stage of Phase One, my circulation reduced During that time when nutrients could not find effective delivery to my swollen foot, the central bones of my ankle collapsed and a minor toe problem gangrened inside of three days. Luckily, somehow I did not have any part of the foot or toe amputated, although some meat was shaved off of the big toe. I’ve been in a Crow Boot since to reinforce the structural weakness of my ankle.
I am now a patient of podiatrist Thomas Mancini, who has offices in North Providence and East Greenwich Rhode Island. Doctor Mancini did great by me in every way. Instead of rehashing the bad things involved in last year’s mess, I’ll refer newer readers to the label for "Sturdy Hospital" and an old post titled "Doctor Dumbass."
So what went wrong this time? I over-exerted. I had to be a little more active with some things through the final weeks of March. That bothered the leg tendon in the thigh somewhat. Just having to walk to the adjoining building from my apartment is some 75 stairs each way. Having to make that walk so many times took more out of me than "it should."
April started with a project of moving things out of the house and setting up for sales in a booth at an antique co op. I arranged to hire an old friend ahead of time, a big brawny guy who can handle moving 40 boxes better than a limpy gimpy blind guy can. The fault in that plan was in hiring someone without a job. This friend has not outgrown his lazy streak since we’d had more exposure to each other. He called on the appointed day with supposed willingness but plenty of work-aversion ideas and theories. I went to the back up plans, which required more direct effort of me and did not get the entire project done in one day. It’s still not finished.
The efforts inflamed the tendon from toe to groin. This re-triggered the Charcot Foot. The foot swelled. Being trapped in a fitted brace that was now too tight, the collapsed ankle bone ulcerated the inside of the ankle against the boot. The Crow Boot is tight and warm, an ideal environment for bacterial growth.
My roommate was away that week. I can neither see nor really feel a problem on that lower leg. I realized it was infected by the smell.
Infection on that leg is literal risk to life and limb. Unchecked, an infection can flood my entire body pretty quickly, or it can root into local bones and necessitate removal of those bones and the part of the leg they form.
Wednesday, April 17, 2013
Awkward Silence
The last thing I wanted was to have the flow of posts interrupted where it was, amid observations about how control freaks make the best caregivers. That could sound like An empty or ungrateful criticism of some of the people who have been there for me most. That’s the furthest thing from my intent, partially because my core statement is true: control freaks make the best caregivers. Those without the ability to plow forward can’t do as much and are often not as effective.
When the blood hemorrhage happened, my friend Pat dove into the deep end of my care. For any minor complaint I could raise, I don’t know how I could have gotten through that time without Pat. The cycle of needs almost cost us the friendship. Pat took over more and more, too much for my liking both as someone trying to learn where and when I had to let go, and more as someone traditionally viewed as uncontrollable. Pat put so much time and effort and energy into my care that Pat’s marriage strained. We both needed a reset of the boundaries for our individual well being. That process was the right thing that never felt right to either of us. Pat had said at one point, I had such a look of hatred in my face; that moment had demonstrated the need to back off to Pat. I had unintentionally inflicted a hurt without being aware of it. I barely remember the incident as anything beyond one of my helpless, self-pitying moods.
It’s been three years. I am more adjusted to my situation and all its stark realities. Pat’s marriage has stabilized. We’ve maintained a friendship with roots back into the mid 1980’s. I am grateful for all that.
When the blood hemorrhage happened, my friend Pat dove into the deep end of my care. For any minor complaint I could raise, I don’t know how I could have gotten through that time without Pat. The cycle of needs almost cost us the friendship. Pat took over more and more, too much for my liking both as someone trying to learn where and when I had to let go, and more as someone traditionally viewed as uncontrollable. Pat put so much time and effort and energy into my care that Pat’s marriage strained. We both needed a reset of the boundaries for our individual well being. That process was the right thing that never felt right to either of us. Pat had said at one point, I had such a look of hatred in my face; that moment had demonstrated the need to back off to Pat. I had unintentionally inflicted a hurt without being aware of it. I barely remember the incident as anything beyond one of my helpless, self-pitying moods.
It’s been three years. I am more adjusted to my situation and all its stark realities. Pat’s marriage has stabilized. We’ve maintained a friendship with roots back into the mid 1980’s. I am grateful for all that.
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