Monday, June 22, 2009

things got a little stingy

Hello Everyone

Here on my second to last day of radiation, we are on our way to Eugene.

I guess I would say that I am doing pretty well........well actually 98.9 % of me is doing well. The nausea has cleared which is a huge relief. There is this one tiny portion of my anatomy....perhaps an inch squared.....that is not doing well.

It is not really a useful part of anatomy except for once, and sometimes twice a day.

However it is really important on those times.

Here is where it gets graphic. My anal canal is suffering from what would be equivalent to second degree burns. That means that the top layer of skin is gone and the underlying tissues are exposed.

I will include a diagram of that part of anatomy for those who would like a reference.

I showed the area to my doctor last Tuesday, and she assured me it would heal after this is all over.  The area extended quite a bit over the past week.

I guess there requires a level of faith here, as often when burns heal they heal with scars, and scar tissue does not behave quite the same as normal tissue. I guess I am hoping my anus will work the same as it used to, as  there are many aspects of life that would be changed if this heals in some "alternative" way.

I guess this is an area that I have some expertise ( in a round about way).  Having been  a physician caring for the elderly , primarily, for the past 11 years, I have quite an expanded knowledge of wound care. Open wounds are wounds where there is no skin overlying the tissues and they are often seen in frail elderly as bedsores (decubitus ulcers) and in diabetics. Normally when you or I scrapes our arm, even when a chunk of skin is gone, it heals anyways, because when you are healthy your body is able to fight off infections and lay down new tissue promptly.

This is not the case in the frail elderly, so often these wounds need help to heal.

The principals of open wound care are to "imitate" what the skin would do. Skin usually lies over the tissues making sure at all times that the tissues do not get too wet or two dry. So when you treat an open wound, you do not want it to dry out, OR get too wet. The other thing the skin does is provide a barrier to infection.

So what the heck do you do in the rectal/anal area where it is constantly exposed to  moisture AND bacteria?

Well I have gone back to my wound care principals to figure this one out. The bacteria that are in that area, are just colonizing the open wound until  they actually invade into the tissues, which means they are just hanging around minding their own business. Even when a wound is not infected, the bacteria get in the way of healing. You cannot get rid of these bacteria with antibiotics because technically they are not supplied by the bodies blood stream. Several years ago a product was developed from activating silver that kills virtually all bacteria and fungus on contact without affecting normal tissues. I have used it on my elderly patients wounds with good success, and recently found evidence in the literature of success on anal radiation burns. So I am putting my faith in t "Arglaes" to keep the area from getting infected AND to keep it dry.

(arglaes powder comes with calcium alginate in it, which is dried seaweed, so it soaks up excess moisture)(Calcium alginate is also often used in wound care to keep wounds from being too moist).

So the next week or so will be intensive wound care trying to make sure it does not get infected,  and to try to help it heal quickly.

I will not be having chemo now for about 3 weeks, so that should also help.

I will be quite relieved to be done with radiation, I have found it hard, especially the rather constant nausea. I have had minimal diarrhea, and I think this is because after the first 10 treatments or so my doctor suggested a full bladder with treatments which keeps the small bowels out of the way.  The area of my anus is a radiation burn, I tend to wonder what is happening on the inside of me, if this is happening on the outside. The bladder takes a hit as well, and at this point it hurts to urinate as well. As I head into the last 2 treatments, I really hope that there will be no long term effects.

In celebration, on Wednesday morning, we are going out to  the beach to experience and take pictures of the lowest tide in a very long long time

a minus 2.5 foot tide at 8:11 in the am

So anyone who wants to join us, .....perhaps at 8 am or just a bit before, we are going to go down to Coquille point.

Hoping to take pictures of starfish over our heads....and celebrate the end of radiation.

love and peace

Janet Bates

jankenb @ 

No comments:

Post a Comment