Sunday, August 2, 2009

pre chemo

Hello everyone
Getting ready for chemo tomorrow. Forgot all about the ginger, and so have no sugared ginger today. The only place that sells it in Bandon is closed today. So just went down to grocery store and bought some ginger root and cut it up and put it in a smoothie. Tasted great.

Although I am afraid to say it for fear of being wrong, I think my wounds are pretty much healed.
I have been extremely dilligent on the open wounds on my perineum, with cleaning and protecting.
These wounds have been there now for 3 months. 
Essentially an open wound is where the top layer of skin is gone and the underlying tissue are exposed. At the end of radiation when the wounds were the largest, I would say that the total size would have been 3 cm squared.  Over the first couple of weeks after radiation  they fairly quickly went down to 1.5cm x 1 cm, and this one lesion has been the persistant one.  This whole problem has been adjacent to the rectum, so quite obviously a hard area to keep really really clean.  I initially had used watered down hibiclense which had been suggested by radiation clinic.  When the wounds did not seem to be healing I consulted my "wound care guru" in Portland who said that hibiclense destroyed the cell membranes, thereby "preventing" wounds from healing.  She suggested Aloe Vesta foam, which I have been using for about 6 weeks now.

Initially  when I started radiation, they suggested to stop using toilet paper and to use baby wipes to be gentler. This was in anticipation of the diarrhea from radiation. I did not really get the diarrhea, but the whole area broke down from the radiation towards the end. I went to costco and bought one of those party packs of facecloths. The really soft ones (pack of 20)
What I have been doing for a few months now is to cleanse the area several times a day with the aloe vesta foam and soft facecloths, and then I put  Aquaphor ointment on the area to protect it.
When I was worried about infection I used clindamycin gel as well. The area had almost healed before I started chemo last time, then opened up again.
Hope it will not do that this time.
The only part that is not healed is an area of what we call in medicine "hypergranulation tissue", otherwise known as "proud flesh". It is often seen when wounds heal slowly like this and there is essentially an area of underlying tissue that ends up "on the outside".  This will need to be removed and that is not usually a big deal, I will just have to find out how to do that in this area. In other parts of the body, I usually use silver nitrate sticks to get rid of the hypergranulation.
On Tuesday Ken and I are going to Eugene, I have appointment to see Dr Dotters, who is my surgeon. I have not seen her since a few weeks after the surgery. I guess she will examine me, and set up some sort of schedule for followup for the next few years.

Peace and love
jankenb @

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