Day 56 - Feb 15 - No more bandages

Things are progressing well. I think today I will stop dressing Right#2 as the two wounds are dry and are no longer oozing. Geez that took a lot longer than I thought it would though. Walking has become much easier since my last post. You wouldn't be able to tell that I have injured feet seeing me walk down the street. I can go five days, ten hours a day in dress shoes barely noticing them. I even did 30 minutes on the elliptical about two weeks ago and was no worse for wear. The people in the locker room still look at me funny when they see my feet: "Buddy, you better get your shower shoes, you don't want this fungus!", I tell them and they run away with a disgusted look on their face. (Just kidding I don't really say that - leaving my malaise to their imagination is much more cruel - heh heh ;) )

The damage is deep though. My toes are still discoloured and I don't know if they will return to normal. My big toes are still firm and waxy looking at the ends instead of supple like they should be. On the surface, the skin is highly sensitive and delicate. They itch like crazy sometimes but I've been able to resist scratching. I have lost a total of four toenails and I expect to lose perhaps one more. Those lost are growing back slowly. Deeper in my toes the feeling is still not there. Or rather - it is - come to think of it the fact that I can feel the INSIDE of my toes is kinda weird no? I don't recall being able to do that before! Let's just say that the feeling in my toes is pretty abnormal - but at least they're functional. The worst part now, or at least the painful part, is on the little toe side, the part of your foot that pressures the outside edge of your ski (for you skiers out there). Although the skin didn't really get much damage there, the freezing went deep into the bone I think and it hurts to stand on the outside edges of my feet (cause I do that all the time you know). Yesterday I went for a hike in N.Van with Shari and Cedar and I had no problem on the up. Coming down though your toes are naturally jammed into the front of your boots/shoes - my toes weren't very happy with me. Oweee. I fully expect this last phase of recovery to be very, very slow, but it seems that from about now forward, my feet shouldn't hold me back from most of my activities - although running or skiing should probably wait - hold on, those were my activities before... okay I take that back. But hey I can walk normally!

I have taken pics of this and the last post but haven't gotten around to posting yet. Just need to get unlazy for a second to do that. Perhaps now. Perhaps not. Okay I did it. Wow they look good!

Day 34 - January 24 - Patience (Warning: Gross Pics Ahead)

In the two days following my last post, nearly all of the old skin has peeled off of my toes. This wasn't a pleasant experience as it was pretty stuck on there and it took some time and effort to get it off. I was encouraged to do this as it is supposed to enable the skin underneath to heal up faster. Both of my big toenails came off in the process - quite by accident actually after an excruciatingly painful day in some dress shoes (for work) I got home and found that the nails had separated from the skin underneath and with a small
amount of leverage they peeled off FORWARDS from the back to the front. With them came the bulk of the dead skin around the rest of my big toes. The nail of Right#2 came off too (which by the way is still an open wound and requires daily dressing changes.
The patience part of this ordeal might already be apparent to you. It is now Day 34 and the wounds have still not closed completely. The rest of my toes are still numb and stiff, the tissue underneath is not supple as your digits normally are. The new skin that has been revealed is shiny, waxy looking and unbelievably sensitive and fragile: the pinky toenail of my right foot has managed to cut into the toe next to it and make it bleed; the spot where it rubs aches enough to make me cringe when I walk. I am told that it may be a total of SIX MONTHS before I am 100% again. One down, five to go.

Day 31 - January 21 - Bye Bye Bandages (save one)

My toes are hideous. But they're getting better. Today my bandages came off at the Burn Clinic and this is what greeted me. All wounds closed and dry, except Right#2, which finished with a bandage. The nurse said she was being gentle but it felt like a belt sander as she picked and pulled and scraped dead skin away. At the end of it I joyfully, yet very carefully, slipped my feet into a pair of my own size 9 dress shoes (for work) and retired the $17 size 10 Canadian Tire duck shoes. It was a tight squeeze but I managed until I got home 10 hours later, with a forty minute shoeless break at lunch (went for Japanese and had to take our shoes off). It's actually quite a gross feeling without the bandages now. Wiggling my toes, it feels like little flaps of hardened skin tickling each other. The new skin is extemely sensitive. Next appointment: one month. I will be changing Right#2 dressings myself with flamazine (?) cream instead of Acticoat, and avoiding getting it wet until the tip and top are healed over. STILL open wounds there.

Day 27 - January 17 - Panic

"Panic is a part of the 'fight or flight' response common in all mammals which causes a sudden rush of epinephrine (adrenalin) to be released, one effect of which is peripheral vasoconstriction (closing off of blood vessels in distal parts of the body, esp. skin) in order to maximize blood flow to the 'core' - large muscles, brain, heart, lungs - to facilitate da fightin' or flightin'. Less blood = less heat = faster frostbite." - Dr. Jeff (my little brother)

I had a moment, or rather about 15-30 minutes on that day, nearly a month ago now, when I was in a state of panic. Real, frightening panic. I wasn't lost - bear right and I would hit the trail eventually. I could see the road and I had a map and compass and a bearing on the car. I had food, water, a headlamp, even a lighter that I had forgotten about. Heck I even had a cell phone with a good signal. But before I got all of that straight in my head, all I could think about was that I had taken a wrong turn and I was separated from the group - I was lost - I only had one hour of light left, who knows how much skiing, and the slide alders were relentlessly snagging me - impassable obstacles between me and my escape, fuck did I go over the bluffs when I should have kept right? ..it was really fucking cold, my puffy was in the car, what if I break my leg or twist an ankle - I'm dead! jesus I might have to dig in and spend the night. Panic.

Could have been those few minutes of panic that caused the frostbite. Now day 27 and still I am Gimpy McGimperson.

Day 24 - January 14 - {{CRINGE}}

Today I was hoping to walk out o the clinic with fewer bandages but alas this was not to be. In fact this visit turned out to be one to of the shakiest that I've had, mostly because the nurse completely shook my confidence in her competency/experience in dressing wounded toes. After a week of being in the bandages, they had dried to my toes quite firmly; she promptly yanked them off with a little sterile water for lubrication. Dead skin, which could have easily been cleaned off was left to hang off of my toes while she sloppily gooped the gel on, slapped on the Acticoat then attempted to wrap the toes in adhesive foam, leaving at least a half an inch of dressing protruding from the end of my toes. This caused concern that I would be able to fit into my shoes at all, not to mention the question of whether the bandages would stay attached for longer than a day (they have). It was the messiest job I have experienced since the get go - even hastier and messier than my trip to the walk-in clinic in Sherwood Park.
Thankfully, my toes have been getting better each day. I retired the cane the day after my last post and have been hobbling around on my own, albeit quite slowly. I still lack any real sensitivity in my toes, but I am confident that this will come back with time. In my next trip to the burn clinic next week I hope to walk out sans bandages so that I can have an actual get-my-feet-wet shower and fit into my shoes. At that point I will also be able to join a new gym close to work - the inability to shower thing is the only thing holding me back.
Highly relevant to my frozen toes, today I attended a Toastmaster's meeting at work and was randomly given the table topic to speak on "How to stay warm in the cold winter". Actually it had more to do with preventing a cold, but I spun it around so that I was talking more about how to prevent your toes from freezing off. Solution: stay warm.

Day 20 - January 10 - can't kick the cane

I know my toes are here to stay but wow, sometimes it just feels like they're ready to snap off. Right #2 is the worst. There is still a long recovery - I have absolutely no strength in my toes and the feeling is still mostly absent. I tried going without my cane today (I've been managing at work to go up and down the stairs between the 26th and 29th floors), but that didn't go so well. So the cane stays.

Day 17 - January 7 - Ten little piggies stayed home

Today was my first visit to the burn clinic at the Vancouver General. It is also the day that I learned that I would be keeping all of my toes, so suffice to say, it was a good day.

The dressing change went smoothly and quickly, the nurse being no-nonsense and going straight for the jugular, manhandling my toes through the old bandage removal, cleaning, photographing (here they photograph the toes for their records), and finally redressing. By my next visit in a couple of weeks, I will hopefully be done with bandages altogether, although Right#2, which seems to be the worst overall, may still need some TLC. In my first sense of weak-stomachness during this whole ordeal, I cringed as she cut away the skin. While all of the other toes have lost skin on their tops, their pads underneath hard, sickly in colour and likely dead, are still intact. Right#2 on the other hand is now an open wound around its full circumference - a naked little piggy.

In another first today, I was astounded by the lack of bedside manner of my doctor, presumably a specialist as I was in the burn unit after all, when he expressed his dismay that I had not been changing my dressings daily. Well as a matter of fact I do just happen to have plenty of stock of Acticote silver dressings, ample gauze, gel, sterile water, saline, tape, not to mention the expertise to assess, clean and dress my own swollen and blistered toes. Despite this, his diagnosis was agreeable - all my them are mine to keep.