What This Remarkable Wound Taught Me About Moving Forward

How I am not letting a medical complication bring my life to halt.

It looks like we’re out of the woods now, my dermatologist said to me after my 4th appointment with him in 10 days.

Time to get out of the woods, even though I hadn’t realized we were in the woods. Photo credit - Midjourney.

Quite frankly, I hadn’t realized we were in the woods, but I was not surprised. The previous week, I saw him 3 days in a row so he could continue checking the progress of my healing wound and to re-wrap my leg.

What the heck happened, and why does the weird, random stuff always seem to happen to me?

Quick Background

My legs have a lot of pre-cancerous spots. They’re called Disseminated Superficial Actinic Porokeratosis, DSAP for short. They are caused by a combination of extensive sun exposure during childhood (playing tennis and running around outside in the hot Midwest summers) plus genetics. My sister has the same thing.

Before picture of my legs, showing Disseminated Superficial Actinic Porokeratosis (aka DSAP). The wound on my right leg is from when my dermatologist took a sample for biopsy, which told us the spots are pre-cancerous. Photo provided by author.

There are a few ways to treat DSAP. The easiest, in terms of treating as many spots at one time and the effort to execute, is a light therapy called Photodynamic Therapy (PDT). I did PDT on my legs twice already but had not yet gotten the desired effect.

When PDT works like it should, it recreates an unpleasant sunburn effect. The treated area becomes extremely red, the spots blister up, and eventually they peel and fall off. This process typically occurs over a 4-week window following light therapy.

Since my previous attempts hadn’t worked, after some research by my dermo and taking a page from my sister, who has done lots of PDT treatments, we decided to increase the intensity of the PDT treatment.

A week after the light therapy session, it became evident there was a complication with the treatment on my legs.

And Here We Are…

I had a couple of massive open wounds on my right leg (well beyond the size of the area where the sample was taken, seen above in the pre-treatment pic), and they were oozing pus.

My left leg also had open wounds and pus beyond the desired effect, but it was not hit as hard as the right. And my legs hurt. The physical pain was real and accompanied by swelling. My right leg was rather large.

By the following Monday, when it wasn’t getting better, it was time to take this seriously. We started treating it like an infection with antibiotics and a steroid.

And this is when my daily visits to my dermatologist started, for a few days in a row, so he could check the healing progress and personally re-wrap my leg each day.

Una, dosa, tresa layers of the boot

The leg wrap is actually pretty cool. It’s called an unna boot and has three layers:

• First layer: picture an Ace bandage soaked in calamine lotion and or zinc oxide. This wet layer goes on first and creates such a soothing feeling, like wrapping areas that sting in a cooling blanket, dulling the sting.

• Second layer: a gauze-like material that helps bind the layers and absorbs wetness from the first layer

• Third layer: an ace bandage wraps on top, providing light compression and making the whole thing presentable to the outside world.

Here is the unna boot on my right leg. You can also get a glimpse of the left leg impact, which is a lot less severe than the right leg. Photo provided by author.

My leg was wrapped from my foot all the way up to just below my knee. Little did I know I needed to get used to the leg being wrapped, as this process would continue for weeks. My original plan to complete this skin treatment prior to a very busy Fall got lost along the way.

And it was fortunate I have a leg cast shower protector from previous foot and leg surgeries as I couldn’t get the unna boot wet between visits.

This leg protector behaves like a suction cup at the top. Absolutely no water gets to my leg. I can’t get the unna boot wet. When the doctor changes the wrap, his medical assistant cleanses the wound area. Photo provided by author.

I’ve learned that nobody wants to see pictures of the actual wounds on my right leg, so don’t worry, I will spare those photos from this article. If you’re a glutton for the gory and gross, let me know if you’d like to see.

Have Unna Boot, Will Travel

Before the busy Fall schedule, I had a spa weekend planned with my daughter. Would I really go with an unna boot on my leg? Why, yes, I would! I had to skip a few of the spa features, but that didn’t mean I couldn't still enjoy other perks.

I thoroughly enjoyed the ice cave and the relaxation rooms. My massage, less the legs, was still worth it, and I had a fantastic facial. More importantly, I enjoyed overdue quality time with my daughter, including a stop at a cheese castle on the way home. We were able to enjoy a quiet, relaxing time together.

It turns out I’ll still be wearing the unna boot on our family vacation next week. I sure didn’t expect that when this whole thing started. But then again, who am I to predict the future?

This is a slow-healing wound. Apparently, we cannot rush the process. This is a one day at a time progression. I guess the good news, it looks like I get to keep the leg.

In Retrospect

Looking back, it would have been a loss to cancel the spa trip just because I had an unna boot on my leg. It had crossed my mind, but I’m so glad I continued the course as planned. I mean, twist my arm to go to a spa.

And now, with a family vacation coming up next week, the emphasis is on family. The focus needs to be on spending quality time together.

Between the spa and the upcoming trip, I am getting constant reminders to live my life despite whatever is thrown at me. Don’t stop the merry-go-round because one of the wooden horses got knocked down. There is an entire carousel of horses waiting.

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I may still be limping out of the woods, but I’m moving forward — one awkward, boot-step at a time.

Have you ever kept your plans despite a medical setback? How did it go?

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