SickleCell Awareness: Dealing With Leg Ulcers; Lessons From My Fourth Hospital Marathon.

At least one warrior we all know will at one point in this journey we call life, face one of the most daunting challenges experienced by people living with sickle cell… recurrent leg ulcers.

It sometimes starts like a tiny scratch… the kind that generally, many of us would ignore after all, it is just a small scratch it would heal within a few days or so we think until that scratch becomes bigger and keeps growing bigger and wider to the point that we have to get up to agonising pains daily while our nostrils get filled again and again with that distinct antiseptic smell only a hospital provides.

Masked men and women aka Drs and nurses in whatever colours of overall the hospital you are in favours hover around you, thinking and scratching their heads because sometimes, it is difficult to comprehend how a tiny scratch suddenly becomes a national emergency in the life of the warriors concerned.

I have faced what I call my hospital marathons four times and I have blogged about these times twice on these pages. The first was on WARRIOR’S STRIPES and the second was on HOW I COPED WITH MY FOURTH HOSPITAL MARATHON. You can search them on here and tell me what you think.  Due to the fact that a lot of warriors I come across are facing this agonising battle, I have decided to focus on the lessons I gained from my recent hospital marathon which fluctuated between October 2015 to April 2017. I say fluctuated because I would get a few weeks respite, sometimes two weeks with the wound healing only to return to the hospital again due to pains and a repeat of the process all over until April 2017 when I didn’t returned after taking off the last plaster at home and which I fervently wish and pray this would be the last.

Coming back to the focus here, let’s take a look at some of the lessons learnt during this fourth and most challenging leg marathon ever. A big brother and Dr Extraordinaire took his time to explain the reason for the recurrence. He not only helped to calmed me down by his explanations, he was also a major contributor to the final healing in April.  Here are some of those valuable lessons I learnt. I hope it may prove helpful to someone too.

1. The repeated recurrence and pains experienced are caused by a number of factors and area affected. For example,  the ankle area where mine usually occurs is rich with tendons, ligaments and nerve terminals making it painful. It is a given that a small wound can easily get infected anywhere, especially  when hygiene is not a strong focus point. The recurrence is partly due to its unfortunate location and a not too excellent oxygen supply to the area (from the underlying anemia, which coincidentally, also renders the subject more susceptible to infections).
2. Sometimes, the repeated recurrence is by no means an indication that the wound has reached the bones especially if, on the most, it is usually a superficial wound. If  the bone gets infected, the medical personnel doing the medications or your doctor will easily notice it. For this reason therefore, it is always important to ask questions when one is unsure and it is even more important for the medical staff to patiently take their time to explain any questions asked and the appropriate drugs given because it is a big help psychologically to the warrior facing this physical and emotional agony.
3. The best possible pain killer during such painful leg ulcer moments is Ibuprofen 600 or 800mg. (or 400mg common here two tablets of 400mg can be taken in a single dosage to get the required 800mg) It will help with the pain and the healing process as well. This is because Ibuprofen is anti-inflammatory, analgesic and anti-fever and so best for the wound which is an inflammation and anti-inflammatory tablets are best. As the inflammation reduces, so too will the pain. Meanwhile, it will reduce the pain present at the moment while fighting off the inflammation as well.
4. Antibiotics such as AZITROMICINE 500m. Or ZITROMAX 500mg are also very good especially if the wound is exposed to some contaminations as they are tough on pathogens. Notice that it is usually not about the strength of the bacteria but how effective antibiotics can be on particular bacteria in a given part of the body. Your doctor will be able to give you the best possible antibiotic and thorough follow up. It is therefore important to note that be it a superficial and stubborn wound or an infected wound, a large spectrum antibiotic will be more helpful at the beginning of treatment.  Also, hydrogen peroxide facilitates tissue regeneration, for it brings oxygen with it without waiting for blood to do it. This therefore makes it the best solution to clean the wound as we are by default, already oxygen deficient due to the anemia in us.
5. Good nutrition is a must. The body is affected and our already poor immune system due to the anemia does not really help matters. To boost the system and encourage enough oxygen and blood flow to the affected area, a healthy meal approach is essential. Therefore, a diet rich in proteins such as red meat and other rich protein sources are very important. Vegetables and fruits should also be a part of the regular diet. I know it is not easy especially for the struggling warrior and family but, making the effort to eat well and healthy will go a long way to make the wound heal and stay thus.
6. When the wound is showing signs of healing, it will itch a lot. It is due to your body releasing histamine to create new blood vessels as the tissues get formed, to bring nutrients.  The side effect of histamine is itching or redness to some people. Keeping the area hydrated with lubricants such as Vaseline will help alleviate the itching because dryness can lead to more itching.
7. Sometimes, the pain is unbearable but looking at it in a somehow positive angle like “dead tissue feels no pain” maybe helpful. It shows you are still among the living difficult as it may seem. The nerves are intact and working and so too the sensory cells! So just patiently give it some time. Slow is best for healing to be effective. If the pains get really unbearable  take some Ibuprofen 800mg. Just be careful not to abuse the drug.

These are some points I came to understand during my hospital marathon. I hope you find it useful too especially if you, your warrior child or any warrior you know is presently undergoing this ulcer trial. A point of caution though: do not take these medicines shown here on your own. Always ask your Dr for advice before taking any medicines. Self-medication does not always help even if it worked for me, it might not work for you because our systems are different.

Let us know what you think about this on the comments section below.

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ARREY-E. AGBOR-NDAKAW