By Jan Chait
My incision from surgery on April 8 to repair a torn Achilles tendon is not healing well. As I understand it, it could be worse, but it isn’t getting any better. So I’m having a procedure that should aid in healing. As I write this, I haven’t had it yet. By the time you read it, I’ll be back home.
During the outpatient procedure, I’ll be taking a nice nap — thanks to the anesthesiologist — while the doctor does a thorough cleaning. A vacuum will be attached to suck the fluids and other gunk out of the wound and to draw the edges of the incision together. Oh, joy.
Mother, who wants to pamper me for a few days, is here for the week, and I’ll apparently also be visited by home health care so they can change the dressings and keep the vacuum-assisted closure, or V.A.C., device (a.k.a. Kirby) happy. I’m used to being alone much of the time and do not like to be hovered over. This is going to be a fun week.
Kirby is no Wal-Mart–variety vacuum. He gets rented at a rate of $146 per day and falls under my durable medical equipment (DME) coverage, which is capped at $2,500 per year. This had better not take more than a couple of weeks: I’d rather spend my money on something else. Like a trip. I tried to find out how much it cost to buy a V.A.C. device, just to see how that $146 a day is justified, but the companies are keeping that a secret. If any of you find out, let me know. I hope there’s solid gold in that sucker (pun may be intended) and not just gold leaf.
The whole deal got my imagination working overtime. I was diagnosed with Type 2 diabetes in 1986 with a fasting blood glucose of 311 mg/dl, meaning I’d already had it for a few years. Unlike Type 1 diabetes, which comes on rather suddenly, Type 2 can develop gradually and hide for years, frequently doing its damage before it’s even discovered. That’s why people need to get checked for Type 2 diabetes so it can be found early. That way, you can work from close to the beginning of when the condition develops to lower your risk of complications. It isn’t fun, but it’s better than finding out you have Type 2 diabetes after your heart attack, stroke, or eye damage occurs.
Despite the 23-plus years I’ve known I have diabetes and all the years before when I didn’t have a clue, I’m pretty much complication-free. Which is to say, I don’t know of any complications or, at least, not of any major ones. My eyes are fine, I have feeling in my feet, and stuff like that. I have reduced blood flow to a small portion of my heart, my microalbumin levels are slightly elevated (but have remained at the same level for years), and I’ve had two impinged shoulders, which people with diabetes are more prone to.
As an aside, did you know that one of the risk factors for Achilles tendon problems is — you guessed it — diabetes?
Anyway, when I got an infection and the wound from the surgery didn’t heal, I decided that this was it: I was beginning my downhill slide to a plethora of diabetes complications. I pictured myself going for years with what my granddaughter says is a “big, gaping hole” in the back of my leg or, worse, no leg. I wondered what would come next: A heart attack? A sudden deterioration of my eyes? End-stage kidney disease? Gastroparesis?
With plenty of people more than happy to tell you about all of the ills that will befall you… sometime… during your shortened life, there was plenty to dwell on.
When my podiatrist called me to answer a question I had about Kirby, I shared with him that, for the first time since diagnosis, I really felt as if I had diabetes since this was, apparently, the beginning of the end.
He quickly convinced me otherwise, saying that, while diabetes most likely didn’t help, infection and healing problems after Achilles tendon surgery were not limited to people with diabetes.
“Traditionally,” he said, “any incision over the Achilles tendon has a relatively high chance of complications. The soft tissue between the tendon and skin is thin and has a limited blood supply. This is true of all individuals. The diabetes might slightly increase the risk, but over all the area is challenging.”
Whew! Dodged that bullet!
However, it isn’t time to become complacent. While surfing around the Internet looking for information about diabetes and wound healing, I came across the Web site for the Wound Healing Center of New York-Presbyterian Hospital/Columbia University Medical Center that helped me better understand how diabetes can affect wound healing. According to the site, poorly controlled diabetes can cause a variety of issues, ranging from the development of skin breaks and infections, to difficulty fighting these infections, to clogged arteries that prevent adequate blood flow from reaching wounds.
I always try to remember that it isn’t diabetes itself that causes complications: It’s poorly controlled blood glucose that does the dirty deed. (And having good genes probably doesn’t hurt.)
Complications do more than inconvenience us when they occur: The darned things are costly, too. Not that taking care of diabetes is easy on your wallet, but at least the daily expenses of medicines and supplies to care for diabetes don’t come close to what Kirby can set you back.
Source URL: https://www.diabetesselfmanagement.com/blog/sometimes-things-really-do-suck/
Jan Chait: Jan Chait was diagnosed with Type 2 diabetes in January 1986. Since then, she has run the gamut of treatments, beginning with diet and exercise. She now uses an insulin pump to help treat her diabetes. (Jan Chait is not a medical professional.)
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