Tuesday, February 05, 2008

You gotta love her, warts and all

It's good to keep laughing when things go spinny. I went into my doctor today and when she asked how my foot was, I said (thinking of Eric), "Good news! It is still attached!"

I heard her telling the nurses later and they all got a good chuckle out of it. A few weeks ago I had joked with the same nurses, saying that I was bringing new meaning to the expression "to love someone warts and all". Not only did I have plantar's warts, they were infected.

The first infection came after my first long run on my birthday in November, a few weeks after the warts showed up.

I have little resistance to warts and waged a battle with them some 10 years ago when I was a Master's student. After 2 years of weekly (unsuccessful) liquid nitrogen treatments, my doctor (the same one I have now) sent me to see a dermatologist. He tried to burn them off with a laser. Twice. To no avail. He eventually prescribed a concoction consisting of Efudex (a chemotherapy) and salasylic acid. That stuff kills all living cells. And it finally worked.

So when I got this new batch of warts, I asked for more Efudex and I got it. I applied the stuff every day, and still went back for weekly liquid nitro treatments. After the first 18-miler in November, they got a bit infected. I used topical antibiotics and that took care of the infection. The warts remained, so I kept treating them.

On January 5, I did my first 20-miler. Within a few days the warts were infected again. I went back to the doctor. She prescribed more topical antibiotics and said that one really shouldn't do long runs with open sores on the bottom of the foot. The long runs compromise the immune system, as does the cold.

I said, "Sure thing, doc. Now can I please have some liquid nitrogen, too?" She grumbled, calling me a glutton for punishment, but hauled out the silver thermos full of cryotherapy and went to work.

That was on a Tuesday. By Friday, I was back in her office. She said, "Oh, I'm not happy. Not happy at all. Your foot is a mess." Not only did I have warts (infected warts, no less), the infection had spread quickly. I had red streaks coming out from it, heading towards my leg.

I learned that those red streaks are the beginning of blood poisoning. The streaks work themselves up your veins to the closest lymph nodes (in this case, the groin) and then you're in big trouble... hospitalized and on IV antibiotics.

She said, "You need a tetanus shot and you need it right now."

I was hauled into a treatment room where a nurse administered the needle. I left the office with a prescription for Novo-cloxin, a form of penicillin, more topical antibiotics, instructions on soaking my foot in epsom salts twice a day. She was vehement about two things. No more Efudex and absolutely, positively no more running; at least not until the infection is gone.

Hell, by that point walking was nasty, so I was OK with not running - at least for a day or two. I did say to the doctor, "All this from a couple of warts? Are you serious???"

She explained that the open wound left by the chemotherapy creates a vulnerable area. The pounding endured by the feet on a long run increases trauma to the area, leaving it incapable of fighting off tiny bacteria that enter through the wound. The result? An infection that spreads quickly and deeply through the tissue.

I joked with the doctor saying that after about 45 minutes into a run, the endorphins kick in and you don't really feel anything. That sent my normally calm Ironman-athlete-of-a-physician off onto a rant of a sort that I have never seen before. She said that it could become very serious very quickly. I was not to run. Period. No discussion.

The first round of penicillin (10 days) was effective in treating the streaks. They're gone now, thank God. After that I had to wait a week before starting a second round. We had hoped that the second round of antibiotics would kill the localized infection. We were wrong.

I've been gulping back pro-biotic yogurt and popping acidophilous like candy to help put some good bacteria back in my system. I've been stuffing myself with fresh veggies and fruit and eating so "clean" that even my yoga teacher would be impressed. I've had lights out every night at 10:00 p.m. And I've been following the treatment plan that includes no running, twice daily foot soaks and the topical and oral antibiotics. This has been effective only in preventing the infection from worsening, but it remains swollen, red (sometimes purple) and oozy. Doesn't that just sound yummy?

The doctor said today that after two rounds of penicillin she would have expected it to be cleared up, adding, "I just can't keep you on antibiotics. If we do, you'll start to get other things... like a bowel infection. We're not going there."

I feel a little tired and worn out, but I guess that's to be expected after all this agressive treatment. Of course, I try desperately not to show any of this, gritting my teeth as I walk anywhere, greeting people with friendly hellos and generally ignoring the reality that my body is trying valiantly to fight an infection I wish it didn't have.

Today the doctor had the nurses call the same dermatologist I saw a decade ago and get me a referral as an emergency case. We got an appointment for May 4. She was wonderful and said, "Do they not understand the word emergency?" She had the nurses call back and say that I needed an appointment sooner. The next date was February 22nd. My doctor said, "Still not good enough. She needs to go this week. She can't walk!"

I think she is worried about the blood poisoning returning. It came on very quickly the first time and now my immune system is pretty much maxed out. Well, I think I'd better bring the dermatologist some take-out, because they've booked me in during his lunch hour tomorrow. Bless my physician's heart for pushing the issue.

So, here we are... Day 26 of no running. I've lost pretty much 4 weeks of training. The idea of doing my first marathon in May is now a distant memory. Hell, the idea of running is almost a distant memory. I go to the gym and ride the bike and do some yoga...maybe lift some weights, if it doesn't involve being on my feet. I've been too mortified to say anything to anyone... I feel like such a wimp. I also feel like I've let down all the people who have been helping me towards this marathon goal - especially myself.

And let's face it - you really can't blame a girl for being in denial about having infected warts, now, can you? I mean, think about it... With Valentine's Day approaching, I contemplate the following personal ad, "Somewhat geeky and anxious, slightly obsessed, neurotic runner with infected plantar's warts seeks soul mate. Claims to enjoy activities that are as much fun as you can have with your boots (or running shoes) on."

And I wonder why they're not lined up at the door with bunches of roses in hand? I mean, really!!


Backofpack said...

That is seriously scary (though the ad is cute and might attract just the right kind of guy!) I didn't know plantars warts could get infected. The warts are viral aren't they? I hope the derma-doc helps! Keep us up to date, and don't be embarassed, my goodness, runners are interested in any and everything involving the feet! (Oh, and the scariest thing of all is thinking of Eric and quoting one of his jokes!)

Journey to a Centum said...

Umm, wow, err, ouch, ahh, ewww!

As a so called "Marketing expert" I think you need to spin the personal ad just a bit to get some results.

Totally Wild
Race Ready!

Woman seeks kind, gentle man.
Athletic runner
Rapture is guaranteed
Totally hot from my feet to my nose

This concise message tells the careful reader about your wart problem but why empahsise the negative when there are so many positives to talk about!

All jesting aside I hope that you will rid yourself of this persistent problem soon. You sound like you are fighting some of the same issues that Diabetics face with foot injuries. Take good care and follow your physicians advice. Even a wonky foot is better than no foot at all! I think your ability to joke about the whole situation is commendable. You will overcome!

angie's pink fuzzy said...

wow, how incredibly stressful/scary!!!

olga said...

OMG, Sarah! I mean, not only do I miss out on your first 20 miler and infection of warts, now it gets spread out! I think it should be contained by now? Like getting better and redness away? Like you can be back to running soon?
And that add of yours is just hilarious! I was thinking about it recently as my ex told me I should get online for dating...you know, that crazy kind of runner who doesn't really like to run daily, yet needs to so she can run long on weekends, so she can go out to races in high mountains for some crazy distances over insane footing and with elements...because, see, she likes to travel and see new places and meet new people all the while suffering, otherwise it's no fun...

Runner Leana said...

OMG, I had no idea that could happen! Yeah, I have a PW issue I haven't told anyone about, except a dermatologist I saw a couple of years ago. They have been there for AGES and I try with the Compound W every once in awhile but they've been there so long that I give up. Your story makes me think I should get on with it before I start running more. Or should I leave it if I want to run more? Yikes, that is scary though! I really hope you kick this thing soon.

Love your personal ad by the way!

robtherunner said...

I think God is just trying to toughen you up a bit even though I know you are already super tough. There is a larger purpose I am sure of it. I'll be praying for you.

Sarah said...

Wow! What an ordeal! I hope it resolves for you soon. I can totally understand the denial. But I think once you let all your expectations go, you can actually move on. Wishing you good health and a speedy return to running! : )

Downhillnut said...

Maybe you need to list your personal ad in dermatology journals. There's gotta be a single dermatologist just waiting for a special case (I mean that in the best way) like you.

It's a really good thing you're dealing with this now, instead of during a trip to south or central america!

Remember what I said about re-setting goals and recovery. I'm pulling for ya!

ipm said...

oh wow!! glad your doc is on the ball. hope this gets cleared up ASAP!!

there is a reason for all things... maybe a marathon in the autumn?