Sun, sand and surf

My week in Key West around Nov. 1 was both good and bad for my feet. As usual, sun and water improved my psoriasis. But not as much as I would have liked. When I saw Dr. Dossetor in December, she changed my prescription, saying the Dovobet was too strong for my shins and was thinning the skin too much.
Besides swimming, I did some walking, lots of standing, and lots of bicycling in Key West. It might have been a little too soon for the biking (although the flat landscape was wonderful!), because Dr. Gartke said my foot bones had not healed as straight as they should have, or as they apparently had on the last x-ray.


I took my dermatologist's advice and went back to the land of sunny weather and salt water. This time, it was Mexico's west coast, where we visited our son and went diving. The sunshine did good work on my itchy shins and rough feet. Changing to the new cream had already made a difference to my shins in December.
As for the mechanical issues with my feet; here's the situation. The left foot, with its straightened toe bone, is getting more and more solid all the time. There are very few twinges anymore, and it seems to work well. I go back to see the orthopedist, Dr Gartke, in March. The right foot, however, is often sore and weak. I am looking forward to getting it straightened out, too, although I may have to keep the cast longer this time.

Internal and external updates

Internal
Footbones
Well, I have been to the orthopedic surgeon to find out about getting my bunions fixed. And I'm going to get the first one done this summer! After they break the long toe bones and realign them, they put you in cast for 6 weeks. Then there's 6 more weeks of gentle motion, and after that, things should get to a new normal. She also prescribed a shoe-fix to help the metatarsals, expecially in my right foot. My new shoes at are at the shoe expert's now. I'm getting the left bunion done first, because the bunion there, although less pronounced than the one on the right foot, accounts for more of the pain in that foot.

External
And the skin?
I have nearly no psoriasis on my feet, except below the ankle bone on my left heel, mostly. But it has been all over my shins all spring. Flaming red, bumpy shins are not nice in shorts weather! It's fading a lot on the left leg and a little on the right. I just keep treating it with Dovabet and the tarry-salicylic cream, and Vaseline if it gets too itchy between doses. I think I've kept it under control: no infections anyway. I have an appointment with Dr. Dossetor next week, so we'll see what she says.

December checkup

Checkup with Dr. D. the Dermatologist yesterday. Feet and elbows passed inspection. Ankles have been itchy and red lately, so Dovobet is the answer (as for all these problems). Renewed prescriptions for Dovobet and tar cream. Sunshine and salt water in Cozumel seem to have done good things, too. Had the moles on my back checked, too, and nothing to report. Good.
See her again in June!

The Arm

So, I took my oozing arm to Dr. Dossetor on Feb. 7, because I already had an appointment. She said some Hmmms and prescribed antibiotics, inside and out.
She also took me off the "scary medicine" (Soriatane), as she thought that might be weakening my system.
It took 2 weeks, but it has healed. Still a little itchy and still a little red, but not much of a bother. What a mess!
(every time I put polysporin on it--especially from the tube at work) it flared up again.)
I'll go back to her in May for a foot check-up.

Feet are great, but what about the Arm?

So, about a week ago Monday-ish, I got a scratch on my left arm, on the inner forearm, in a spot that's always resting on desks, counters, knees, etc. It was a deep, straight scratch, but I don't remember it happening. In fact, people pointed it out to me before I noticed it myself. It didn't hurt. After a couple of days, though, it got itchy and reddish; oh, oh, an infection!
After that, things went straight to hell. I tried Polysporin, I tried alcohol (applied externally), I tried hot, hot water to urge the infection to hurry up and leave. On Friday when I went to Toronto, I had it well bandaged to keep out germs and keep ooze in.
But it got worse and worse. By Monday, it was a big bump that oozed yellow (and sometimes red) liquid all the time! It got redder and itchier. Then I remembered I still had some silver absorbent stuff left over from wound care of the foot, and I applied that on Wed. and Thurs. It seemed to do the trick. The oozing and itching have diminished a lot. It's still red and tender, but motly dry. What a pain!

Doctor Chestnut's Reaction

Yesterday I went to Dr. C about other stuff, and she was curious to see my feet (practically more curious than the dematologist). So we had a look. She said, "I never thought I'd describe feet like that as looking good." But they are pretty fine, for me, for now. Only a few open bits, and no inflammation.

Psoriasis is the diagnosis.
Improvements continue every day, but I still have some sore areas.
The swelling has gone down greatly, especially since I finished the antibiotics.

Dr Pratt was a very unpleasant person, but she knows skin, and her prescriptions have been effective.
I also saw Dr. Dossetor, who is a much nicer person, and who agreed with Dr Pratt's plan, except maybe the Soriatane... which she thinks mught be too much.
I also saw Dr Rose of Infectious Diseases (Civic) and a nurse who usually works in the psoriasis clinic, and they felt I was on the right track. He (Rose) said the swelling was due to the infection.
Last week was a busy one for doctoring.
Yesterday I had my colonoscopy (irrelevant to feet, but more doctors). Today I was discharged by the CareFor nurses re infection/wound care, but I will be going back for foot care for the remaining calluses.
Tomorrow, Dr. Chestnut, for a checkup, pap test, and obviously a follow-up on all this.