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Saturday, September 10, 2011

Erythema Nodosum - Forgot to Post and Place Pictures

I was looking through pictures that I uploaded from my camera to computer tonight and was placing them in a new file for September. I then went back to my August album to scroll thru and look. As I was scrolling up, I saw the pitiful pictures of my legs and immediately was disappointed! Why? Because I ALWAYS try and post pictures with my posts if able!

I do this for a few reasons. One reason is the same as I had posted earlier, I want y'all to  experience ALL of this with me! Christ has called me, just as He did Job! I want you to feel what I feel and see what I see...because as my brothers and sisters in Christ you also are going through this with me! As prayer warriors, supporters, friends, etc.! We are a body as He tells us! It is important to me that I hold nothing back from you - just like a testimony! So know that I love you each very much!

Another reason I like to place pictures with my posts - I CAN NEVER forget! I wish I could have a picture for every post, but that is impossible! Some things you just can't photograph....you have your subjective symptoms and objective symptoms. Subjective symptoms are there, but others cannot see them, feel them, hear them, and so on. The way you prove a subjective symptom is through something objective. Example for ya:

*Pain - My doctor can't see my pain, or feel my pain, or hear it, so it is subjective. He can take my blood pressure however and see that it is elevated above the roof...that in turn takes my pain from subjective to objective.

That is why blood pressure, temp, pulse, xrays, blood work, etc is SO vital with the medical field...if something is subjective, you HAVE to have a way to turn that SUBJECTIVE into OBJECTIVE! I know that was a nursing lesson, but I'm trying to show how nice and how important it is to have EVERYTHING that IS objective documented! That way YOU and I can ALWAYS have proof and never forget!

*So inside tip for my readers...if you EVER have anything unusual with your body...ANYTHING -swelling, discoloration, mole, capillary, bump, bite...TAKE A PICTURE! If it goes away you will have the picture and no harm done!  BUT what if it comes back!? You will be ahead of the game...you will then be able to continue monitoring - as you continue taking your pictures you can see how the problem is progressing and how it is changing in shape, size, etc.! Just felt led to share this and tell yall! Your body is YOUR body! Always be in tune with every little dot and line you have! You are your BIGGEST advocate! Please do this for me...promise you will for me*

So back to that reason...as I said you will NEVER forget! You have that visualization in your mind...not only for you, but also, to take and show your doctor! I have written before that these treatments really do mess with my memory so the pictures are a life saver at times!

I guess my third reason for posting the pictures with the posts, is so that if I meet another doctor, I can always scroll back through and write down things that I have forgotten about and print the pictures out! My blog has actually come in handy a few times for some of these new doctors, so it's been a blessing for me when it comes to my memory!

So...back to my legs...in the last post I wrote about me having Erythema Nodosum, and I had also written about this problem on facebook asking for prayers!

You already know that it is not a good sign of Crohn's Disease - doctors raise their eyebrows up and think to themselves "ohh....you are to that point...". A little more about Erythema Nodosum and Crohn's - First, many CD victims never experience this outbreak or even have a clue it exists/can happen with their disease. Second, it only happens to CD victims that have a very severe case and even with that the % of having an outbreak is very low. Third, it is an extraintestinal symptom, so you are dealing with ANOTHER symptom besides all the many digestive system ones!

From reading the last blog post, you ALSO know that this symptom/condition happens with Sarcoid - the disease that we are almost positive I have! After the outbreak I thought it was so ironic...the first time I saw Dr. Hecker he had asked if I had ever had an outbreak/rash of bumps/nodules on legs. I told him "No", and within the next few days *BAM* it happened. Now yes, I will say as I always do...and yes it will sound funny saying it....but "God is GOOD!"  It was just another symptom to validate and help get us to the sarcoid, and can I say RIGHT IN TIME!

Moving along to the outbreak and duration. From the time the first nodules appeared to the time the last one was fully healed, that total length - start to finish was close to 4 weeks.

The evolution of Erythema Nodosum - The first bumps/nodules appeared, and I guess with me being a nurse and knowing my body, truly an alarm went off in my head. Most people would have thought a mosquito bite, and that is EXACTLY what the first nodules will look like! Around the nodules are perfect red borders that surround them completely...so you have a red inflamed circle, with a raised little bump in the middle. The first physical sensation dealing with the outbreak was PERSISTENT ITCHING! I promise...I wanted to take a bristle brush and just rake my legs with it! Now not all were the same, it was as though they went through stages. For many of the little mosquito look-a-like bites, if you pressed them, it LITERALLY felt like a marble under the skin. Hard as a rock and very painful. Some places were pustules *you could actually see the pus through the bump - they were also PAINFUL and itched the most* Now the ones that I said were in the latter stage, they actually had gone from nodule to pustule to actual ulcer *if you have had an ulcer in your mouth, it was just like that but much smaller...they did grow a light scab, so that was nice that it just wasn't openly exposed for long*. The itching would become terrible when new ones would appear, and the pain would not stop because it was present with all the inflammation and knotting of my tissue.

Out of that...the funniest thing I can remember was not being able to shave my legs! My legs were itching and hurting so bad one night, and I wanted air to be able to get to them because with inflammation that in depth...your skin is on FIRE! So I placed my legs in Andrew's laps and he pulled up my pajama legs so the air would hit them....let's just say I had BIG FOOT LEGS! Come on now...I couldn't shave with all these scary little things! I poked my lip out at Andrew and then smiled and said "SOOOOOWWWWWY!" He is the sweetest and just said "it's ok baby!" what he was really thinking was *Oh dear Jesus...make these things better...her legs look like mine!* LOL!

I only took pictures I think three days, and they were back to back! I wanted to document better, but along with other reasons, my camera has just about bit the dust, so it won't focus very well....so the pictures aren't what I was hoping for, but they at least showed red dots! I was hoping to be able to differentiate between the nodules, ulcers, and pustules...I can when I zoom and scroll up and down looking...but I highly doubt you care to scope my legs that nicely!

Anywhooo....Dr. Rodriguez wanted to start me on leprosy medicine if they didn't get better, but as you all know HE NEVER CALLED BACK when I called him the second time! He was *soooo worried* when I called that first time, "start Benadryl immediately...we HAVE to get your body calmed down, REST....do not do much at all...THIS IS SERIOUS" *a bunch of yadda yadda if you aren't going to call me back and they already were ten times worse* Most of you already know he and I have a love/dislike relationship anyways!  Ok...now to the pictures!

One more thing - I was VERY disappointed, because I was hoping for complete healing. That most of the nodules would just go away nicely! My legs definitely are scared now...to the point the doctors were examining them and looking at where the inflammation was all located! I would put cream on them, but these are not the type of scars you can put Mederma on...they are dented in the skin and darker than surrounding the skin! *booo* I could be polka dot legs woman!? Does that sound like a super hero?


Day One - You would expect maybe just 1 big one for the first day or two!

Of course not me, I'm ALWAYS a record breaker, I HAVE to go ALL out...lol!


Day 2 : ALREADY popping up everywhere! This is my Left Leg in this picture
which was the worst between the two legs.Remember to try and look close -
if you see places that are circular and white,that is where a new one will pop up!
 When I would go to bed, I would look over legand see where I would have my
marked spots, and sure enough, they would be there by morning.


Day 2 : Just a close up, so you can only see a few. In this one they
are mostlynodules, but I can see two pustules that were ulcerating.
The one at very bottom left and the one up towards  mid right.


Day 2 : This was the only up close pic I was able to get that was kind of focused.
If you look to the far right. That one was VERY painful. Look very closely and you can
see how the center of the nodule is shiny and is raised - it was pustule, along with the
one to the far left. These two turned into fairly decent ulcers.


Day 3: For only three days, I couldn't believe how many I already had!
I'm sure you can visually imagine just how bad after 2 - 2 1/2 weeks!
In this one you can even see more white spots where new ones were coming up.


Day 3: I wish I would have continued to take pictures to show the progression, but between
the itching, pain, and continuous multiplying of them - not to mention after 1,2,3,4 weeks
of NO SHAVING....I was somewhere between frustration, embarrassment, and just
EXHAUSTION! Like I said, wish would have taken more, but it's a-okay with me!



Day 3 : OH MY GOODNESS! So I was about to post, and was like hmmm...
My brain, forgot, as I was warning y'all about. Tada, I did have ONE picture of
an ulceration with the Erythema Nodosum. This was on my left? ankle.

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