EEEEEWWWW! vs. HMMMMMM…?

Friday, March 27th — The infected area on my right shin didn’t respond fully to three courses of antibiotics. Some of the inflammation disappeared, of course. But there is still an area of eschar, or what we ordinary mortals would call “scab”, about the size of a business card, as well as a warm, red, puffy area. Also, I’m shedding my skin like a snake, all around the leg from the ankle to above the sore area. It’s pretty disgusting, overall.

So my doctor sent me for an x-ray and an MRI last week, just to “rule out” infection of the bone. Okay, it’s all good, no bone infection. Next, he sent me to the Wound Care Center in the same Scripps Clinic with which he’s associated. The surgeon looked it over and told me it would be necessary to remove the eschar and “debride” the whole thing — scrape off the top layer and let it start to heal all over again. He booked me for an outpatient surgery next week.

The good thing about outpatient surgery is that I won’t get general anesthetic; instead, I will be “heavily sedated,” with Valium and Versed (you know Versed? it’s the I-can’t-remember-anything-that-happened drug). The bad thing is that it’s supposed to take place at yet another Scripps Clinic, which can only be accessed by driving up the I-5 freeway a few exits’ worth. That would mean the Beloved Spouse would have to be the Designated Driver, and he does not drive the freeways any longer. I’m not at all happy about that possibility.

Another REALLY BAD THING is that after the surgery, I would have to spend most of my time lying around with my leg elevated for… I don’t know, two or three weeks, apparently. For sure, I wouldn’t be doing any yoga or having any chiropractic adjustments.

But this is good as an ace-in-the-hole plan.

Next, I went to Seaside Chiropractic last Wednesday, for a final adjustment before my enforced period of lying down with my leg up. Coincidentally (except I do not believe in coincidence), Dr. David Klein was all excited about something he had read online, about yet another branch of the Scripps hospital system, in downtown San Diego, whose Wound Care Center operates a Maggot Debridement Therapy (MDT) program.

MAGGOTS?? You got that right! Fly larvae… maggots… those squishy little guys you see on dead birds and roadkill. But it appears that the maggots in the Debridement Therapy program are the creme de la creme of Maggothood: they are raised in sterile conditions, or “farmed”, by a guy up the coast in Orange County.

David and I phoned the Wound Care Center and spoke to someone there, just gathering a little more information. Then when I got home, I called the surgeon’s office. I asked his nurse to inquire if he knew anything about MDT, and if so, what was his opinion on it. She called me back at the end of the day. He had said that “he does not personally use MDT because he doesn’t have the resources, but it is not something he would frown on.” Now, that sounds like a guarded OKAY to me!

The next day I spoke to the Wound Care Center downtown, to Stacy, the Maggot Lady. The upshot is that after my pre-op physical and my EKG on Monday, I have an appointment with Stacy to “evaluate the wound” and see if I would be a good candidate for MDT. She said: “They prefer the yellowish necrotic tissue; they don’t do so well with large areas of eschar.” I took that to mean, “So they don’t like the crust, but they do like the filling?” Hmmmmm… much like me with pumpkin pie. I can relate to that.

Now, the EEEEWWWW!  factor is pretty big here, I have to admit. The thought of deliberately “applying” maggots to my own dear leg is extremely disgusting, and a little scary. Stacy breezily told me that the maggots look like grains of rice; but from what I’ve recently read, after they’ve had their way with me for a couple of days, they will look more like plump and shiny little hominy grits. However, the HMMMM…? factor is getting stronger and stronger, the more I think about it.

The deal is: I could drive myself there and back; no sedation, no anesthetic; they “apply” the maggots to the wound, then bandage over them securely; and away I go, back home. I pick up my life as usual for 48 hours, then return to have the beasties removed. I gather that to do this, they simply flush them out with water. Then they put a dressing on, and refer me back to the surgeon for follow-up care. I still need to find out more about this, but I think it will involve dressings for a while, and possibly a graft, if necessary. I am hoping I won’t have to spend two weeks lying indolently around, as I would have with the surgery.

Another nice thing about maggots is that they work for cheap: the cost is probably half of what the surgery would be! They don’t get benefits or worker’s comp, they are neither salaried nor paid hourly. They work for their dinner, as it were. I don’t know what happens to them after the feast, but I’m going to find out. Maybe they just pass away in a blissful overstuffed dream. Or maybe they drown in the flushing-out process. I’ll ask the Maggot Lady.

It’s going to be a very interesting week for me, either way. At last something will be done about this really awful leg ulcer — such a surprise to me, something I had never anticipated! And I certainly NEVER anticipated voluntarily submitting to a host of maggots, at least not for the next few decades.

I shall keep you all apprised. At least, wish me luck: surgically or by dint of maggots, I’ll be on the mend in a few days.

Thanks for reading — Betsy