TOPIC: Scar question (some graphic pics)

It\'s like a colony of various bacteria species that is generally resistant to oral antibiotics because it forms a structure (a \"film\") that can\'t be reached easily through the bloodstream. They happen in chronic wounds and particularly where there is foreign material because the immune response is altered and foreign material helps them latch on. I\'m not sure where it comes from, but that makes sense that PMMA wouldn\'t bind there because the immune response is totally abnormal in the biofilm.

Nearly all my Linnea safe bound to the outer skin in lumps - NOT to the existing implant made of metacrill..which is kinda weird. All the metacrill bound to the lower fascia like it\'s supposed to. But, all my other excisions closed fine. So, I really think the cautery contributed to this . People with burns develop biofilms a lot too. They are in oceans, on buildings, on your teeth, etc... it\'s more complicated than this but that\'s the general idea.

A doctor just burned my Balls off by putting in silver nitrate (which I didn\'t want) and letting it ooze out onto my Balls (a gauze pad would\'ve been too complicated?) I didn\'t even want this crap again - but he was insisting it was the right treatment.

My wound was actually healing fine too. This \"wound care specialist\" was such an unbearable arrogant prick, I can\'t even begin to describe it. I only went there to follow up on Lemperle\'s biofilm issue - and this is what I got! I did have debridement before this visit and it was healing very well. Then, he smothered my wound (and Balls apparently) in silver nitrate. My Balls are practically melting off - there\'s like jelly substance coming from them where the silver is.

I cant even believe this is my life. I mean, how the hell does this keep going??

I\'ve been up all night with my Balls on fire and it\'s the morning now.

You aren\'t gonna believe this... I called this idiot back to day - and he\'s like \"there aren\'t many people who deal with PMMA in the usa - but i\'ve been doing some research and there\'s a Dr. Elist who you might be able to see if you\'re willing to fly to Beverly hills...it looks like he\'s worked with PMMA and Phalloplasty\"

Oh - he said this as he then lectured me that PMMA in the penis isn\'t safe. But, Dr. Elist is the solution!

I can\'t make this stuff up.

Restoration wrote: You aren\'t gonna believe this... I called this idiot back to day - and he\'s like \"there aren\'t many people who deal with PMMA in the usa - but i\'ve been doing some research and there\'s a Dr. Elist who you might be able to see if you\'re willing to fly to Beverly hills...it looks like he\'s worked with PMMA and Phalloplasty\"

Oh - he said this as he then lectured me that PMMA in the penis isn\'t safe. But, Dr. Elist is the solution!

I can\'t make this stuff up.

Dam! I\'m sorry to hear about that restoration.

Thanks Iron. I don\'t know why I am the Typhoid Mary of the board (or something like that)... I hope I am not annoying people. It\'s just been a calamity of errors. I mean, what are the odds...of ALL of this? I went to a wound care specialist who burned the skin off my Balls and recommended Dr. ELIST?? How is this real?!?

Maybe I just have to laugh at this... I don\'t know what else to do.

Restoration wrote: Thanks Iron. I don\'t know why I am the Typhoid Mary of the board (or something like that)... I hope I am not annoying people. It\'s just been a calamity of errors. I mean, what are the odds...of ALL of this? I went to a wound care specialist who burned the skin off my Balls and recommended Dr. ELIST?? How is this real?!?

Maybe I just have to laugh at this... I don\'t know what else to do.

Well the recommendation of Dr. Elist is hilarious and ironic. It is unfortunate that this mishaps keep occurring, but where there\'s a will there\'s a way. My only advice can be to remain positive brother. Best wishes and good vibes from your brother Iron.

Unfortunately if you type \"PMMA penis\" into google search Dr Elist is the first result listed. Obviously he is spending $$ to boost his search rank and I\'m sure this contributes to the sad fact that many fall into his deceitful hands. There is a good chance this is how your Dr stumbled upon Elist, as opposed to asking colleagues for a referral. Unfortunately there are so few legitimate Urologists aware of PMMA Phalloplasty. Of course this does not excuse the terrible care you received !

I hope the pain and inflammation clears quickly. Thanks for keeping us up to date, and please never apologize for telling the truth! Your honesty is a huge asset to this community.

I agree with Bigben. No apologies needed and here\'s hoping he\'s the last doctors visit for some time. Be well.

Thanks guys. Yeah bigben - I think he just googled it. He definitely didn\'t get a recommendation because he said \"Dr. eleesta\" or something at first, and I said \"Elist?\" and he was like \"yeah thats right\".

Every morning I have checked the wound since the silver nitrate and it looks so bad... I can\'t believe how small & close to closing it was - and now it\'s awful. I bought some special burn dressing for my Balls which helped. I made the doctor give my copay back and pretty much reamed him out on the phone. He claims he asked his colleague and they both agreed that it was the right approach...yes, let\'s perfectly healthy tissue in a wound that\'s undergone debridement 3 times and finally looks good... right - exactly the way to go.

Restortation, PM me for some peer reviewed clinical suggestions. If you are pressed for time: Bleach baths 2 times a day in infected area, and never use previously used towels when drying. Apply Eugenol sparingly in infected area. Without running a PCR assay on your specific biofilm, I wouldn\'t know if its a MRSA biofilm strand, though I\'m leaning more in that direction. Now, there are tons of recommendations on the use of MgSO4 (Epson Salt) baths, but in this circumstance i would suggest not to, reason being is S. aureus is a halotolerant bacterium and can be cultured in media with salinities as high at 7.5% to slightly higher. So if the organism, in this case the biofilm colony can survive in a saline environment, the use of epson salt would have no effect. There are other biofilm type of bacterium, and epson salt baths could be a final resort. Clinically when patients are diagnosed with the MecA gene strand of MRSA, bleach baths are implemented. At that time, these patients are treated via IV with an arsenal of antibiotics. Another name for Eugenol is clove oil, Eugenol if often found in the dentistry section at your local pharmacy, its often used to treat biofilms in our oral cavity. But in vitro work is suggesting that eugenol has broader applications since the resistance factor to many of these biofilm species is increasing. Bueno suerte amigo

-CHL

www.ncbi.nlm.nih.gov/pubmed/25781975

Thanks CHL - I\'ve been on zithromax + doxy & topical mupirocin w/ neosporin. So far, they felt I was covered...though I think I may get some kind of culture or PCR at some point. It\'s complicated with biofilms since they need PCR and lots of docs don\'t want to bother with it.

What is your opinion of this whole silver nitrate situation? He claims he wanted to the granulation tissue and get it to epithelialize and close \"faster\"...but it was doing really well before this.

They\'re treating you with medications that the organism already has a resistance too, thats why they need to find out if the mecA gene or others are part of this particular bacterium\'s plasmid. It\'s only going to cost you more money on co-pays and meds if you delay the PCR test, one thing i\'m sure they\'ll label you community acquired MRSA if they do determine it is a particular strand of S. aureus that has the particular genes for resistance. It\'s your penis, i\'d recommend stern and direct body language, skip the family doc, and see an internal medicine physician or walk into your local emergency room and have them admit you. If they admit you, PCR will be standard especially if its a teaching hospital. If you start experiencing fever, chills, weakness or become hypotensive, you need to walk into your local ER. Topical application of Clindamycin, or Bactrim DS, Linezolid or Rifadin orally may treat your condition as well. Be stern and direct and demand these options. But after you\'re done with the antibiotic dose, immediately start a 30 day min. probiotic regiment. There are recommendations i can make for effective strains of probiotic organisms if you are interested. MRSA already has a known resistance to Vancomycin, but the admitting hospital with probably start on an IV with that. Silver nitrate...I\'m only familiar with silver sulfadiazine for burns, I had a second degree oil burn some years ago and the silver sulfa cream provided tons of relief in the healing process. At this point, your last photo of your testicles looks like a chemical burn, keep it dry. If the purpose of the silver nitrate was to close the wound, it seems overly done, and blistering of your skin has occured, this melting of the skin appearance is a clinical sign of chemical burns. Keep it dry, an epson salt bath won\'t hurt but may facilitate in the healing. I\'m sorry you are experiencing a level of distress, take the recommendations i\'ve already made, and if any clinician wants to pour silver nitrate on your penis/testis say you have an allergic reaction to the compound. You actually might, the very least you are extremely sensitive to it upon topical exposure.

I\'m not sure what could be biopsied at this point. The yellow escar from the silver nitrate? That\'s about all there is to biopsy, but it\'s very fragile there now. The Nodule is in a tissue block at the pathologists office, but do you think there\'s a chance of it having bacteria embedded in it? Swabs and cultures don\'t generally allow biofilm detection...that\'s one thing Lemperle said too. It would need to be a biopsy with PCR, but I don\'t know where the biopsy would be taken from. Since I am asymptomatic for infection, they have been resistant to doing a biopsy. MRSA presentation is usually pretty obvious, right? Everyone I\'ve asked says it\'s not really done, unless you have a massive infection and are in a wound care clinic. I went to the wound care doctor (ass hole) who didn\'t address the bacteria issue and just burned my penis and Balls...but he was supposed to do a biofilm biopsy. Instead...he had other ideas.

There is an innate problem when a patient sees too many clinicians, everybody is providing suggestions, and the primary objective becomes a dilute-less direct approach (let things play out per say), this approach often results in the clinician just billing your insurance company while your condition may get worse. I would swab the site of infection and take a small tissue sample, culture the swab and run the PCR on the tissue biopsy (something that can easily be done at any major teaching hospital). PCR is such an easy assay to run, have the necessary primers, and in a few hours your results should be made available. New qPCR assay technology may even allow for sooner results. In the meantime, bleach bath & eugenol, and next time you visit your primary Bactrim DS & topical clindamycin, then after the 30 days a probiotic to replenish your intestinal flora. Keep the site of infection dry, and always wear clean underwear.

Thanks CHL. I will see my prior derm soon.

this approach often results in the clinician just billing your insurance company while your condition may get worse

lol yep.