TOPIC: Scar question (some graphic pics)

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.

I can order clove oil on amazon. I guess the one thing I don\'t really understand is how I can have MRSA or an infection like that without any pain, redness, heat, discharge, etc... and why all the other excisions closed without any issue if that area (or the pmma) is colonized. And, it hasn\'t changed in 2 months (no worsening, I mean). Is that the clinical presentation of a biofilm infection?

I was expecting that wound care doctor to culture / biopsy it...now I\'ve been set back two week since he decided to chemically burn it like a lunatic.

Is this what you had in mind?
www.amazon.com/NOW-Foods-Clove-Oil-ounce..._product_top?ie=UTF8

I\'ll have to wait for another Dr. appt to ask about the others. I have clindamycin for acne topically, though it has benoyl peroxide in it. What do you think? It\'s called acanya (brand name)

I\'ve heard great things about Now Foods, they offer an OTC version of clove oil, but Walgreens also has a dental product known as Red Cross Toothache (85% eugenol and sesame oil). I know it would be odd buying a dental product as such, but clinically and abroad eugenol is a strong agent against mrsa infection. It\'s odd you aren\'t experiencing any pain, inflammation, tenderness or a fever. Lets consider the eugenol and bleach baths a prophylactic measure. I recommended Bactrim DS, since it doesn\'t irritate the stomach too much. Clindamycin phosphate topical lotion 1% was the second medication i\'d recommend, the benzoyl peroxide is known to cause chemical burns (DO NOT use it on your genitals), when you get the Clindamycin phosphate lotion use sterile q-tips when applying to wound site. If it isn\'t a biofilm, the epson salt baths may help in closing the wound. Unless we have a small biopsy, we couldn\'t be 100% certain you have a mrsa biofilm. Quite honestly, we see these biofilms with surgical patients due to the hospital acquired mecA gene being rampant.

If i were you, the patient, I would take the recommendations previous made until your treating physician writes you a prescription for the correct clindamycin lotion and bactrim ds. We\'ve already done half the physicians work, this is why i\'m a firm believer of telemedicine. University of Arizona is conducting some great pilot telemedicine programs with chronically ill patients. Don\'t worry everything should be fine, but if you do develop a fever, please admit yourself to your local emergency dept.

CHL - thank you so much.

Yeah I totally agree about telemedicine.

I\'m going in tomorrow so a dem can look to see if he maybe wants to biopsy the area (7 minute visit - $60 copay), but then - of course the biopsy will be weeks away. I\'ll print some of your comments out for him as I agree those antibiotics are going to be the right ones. He also gave me clindamycin lotion for acne way back in 2012 (it\'s expired) - and then after that, acanya (the benzoyl peroxide + clindy one) which works really well.

Doxy has been hard on my stomach unless I take it w/ food - but then supposedly it\'s less effective or absorbtion goes down (though this is debated...and then they mostly point to calcium).

I saw that tooth stuff yesterday!- And I was like, hmm...is this what CHL was talking about? haha.

My Urologist only does procedures in the hospital (even excisions)...and he wants to do an excision with mattress or buried closure of PDS or Chromic - taking out this area (leaving a bigger scar) and one other Nodule. But, there are 3 probs... 1. Infection is going on and 2. hospital environment is even more contaminated (though less so in an OR). 3. Bigger scar.

I think I\'d rather wait - and medically, it should be healthy tissue before a third attempt to close it is made, wouldn\'t you agree? It\'s frustrating because only his PA saw me to schedule the procedure, and I couldn\'t explain any of this...and he charges a huge cancellation fee. I could go and just ask him to take out the lower Nodule... or wait and see.

The way it looks - basically metacrill all stuck to my inner shaft, and linnea safe all stuck to my outer fascia. So, he has to dissect it off dartos. Metacrill is all bound to bucks and smooth.

Also, I\'m having some pain in one of the nodules that had a partial excision. Scar is looking good but it is very sore.

Here\'s the update:

Derm -- looked at wound & as it has recovered from silver nitrate - I watched it like a hawk & applied bactroban, neosporin, celacyn, etc... and he said he really doesn\'t see signs of a biofilm. He read Prof Lemperle\'s email, but he thinks that it might have been hard for Lemperle to know for sure, given that it was only on email. He thought systemic antibiotics didn\'t pay - and topicals were working fine. He said NOT to have anymore surgery or excisions for at least 2-3 months on that site. His office and pathologist cannot do PCR.

Uro -- He\'s the one at the major teaching hospital. He hasn\'t seen me since he\'s booked up solid, but he saw the same pics Lemperle did. He thinks that excision will take care of the problem, and the biofilm won\'t return if it is there (though he hasn\'t seen post silver-nitrate pics since I hate to bog him down with emails & it takes him a while to get back). He didn\'t comment on my PCR question...but I checked with my insurance and the whole thing would be around $300 since I am at my out-of-pocket max already (good lord! It\'s definitely not all penis related, but about half was). To cancel would be $250 and would also piss him off...and he\'s one of the best male urologists around so I don\'t want to do that. I\'m thinking he could do some excisions of the other nodules and address this in person. I wish I could see him before the procedure, but it\'s just impossible with his schedule.

My urine drips again after I finish...which was happening when I had that base Nodule pushing on my urethra that got Kenalog + 5fu and shrunk. It almost seems like it increased in size over the past 3 months. Maybe he can take that out during the procedure...or the ventral Nodule that also pushes on my urethra...so in a way, it\'s still worth doing. I just hope these freaking incisions CLOSE. Most of them did, but we didn\'t use the hyfrecator which can melt PMMA (after the first one didn\'t close). Uro wants to use it...said he\'ll be very selective about just a few blood vessels...not just burn the whole area out... but that\'s easier said than done.

(Edit - I saw a wound care specialist who made things worse & then had the Urologist do the excision. The details are continued here)