Sunday, June 12, 2011

Necrobiosis Lipoidica Diabeticorum

I'm going about my day when I feel that telltale sting on my lower leg and I can't stop the string of cuss words that leave my mouth. It doesn't really hurt, but I know that in moments the pain will increase exponentially. I look down and see what amounts to little more than a scratch. I watch as a clear liquid begins to seep from the wound then count to ten as the pain begins to ramp up and I try to remember how to breathe.

My necrobiosis lipoidica diabeticorum lesions look like burns and ironically when they are injured they burn like they are literally on fire. A fire that will be repeated at random times during the next week or two that it takes for the injury to heal. The length of time depends on whether or not the living tissue beneath the lesion was injured too. The deeper the wound the longer the healing time. Also, the more frequent the shooting pains through the wound.

Although my loved ones and co-workers are used to seeing the lesions, when I've injured one, they can't help but ask if I'm okay. I can't say that I blame them. The wounds look nothing less than angry. Sometimes they will puff up or swell and often they will actually look like they are infected. Even though they aren't.

For years, I had kept my legs hidden at all costs even at home. No shorts or skirts. I wouldn't even leave my bedroom in my nightgown. I was just positive that everyone would stare at my legs. That this visual evidence of my diabetes made me even more of a freak. Not all of that was vanity or fear. I'm quite pale and can sunburn in a matter of minutes. The lesions can get burned in about half that time.

Some of it is vanity though. These hideously ugly lesions have turned my once porcelain skin to an orange, red, & purple mottled mess. No lesions have moved to my feet, but the colouring has. A possible foreshadowing of what is to come. One that leaves me fearful and worried when I'm completely honest with myself.

Despite their almost disgusting appearance, I have been very lucky. Most patients have developed pits and bumps because of their lesions. For the most part, my legs are even and smooth. Only their colour and cellular make-up has been irrevocably changed by this disease. And of course my already nearly non-existent self-esteem has taken a hard knock, but not a lasting one.

I don’t remember what exactly made me change my mind about covering up my legs. But I do remember that my loved ones made an effort not to bring up the change. In fact, I remember walking into the kitchen in shorts one Saturday, and hearing my Pops’ comment cut short by my Mommy’s elbow in his side. Poor man. He did tell me later than day (when Mommy was out of earshot) that I had nice legs and I shouldn’t hide them all the time. I took that comment to heart and rarely hide them now. And on good days, I agree with him. They are nice legs. There are a lot of women I know that wish they had 24 inch thighs. Now if the rest of me just matched. :D

For those of you who aren’t familiar with necrobiosis lipoidica diabeticorum, here is an overview of it.

And here are a few pictures of my legs and feet.

My Left Foot

My Right Foot

My Left Leg

My Right Leg

My Right Leg

That divot is not from the NLD. I had a benign tumor removed from a blood vessel there in February 2006.

My Right Ankle

Both of these are the outside of my Right Ankle. This is where the pressure ulcer was when I was diagnosed in June of 1991. I wrote about it here. The ankle is a bit misshapen because of the muscle tissue I lost, but to me it's beautiful because I nearly lost not just my ankle but my whole foot.