Seeking Advice on a Severe Blister
Hello everyone, I hope you're all doing well. I'm reaching out because I recently encountered an issue that I'd like some guidance on. As a 60-year-old dealing with neuropathy, I went for a long walk today and unknowingly developed a significant blister on one of my toes, specifically on the one beside my pinky. Due to my neuropathy, I didn't notice until later that the blister had actually burst, and when I finally examined it, I realized that two layers of skin had peeled away. Currently, the area is quite large, covering the entire underside of my toe and extending a bit up the sides, resembling raw flesh. I have some bandaids and Vaseline with me, but I'm unsure if I need additional supplies. I still have to walk for the next couple of days, approximately four miles each day, albeit not too strenuously. During the day, I plan to apply Vaseline and cover it with a bandaid, but I’ve heard it's beneficial to let it breathe, especially at night. Would that be advisable? Should I avoid bandaging it when I go to sleep? I appreciate any advice you can offer! Thank you for your understanding regarding the details I shared.
Answers (1)
7/6/2025, 7:40:37 PM
OpenHealth AI
It sounds like you’ve encountered a painful blister due to your long walk, and it’s important to care for it properly, especially with your neuropathy. Here’s how to manage it effectively:
Main Points
- Blister Care: Proper cleaning and covering to prevent infection.
- Mobility Considerations: Balancing protection while continuing your walking routine.
- Skin Breathing: Finding a balance between covering and allowing the area to breathe.
Explanation
Blisters often form when there’s friction against the skin, especially on sensitive areas like your toes. Since the blister has burst and the inner skin layers are exposed, this area can be vulnerable to infection. Given your condition, managing this appropriately is essential to avoid complications.
Next Steps
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Clean the Area: Gently wash the blister site with mild soap and water. Pat it dry with a clean towel.
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Apply Vaseline: After cleaning, apply a thin layer of Vaseline to keep the area moisturized. This can help protect it from further friction.
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Cover It: Use a clean Bandaid or adhesive bandage to cover the area. This will protect it from rubbing against your shoe and potential infection. Change the bandage daily or if it becomes wet or dirty.
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Allow Breathing at Night: If possible, let the blister breathe at night to promote healing, provided doing so won’t expose it to further injury. Consider removing the bandage before bed, but only if you are certain you won’t accidentally bump or irritate it while sleeping.
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Monitor for Signs of Infection: Keep an eye on the area for redness, swelling, increased pain, or discharge. If you notice any of these signs, it’s important to seek medical assistance.
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Footwear Choice: When you walk, try to wear shoes that are spacious and comfortable to minimize friction on the blistered area.
By following these steps, you can help ensure that your blister heals properly while continuing your activities as much as possible. If you feel any discomfort increases or if there’s persistent swelling, it might be wise to reassess your walking routine. Take care, and I hope your blister heals quickly!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.