Prayers up for Jim...
Hey, Jim,
This is a long-shot, but my brother had what they at first thought was a major infection on the skin of his ankle, but it - much later - turned out to be a fairly rare (but known) auto-immune issue... I think it was called pyoderma grangrenosum. Very painful; basically the skin looks like it is burned off down to the muscle/tendons and spread over the whole foot and ankle.... 2 1/2 years later; he can finally function without extreme pain, it is under control, and they ended up doing major skin grafts that have mostly healed. It took almost two years before they really figured out what triggered it - and now in retrospect, it is clear what they missed initially...
If you (Jim) have this go on and on and worsen, and they just can’t diagnose it... I suppose it is possible that they may need to check for auto-immune disorders such as this one which can be triggered by certain issues in the gut. Hope it isn’t that serious! If this could be you, let me know, and I’ll tell you what they finally figured out - it wasn’t at all obvious until it was known after the fact, and then it seemed so obvious ...
Sincere best wishes,