The end of January left me incredibly happy. My surgeon had discontinued the Wound VAC and so it and all of the associated supplies were no longer taking up valuable space in my room. In addition, arrangements were made for the Clinitron At-Home bed to be picked up and for a new regular mattress to be delivered.
The nurses and my surgeon continued to treat the wound with the Calcium Alginate inside of the wound and then a dry dressing on top of it from mid January until the beginning of February when my surgeon said we were going to change what we were using. While I have pretty much always been a believer in the 'if it ain't broke, don't fix it' philosophy I have come to realize that sometimes even if a treatment is working it is important to change it up once in awhile. The human body will 'get used to' a type of treatment, sometimes to the extent that it will stop working. Therefore, it was in early February that my surgeon decided to switch me from the Calcium Alginate to something called Hydrofera Blue.
Hydrofera Blue is a synthetic sponge that is made of polyvinyl alcohol foam. The foam is infused with two pigments that protect against a wide spectrum of bacteria. The pigments, (Methylene Blue and Gentian Violet) give the hydrofera a blue-ish purple color. What is supposed to happen, is that any drainage will be pulled away from the wound bed, while the pigments are helping to prevent an infection.
The hydrofera blue was working to a certain extent, but after using it for two weeks, my surgeon wanted to change what we were doing again. He changed the orders back to the Prisma dressing with a foam dressing on top. Everything seemed to be going well, except that I was noticing more drainage. At that point, I wasn't sure if it was draining more because, something was wrong or because, the Prisma wasn't holding as much as the hydrofera was. I mentioned it to my nurses but they did not seem overly concerned about it. I was continuing to see my surgeon on a weekly basis throughout this period for the most part. When I woke up the day of my regular appointment with him, again I had a really weird feeling that something wasn't right. In fact, in the car on the way to the wound care center I kept telling my boyfriend that I had a feeling that the appointment wasn't going to go well.
When I got to the appointment I mentioned the excess drainage to the nurse and the surgeon. When the surgeon probed inside the wound I felt pain. I told him that it hurt and he basically asked if I knew what that meant. I did know, it meant that he was poking at bone and that I would need to have yet another surgery. Obviously, I was not at all pleased with this news but, I was not surprised by it due to my incredibly strong feeling. The surgeon told me that someone from his office would be in touch with me so that the surgery could be scheduled. In the meantime, he wanted me to go back to using the hydrofera blue.
When I got home, I called my visiting nurse and explained to her all that had gone on at my appointment and what the wound care orders were. It turns out, that we had run out of the hydrofera, so it would need to be ordered. In the meantime, I got in touch with the nurse at the wound care center and told her that we had Prisma and asked if that would be okay for a few days. I was told that it would be fine. We used the Prisma only until a few days before the surgery while we waited for the hydrofera to be delivered. The surgery was scheduled for the end of March.
Friday, April 20, 2012
Tuesday, April 17, 2012
More Surgery
I went into the surgery in a generally positive mindset. The surgeon explained to me that he was going to scrape away a small portion of the bone so that it could be tested for infection. He then cleaned up the bone until he was at healthy bone so that if an infection was present it would be taken care of. After that he placed antibiotic seeds inside the wound cavity. He then placed Adaptic over the seeds, followed by a dry dressing. Adaptic is a type of knitted dressing that is coated in a petrolatum emulsion (petroleum jelly), so that it will not stick to the wound. The intent of this dressing is that it would allow any drainage to come out of the wound, meanwhile it was going to prevent the antibiotic seeds from falling out before my body was able to absorb them.
I woke up from the surgery feeling really well. I saw my surgeon who then explained to me what he had done. I was allowed food and then able to see my boyfriend a short time later. Shortly thereafter, I was discharged to my house. When I got home I was feeling remarkably well and I immediately called my nurse to update her on the new wound care orders that she would begin with me the following day. The new wound care orders consisted of cleansing the wound with normal saline, packing it with Calcium Alginate and then covering it with a simple dry dressing.
The few days following the surgery went really well. I was still stuck at home in a bed recovering from surgery but I felt remarkably well. So well in fact, that it was only about three days post-op that I began writing this blog. See, I had been encouraged by my surgeon during one of my prior appointments to do something while I was stuck at home. When I asked him what I should do he suggested a blog. After getting a resounding 'yes! Do it, I really think you should' from my best friend I began writing.
I continued to have visiting nurse visits at my home and saw the surgeon on average once a week. Things seemed to be going very well. I had every indication that it was getting smaller and that an end may actually be in sight. Being that the surgeon was very happy with the way things were going it was toward the end of January that I had the courage to ask him if he could give me an indication of when I could get rid of the Clinitron At-Home bed. My asking was mostly due to the sand leaking everywhere. I along with my parents were sick of the mess. I was thrilled that he said that I could get rid of it at that point! Finally I'd be getting my room back.
I woke up from the surgery feeling really well. I saw my surgeon who then explained to me what he had done. I was allowed food and then able to see my boyfriend a short time later. Shortly thereafter, I was discharged to my house. When I got home I was feeling remarkably well and I immediately called my nurse to update her on the new wound care orders that she would begin with me the following day. The new wound care orders consisted of cleansing the wound with normal saline, packing it with Calcium Alginate and then covering it with a simple dry dressing.
The few days following the surgery went really well. I was still stuck at home in a bed recovering from surgery but I felt remarkably well. So well in fact, that it was only about three days post-op that I began writing this blog. See, I had been encouraged by my surgeon during one of my prior appointments to do something while I was stuck at home. When I asked him what I should do he suggested a blog. After getting a resounding 'yes! Do it, I really think you should' from my best friend I began writing.
I continued to have visiting nurse visits at my home and saw the surgeon on average once a week. Things seemed to be going very well. I had every indication that it was getting smaller and that an end may actually be in sight. Being that the surgeon was very happy with the way things were going it was toward the end of January that I had the courage to ask him if he could give me an indication of when I could get rid of the Clinitron At-Home bed. My asking was mostly due to the sand leaking everywhere. I along with my parents were sick of the mess. I was thrilled that he said that I could get rid of it at that point! Finally I'd be getting my room back.
Friday, April 13, 2012
What is Going On
I had the PICC line in place for the next six weeks as I needed to have at least a six week course of the antibiotic. The nurse was right when she told me that after doing the medication a few times that it would end up being something that I wouldn't really need to think about doing. Meanwhile I was still using the Wound VAC.
Everything seemed to be going really well as I adjusted to using the PICC, I was at this point pretty much used to the Wound VAC so I was in a relatively decent place mentally. It was approximately the beginning of October at this point, I was told that as long as the Wound VAC was on and that I remembered not to lift anything weighing more than a gallon of milk that I could pretty much be up and out of bed once in awhile. While I was happy that I could be vertical more often I pretty much only allowed myself up when I deemed it absolutely necessary. I was beginning to get somewhat down about the entire situation and so I figured that if in essence grounding myself was going to make it heal that that was what I was going to do.
After I was on the antibiotics for the full six weeks my blood tests were showing that the infection had improved so much that the PICC line could be removed. The infectious disease doctor removed it, during one of my regular wound care appointments. Removing it was absolutely painless and it was completely out in less than a minute.
I would remain on the Wound VAC from that point all the way into the second week of January. In January I woke up to go to my normal wound care appointment with the surgeon, the car ride up was fine, except for the weird pit in my stomach. I had no evidence that anything was wrong other than just a weird feeling in my gut.
It turns out that when the surgeon started poking around he felt something sticking up in the center. He explained that he thought it was only a bone spur but that he wanted me to get an X-ray before I left. I was placed back on the wound VAC and sent down for the x-ray with the expectation that the surgeon would call me in a couple days to tell me everything was fine. I was hoping that a positive outlook was going to help. A couple of days later came the highly anticipated call, unfortunately the pictures were obstructed by a different unrelated procedure that I had when I was very young. The obstructed view meant that I would now need to undergo a Magnetic Resonance Imaging (MRI). I knew from past experience that while an MRI was going to be a loud and probably lengthy test I knew that it was completely painless so I went ahead and scheduled the test for after my wound care appointment the following week.
The test was done and I would end up getting the results during my visit with my surgeon. He said that he could not be positive that there was or was not an infection in the bone so he wanted to do another surgery so we would know what we were dealing with.
Everything seemed to be going really well as I adjusted to using the PICC, I was at this point pretty much used to the Wound VAC so I was in a relatively decent place mentally. It was approximately the beginning of October at this point, I was told that as long as the Wound VAC was on and that I remembered not to lift anything weighing more than a gallon of milk that I could pretty much be up and out of bed once in awhile. While I was happy that I could be vertical more often I pretty much only allowed myself up when I deemed it absolutely necessary. I was beginning to get somewhat down about the entire situation and so I figured that if in essence grounding myself was going to make it heal that that was what I was going to do.
After I was on the antibiotics for the full six weeks my blood tests were showing that the infection had improved so much that the PICC line could be removed. The infectious disease doctor removed it, during one of my regular wound care appointments. Removing it was absolutely painless and it was completely out in less than a minute.
I would remain on the Wound VAC from that point all the way into the second week of January. In January I woke up to go to my normal wound care appointment with the surgeon, the car ride up was fine, except for the weird pit in my stomach. I had no evidence that anything was wrong other than just a weird feeling in my gut.
It turns out that when the surgeon started poking around he felt something sticking up in the center. He explained that he thought it was only a bone spur but that he wanted me to get an X-ray before I left. I was placed back on the wound VAC and sent down for the x-ray with the expectation that the surgeon would call me in a couple days to tell me everything was fine. I was hoping that a positive outlook was going to help. A couple of days later came the highly anticipated call, unfortunately the pictures were obstructed by a different unrelated procedure that I had when I was very young. The obstructed view meant that I would now need to undergo a Magnetic Resonance Imaging (MRI). I knew from past experience that while an MRI was going to be a loud and probably lengthy test I knew that it was completely painless so I went ahead and scheduled the test for after my wound care appointment the following week.
The test was done and I would end up getting the results during my visit with my surgeon. He said that he could not be positive that there was or was not an infection in the bone so he wanted to do another surgery so we would know what we were dealing with.
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