I had a visiting nurse the next day and told her that I was nervous that my wound had possibly opened again but that I was getting mixed signals from my body. When the nurse looked she said that it was still closed and that I should try to calm down, while still paying attention to what my body was telling me. I was happy to learn that it was still closed but was confused by where the drainage had come from. My nurse looked around the entire area of my wound and said that she did not see anything that looked like it had opened or bled. I was relieved that it still appeared to be closed. That is when my nurse told me that either she or my other nurse would see me a week later. Already they were starting the discharge process, which begins with them only seeing me once a week for several weeks. They do this so that we can be sure that the wound is fully closed and seems to be staying closed. I knew how this process was, based on what had occurred several months earlier and I was comfortable with the process, I just did not think that it was going to start so soon. I expressed to my nurse that I was nervous that no one was going to see it for an entire week and she assured me that everything looked fine and also said that she was really only a phone call away if I really felt that things were going wrong. Before she left she asked how my boyfriend was doing and verified that he was going to be seen at the wound care center within a few days.
The next day when my boyfriend came to my house he said that he had to listen to a voicemail because he had missed a call from the wound care center while he was driving to my house. He only listened to part of the message and then told me that he had to call to reschedule for later in the day. I asked to listen to the message and when I heard it I realized that he wasn’t being asked to reschedule for later in the day, but for the following week at a completely different time. I told him that that was what I understood it to be and though I was displeased, I knew he was the patient and so these decisions were his to make. Before he returned their call I told him that to me it did not sound like they were making the connection that we were together and that he should use my name, or at least tell them that I said hello so that maybe something would click in their heads. My boyfriend chose not to use my name or really do a whole lot of advocating for himself so that he would be able to be seen. I sort of overheard the conversation and was peeved that he didn’t say anything about being with me, because it sure did not sound like the wound care center realized it.
When my boyfriend got off the phone I asked him when it was rescheduled for and when he told me I was then even more positive that they did not know we were together just based on the day and time his appointment was made for. I told him that I was pretty sure he was going to get a different doctor than he was originally scheduled to see, my boyfriend disagreed but we both dropped the subject.
The next day was when my boyfriend’s appointment was supposed to have been and I needed to go to the surgeon’s office to speak to people about a different matter. When I was getting out of the car my boyfriend asked me if I could ask the office manager if she had any idea if the surgeon was going to be at the wound care center during the time his appointment had been rescheduled for. I agreed to ask, happy that he was possibly beginning to realize that things were maybe not as he first thought they were.
When I got into the office I was surprised to see my surgeon! I have been in his office quite a bit for reasons and I have never seen him there. When he noticed me he asked what I was doing there and then questioned what had happened with my boyfriend’s appointment. I explained the situation and then asked him if the rescheduled appointment was even going to be with him, he said that it was not. The surgeon then asked if my boyfriend needed to be seen that day and asked if waiting if he was running late would be okay. I said that yes he should be seen and that waiting was not a problem at all. The surgeon then, worked his magic and the appointment was made for a couple of hours later that afternoon. When I left the office and told my boyfriend, he was very happy that it had all gotten worked out.
A couple of hours later when we were about to go into the wound care center I asked my boyfriend if he wanted me to go in with him or if he would prefer if I waited in the waiting room. My boyfriend said that yes he wanted me to go in the appointment with him. While we were waiting in the exam room for the nurse to come in, I asked my boyfriend if he wanted me to do any of the talking or if he wanted me to be a silent observer. He said that I could do some of the talking. When the nurse came into the exam room she did the typical things that happen at a first appointment. My boyfriend and I explained to her how it had recently been treated and then we waited for the surgeon to come in. Admittedly, I was sort of amused by this point; I was not the patient, finally! I also sort of made a joke to the nurse that I was interested to see the surgeon actually do something because based on the location of my wound I had never actually seen him do anything.
When the surgeon came in he examined the wound and asked my boyfriend how he thought he had gotten it in the first place. The surgeon decided that he was going to culture it and also to biopsy it so that we would know if anything really funky was going on inside. The surgeon also said that he wanted my boyfriend to get his leg x-rayed before we left. All of that sounded like a good plan so the surgeon took a small tissue sample. When he took the sample, the wound began to bleed, I watched it but was not alarmed because I knew that good blood flow was a good sign for wound healing. The surgeon then cauterized it so that the bleeding would stop and told the nurse what type of dressing to put on it. He then told my boyfriend he would see him the following week but would call him sooner if the lab results showed anything that he would need to know sooner.
The nurse then came over and explained to both of us the type of dressing that she was putting on it and how often it would need to be changed. My boyfriend was not going to need visiting nurses so it was going to be up to him and to a lesser extent myself to change the dressings and monitor the wound. She was going to put a type of Hydrocolloid dressing on it and said that we should change it every three to five days and more often if the amount of drainage required it. The nurse then looked at the wound and realized that it had begun to bleed again. She held pressure to it and it slowed down, she then said she was going to place a small piece of calcium alginate just over the part that was bleeding, She then placed the Hydrocolloid dressing on top and while looking at the amount of drainage explained that that dressing would need to be changed sooner than in a few days. We left the wound care center certain that we were capable of handling it.
A couple of hours after we got back to my house we decided that the dressing should be changed. I took off the dressing and noticed that it was still bleeding from that one area but only a small trickle. I did not think much of it and so I just put a small piece of calcium alginate over that area and then put the dressing in place. Everything seemed to be going well until just before my boyfriend was about to leave, that is when we realized that a small circle of blood was on the floor. My boyfriend came over to where I was and showed me his leg so that we could determine how to proceed. When I saw that the dressing was saturated with blood and that it was coming out of all the sides I knew instantly that it needed to be changed. When I took off the dressing I was rather appalled by the amount of blood that I saw. The dressing that had been prescribed does not absorb exudate as much as it turns it into a gel. The bloody gel was sitting on top of the wound, I knew that it had to be removed so that I could both change the piece of calcium alginate and examine the area that was bleeding. I took a deep breath as I was putting on a pair of gloves and then carefully grabbed the gel like substance from the wound to dispose of it. After I did that I looked at the part that the blood was coming from and noticed that it was actually bleeding this time and not with just a trickle.
My brain clicked on almost immediately and I shoved a bunch of pillows under my boyfriend’s leg, hoping that the blood would stop if it were elevated. I also held pressure to the wound knowing that the combination of elevation and pressure usually makes bleeding stop. This had gone on for quite awhile and although I did not want to bother the surgeon I knew I was in over my head, so I sent him a text message explaining that it was still actively bleeding and that my boyfriend would only have one dressing left to last the entire week after I redressed it. The surgeon clarified which dressing he had prescribed. I answered his question and then explained that I had changed it once already but that this time the bleeding was worse. The surgeon then told me to use calcium alginate and then instructed me on how to properly apply direct pressure to get the bleeding to stop. I explained that yes we had calcium alginate and that we had used it before also. The surgeon told me, “no worries. It will stop”. The bleeding eventually slowed down considerably but did not seem to stop. When the surgeon sent me a message about an hour later asking if everything was okay, I explained that it had slowed down but never stopped but that a few minutes before his messaged me it had started to actively bleed again and asked him what he thought we should do. I explained that I had applied the dressing and it was saturated. While I waited for him to respond I called and left a message at the wound care center explaining that we were rapidly running out of dressings and questioned if we would be able to pick some up the following morning and to please call me.
Meanwhile we were now at the wee-hours of the morning and my boyfriend had fallen asleep! I was tending to his bloody mess while he lay on the bed snoring. I was not exactly happy with him at that moment but I didn’t really mind it all that much because there was really no logical reasons for the two of us to be awake the entire night. I eventually couldn’t help myself and fell asleep. I slept for about two hours and then woke up. About an hour after I woke up the surgeon replied to my text message and told me that I should wrap it with an Ace bandage over top of the saturated dressing. I woke up my boyfriend and asked him to get an Ace bandage so that I could follow the surgeon’s instructions. Shortly after I applied the Ace wrap I received a phone call from one of the nurses at the wound care center. I explained everything that had gone on the day before and through the night. The nurse said that she was going to get in touch with the surgeon and would call me back shortly. When she called back she explained that she would be at the wound care center for a few hours and that we could come in if we wanted.
We decided that we were going to go to the wound care center to get the wound looked at and also to pick up enough dressings to last the six remaining days until his next appointment. The nurse unwrapped the wound and we saw that it was bleeding the nurse then said that she was going to cauterize it. I explained that the surgeon had done that the previous day and it still bled. The nurse questioned that he had because he had told her that she should cauterize it when she saw it. I said that yes I was pretty sure he had, the nurse then said that she was still going to do it. When she did that the blood seemed to stop, finally! She then asked me what types of dressings I had in my arsenal at home and I named a couple. She then said that she was going to switch him to an Abdominal Pad Dressing (ABD Dressing) and was then going to apply an Ace wrap tightly on top of that. She told us that that needed to be changed on a daily basis and reminded us that she would be at the wound care center the following day if we needed her for anything. We left the wound care center glad that we had made the decision to get the wound looked at and hopeful that we wouldn’t have anymore drama before the next appointment.
