My boyfriend and I have spent approximately two years without wound issues. He did have a couple of unrelated surgeries which I was entirely too busy to write about. Additionally, I had a laparoscopic cholecystectomy back in January. Other than that though, I had moved on from being a patient with a chronic wound to becoming a full-time student. As I have been in school, my priorities changed and I had to desert the blog. I am back now though...
It started a few weeks ago with some pain in my hip area. I asked my boyfriend to look in the area and all he said was that I had some bruising but it did not look bad and that the skin was intact. While I was experiencing pain and bruising I did not really think too much of it. Frankly, I was entirely too busy focusing finishing my school semester.
While the pain did not really increase, I did experience some clear drainage for a day or two so I asked my boyfriend to look at it this past Tuesday. His reaction to what he saw was to say, "um yeah, you should get that checked out". I asked him to take a picture of it and show it to me so that I knew what I was talking about when I called the wound care center. What I saw honestly did not look that bad to me either but I knew it had the potential to deteriorate quickly. What I did see was, something that looked like the top layer of skin had come off and some small bruises in the center, the border of it looked more red and raw.
When I called the wound care center, they were able to see me on Thursday and I was instructed to stay off the area as much as I could.
At that point, it was just a matter of waiting a couple of days until my appointment, which I hoped would really turn out to be just another case of me being paranoid and with nothing actually wrong.
Sunday, May 21, 2017
Saturday, May 2, 2015
Sometimes Things Can be a Real Pain in the Neck
While my boyfriend and I were waiting for authorization from his insurance company, he and to a lesser extent, I were continuing to treat his wounds with the Iodosorb and a foam dressing. Although, I want to be more involved than I have been, his schedule has required him to take more of the responsibility for his usual dressing changes. At his recent wound care appointment, his doctor explained that she felt the wound on the lateral (outside) part of his foot was doing so well and had become so superficial that she felt she would be able to glue it closed and then apply steri-strips to secure the edges of it. My boyfriend and I were pleased that at least one of his wounds was beginning to come along so the doctor applied medical grade superglue. His medial (inside) wound was also looking very good and the doctor told us to continue using the Iodosorb and the foam dressing. She then asked how the progress was with his new braces, which he then explained that he had received authorization and was just waiting to make the appointment. Although, I did not say anything at that point, I did feel somewhat blindsided by the information because I had repeatedly asked him if he had heard anything and was consistently told, “no”. To say that I was peeved, is an understatement, but I tried to take a step back and understand that all of this really was his responsibility and I should perhaps try to take more of a hands-off approach, especially because I had a lot of my own stuff to deal with as far as my shoulder was concerned.
By this point, I have seen three; orthopedists for my shoulder injury. The first orthopedist disagreed with the MRI report, based on her viewing the images personally, and also on the physical exam she performed on my arm. She said that in her opinion, I had not torn anything and what I had was a case of bursitis, and some early arthritis in the top of my shoulder but that ultimately, one of my muscles was just not as built up as she would have liked. She then recommended a cortisone shot to try to help my pain. I had had one previously, in my hip and I knew that cortisone shots were painful but that it had helped my hip so I agreed. I also agreed, because I had done some prior research and knew that getting one shot in my shoulder would be okay but that getting too many, could lead to any surgical repair being more difficult. I had originally, gone into the appointment, thinking that I would just hear her out and wouldn’t make any actual decisions but all of that seemed to go out the window. I think what happened was, I was thrown for a loop when she said that I did not have tendon damage and so I may have somewhat let my guard down. My initial thought was that I of course would not have gone ahead and scheduled any type of repair of the shoulder until I had at least gotten a second orthopedic opinion but maybe I felt that, that wouldn’t be needed so I went ahead with the shot. After I got the shot I went home and applied ice to my shoulder to try to minimize the pain and swelling and took it easy for the rest of the day.
I decided to get a second orthopedic opinion on my shoulder situation prior to beginning any physical therapy as a “tie-breaker” of sorts because the MRI report had said one thing and the orthopedist’s opinion was different. I went to the second orthopedist with copies of all the imaging that I had done of my shoulder and also the patient portal app that I had on my phone that documented everything from my initial orthopedist appointment. That orthopedist viewed the images and also agreed that it didn’t look like I had torn anything. He then did an exam of my shoulder, during which he asked me to move in all sorts of painful positions. At the end of all of this he explained the diagnoses he had come up with. According to him, I had Bursitis, a contusion of the shoulder, impingement syndrome and a neck strain. After hearing all of this I asked what my options are and was told that he could give me another cortisone shot but that at this time all he would recommend would be physical therapy. I accepted the cortisone shot because by that point I was more confident that I would not need surgery. I received the shot and left with the instruction to start physical therapy in about a week.
Of course while I was trying to handle all of the pain and inconvenience of having a shoulder injury, I was also continuing to assist my boyfriend with his wound care. His wounds in my opinion were beginning to stall in the healing process which somewhat bothered me but they weren’t really looking worse at that point so we continued to treat his wounds as directed, until I noticed something different. All of a sudden, when I was changing the dressings on his wounds, I noticed that some undermining was developing on one of them. I looked into the small opening as closely as I could, with the flashlight of my cell-phone and I realized that the undermining area looked to be very dry. Of course, I had learned all about moist wound healing so my first instinct was that something should be done so that the area could gain a bit more moisture. I explained to my boyfriend what I saw and what my thought process was and asked him if it would be okay if I called the wound care center and got some input on the situation.
When I called I spoke with the nurse that I communicate with very well and explained to her what I felt was going on. She then asked me what I wanted to do based on the supplies I had available. I told her that I would like to use Hydrogel in the new area and she said that if I felt it was too dry to go ahead and stop using the Iodosorb and to apply the Hydrogel. When I hung-up with the nurse I explained to my boyfriend what she had said and he said to go ahead with the new plan. I then had to figure out a way to apply the Hydrogel, which comes in a tube similar to a toothpaste tube, into a very small opening. After thinking it over for a minute, I decided that I could probably put some of the gel into a syringe and push it in that way. I was unsure if it would work completely as the diameter of the syringe was slightly larger than the opening I needed to squirt the gel into. I gave it a try and although I wasn’t sure if the gel went down as far as was necessary I knew that what I was able to get into it, would most likely help. Afterward, my boyfriend went home and I wasn’t going to see him or his wounds for a few more days. It ended up that I didn’t even get to see his wounds until the following wound care appointment. When we got there I was happy that we got the nurse that I had spoken to on the phone so I wouldn’t have to explain to a different nurse why we weren’t following the written orders. The doctor came in and told me that she had heard all about what was going on and what I had done. When she examined him she saw the part I was talking about and because the Hydrogel that I applied had done it’s job she told us to discontinue that and to go back to the Iodosorb, she also took a culture of his wounds because it had been awhile since one had been taken and she wanted to make sure that the new undermining area wasn’t caused by an infection.
The doctor called me a couple of days later and told me that some infection had shown up in the culture and she was considering putting my boyfriend on a topical antibiotic ointment. I said that it was probably a good idea based on what I had been seeing and gave the information for the pharmacy my boyfriend uses. I then called my boyfriend and explained to him what the doctor and I had discussed. He then told me that if we needed to do daily dressing changes while using the antibiotic, new supplies would need to be ordered because as it was he barely had enough to get him through until his scheduled visit to the wound care center. I was slightly peeved that he had forgotten to mention it at the appointment and though I voiced this annoyance to him, I also called the wound care center and asked that new supplies be ordered. It took several days for the pharmacy to get his antibiotic in stock so while we waited we stuck to the dressings schedule that we had been using.
By this point I had been going to physical therapy to try to decrease my neck and shoulder pain and to increase my range of motion. After a few sessions that consisted mostly of stretching, my physical therapist determined that in her opinion my first rib was slightly out of whack and she wanted to adjust it. Without entirely thinking it through, I allowed her to manipulate me so that my rib would go back into place. I went home afterward and actually felt somewhat better, almost like she had loosened something and although moving was still painful, I felt like I was able to move slightly farther. All of this continued for several weeks when I noticed that I wasn’t really getting any more improvement or pain relief. I had a follow-up appointment with the orthopedist after seeing my therapist for approximately seven weeks. During the appointment, we discussed that my shoulder pain was improved slightly but that my neck was still really bothering me, I also asked him if he thought my rib had been out of place and explained that my physical therapist had been doing some adjustments to it. He said that he didn’t feel that my rib was out of place at all but he recommended that we take a neck x-ray to determine a cause of my neck pain. When my orthopedist pulled-up the x-ray images on the computer, I myself was able to see that something didn’t look quite right. The orthopedist explained that I had a slipped disc in my neck. I was somewhat relieved that I had a real reason for being in so much pain and yet I was concerned because a slipped disc didn’t sound like a minor diagnosis. When I asked what should be done about it, I was told to continue therapy and that he would see me again if I felt I was still not improving after awhile. I continued physical therapy for about another week when I decided perhaps it was time for yet a third opinion. I called the orthopedist that my wound care surgeon had recommended and was able to get an appointment relatively quickly.
By this point, I have seen three; orthopedists for my shoulder injury. The first orthopedist disagreed with the MRI report, based on her viewing the images personally, and also on the physical exam she performed on my arm. She said that in her opinion, I had not torn anything and what I had was a case of bursitis, and some early arthritis in the top of my shoulder but that ultimately, one of my muscles was just not as built up as she would have liked. She then recommended a cortisone shot to try to help my pain. I had had one previously, in my hip and I knew that cortisone shots were painful but that it had helped my hip so I agreed. I also agreed, because I had done some prior research and knew that getting one shot in my shoulder would be okay but that getting too many, could lead to any surgical repair being more difficult. I had originally, gone into the appointment, thinking that I would just hear her out and wouldn’t make any actual decisions but all of that seemed to go out the window. I think what happened was, I was thrown for a loop when she said that I did not have tendon damage and so I may have somewhat let my guard down. My initial thought was that I of course would not have gone ahead and scheduled any type of repair of the shoulder until I had at least gotten a second orthopedic opinion but maybe I felt that, that wouldn’t be needed so I went ahead with the shot. After I got the shot I went home and applied ice to my shoulder to try to minimize the pain and swelling and took it easy for the rest of the day.
I decided to get a second orthopedic opinion on my shoulder situation prior to beginning any physical therapy as a “tie-breaker” of sorts because the MRI report had said one thing and the orthopedist’s opinion was different. I went to the second orthopedist with copies of all the imaging that I had done of my shoulder and also the patient portal app that I had on my phone that documented everything from my initial orthopedist appointment. That orthopedist viewed the images and also agreed that it didn’t look like I had torn anything. He then did an exam of my shoulder, during which he asked me to move in all sorts of painful positions. At the end of all of this he explained the diagnoses he had come up with. According to him, I had Bursitis, a contusion of the shoulder, impingement syndrome and a neck strain. After hearing all of this I asked what my options are and was told that he could give me another cortisone shot but that at this time all he would recommend would be physical therapy. I accepted the cortisone shot because by that point I was more confident that I would not need surgery. I received the shot and left with the instruction to start physical therapy in about a week.
Of course while I was trying to handle all of the pain and inconvenience of having a shoulder injury, I was also continuing to assist my boyfriend with his wound care. His wounds in my opinion were beginning to stall in the healing process which somewhat bothered me but they weren’t really looking worse at that point so we continued to treat his wounds as directed, until I noticed something different. All of a sudden, when I was changing the dressings on his wounds, I noticed that some undermining was developing on one of them. I looked into the small opening as closely as I could, with the flashlight of my cell-phone and I realized that the undermining area looked to be very dry. Of course, I had learned all about moist wound healing so my first instinct was that something should be done so that the area could gain a bit more moisture. I explained to my boyfriend what I saw and what my thought process was and asked him if it would be okay if I called the wound care center and got some input on the situation.
When I called I spoke with the nurse that I communicate with very well and explained to her what I felt was going on. She then asked me what I wanted to do based on the supplies I had available. I told her that I would like to use Hydrogel in the new area and she said that if I felt it was too dry to go ahead and stop using the Iodosorb and to apply the Hydrogel. When I hung-up with the nurse I explained to my boyfriend what she had said and he said to go ahead with the new plan. I then had to figure out a way to apply the Hydrogel, which comes in a tube similar to a toothpaste tube, into a very small opening. After thinking it over for a minute, I decided that I could probably put some of the gel into a syringe and push it in that way. I was unsure if it would work completely as the diameter of the syringe was slightly larger than the opening I needed to squirt the gel into. I gave it a try and although I wasn’t sure if the gel went down as far as was necessary I knew that what I was able to get into it, would most likely help. Afterward, my boyfriend went home and I wasn’t going to see him or his wounds for a few more days. It ended up that I didn’t even get to see his wounds until the following wound care appointment. When we got there I was happy that we got the nurse that I had spoken to on the phone so I wouldn’t have to explain to a different nurse why we weren’t following the written orders. The doctor came in and told me that she had heard all about what was going on and what I had done. When she examined him she saw the part I was talking about and because the Hydrogel that I applied had done it’s job she told us to discontinue that and to go back to the Iodosorb, she also took a culture of his wounds because it had been awhile since one had been taken and she wanted to make sure that the new undermining area wasn’t caused by an infection.
The doctor called me a couple of days later and told me that some infection had shown up in the culture and she was considering putting my boyfriend on a topical antibiotic ointment. I said that it was probably a good idea based on what I had been seeing and gave the information for the pharmacy my boyfriend uses. I then called my boyfriend and explained to him what the doctor and I had discussed. He then told me that if we needed to do daily dressing changes while using the antibiotic, new supplies would need to be ordered because as it was he barely had enough to get him through until his scheduled visit to the wound care center. I was slightly peeved that he had forgotten to mention it at the appointment and though I voiced this annoyance to him, I also called the wound care center and asked that new supplies be ordered. It took several days for the pharmacy to get his antibiotic in stock so while we waited we stuck to the dressings schedule that we had been using.
By this point I had been going to physical therapy to try to decrease my neck and shoulder pain and to increase my range of motion. After a few sessions that consisted mostly of stretching, my physical therapist determined that in her opinion my first rib was slightly out of whack and she wanted to adjust it. Without entirely thinking it through, I allowed her to manipulate me so that my rib would go back into place. I went home afterward and actually felt somewhat better, almost like she had loosened something and although moving was still painful, I felt like I was able to move slightly farther. All of this continued for several weeks when I noticed that I wasn’t really getting any more improvement or pain relief. I had a follow-up appointment with the orthopedist after seeing my therapist for approximately seven weeks. During the appointment, we discussed that my shoulder pain was improved slightly but that my neck was still really bothering me, I also asked him if he thought my rib had been out of place and explained that my physical therapist had been doing some adjustments to it. He said that he didn’t feel that my rib was out of place at all but he recommended that we take a neck x-ray to determine a cause of my neck pain. When my orthopedist pulled-up the x-ray images on the computer, I myself was able to see that something didn’t look quite right. The orthopedist explained that I had a slipped disc in my neck. I was somewhat relieved that I had a real reason for being in so much pain and yet I was concerned because a slipped disc didn’t sound like a minor diagnosis. When I asked what should be done about it, I was told to continue therapy and that he would see me again if I felt I was still not improving after awhile. I continued physical therapy for about another week when I decided perhaps it was time for yet a third opinion. I called the orthopedist that my wound care surgeon had recommended and was able to get an appointment relatively quickly.
Sunday, February 22, 2015
I am Sick of Being Confused and Frustrated
It was approximately, two weeks later when finally the day of my shoulder MRI arrived. I went to the MRI a whole lot calmer than I usually am, due to a mild sedative that I had asked my primary doctor to prescribe. Ordinarily, I do not take any medication prior to an MRI but this time I decided that it was a good idea because I had been told that I had moved during the one I had on my wrist and I did not want any potential movement to distort the images. After the test I tried to relax for a few days and focus on celebrating the holidays with my friends and family. When my primary doctor’s office got in touch with me to discuss the findings of my MRI, I was told by my doctor’s Physicians Assistant (PA) that one of the tendons in my shoulder was partially torn and another was completely torn and that a third may have been involved. As such it was my doctor’s recommendation that I be evaluated by an orthopedist. My initial reaction to hearing that I had torn tendons was unfit for print but let’s just say it was rather loud and colorful.
It was a couple of days after speaking with my doctor’s office, when I was finally able to think clearly enough to process what the PA had told me, when suddenly, what she had said didn’t seem to make sense. I contacted my doctor’s office via the patient portal and asked that my physician call me so that I could speak to her directly for clarification. When she called me back, my primary question, was how the method of injury corresponded with my diagnoses; because to me it didn’t seem like banging the back of my shoulder would have actually torn a tendon, let alone two and potentially three. My doctor, told me that I was asking a very good question and the only thing she could come up with was that I had slightly and only momentarily dislocated my shoulder, which had damaged the tendons, but that I should ask the orthopedist that question. I made an appointment with the orthopedist that my doctor recommended for the following week. While I was waiting for the day of my appointment to arrive, it occurred to me that if I had actually torn tendons that the usual treatment is surgery. I have finally learned though that second opinions are useful and so I reached out to my former wound care surgeon to see if he would be willing to recommend an orthopedist. It may seem strange that I contacted my wound care surgeon for an issue with my shoulder and maybe it is, it’s just that I have such a level of trust with him and obviously, he knows surgeons that have other specialties, my theory, was really, what did I have to loose?
During this time, boyfriend and I have continued to use the Iodosorb to treat his wounds and although they are not healed yet, his cultures haven’t shown any infection that needs to be treated. While this is clearly, good news, the doctor has suggested that he get evaluated for new braces because perhaps the fit is contributing to his wounds. While my boyfriend agreed that the evaluation seemed like a good idea, he kept putting off being evaluated. By then of course I was frustrated that my boyfriend’s wounds were not closed but I was more frustrated by his failure to be evaluated for new braces. My thought process was, if there is something that could potentially help his wounds heal and also prevent more from forming in the future, why the heck isn’t he getting it done? During his wound care appointment a few weeks ago, my boyfriend’s doctor, asked him both what was stopping him from having his braces evaluated and what they could do in order to help facilitate it. My boyfriend said that making an appointment that corresponded with his work schedule was a challenge but that he didn’t really need anyone at the wound care center to do anything to make getting the evaluation any easier. The doctor, told us to continue treating the wounds as we had been but that she really wanted his braces evaluated. She also turned to me and I think half-jokingly told me to make it happen. While she may or may not have been half joking, I took her seriously, because I understood where she was coming from in explaining that nothing she could do would help him if he didn’t take care of the root cause of the problem.
I let all of this go for a couple of days, hoping that my boyfriend would step up and do what everyone felt needed to be done. While I was waiting, I was also stewing to myself and talking to the therapist that I have been seeing for approximately a year and a half. After hearing her out and really considering all that she had said about my boyfriend and I each having different “roles” in our relationship that we tend to excel at, I decided on a plan. I determined that pleading with him to make his own appointment hadn’t been successful, which in my view left me with two options. I could both sit and do nothing about it and potentially, “let him fall on his ass” metaphorically speaking, Or I could offer help. I chose the latter, which I am pleased to report that he took me up on. Knowing, his schedule and all of our commitments for the near future, I was able to call and make him an appointment so that his braces could be evaluated. My boyfriend also allowed me to speak with his wound care doctor to request that she call the place where he gets his braces adjusted so she could give her medical opinion on his wounds and what adjustments may potentially help.
My boyfriend and I went to his braces evaluation together approximately one and a half weeks ago during which he and I did our typical “dance” of him explaining what is happening and me sitting silently and just observing. I think this tends to be my modus operandi because I have very strong boundaries when it comes to people speaking up for me and therefore am hesitant to do it for others, yet in this instance I do not think it was a wise decision. What ended up happening was little more than a colossal waste of time. Two things were done during this appointment, one of which was for a portion of his brace to be smoothed out so that it didn’t cut into his skin anymore. Of course that was a wise decision because his skin under that area of the brace is starting to wear down but it is not on his feet where his actual wounds are, although I do realize that smoothing that portion may help prevent his skin from breaking down further. The only other thing that happened was that my boyfriend was told that the company needed to contact his insurance company so that they could obtain authorization for new braces. It is my belief that this could have been done prior to his appointment because now he will have to go back at some point after insurance approves new braces so that he can be measured and casted for them. We are now waiting to hear back from either the braces company or his insurance company with either an approval or a denial of his new braces. Personally, I am not worried about his insurance company denying his request because he hasn’t gotten a new brace in several years and this one is clearly not fitting properly, I am just frustrated by yet another delay.
It was a couple of days after speaking with my doctor’s office, when I was finally able to think clearly enough to process what the PA had told me, when suddenly, what she had said didn’t seem to make sense. I contacted my doctor’s office via the patient portal and asked that my physician call me so that I could speak to her directly for clarification. When she called me back, my primary question, was how the method of injury corresponded with my diagnoses; because to me it didn’t seem like banging the back of my shoulder would have actually torn a tendon, let alone two and potentially three. My doctor, told me that I was asking a very good question and the only thing she could come up with was that I had slightly and only momentarily dislocated my shoulder, which had damaged the tendons, but that I should ask the orthopedist that question. I made an appointment with the orthopedist that my doctor recommended for the following week. While I was waiting for the day of my appointment to arrive, it occurred to me that if I had actually torn tendons that the usual treatment is surgery. I have finally learned though that second opinions are useful and so I reached out to my former wound care surgeon to see if he would be willing to recommend an orthopedist. It may seem strange that I contacted my wound care surgeon for an issue with my shoulder and maybe it is, it’s just that I have such a level of trust with him and obviously, he knows surgeons that have other specialties, my theory, was really, what did I have to loose?
During this time, boyfriend and I have continued to use the Iodosorb to treat his wounds and although they are not healed yet, his cultures haven’t shown any infection that needs to be treated. While this is clearly, good news, the doctor has suggested that he get evaluated for new braces because perhaps the fit is contributing to his wounds. While my boyfriend agreed that the evaluation seemed like a good idea, he kept putting off being evaluated. By then of course I was frustrated that my boyfriend’s wounds were not closed but I was more frustrated by his failure to be evaluated for new braces. My thought process was, if there is something that could potentially help his wounds heal and also prevent more from forming in the future, why the heck isn’t he getting it done? During his wound care appointment a few weeks ago, my boyfriend’s doctor, asked him both what was stopping him from having his braces evaluated and what they could do in order to help facilitate it. My boyfriend said that making an appointment that corresponded with his work schedule was a challenge but that he didn’t really need anyone at the wound care center to do anything to make getting the evaluation any easier. The doctor, told us to continue treating the wounds as we had been but that she really wanted his braces evaluated. She also turned to me and I think half-jokingly told me to make it happen. While she may or may not have been half joking, I took her seriously, because I understood where she was coming from in explaining that nothing she could do would help him if he didn’t take care of the root cause of the problem.
I let all of this go for a couple of days, hoping that my boyfriend would step up and do what everyone felt needed to be done. While I was waiting, I was also stewing to myself and talking to the therapist that I have been seeing for approximately a year and a half. After hearing her out and really considering all that she had said about my boyfriend and I each having different “roles” in our relationship that we tend to excel at, I decided on a plan. I determined that pleading with him to make his own appointment hadn’t been successful, which in my view left me with two options. I could both sit and do nothing about it and potentially, “let him fall on his ass” metaphorically speaking, Or I could offer help. I chose the latter, which I am pleased to report that he took me up on. Knowing, his schedule and all of our commitments for the near future, I was able to call and make him an appointment so that his braces could be evaluated. My boyfriend also allowed me to speak with his wound care doctor to request that she call the place where he gets his braces adjusted so she could give her medical opinion on his wounds and what adjustments may potentially help.
My boyfriend and I went to his braces evaluation together approximately one and a half weeks ago during which he and I did our typical “dance” of him explaining what is happening and me sitting silently and just observing. I think this tends to be my modus operandi because I have very strong boundaries when it comes to people speaking up for me and therefore am hesitant to do it for others, yet in this instance I do not think it was a wise decision. What ended up happening was little more than a colossal waste of time. Two things were done during this appointment, one of which was for a portion of his brace to be smoothed out so that it didn’t cut into his skin anymore. Of course that was a wise decision because his skin under that area of the brace is starting to wear down but it is not on his feet where his actual wounds are, although I do realize that smoothing that portion may help prevent his skin from breaking down further. The only other thing that happened was that my boyfriend was told that the company needed to contact his insurance company so that they could obtain authorization for new braces. It is my belief that this could have been done prior to his appointment because now he will have to go back at some point after insurance approves new braces so that he can be measured and casted for them. We are now waiting to hear back from either the braces company or his insurance company with either an approval or a denial of his new braces. Personally, I am not worried about his insurance company denying his request because he hasn’t gotten a new brace in several years and this one is clearly not fitting properly, I am just frustrated by yet another delay.
Saturday, January 31, 2015
Can Things Get Anymore Absurd?
I am so sorry that it has been so long since I have updated, things got kind of hectic for a while and I temporarily needed to focus my mind on more pressing things than on updating you all. That said; buckle your seatbelts because I am about to unload just some of the absurdities of my situation to you all.
Approximately a week later I got the chance to look at my boyfriend’s wounds again and discovered that it had changed how it was responding to the treatments we were using. When I attempted to remove the Calcium Alginate from inside the wound I realized that it was sticking, as opposed to easily disengaging. To me that was a sign that the wound was no longer moist enough to warrant using Calcium Alginate and something else needed to be used to care for the wound. I then told my boyfriend what I felt like was happening and that it was my opinion that we should again put the Iodosorb in so that some of drainage would be absorbed but that a portion of it would react with the iodine and form a gel so that the wound wouldn’t become too dry. My boyfriend at that point said it was okay with him if I again changed what we were doing because his wound care appointment was a couple of a days later and we would be able to get professional advice then.
When my boyfriend and I were on the way to his appointment I asked him if he wanted me to explain to the doctor why we were no longer following her directions to care for his wounds. My boyfriend said that he absolutely wanted me to explain our thought process to the doctor so I went into the appointment with him ready to explain and yet also somewhat nervous that the doctor would be upset that we weren’t listening to her. When we got to the appointment my boyfriend and I explained what had changed and what we were doing to the nurse so that she could document all we had done as well as photograph the wound for my boyfriend’s records. When the doctor came in she told us that she had seen a picture and that we were right it did look different. I then told her what it had looked like the previous week and hesitantly, the steps we had taken to take care of it. The doctor told me that she liked the change I had made and that it was okay that I decided that because I, “know wound care”. I was relieved that she didn’t feel like I was overstepping and also that she agreed that what we had decided to do was the right decision. She then told us that she was somewhat concerned that its wet and somewhat macerated appearance was due to an infection although we all felt that was unlikely because my boyfriend had no other signs of infection. A wound culture was taken and we were told to continue treating the wounds as we had been and that she would call if the cultures showed anything that “impressed her”. We made a follow-up appointment for two weeks later and left hoping that we would not receive a phone call saying that he needed to start antibiotics.
It was around this time that I experienced a freak accident. I was getting into the passenger side of my boyfriends car as I always do when somehow I managed to bang the back of my shoulder incredibly hard on the doorframe. My boyfriend who was outside of the car at the time actually heard the impact and was at my side seconds later asking what had happened. After a minute, when I was able to get words out, I told him what had happened and that I was in a considerable amount of pain. My boyfriend then quickly put my wheelchair in the trunk and got in his car so that we could decide what needed to be done about my shoulder. I explained to him that the point of impact was on the back of my shoulder in the area where the arm meets the shoulder but that I also had pain radiating up my neck and down my arm, about half way to my elbow. My boyfriend then looked at my shoulder to see if it looked swollen or was beginning to bruise. He told me that it looked fine but that it was up to me what I wanted to do as far as treatment. I decided that we would just go back to my house where I would apply ice and take some ibuprofen. I did that, knowing that it was important to try to prevent or at least decrease swelling. A few hours later, before my boyfriend left, he asked me what I was planning to do as far as my shoulder because the Ibuprofen and ice hadn’t really helped my pain. I told him that I was just going to go to bed and would reevaluate it in the morning. I went to bed anticipating feeling muscle soreness the next day but not really anything more than that. Unfortunately, after five days of regularly icing my shoulder and taking ibuprofen on a schedule, my pain had not gotten any better. I knew it was time to make an appointment with my primary physician.
I was able to get an appointment with my doctor for the next morning, which my boyfriend brought me to. When I saw her I explained to her what I had done and also handed her a rough drawing of my injury. She found my drawing helpful and after examining me she told me that she could feel a very severe muscle spasm and said that she was going to give me a prescription for something stronger than regular ibuprofen. My doctor also told me that she wanted an x-ray of my shoulder, although she felt it was highly unlikely that I had broken anything. As it was much more likely that I had done some damage to the tendons or ligaments, she explained that she was going to have her office staff contact my insurance company, regarding authorization for an MRI.
After I left her office my boyfriend and I dropped my prescription off at the pharmacy and proceeded to get an x-ray. When I went to get my x-ray, the technician asked me how I felt like it was going to be easiest to get the views they needed, while also trying to prevent my pain from getting worse. I explained that while I understood it was unlikely to work, that I would prefer to stay in my wheelchair. The radiology technician was unsure if that would work so she asked one of her coworkers into the room so that we could brainstorm. Ultimately, we decided to try it with me in my wheelchair and see if the images were clear, I was happy to hear that they could view what needed to be seen and that I was not going to have to transfer out of my wheelchair. I waited a couple of days for the results of the x-rays before I heard back from my doctor. I was told that the x-rays had come back negative for fractures and also for signs of a separation. At that point, I wasn’t being told anything other than what I already assumed. Then it was just a waiting game, while I waited for authorization for the MRI. For a few days during this time, my mind did start to wander into the “land of pity party” while I do not like it when other people pity me, I couldn’t help but feel somewhat sorry for myself. Here I was, still in a splint months after injuring my wrist so my mobility had already suffered when I suddenly injured my shoulder causing me to be nearly completely immobile. Luckily enough, I do have a support system in place so I was able to rest and let other people take care of me to a certain extent, all the while, helping to monitor my boyfriend’s wounds.
Approximately a week later I got the chance to look at my boyfriend’s wounds again and discovered that it had changed how it was responding to the treatments we were using. When I attempted to remove the Calcium Alginate from inside the wound I realized that it was sticking, as opposed to easily disengaging. To me that was a sign that the wound was no longer moist enough to warrant using Calcium Alginate and something else needed to be used to care for the wound. I then told my boyfriend what I felt like was happening and that it was my opinion that we should again put the Iodosorb in so that some of drainage would be absorbed but that a portion of it would react with the iodine and form a gel so that the wound wouldn’t become too dry. My boyfriend at that point said it was okay with him if I again changed what we were doing because his wound care appointment was a couple of a days later and we would be able to get professional advice then.
When my boyfriend and I were on the way to his appointment I asked him if he wanted me to explain to the doctor why we were no longer following her directions to care for his wounds. My boyfriend said that he absolutely wanted me to explain our thought process to the doctor so I went into the appointment with him ready to explain and yet also somewhat nervous that the doctor would be upset that we weren’t listening to her. When we got to the appointment my boyfriend and I explained what had changed and what we were doing to the nurse so that she could document all we had done as well as photograph the wound for my boyfriend’s records. When the doctor came in she told us that she had seen a picture and that we were right it did look different. I then told her what it had looked like the previous week and hesitantly, the steps we had taken to take care of it. The doctor told me that she liked the change I had made and that it was okay that I decided that because I, “know wound care”. I was relieved that she didn’t feel like I was overstepping and also that she agreed that what we had decided to do was the right decision. She then told us that she was somewhat concerned that its wet and somewhat macerated appearance was due to an infection although we all felt that was unlikely because my boyfriend had no other signs of infection. A wound culture was taken and we were told to continue treating the wounds as we had been and that she would call if the cultures showed anything that “impressed her”. We made a follow-up appointment for two weeks later and left hoping that we would not receive a phone call saying that he needed to start antibiotics.
It was around this time that I experienced a freak accident. I was getting into the passenger side of my boyfriends car as I always do when somehow I managed to bang the back of my shoulder incredibly hard on the doorframe. My boyfriend who was outside of the car at the time actually heard the impact and was at my side seconds later asking what had happened. After a minute, when I was able to get words out, I told him what had happened and that I was in a considerable amount of pain. My boyfriend then quickly put my wheelchair in the trunk and got in his car so that we could decide what needed to be done about my shoulder. I explained to him that the point of impact was on the back of my shoulder in the area where the arm meets the shoulder but that I also had pain radiating up my neck and down my arm, about half way to my elbow. My boyfriend then looked at my shoulder to see if it looked swollen or was beginning to bruise. He told me that it looked fine but that it was up to me what I wanted to do as far as treatment. I decided that we would just go back to my house where I would apply ice and take some ibuprofen. I did that, knowing that it was important to try to prevent or at least decrease swelling. A few hours later, before my boyfriend left, he asked me what I was planning to do as far as my shoulder because the Ibuprofen and ice hadn’t really helped my pain. I told him that I was just going to go to bed and would reevaluate it in the morning. I went to bed anticipating feeling muscle soreness the next day but not really anything more than that. Unfortunately, after five days of regularly icing my shoulder and taking ibuprofen on a schedule, my pain had not gotten any better. I knew it was time to make an appointment with my primary physician.
I was able to get an appointment with my doctor for the next morning, which my boyfriend brought me to. When I saw her I explained to her what I had done and also handed her a rough drawing of my injury. She found my drawing helpful and after examining me she told me that she could feel a very severe muscle spasm and said that she was going to give me a prescription for something stronger than regular ibuprofen. My doctor also told me that she wanted an x-ray of my shoulder, although she felt it was highly unlikely that I had broken anything. As it was much more likely that I had done some damage to the tendons or ligaments, she explained that she was going to have her office staff contact my insurance company, regarding authorization for an MRI.
After I left her office my boyfriend and I dropped my prescription off at the pharmacy and proceeded to get an x-ray. When I went to get my x-ray, the technician asked me how I felt like it was going to be easiest to get the views they needed, while also trying to prevent my pain from getting worse. I explained that while I understood it was unlikely to work, that I would prefer to stay in my wheelchair. The radiology technician was unsure if that would work so she asked one of her coworkers into the room so that we could brainstorm. Ultimately, we decided to try it with me in my wheelchair and see if the images were clear, I was happy to hear that they could view what needed to be seen and that I was not going to have to transfer out of my wheelchair. I waited a couple of days for the results of the x-rays before I heard back from my doctor. I was told that the x-rays had come back negative for fractures and also for signs of a separation. At that point, I wasn’t being told anything other than what I already assumed. Then it was just a waiting game, while I waited for authorization for the MRI. For a few days during this time, my mind did start to wander into the “land of pity party” while I do not like it when other people pity me, I couldn’t help but feel somewhat sorry for myself. Here I was, still in a splint months after injuring my wrist so my mobility had already suffered when I suddenly injured my shoulder causing me to be nearly completely immobile. Luckily enough, I do have a support system in place so I was able to rest and let other people take care of me to a certain extent, all the while, helping to monitor my boyfriend’s wounds.
Sunday, December 7, 2014
When Normal Test Results Are More Stressful Than Helpful & Why Won’t My Boyfriend’s Wounds Just Heal Already?
In the time since I last wrote, I have had several doctors’ appointments and have undergone various tests in hopes of finding some solutions to all of the medical issues I have been dealing with. I have seen an Infectious Disease Specialist, a Vascular Surgeon and have begun physical therapy for my wrist. I originally went to those appointments somewhat hoping that something abnormal would actually be found. It may seem somewhat strange to you but my thought process was that if the doctors could find an actual physical cause of these issues than a solution could be recommended.
One of the first appointments I had was with the Infectious Disease specialist. Being that, I had seen Infectious Disease specialists for various wound-healing issues and a few times for different kidney infections, I was not at all concerned about what he was going to do during my initial appointment. I sort of went into it as it being an information-gathering meeting. Of course I wanted him to fix the infection so that I could start feeling like myself but I was curious to pick his brain and learn what options I would have as far as a mode of delivery for any medication he would want to prescribe.
When I first went in I gave him the background on the kidney stone that had been removed eight months prior and all of the associated infection information. I also explained that I had been experiencing lingering back pain since even a month prior to the stone being removed. Of course I also told him the primary reason I was there was because I had been diagnosed with an asymptomatic infection approximately a month prior to seeing him that suddenly had me experiencing symptoms and that my urologist had concerns that the bacteria was resistant. The Infectious Disease specialist asked various questions about what symptoms I was experiencing and looked into which antibiotics I had been on previously for Urinary Tract Infections. I gave him a list of the medications that I had been on and when I was on them and also how I had felt on them. After looking into my medical record, he questioned about “The wound” that originally began this blog. I gave him a condensed version of what had happened and who had ultimately gotten the wound to heal. It turns out that the Infection Disease Specialist knows the surgeon that I had such a great experience with, what a small world! The infectious disease specialist suggested that I drop off a urine sample at the lab so that it could be determined if the bacteria that had shown up in the last urinalysis were still present or if it had changed. I was on board with that and asked what he was planning to do to treat the infection, he then explained that he couldn’t answer that without knowing definitively which bacteria he was going to have to treat. He also said that he wanted to look into some more diagnostic testing to see if he could find a reason for the recurrent UTI’s and also to see if my kidney was what was actually causing my back pain.
The diagnostic testing that he wanted me to have was just a simple CAT scan, which we were able to schedule for two weeks later. I went to the CAT scan knowing that the technician that performed the scan would not be able to tell me anything but confident that the Infectious Disease doctor would call me within a couple of days to give me my results and to help me decide where to go from there. During the time that I was waiting for the day of the CAT scan to arrive, I received a call about my urinalysis. I was told that the bacteria had changed to something that would respond to oral antibiotics. I was relieved by this information because I really did not want to experience having an IV or a Central line or PICC line again which I know is how they would have had to administer any type of intravenous antibiotic. I began taking the antibiotic and the symptoms of the UTI that I had been experiencing began to diminish. I continued to take the antibiotics for the prescribed time and a few days after my CAT scan was completed I made a call to the Infectious Disease doctor because I had not heard back regarding the CAT scan. When I spoke to him he informed me that my kidneys both look good and that he did notice some thickening of my bladder wall. He said that that was likely just due to the irritation of having to use a urinary catheter. He also told me that I have several gallstones but that typically they are left alone unless symptoms develop. I questioned if the gallstones could be causing what I was calling kidney pain and he said no because the gallbladder is on the right side of the body and my pain was in my left flank. We sort of left it under the understanding that he would forward all of my results to my urologist but that he was confident in saying my kidney was not causing my pain, he did recommend seeing my orthopedist in case something related to my disability was causing my pain. I am not entirely sure that I agree with him, what is a patient to do when a doctor is saying the body part the patient is concerned about is fine but the patient knows in their gut that it is not?
A couple of weeks later, I had an appointment with the vascular surgeon, as my podiatrist had suggested. As I have said, I didn’t want their to be anything catastrophic wrong with me but I was somewhat hopeful that the vascular surgeon would be able to come up with a reason for my lingering toe pain, even after the subungual hematoma had healed. I explained to the vascular surgeon, when the injury to my toe had taken place and the steps I had taken to get it to heal. When he examined my foot and lower leg he was unable to feel a pulse. I was not entirely concerned by this news, as I know that I have poor circulation and my podiatrist had been able to feel a pulse a few weeks earlier. The vascular surgeon said that he wanted to basically test the blood pressure in my lower legs and feet and that we would go from there. I went into another room with the person that was going to perform the test and was hooked up to several blood pressure cuffs and leads, all going into a computer. The test did not take very long at all and the results were immediately given to the vascular surgeon. He then came back and explained to me that whatever was causing my lingering toe pain was not vascular and he told me that he would forward the results to my podiatrist. Typically, I would be happy that nothing was wrong but I found myself feeling nothing but frustration. I left the appointment and explained to my boyfriend what the vascular surgeon had said and that I myself was beginning to question if this pain was in my head. My boyfriend agreed with me that it was possible but he doubted it because I am so in tune with my body.
This was also, right around the time that I had begun going to occupational therapy for my sprained wrist. It had been well over a month since my injury and I was still experiencing some pain and swelling. During my first appointment with the therapist she compared the size of my injured wrist and the functional strength of it to that of the wrist that I had not injured. She said that it was definitely swollen but nothing too terrible. She also said the area that was swollen felt squishy and that it was just fluid that my body would most likely just reabsorb. We spent the first several appointments with her just icing my wrist and massaging it in hopes that it would get the swelling to decrease. She explained to me that we wouldn’t really be able to do very much else for it until the pain went away and that once we could begin to move it we would have to go slow. While I understood where she was coming from and appreciated her honesty, I was becoming very frustrated because all of the copayments to see her were beginning to add up and I didn’t feel like she was doing anything that I wouldn’t be able to do for myself at home. Eventually, I had gotten myself mentally prepared to have that conversation with her when I realized, that although, it was still somewhat swollen, my wrist was suddenly not painful! When I went to her a couple of days later I told her that my wrist hadn’t hurt for a few days and that although I was continuing to ice it at home, it was still swollen. At that point, she and I began to do some gentle stretches and range of motion exercises in the hopes of both decreasing the swelling and hoping that slowly I would be able to move my wrist more normally.
All the while, I have still been helping my boyfriend take care of the two wounds on his foot. He has been seeing the other doctor from the Wound Care Center because the surgeon that we had both seen previously is changing his schedule so he hasn’t been as available. When the doctor first evaluated his wounds, she was thrilled that we had been told to use Iodosorb and a foam dressing to care for his wounds. During the initial appointment with her I explained that in my opinion the small one in the center of the callous was a puncture and that I wasn’t sure of the depth of it. She then decided to remove some of the callous so that she could better evaluate if the puncture had any depth or if it was mostly superficial. We were pleased to discover that it was pretty much superficial. I was very relieved because part of me feared that the puncture had formed a tunnel and I personally know what it is like to deal with a tunneling wound. After several weeks of doing the same dressings and the wounds beginning to look very good, the doctor proclaimed the puncture to be basically closed and the other one very superficial and although it looked healthy she was concerned that it was beginning to appear too dry. She instructed us to switch from using the Iodosorb on that wound to a Hydrogel so that the wound could gain more moisture. She asked to follow up in about a month and told us that she expected to be able to discharge him at that point.
I and too a lesser extent my boyfriend, continued to dress his wounds as the doctor had instructed and although I was happy with how they looked, I did not think that the puncture was as close to closed as the doctor did and I highly doubted that the other wound would enable her to discharge my boyfriend within the month. At approximately, the three week mark, I was doing my boyfriend’s wound care and was sad to discover that the wound we were trying to keep moist, had become entirely too wet and macerated. I then asked my boyfriend if he felt that I should continue to do what the doctor had instructed or if he wanted me to change what I was doing to something to help control some of the excess moisture. The reason we did not try to get in touch with the wound care center at that point was because in my experience they would have just asked him to come in the week before he was originally scheduled and he was unable to reschedule due to his job. My boyfriend told me that he wanted me to continue doing what the doctor had said and that she could change the orders the next week if necessary. I understood where he was coming from in the sense that it is not up to the patient to change the course of treatment but I was concerned that it would get much worse in the time we were waiting for his appointment. I explained all of this to him while explaining that I would not do anything that would harm him and that I would only change the plan if he approved. I myself have learned a ton about wound care and how wounds that are healing are supposed to look and so I didn’t doubt myself, as much as I was trying not to override my boyfriend’s rights as the patient. Ultimately, he allowed me to change his dressing from the Hydrogel to Calcium Alginate that I would put inside of the wound to try to help absorb some of the moisture, prior to putting the foam dressing on top of it. He was going to be at his house for the next few days and so I gave him some dressings as well as the Calcium Alginate and some Iodosorb and even the Hydrogel just in case the situation changed again. I asked him to please text me a photo of his wound a few days later so that I might be able to help him decide what he should be using.
One of the first appointments I had was with the Infectious Disease specialist. Being that, I had seen Infectious Disease specialists for various wound-healing issues and a few times for different kidney infections, I was not at all concerned about what he was going to do during my initial appointment. I sort of went into it as it being an information-gathering meeting. Of course I wanted him to fix the infection so that I could start feeling like myself but I was curious to pick his brain and learn what options I would have as far as a mode of delivery for any medication he would want to prescribe.
When I first went in I gave him the background on the kidney stone that had been removed eight months prior and all of the associated infection information. I also explained that I had been experiencing lingering back pain since even a month prior to the stone being removed. Of course I also told him the primary reason I was there was because I had been diagnosed with an asymptomatic infection approximately a month prior to seeing him that suddenly had me experiencing symptoms and that my urologist had concerns that the bacteria was resistant. The Infectious Disease specialist asked various questions about what symptoms I was experiencing and looked into which antibiotics I had been on previously for Urinary Tract Infections. I gave him a list of the medications that I had been on and when I was on them and also how I had felt on them. After looking into my medical record, he questioned about “The wound” that originally began this blog. I gave him a condensed version of what had happened and who had ultimately gotten the wound to heal. It turns out that the Infection Disease Specialist knows the surgeon that I had such a great experience with, what a small world! The infectious disease specialist suggested that I drop off a urine sample at the lab so that it could be determined if the bacteria that had shown up in the last urinalysis were still present or if it had changed. I was on board with that and asked what he was planning to do to treat the infection, he then explained that he couldn’t answer that without knowing definitively which bacteria he was going to have to treat. He also said that he wanted to look into some more diagnostic testing to see if he could find a reason for the recurrent UTI’s and also to see if my kidney was what was actually causing my back pain.
The diagnostic testing that he wanted me to have was just a simple CAT scan, which we were able to schedule for two weeks later. I went to the CAT scan knowing that the technician that performed the scan would not be able to tell me anything but confident that the Infectious Disease doctor would call me within a couple of days to give me my results and to help me decide where to go from there. During the time that I was waiting for the day of the CAT scan to arrive, I received a call about my urinalysis. I was told that the bacteria had changed to something that would respond to oral antibiotics. I was relieved by this information because I really did not want to experience having an IV or a Central line or PICC line again which I know is how they would have had to administer any type of intravenous antibiotic. I began taking the antibiotic and the symptoms of the UTI that I had been experiencing began to diminish. I continued to take the antibiotics for the prescribed time and a few days after my CAT scan was completed I made a call to the Infectious Disease doctor because I had not heard back regarding the CAT scan. When I spoke to him he informed me that my kidneys both look good and that he did notice some thickening of my bladder wall. He said that that was likely just due to the irritation of having to use a urinary catheter. He also told me that I have several gallstones but that typically they are left alone unless symptoms develop. I questioned if the gallstones could be causing what I was calling kidney pain and he said no because the gallbladder is on the right side of the body and my pain was in my left flank. We sort of left it under the understanding that he would forward all of my results to my urologist but that he was confident in saying my kidney was not causing my pain, he did recommend seeing my orthopedist in case something related to my disability was causing my pain. I am not entirely sure that I agree with him, what is a patient to do when a doctor is saying the body part the patient is concerned about is fine but the patient knows in their gut that it is not?
A couple of weeks later, I had an appointment with the vascular surgeon, as my podiatrist had suggested. As I have said, I didn’t want their to be anything catastrophic wrong with me but I was somewhat hopeful that the vascular surgeon would be able to come up with a reason for my lingering toe pain, even after the subungual hematoma had healed. I explained to the vascular surgeon, when the injury to my toe had taken place and the steps I had taken to get it to heal. When he examined my foot and lower leg he was unable to feel a pulse. I was not entirely concerned by this news, as I know that I have poor circulation and my podiatrist had been able to feel a pulse a few weeks earlier. The vascular surgeon said that he wanted to basically test the blood pressure in my lower legs and feet and that we would go from there. I went into another room with the person that was going to perform the test and was hooked up to several blood pressure cuffs and leads, all going into a computer. The test did not take very long at all and the results were immediately given to the vascular surgeon. He then came back and explained to me that whatever was causing my lingering toe pain was not vascular and he told me that he would forward the results to my podiatrist. Typically, I would be happy that nothing was wrong but I found myself feeling nothing but frustration. I left the appointment and explained to my boyfriend what the vascular surgeon had said and that I myself was beginning to question if this pain was in my head. My boyfriend agreed with me that it was possible but he doubted it because I am so in tune with my body.
This was also, right around the time that I had begun going to occupational therapy for my sprained wrist. It had been well over a month since my injury and I was still experiencing some pain and swelling. During my first appointment with the therapist she compared the size of my injured wrist and the functional strength of it to that of the wrist that I had not injured. She said that it was definitely swollen but nothing too terrible. She also said the area that was swollen felt squishy and that it was just fluid that my body would most likely just reabsorb. We spent the first several appointments with her just icing my wrist and massaging it in hopes that it would get the swelling to decrease. She explained to me that we wouldn’t really be able to do very much else for it until the pain went away and that once we could begin to move it we would have to go slow. While I understood where she was coming from and appreciated her honesty, I was becoming very frustrated because all of the copayments to see her were beginning to add up and I didn’t feel like she was doing anything that I wouldn’t be able to do for myself at home. Eventually, I had gotten myself mentally prepared to have that conversation with her when I realized, that although, it was still somewhat swollen, my wrist was suddenly not painful! When I went to her a couple of days later I told her that my wrist hadn’t hurt for a few days and that although I was continuing to ice it at home, it was still swollen. At that point, she and I began to do some gentle stretches and range of motion exercises in the hopes of both decreasing the swelling and hoping that slowly I would be able to move my wrist more normally.
All the while, I have still been helping my boyfriend take care of the two wounds on his foot. He has been seeing the other doctor from the Wound Care Center because the surgeon that we had both seen previously is changing his schedule so he hasn’t been as available. When the doctor first evaluated his wounds, she was thrilled that we had been told to use Iodosorb and a foam dressing to care for his wounds. During the initial appointment with her I explained that in my opinion the small one in the center of the callous was a puncture and that I wasn’t sure of the depth of it. She then decided to remove some of the callous so that she could better evaluate if the puncture had any depth or if it was mostly superficial. We were pleased to discover that it was pretty much superficial. I was very relieved because part of me feared that the puncture had formed a tunnel and I personally know what it is like to deal with a tunneling wound. After several weeks of doing the same dressings and the wounds beginning to look very good, the doctor proclaimed the puncture to be basically closed and the other one very superficial and although it looked healthy she was concerned that it was beginning to appear too dry. She instructed us to switch from using the Iodosorb on that wound to a Hydrogel so that the wound could gain more moisture. She asked to follow up in about a month and told us that she expected to be able to discharge him at that point.
I and too a lesser extent my boyfriend, continued to dress his wounds as the doctor had instructed and although I was happy with how they looked, I did not think that the puncture was as close to closed as the doctor did and I highly doubted that the other wound would enable her to discharge my boyfriend within the month. At approximately, the three week mark, I was doing my boyfriend’s wound care and was sad to discover that the wound we were trying to keep moist, had become entirely too wet and macerated. I then asked my boyfriend if he felt that I should continue to do what the doctor had instructed or if he wanted me to change what I was doing to something to help control some of the excess moisture. The reason we did not try to get in touch with the wound care center at that point was because in my experience they would have just asked him to come in the week before he was originally scheduled and he was unable to reschedule due to his job. My boyfriend told me that he wanted me to continue doing what the doctor had said and that she could change the orders the next week if necessary. I understood where he was coming from in the sense that it is not up to the patient to change the course of treatment but I was concerned that it would get much worse in the time we were waiting for his appointment. I explained all of this to him while explaining that I would not do anything that would harm him and that I would only change the plan if he approved. I myself have learned a ton about wound care and how wounds that are healing are supposed to look and so I didn’t doubt myself, as much as I was trying not to override my boyfriend’s rights as the patient. Ultimately, he allowed me to change his dressing from the Hydrogel to Calcium Alginate that I would put inside of the wound to try to help absorb some of the moisture, prior to putting the foam dressing on top of it. He was going to be at his house for the next few days and so I gave him some dressings as well as the Calcium Alginate and some Iodosorb and even the Hydrogel just in case the situation changed again. I asked him to please text me a photo of his wound a few days later so that I might be able to help him decide what he should be using.
Wednesday, October 22, 2014
Why Can’t I Just Be Pain-Free and Healthy? Dealing with Several Issues (PART 2)
After soaking my toe in warm water daily, with absolutely no improvement, I followed up with the podiatrist’s partner one week later at the wound care center. When I got there, the nurse that I had always been most comfortable with saw me. She examined my toe, and said that it looked really healthy; that she didn’t see any signs of infection and that it seemed to be healing well. I told her that I agreed it did not seem to be infected but that my pain has not changed at all. At that point I attempted to pick her brain to see what she could come up with for possible causes of my discomfort and what solutions she may have. She was completely stumped and said we would have to ask the podiatrist. When the podiatrist examined my toe he was thrilled with how it looked, I explained that I was still experiencing pain and nothing I was doing was relieving it.
His only suggestion was to cut the toe off of an old pair of sneakers so that it wouldn’t have any pressure on it. I am not sure why I didn’t press further, but the fact is, aside from that appointment I hadn’t really been wearing shoes at all and was still in pain so I did not really think that destroying a pair of sneakers was going to help. The podiatrist sent me home with instructions to cover the toenail area with Silver Gel and to cover it with a band aid and a very small dressing that is the equivalent of a compression stocking, to help the swelling. He also recommended that I return the following week so that my original podiatrist could see me. After that, the nurse came in to apply the dressing to my toe. While she was doing that, she explained that Silver Gel is basically Bacitracin that has silver in it, which as I know by now, has antimicrobial properties. I left confident that I would be able to adequately care for my toe until I could be seen again.
During the time I was waiting for my appointment with the podiatrist, several other health issues needed to be addressed. Firstly, I had two appointments with the orthopedist regarding the pain in my wrist that was not decreasing, though I was on the prescription dosage of Ibuprofen and had been using the splint regularly. During the first appointment he had told me to just wait it out a few more weeks, unfortunately, waiting it out did not seem to be helping. When I went back to the orthopedist he examined my wrist and then left the decision as to the next step up to me. He said that it was certainly reasonable to wait it out a little longer yet he also explained that getting an MRI scheduled was absolutely warranted. I decided to schedule the MRI firstly, because I really did want answers and secondly, I figured with scheduling the way it usually is, my wrist would have time to feel better prior to getting it, which would enable me to cancel the test.
Awhile back, my urologist ordered a routine urinalysis because I am still looking for a cause of my lingering back pain. A few days later I called the urologist’s office, after receiving my lab results via the Patient Portal that my local hospital has. While I as a patient, do like that I personally get to see my results, along, with a chart that gives the normal ranges of numbers. The lab results from the patient portal of course do not erase the need for a physician, both to explain things to me in plain English and also to call in medication if necessary. When I spoke with the nurse, she said that my urologist was wondering if I was experiencing any other symptoms that would indicate a Urinary Tract Infection (UTI). I then explained to her that the only symptom was the back pain but no new symptoms had developed. She then explained to me that the reason she was asking was because my urologist was wondering how I felt about Not treating the infection if I was asymptomatic. The doctor’s concern with treating my infection was that I was becoming resistant to antibiotics that he was able to prescribe and so treating the resistant bacteria would be the job of the infection disease doctors. I explained, to the nurse that I felt like not treating it was the wiser decision at that point and that I would call the office if any symptoms developed.
All the while, my boyfriend informed me that he had wounds on his foot. Seriously, how much more medical drama could I be expected to handle? I admittedly, ignored my boyfriend’s wounds for a couple of weeks, because I was dealing with my own stuff. I also know that my boyfriend, while stubborn at times, was not going to let a wound get out of control so a part of me didn’t feel all that bad for somewhat ignoring his needs. When I did get asked to look at them, I did and saw two wounds, both of which were caused by his ill-fitting braces. I knew that my boyfriend had already gotten his braces adjusted so that they would hopefully no longer add to the problem. I then examined the wounds; the first one was open but had very little depth and to the best knowledge was not showing signs of being infected. The second wound, looked like a very small puncture in the center of a large callous. While the second wound appeared smaller than the other wound, it actually worried me more. I was concerned because I could see that it had some depth but due to its size I was not able to visualize exactly how much depth it had. I then covered both of his wounds with Bacitracin and put one of the only dressings I had on them. At that point we decided to call and schedule an appointment at the wound care center so that my boyfriend could be evaluated and we could be given some appropriate dressings. When I called to try to get an appointment for my boyfriend, we hoped that one would be able to be scheduled with the same wound care surgeon that we had both grown so comfortable with. We were pleased to hear that the surgeon was scheduled to be at the wound care center the following week so an appointment was scheduled. It seemed to me that we were going to be spending the day at the hospital because that day was when I was also scheduled to see the podiatrist.
The day before my boyfriend and I had our appointments at the wound care center was the day that I had the MRI of my wrist scheduled for. I went to the MRI appointment not at all worried about the test, mostly because I had certainly had MRI’s before but also because I had several other concerning things on my mind.
That week, I had noticed that I was starting to develop signs of a UTI; of course I had already been warned that the cultures had come back indicating that I had one so I was not surprised when suddenly I noticed that my urine was cloudy and had an odor to it, what did surprise me and temporarily scare me however, was when I noticed small amounts of blood in my urine. Of all the UTI symptoms the blood was of course the most concerning, until I remembered that with all of the Ibuprofen I had been taking, it was possible that the medication itself was causing that particular symptom. I mentioned all of this to the nurse at my urologist’s office and she agreed that it was possible that the Ibuprofen was causing the small amount of blood and as such she suggested I try to ease up on the dosage if it was at all comfortable. She also recommended that I have a consultation with an Infectious Disease doctor at my local hospital because, the previous bacteria was resistant. I did ease up on the medication and the blood in my urine eased to exist, at least to the naked eye. I also called and made an appointment with Infectious Disease, just to cover my bases.
In addition to the kidney pain and my painful wrist, I was of course following up with the podiatrist for my painful and still swollen toe. When I got there I casually mentioned all of the other health issues that were going on. When the podiatrist looked at my toe she was incredibly pleased with how it looked. The hematoma was gone and the nail was beginning to grow in nicely and I showed no obvious signs of infection. I then asked her why she thought I might still be in pain and she was somewhat unsure. It was then that she asked me if I had any other symptoms that might seem unrelated, that she would be able to use. After thinking for a minute I told her that I had been having some muscle spasms in the calf of the leg that was having the toe issue. At that point she excused herself to go talk to the other podiatrist, when she came back, she had a business card with her. She suggested that I see a vascular surgeon just to rule out anything that could be fixed. She also said that if the vascular surgeon was unable to help that I should seriously consider going to a pain specialist. Clearly, I had some things to think about and maybe even some doctor’s appointments to make, that would have to wait though, because an hour later, my boyfriend had his appointment with the wound care surgeon.
During his appointment we both explained what had caused his wounds, what we had been doing to treat them and that the issue with his brace, which caused them had been fixed. During the evaluation, the wound care surgeon voiced his concern that the situation was not entirely fixed because the callous was still present. The small wound that was on the callous was considered closed, too the wound care surgeon. I am currently slightly worried that it has more just formed a scab but that the puncture depth may still be a problem. The only reason I can come up with for not voicing my concern was that I somewhat felt like it wasn’t any of my business. If my boyfriend wasn’t worried, then why should I be? The wound care surgeon told my boyfriend and I that we were to put Iodosorb in the wound and then cover it with Aquacel Foam. Iodosorb is a brown paste, the purpose of which is to absorb fluid, and remove any fluid or debris that the wound may have. As the Iodosorb absorbs the drainage from the wound, iodine is released from the paste, which helps to kill bacteria. Aquacel Foam works, by gelling on contact with the wound’s drainage and then pulling the majority of the moisture away from the wound so that maceration does not occur, yet it also, allows for an appropriately moist environment for optimal healing. We were then told, to use foam dressing on top of the callous, not so much for absorption but to provide some protection from his brace. After we were both clear on the instructions to take care of his wounds we were told to schedule a follow-up appointment a few weeks later.
His only suggestion was to cut the toe off of an old pair of sneakers so that it wouldn’t have any pressure on it. I am not sure why I didn’t press further, but the fact is, aside from that appointment I hadn’t really been wearing shoes at all and was still in pain so I did not really think that destroying a pair of sneakers was going to help. The podiatrist sent me home with instructions to cover the toenail area with Silver Gel and to cover it with a band aid and a very small dressing that is the equivalent of a compression stocking, to help the swelling. He also recommended that I return the following week so that my original podiatrist could see me. After that, the nurse came in to apply the dressing to my toe. While she was doing that, she explained that Silver Gel is basically Bacitracin that has silver in it, which as I know by now, has antimicrobial properties. I left confident that I would be able to adequately care for my toe until I could be seen again.
During the time I was waiting for my appointment with the podiatrist, several other health issues needed to be addressed. Firstly, I had two appointments with the orthopedist regarding the pain in my wrist that was not decreasing, though I was on the prescription dosage of Ibuprofen and had been using the splint regularly. During the first appointment he had told me to just wait it out a few more weeks, unfortunately, waiting it out did not seem to be helping. When I went back to the orthopedist he examined my wrist and then left the decision as to the next step up to me. He said that it was certainly reasonable to wait it out a little longer yet he also explained that getting an MRI scheduled was absolutely warranted. I decided to schedule the MRI firstly, because I really did want answers and secondly, I figured with scheduling the way it usually is, my wrist would have time to feel better prior to getting it, which would enable me to cancel the test.
Awhile back, my urologist ordered a routine urinalysis because I am still looking for a cause of my lingering back pain. A few days later I called the urologist’s office, after receiving my lab results via the Patient Portal that my local hospital has. While I as a patient, do like that I personally get to see my results, along, with a chart that gives the normal ranges of numbers. The lab results from the patient portal of course do not erase the need for a physician, both to explain things to me in plain English and also to call in medication if necessary. When I spoke with the nurse, she said that my urologist was wondering if I was experiencing any other symptoms that would indicate a Urinary Tract Infection (UTI). I then explained to her that the only symptom was the back pain but no new symptoms had developed. She then explained to me that the reason she was asking was because my urologist was wondering how I felt about Not treating the infection if I was asymptomatic. The doctor’s concern with treating my infection was that I was becoming resistant to antibiotics that he was able to prescribe and so treating the resistant bacteria would be the job of the infection disease doctors. I explained, to the nurse that I felt like not treating it was the wiser decision at that point and that I would call the office if any symptoms developed.
All the while, my boyfriend informed me that he had wounds on his foot. Seriously, how much more medical drama could I be expected to handle? I admittedly, ignored my boyfriend’s wounds for a couple of weeks, because I was dealing with my own stuff. I also know that my boyfriend, while stubborn at times, was not going to let a wound get out of control so a part of me didn’t feel all that bad for somewhat ignoring his needs. When I did get asked to look at them, I did and saw two wounds, both of which were caused by his ill-fitting braces. I knew that my boyfriend had already gotten his braces adjusted so that they would hopefully no longer add to the problem. I then examined the wounds; the first one was open but had very little depth and to the best knowledge was not showing signs of being infected. The second wound, looked like a very small puncture in the center of a large callous. While the second wound appeared smaller than the other wound, it actually worried me more. I was concerned because I could see that it had some depth but due to its size I was not able to visualize exactly how much depth it had. I then covered both of his wounds with Bacitracin and put one of the only dressings I had on them. At that point we decided to call and schedule an appointment at the wound care center so that my boyfriend could be evaluated and we could be given some appropriate dressings. When I called to try to get an appointment for my boyfriend, we hoped that one would be able to be scheduled with the same wound care surgeon that we had both grown so comfortable with. We were pleased to hear that the surgeon was scheduled to be at the wound care center the following week so an appointment was scheduled. It seemed to me that we were going to be spending the day at the hospital because that day was when I was also scheduled to see the podiatrist.
The day before my boyfriend and I had our appointments at the wound care center was the day that I had the MRI of my wrist scheduled for. I went to the MRI appointment not at all worried about the test, mostly because I had certainly had MRI’s before but also because I had several other concerning things on my mind.
That week, I had noticed that I was starting to develop signs of a UTI; of course I had already been warned that the cultures had come back indicating that I had one so I was not surprised when suddenly I noticed that my urine was cloudy and had an odor to it, what did surprise me and temporarily scare me however, was when I noticed small amounts of blood in my urine. Of all the UTI symptoms the blood was of course the most concerning, until I remembered that with all of the Ibuprofen I had been taking, it was possible that the medication itself was causing that particular symptom. I mentioned all of this to the nurse at my urologist’s office and she agreed that it was possible that the Ibuprofen was causing the small amount of blood and as such she suggested I try to ease up on the dosage if it was at all comfortable. She also recommended that I have a consultation with an Infectious Disease doctor at my local hospital because, the previous bacteria was resistant. I did ease up on the medication and the blood in my urine eased to exist, at least to the naked eye. I also called and made an appointment with Infectious Disease, just to cover my bases.
In addition to the kidney pain and my painful wrist, I was of course following up with the podiatrist for my painful and still swollen toe. When I got there I casually mentioned all of the other health issues that were going on. When the podiatrist looked at my toe she was incredibly pleased with how it looked. The hematoma was gone and the nail was beginning to grow in nicely and I showed no obvious signs of infection. I then asked her why she thought I might still be in pain and she was somewhat unsure. It was then that she asked me if I had any other symptoms that might seem unrelated, that she would be able to use. After thinking for a minute I told her that I had been having some muscle spasms in the calf of the leg that was having the toe issue. At that point she excused herself to go talk to the other podiatrist, when she came back, she had a business card with her. She suggested that I see a vascular surgeon just to rule out anything that could be fixed. She also said that if the vascular surgeon was unable to help that I should seriously consider going to a pain specialist. Clearly, I had some things to think about and maybe even some doctor’s appointments to make, that would have to wait though, because an hour later, my boyfriend had his appointment with the wound care surgeon.
During his appointment we both explained what had caused his wounds, what we had been doing to treat them and that the issue with his brace, which caused them had been fixed. During the evaluation, the wound care surgeon voiced his concern that the situation was not entirely fixed because the callous was still present. The small wound that was on the callous was considered closed, too the wound care surgeon. I am currently slightly worried that it has more just formed a scab but that the puncture depth may still be a problem. The only reason I can come up with for not voicing my concern was that I somewhat felt like it wasn’t any of my business. If my boyfriend wasn’t worried, then why should I be? The wound care surgeon told my boyfriend and I that we were to put Iodosorb in the wound and then cover it with Aquacel Foam. Iodosorb is a brown paste, the purpose of which is to absorb fluid, and remove any fluid or debris that the wound may have. As the Iodosorb absorbs the drainage from the wound, iodine is released from the paste, which helps to kill bacteria. Aquacel Foam works, by gelling on contact with the wound’s drainage and then pulling the majority of the moisture away from the wound so that maceration does not occur, yet it also, allows for an appropriately moist environment for optimal healing. We were then told, to use foam dressing on top of the callous, not so much for absorption but to provide some protection from his brace. After we were both clear on the instructions to take care of his wounds we were told to schedule a follow-up appointment a few weeks later.
Sunday, October 5, 2014
Why Can’t I Just Be Pain-Free and Healthy? Dealing with Several Issues (Part 1)
It has now been approximately two months since my wound care appointment was scheduled for the issue with my toe. When I got there it was determined that the doctor that I was scheduled to see would not be able to do anything to help me. I was then informed that if I did not mind waiting, a podiatrist was going to be in wound care shortly. I did wait and had my toe seen by a podiatrist. The podiatrist ended up removing a small portion of the tip of my toenail in hopes that its removal would relieve some of the pressure. She also sent me for an x-ray of my foot to make sure nothing internal was causing my pain. Before I left she explained that she is of the “no news is good news” camp and therefore, unless something was catastrophically wrong, she would not call me and that I should just give my foot some more time to heal.
When I left the appointment at the wound care center, my boyfriend and I had to hurry home so that we could leave on time to go to the play in the city that we had both been looking forward to. We got to the play in the nick of time and it was wonderful. After we saw the play we went to dinner at a restaurant close to the theater. During dinner, it somewhat occurred to me that I was not as exhausted as I was somewhat expecting to be. It seems that the increase of Vitamins D3 and B-12 are helping my energy levels increase.
I spent the next couple of weeks appreciating the increase in my energy level, while also not doing a whole bunch to enjoy it because I was; for the most part trying to keep my foot elevated. During this time, something that can only be described as a freak accident occurred. I was sitting in my wheelchair with my hands resting on my wheels watching television with my boyfriend, when I decided to push my wheelchair. Evidently, my thumbnail was very close to the pocket of my clothing because it got stuck when I tried to move and my wrist bent in a position that no wrist should find itself in. I immediately examined my incredibly painful wrist and noticed that it was swelling. I decided to ice my wrist for a little while to see if it would help. After icing it for some time with no improvement I made the decision to get it evaluated at my local hospital.
My boyfriend and I went to the hospital and I explained to everyone what I had done to cause my injury. I knew that it sounded like a far-fetched story but it was honestly the way it happened so there wasn’t much else I could say. After the doctor examined my wrist and forearm and had reviewed the x-rays, it was determined that I had sprained my wrist. I was sent home with my wrist wrapped in an ACE (compression) bandage and was told to take ibuprofen every few hours. I followed all of the instructions that I was given but a week later I felt like I was experiencing more pain.
I went to a doctor that is in the same group as my primary physician and explained to her what had happened and how I had been treating it. When she examined me she noticed a small nodule on my forearm. She had a suspicion that it was a blood clot and so she instructed me to go directly back to the emergency room so that I could have an ultrasound. Prior to leaving her office she did say that she was going to call a prescription into my pharmacy that might help my pain a little more than the ibuprofen was, she also encouraged me to see an orthopedist as soon as possible to be further evaluated. It was on the way back to the hospital that I received a text message from my parents asking where I was because they had gotten locked out of our house. All of this crazy business with my wrist inconveniently had to happen when my parents were out of town. I responded saying that I was at an appointment and that I would be home soon. My dad’s response was that it was no big deal because my cousin, whom I had left sleeping on my couch, was still there and had let them into the house. At that point my boyfriend and I continued onto the hospital while I tried to put the unnecessary text messages out of my head. At the hospital I received an ultrasound of my arm and they did not see a blood clot (yay!) They did however, suggest changing my ACE bandage to a splint so that I could be a bit more supported, while allowing me to have some movement so that I could at least maneuver my wheelchair without assistance.
By this point, it had been about a month since the podiatrist had evaluated my toe and I had noticed that despite elevation and the copious amounts of ibuprofen I was taking, my toe was still swollen and incredibly painful. Realizing that I hadn’t heard from her I decided to take it upon myself to call her to first, verify that nothing out of the ordinary had been seen on the x-rays and to also get her opinion on what I should do about the pain that I was still experiencing. She explained that the x-rays had come back completely normal but if I was still having pain I should make an appointment to come in and see her. At that point I tried to pick her brain and ask her what her thinking was and she said that she really didn’t have any thoughts other than to re-examine it. When the podiatrist saw my toe during my appointment, she noticed that part of my nail was ingrown she thought that perhaps it was causing my pain so she removed the ingrown portion and instructed me to soak my toe in warm water daily and to follow-up with her in a week.
*** I intended to write more but I feel it is becoming too long for one post. I promise I will continue writing in a day or two. I won’t neglect my blog for this long, I’ve learned my lesson. ***
When I left the appointment at the wound care center, my boyfriend and I had to hurry home so that we could leave on time to go to the play in the city that we had both been looking forward to. We got to the play in the nick of time and it was wonderful. After we saw the play we went to dinner at a restaurant close to the theater. During dinner, it somewhat occurred to me that I was not as exhausted as I was somewhat expecting to be. It seems that the increase of Vitamins D3 and B-12 are helping my energy levels increase.
I spent the next couple of weeks appreciating the increase in my energy level, while also not doing a whole bunch to enjoy it because I was; for the most part trying to keep my foot elevated. During this time, something that can only be described as a freak accident occurred. I was sitting in my wheelchair with my hands resting on my wheels watching television with my boyfriend, when I decided to push my wheelchair. Evidently, my thumbnail was very close to the pocket of my clothing because it got stuck when I tried to move and my wrist bent in a position that no wrist should find itself in. I immediately examined my incredibly painful wrist and noticed that it was swelling. I decided to ice my wrist for a little while to see if it would help. After icing it for some time with no improvement I made the decision to get it evaluated at my local hospital.
My boyfriend and I went to the hospital and I explained to everyone what I had done to cause my injury. I knew that it sounded like a far-fetched story but it was honestly the way it happened so there wasn’t much else I could say. After the doctor examined my wrist and forearm and had reviewed the x-rays, it was determined that I had sprained my wrist. I was sent home with my wrist wrapped in an ACE (compression) bandage and was told to take ibuprofen every few hours. I followed all of the instructions that I was given but a week later I felt like I was experiencing more pain.
I went to a doctor that is in the same group as my primary physician and explained to her what had happened and how I had been treating it. When she examined me she noticed a small nodule on my forearm. She had a suspicion that it was a blood clot and so she instructed me to go directly back to the emergency room so that I could have an ultrasound. Prior to leaving her office she did say that she was going to call a prescription into my pharmacy that might help my pain a little more than the ibuprofen was, she also encouraged me to see an orthopedist as soon as possible to be further evaluated. It was on the way back to the hospital that I received a text message from my parents asking where I was because they had gotten locked out of our house. All of this crazy business with my wrist inconveniently had to happen when my parents were out of town. I responded saying that I was at an appointment and that I would be home soon. My dad’s response was that it was no big deal because my cousin, whom I had left sleeping on my couch, was still there and had let them into the house. At that point my boyfriend and I continued onto the hospital while I tried to put the unnecessary text messages out of my head. At the hospital I received an ultrasound of my arm and they did not see a blood clot (yay!) They did however, suggest changing my ACE bandage to a splint so that I could be a bit more supported, while allowing me to have some movement so that I could at least maneuver my wheelchair without assistance.
By this point, it had been about a month since the podiatrist had evaluated my toe and I had noticed that despite elevation and the copious amounts of ibuprofen I was taking, my toe was still swollen and incredibly painful. Realizing that I hadn’t heard from her I decided to take it upon myself to call her to first, verify that nothing out of the ordinary had been seen on the x-rays and to also get her opinion on what I should do about the pain that I was still experiencing. She explained that the x-rays had come back completely normal but if I was still having pain I should make an appointment to come in and see her. At that point I tried to pick her brain and ask her what her thinking was and she said that she really didn’t have any thoughts other than to re-examine it. When the podiatrist saw my toe during my appointment, she noticed that part of my nail was ingrown she thought that perhaps it was causing my pain so she removed the ingrown portion and instructed me to soak my toe in warm water daily and to follow-up with her in a week.
*** I intended to write more but I feel it is becoming too long for one post. I promise I will continue writing in a day or two. I won’t neglect my blog for this long, I’ve learned my lesson. ***
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