I had the PICC line in place for the next six weeks as I needed to have at least a six week course of the antibiotic. The nurse was right when she told me that after doing the medication a few times that it would end up being something that I wouldn't really need to think about doing. Meanwhile I was still using the Wound VAC.
Everything seemed to be going really well as I adjusted to using the PICC, I was at this point pretty much used to the Wound VAC so I was in a relatively decent place mentally. It was approximately the beginning of October at this point, I was told that as long as the Wound VAC was on and that I remembered not to lift anything weighing more than a gallon of milk that I could pretty much be up and out of bed once in awhile. While I was happy that I could be vertical more often I pretty much only allowed myself up when I deemed it absolutely necessary. I was beginning to get somewhat down about the entire situation and so I figured that if in essence grounding myself was going to make it heal that that was what I was going to do.
After I was on the antibiotics for the full six weeks my blood tests were showing that the infection had improved so much that the PICC line could be removed. The infectious disease doctor removed it, during one of my regular wound care appointments. Removing it was absolutely painless and it was completely out in less than a minute.
I would remain on the Wound VAC from that point all the way into the second week of January. In January I woke up to go to my normal wound care appointment with the surgeon, the car ride up was fine, except for the weird pit in my stomach. I had no evidence that anything was wrong other than just a weird feeling in my gut.
It turns out that when the surgeon started poking around he felt something sticking up in the center. He explained that he thought it was only a bone spur but that he wanted me to get an X-ray before I left. I was placed back on the wound VAC and sent down for the x-ray with the expectation that the surgeon would call me in a couple days to tell me everything was fine. I was hoping that a positive outlook was going to help. A couple of days later came the highly anticipated call, unfortunately the pictures were obstructed by a different unrelated procedure that I had when I was very young. The obstructed view meant that I would now need to undergo a Magnetic Resonance Imaging (MRI). I knew from past experience that while an MRI was going to be a loud and probably lengthy test I knew that it was completely painless so I went ahead and scheduled the test for after my wound care appointment the following week.
The test was done and I would end up getting the results during my visit with my surgeon. He said that he could not be positive that there was or was not an infection in the bone so he wanted to do another surgery so we would know what we were dealing with.
Showing posts with label Wound VAC. Show all posts
Showing posts with label Wound VAC. Show all posts
Friday, April 13, 2012
Monday, March 19, 2012
Using the PICC line
When I left the hospital I went directly to my house so that I could meet the nurse that was going to teach me how to use the PICC line. I had a friend that had one in the past and while I was a little bit unsure about using the PICC myself I sort of had an idea of how it worked. I got to my house just as my antibiotic and supplies were being delivered and the nurse came shortly thereafter.
The nurse explained that I really would not have anything to worry about as far as giving myself the medication because it was all written down for me and she was going to also teach me a simple way to remember it. She told me that I would be using the 'SASH' method to push the medication into the line. Using that method, I would first flush the line with normal saline, then would administer the antibiotic, then I would need to flush the line with saline again and finally I would need to use Heperin, a blood thinner so that the line would not clot.
Once she told me about the SASH method I was more confident because it sounded relatively simple. At that point the only part of the entire situation that had me concerned was the schedule that I would need to adhere to. The hospital always seemed to tell me that it was time for my antibiotic at the strangest hours, but before I was discharged the infectious disease doctor told me that I could adjust the schedule so that I could get some sleep. The nurse and I discussed that and altered the schedule slightly so that after the first couple days I would no longer need to wake up in the middle of the night to do it.
Once she had told me how to administer the medication it was time for me to try doing it, with her watching and available if I should need any help. I was able to do it absolutely fine and with minimal questions. After the dosage was administered she had stuck around for about an hour to monitor me for signs of a reaction to the medication. I did not have a bad reaction so she left, saying she would be back the following day to change the dressing.
The next morning the visiting nurse called me to schedule her visit so that she could again, re-admit me into their service, and so she could change my Wound VAC dressing. The visit was scheduled for a few hours later so that I would have time to give myself my antibiotic and could also shower. When I was in the hospital the surgeon had told me that he had placed antibiotic seeds into the wound and that they should be left alone, but that I was allowed to shower. Well, when I got out of my shower I was disturbed to see something that I can only describe as the white candies that are ontop of Sno-Caps chocolates laying on both my shower chair and on the bottom of the tub. I knew that the nurse was going to be arriving at any moment so while I was worried about what I had seen I did not dwell on it because I was confident that my nurse would be able to handle the situation. The nurse arrived and I immediately asked her to look in my shower so she could see what had happened. It turns out that what I was seeing were the antibiotic seeds. We called the office and explained what had happened, but that the nurse still saw some left in the wound. We were told that with the other medication I was taking that while it wasn't ideal that they had fallen out it was not anything to be overly concerned with. The nurse changed the VAC dressing and we scheduled her next visit for a few days later.
The nurse explained that I really would not have anything to worry about as far as giving myself the medication because it was all written down for me and she was going to also teach me a simple way to remember it. She told me that I would be using the 'SASH' method to push the medication into the line. Using that method, I would first flush the line with normal saline, then would administer the antibiotic, then I would need to flush the line with saline again and finally I would need to use Heperin, a blood thinner so that the line would not clot.
Once she told me about the SASH method I was more confident because it sounded relatively simple. At that point the only part of the entire situation that had me concerned was the schedule that I would need to adhere to. The hospital always seemed to tell me that it was time for my antibiotic at the strangest hours, but before I was discharged the infectious disease doctor told me that I could adjust the schedule so that I could get some sleep. The nurse and I discussed that and altered the schedule slightly so that after the first couple days I would no longer need to wake up in the middle of the night to do it.
Once she had told me how to administer the medication it was time for me to try doing it, with her watching and available if I should need any help. I was able to do it absolutely fine and with minimal questions. After the dosage was administered she had stuck around for about an hour to monitor me for signs of a reaction to the medication. I did not have a bad reaction so she left, saying she would be back the following day to change the dressing.
The next morning the visiting nurse called me to schedule her visit so that she could again, re-admit me into their service, and so she could change my Wound VAC dressing. The visit was scheduled for a few hours later so that I would have time to give myself my antibiotic and could also shower. When I was in the hospital the surgeon had told me that he had placed antibiotic seeds into the wound and that they should be left alone, but that I was allowed to shower. Well, when I got out of my shower I was disturbed to see something that I can only describe as the white candies that are ontop of Sno-Caps chocolates laying on both my shower chair and on the bottom of the tub. I knew that the nurse was going to be arriving at any moment so while I was worried about what I had seen I did not dwell on it because I was confident that my nurse would be able to handle the situation. The nurse arrived and I immediately asked her to look in my shower so she could see what had happened. It turns out that what I was seeing were the antibiotic seeds. We called the office and explained what had happened, but that the nurse still saw some left in the wound. We were told that with the other medication I was taking that while it wasn't ideal that they had fallen out it was not anything to be overly concerned with. The nurse changed the VAC dressing and we scheduled her next visit for a few days later.
Monday, March 12, 2012
Frustrations
Due to an error with the paper work being sent for the Wound VAC we were unable to begin using the Wound VAC until almost a week later. I was disappointed that it was going to be postponed but I realized that there was nothing I could do so I just accepted the fact that I needed to wait.
When the VAC finally arrived we began the VAC therapy. It was approximatly a week later that the surgeon wanted to see me again so he could check on how everything was going. The appointment with the surgeon was uneventful and all signs were pointing in a positive direction. The surgeon then explained to me that he was going to be out of town for a few weeks and that I should make an appointment to see him in a month.
During that month I continued to use the Wound VAC and have a few nursing visits a week so that the VAC dressing could be changed and so that the wound could be monitored. Everything with the wound seemed to be going well.
By this point the wound was not what was causing me the most stress. The Clinitron At-Home bed was a different story though. The part of the bed that holds the 'sand' is covered by a polyester sheet, which I did not find to be very durable at all. After having had this bed for so long I was finding that it seemed to be tearing which was causing the sand to go everywhere. This was not only uncomfortable to sleep on but I found it nearly impossible to eat while I was in bed. It felt like even if I had just washed my hands that they had a gritty feel to them. When I called the company to ask what to do about it, I was told that because of insurance I was no longer renting the bed so the replacement cover was not going to be replaced for free. Figuring that a piece of polyester really couldn't cost that much I inquired as to the cost. When they told me how much it was going to cost I asked if they had any suggestions how I could fix it without replacing it. I was basically told that I should try to use either electrical tape or duct tape over the tears. That suggestion was fine but only for a very temporary basis. The heat of the bed all but destroys the adhesive on the tape so it basically needed to be re-taped a few times a week.
While this was incredibly frustrating I kept reminding myself that it really would be only needed temporarily, due to the fact that I was on the Wound VAC and so the wound should close. Things seemed to be going well until about a week before I was supposed to see the surgeon. That week I was starting to feel more pain from the wound. I had been told previously that sometimes pain is due to healing so I was not super concerned about it. The other thing that kept me from worrying was the fact that the pain could be relieved with medication. I figured that if something were really wrong that the pain would be more constant and that the medication would not be as effective in stopping it. I mentioned the pain to my nurse during a couple visits and she was only mildly concerned about it based on her opinion of how the wound looked.
I did not really consider making a phone call to the wound care center until a couple of days before my appointment was already scheduled for. I figured that I had dealt with it and it wasn't very severe so it could wait until I saw my surgeon. The day of my appointment arrived and I mentioned to the nurse and the surgeon that I was experiencing some pain. When the surgeon examined the wound was when I felt a whole bunch more pain. It turns out, that bone was now exposed and that I would need surgery. The appointment was on a Tuesday and he looked at me and basically said, 'ok, Friday or Monday which works for you?' I chose Friday being that I figured based on the options I was given that sooner was probably better than later.
When the VAC finally arrived we began the VAC therapy. It was approximatly a week later that the surgeon wanted to see me again so he could check on how everything was going. The appointment with the surgeon was uneventful and all signs were pointing in a positive direction. The surgeon then explained to me that he was going to be out of town for a few weeks and that I should make an appointment to see him in a month.
During that month I continued to use the Wound VAC and have a few nursing visits a week so that the VAC dressing could be changed and so that the wound could be monitored. Everything with the wound seemed to be going well.
By this point the wound was not what was causing me the most stress. The Clinitron At-Home bed was a different story though. The part of the bed that holds the 'sand' is covered by a polyester sheet, which I did not find to be very durable at all. After having had this bed for so long I was finding that it seemed to be tearing which was causing the sand to go everywhere. This was not only uncomfortable to sleep on but I found it nearly impossible to eat while I was in bed. It felt like even if I had just washed my hands that they had a gritty feel to them. When I called the company to ask what to do about it, I was told that because of insurance I was no longer renting the bed so the replacement cover was not going to be replaced for free. Figuring that a piece of polyester really couldn't cost that much I inquired as to the cost. When they told me how much it was going to cost I asked if they had any suggestions how I could fix it without replacing it. I was basically told that I should try to use either electrical tape or duct tape over the tears. That suggestion was fine but only for a very temporary basis. The heat of the bed all but destroys the adhesive on the tape so it basically needed to be re-taped a few times a week.
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| sand on the side |
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| sand going up to the top |
I did not really consider making a phone call to the wound care center until a couple of days before my appointment was already scheduled for. I figured that I had dealt with it and it wasn't very severe so it could wait until I saw my surgeon. The day of my appointment arrived and I mentioned to the nurse and the surgeon that I was experiencing some pain. When the surgeon examined the wound was when I felt a whole bunch more pain. It turns out, that bone was now exposed and that I would need surgery. The appointment was on a Tuesday and he looked at me and basically said, 'ok, Friday or Monday which works for you?' I chose Friday being that I figured based on the options I was given that sooner was probably better than later.
Friday, March 9, 2012
Edge Trimming Surgery
While I was waiting for the day of the surgery to arrive I tried not to think about it very much at all. Not because I was nervous, but because I was excited about the possibilities and I did not want to feel let down if things did not go exactly as planned. While I believed that the surgeon could close the wound surgically, he had warned me that based on the location of the wound and just by moving around that the sutures may not actually hold it.
The morning of the surgery I was cautiously optimistic. I went in and met with the surgeon to go over all of the last minute details. That entire conversation was fine, I had a very good feeling that I was where I was supposed to be, being treated by the person that was supposed to treat me so I went into the surgery with absolutely no hesitation.
Being that this was a relatively minor procedure, the surgeon and I had discussed the type of medication that I was going to be given so that I would not feel what was going on. We decided that instead of undergoing general anesthesia that I would just be given "twilight sedation." When they gave me the medication, I basically fell asleep and knew nothing until a little while later when I was roused by an uncomfortable pillow. I asked the person at my head to move it and that was done without a problem. Once that was moved I did not feel any pain, yet I was not groggy enough that I was falling back to sleep so I just laid there and let whatever was happening continue.
Eventually, I asked the person at my head how it was going and what was going on. I was told that it was almost done and that the surgeon was closing the wound, pretty much at that moment. I was really happy when I heard that news. I was wheeled into the recovery room shortly thereafter and pretty soon after that my family member was allowed in to see me. I was fine by then, I felt spectacular. I was given a sandwich and basically being that I was able to eat it without any problem, they discharged me to my home.
I was sent home, with instructions to stay off the wound, and stay in my Clinitron bed except to get up and go to the bathroom. I went straight to my bed when I got home and pretty much did not move until many hours later when I had to go to the bathroom. Getting up out of bed was no problem at all and did not really scare me but when I was getting back into bed I suddenly saw blood, it seemed like it was a lot so I called in a family member to have a look at the situation. My clothes were bloody but it was not pooling, we got in touch with the doctor and he basically said that it was not anything to be super concerned about, especially being that my visiting nurse was going to see me first thing the next morning.
The next morning, when my nurse came I explained to her all that had gone on during the surgery and about the blood situation that had happened once I got home. She then took a look at the surgical site and said that while their was a lot of blood on the clothing I had taken off the night before that the site looked very good and that it was awesome to look at me and not to see a giant hole. She covered the wound and said that she would be back a few days later to change the dressing again.
I spent those few days in my bed and not really moving at all. I was determined that if this wound wasn't going to stay closed that it would not be because of anything I had directly done or not done. When my nurse called me to schedule her next visit we discussed me getting up to take a shower immediately before her visit and we decided that based on the discharge instructions from the hospital that that would be okay. When she saw the site after my shower she said that it still looked really good but that one of the stitches was beginning to pull but she did not think that anything was wrong, She just warned me to be incredibly careful about it, let me tell you, she did not have to warn me twice. When she called a few days later about scheduling the next visit I she said that again I could take a shower right before she arrived. I asked her if she really felt it was a good idea based on the fact that the stitches were beginning to pull at her last visit. She said that it was okay, so I hesitantly got up and took a quick shower.
When she came and looked at the wound she saw that a bunch of the stitches that had been holding the wound closed that pulled and were no longer doing any good. I was supposed to see the surgeon the following day so all she did was redress the wound and made a call into the office to give him a heads up about what was going on. I was obviously not happy with this news that I was hearing but I was warned that this was a possibility, along with warning me about that possibility the surgeon also said that he was confident that even if it did not stay closed after the surgery that once the edges were removed that it would heal better than it was before.
The next day I met the surgeon at his office so that he could see what was going on with the stitches. When I was in the car on the way to his office I kept feeling some drainage, so I had a feeling that it was not going to be spectacular news. When he looked at it, sure enough the stitches were doing no good at all so he removed them and packed the wound with calcium alginate dressing. I was not really happy that I now had an even larger wound that was open. Yet I believed that it was the thick rolled edges that were preventing it from closing before and that being that those were gone that my body would start to heal it again.
The surgeon then asked me if I would really object to having the Wound VAC started up again to get it going. At that point I did not necessarily care what he said we had to do, I was going to go with his suggestions, based on the really good feeling I had gotten about him all along. I left the office and called my visiting nurse when I got home to bring her up to speed on what all had gone on and what direction we were thinking about going in. The visiting nurse was not happy that the stitches had to be removed but we all new it was a possibility so dwelling on it was not going to help anyone.
Being that this was now a Saturday afternoon the nurse wanted to get the Wound VAC orders as soon as possible so that the company could ship it to me so we could begin the therapy. She asked me for the surgeon's phone number, she called the surgeon, called the VAC company and then called me back. She explained that she had given all of the necessary information and that the VAC would probably arrive on that Wednesday so she would just dress the wound the same way the surgeon had until the VAC arrived.
The morning of the surgery I was cautiously optimistic. I went in and met with the surgeon to go over all of the last minute details. That entire conversation was fine, I had a very good feeling that I was where I was supposed to be, being treated by the person that was supposed to treat me so I went into the surgery with absolutely no hesitation.
Being that this was a relatively minor procedure, the surgeon and I had discussed the type of medication that I was going to be given so that I would not feel what was going on. We decided that instead of undergoing general anesthesia that I would just be given "twilight sedation." When they gave me the medication, I basically fell asleep and knew nothing until a little while later when I was roused by an uncomfortable pillow. I asked the person at my head to move it and that was done without a problem. Once that was moved I did not feel any pain, yet I was not groggy enough that I was falling back to sleep so I just laid there and let whatever was happening continue.
Eventually, I asked the person at my head how it was going and what was going on. I was told that it was almost done and that the surgeon was closing the wound, pretty much at that moment. I was really happy when I heard that news. I was wheeled into the recovery room shortly thereafter and pretty soon after that my family member was allowed in to see me. I was fine by then, I felt spectacular. I was given a sandwich and basically being that I was able to eat it without any problem, they discharged me to my home.
I was sent home, with instructions to stay off the wound, and stay in my Clinitron bed except to get up and go to the bathroom. I went straight to my bed when I got home and pretty much did not move until many hours later when I had to go to the bathroom. Getting up out of bed was no problem at all and did not really scare me but when I was getting back into bed I suddenly saw blood, it seemed like it was a lot so I called in a family member to have a look at the situation. My clothes were bloody but it was not pooling, we got in touch with the doctor and he basically said that it was not anything to be super concerned about, especially being that my visiting nurse was going to see me first thing the next morning.
The next morning, when my nurse came I explained to her all that had gone on during the surgery and about the blood situation that had happened once I got home. She then took a look at the surgical site and said that while their was a lot of blood on the clothing I had taken off the night before that the site looked very good and that it was awesome to look at me and not to see a giant hole. She covered the wound and said that she would be back a few days later to change the dressing again.
I spent those few days in my bed and not really moving at all. I was determined that if this wound wasn't going to stay closed that it would not be because of anything I had directly done or not done. When my nurse called me to schedule her next visit we discussed me getting up to take a shower immediately before her visit and we decided that based on the discharge instructions from the hospital that that would be okay. When she saw the site after my shower she said that it still looked really good but that one of the stitches was beginning to pull but she did not think that anything was wrong, She just warned me to be incredibly careful about it, let me tell you, she did not have to warn me twice. When she called a few days later about scheduling the next visit I she said that again I could take a shower right before she arrived. I asked her if she really felt it was a good idea based on the fact that the stitches were beginning to pull at her last visit. She said that it was okay, so I hesitantly got up and took a quick shower.
When she came and looked at the wound she saw that a bunch of the stitches that had been holding the wound closed that pulled and were no longer doing any good. I was supposed to see the surgeon the following day so all she did was redress the wound and made a call into the office to give him a heads up about what was going on. I was obviously not happy with this news that I was hearing but I was warned that this was a possibility, along with warning me about that possibility the surgeon also said that he was confident that even if it did not stay closed after the surgery that once the edges were removed that it would heal better than it was before.
The next day I met the surgeon at his office so that he could see what was going on with the stitches. When I was in the car on the way to his office I kept feeling some drainage, so I had a feeling that it was not going to be spectacular news. When he looked at it, sure enough the stitches were doing no good at all so he removed them and packed the wound with calcium alginate dressing. I was not really happy that I now had an even larger wound that was open. Yet I believed that it was the thick rolled edges that were preventing it from closing before and that being that those were gone that my body would start to heal it again.
The surgeon then asked me if I would really object to having the Wound VAC started up again to get it going. At that point I did not necessarily care what he said we had to do, I was going to go with his suggestions, based on the really good feeling I had gotten about him all along. I left the office and called my visiting nurse when I got home to bring her up to speed on what all had gone on and what direction we were thinking about going in. The visiting nurse was not happy that the stitches had to be removed but we all new it was a possibility so dwelling on it was not going to help anyone.
Being that this was now a Saturday afternoon the nurse wanted to get the Wound VAC orders as soon as possible so that the company could ship it to me so we could begin the therapy. She asked me for the surgeon's phone number, she called the surgeon, called the VAC company and then called me back. She explained that she had given all of the necessary information and that the VAC would probably arrive on that Wednesday so she would just dress the wound the same way the surgeon had until the VAC arrived.
Wednesday, February 22, 2012
Is Anything Going to Change
When I was taken off of the Dakin's solution I was thrilled. Not only would I no longer have to worry about my clothing and bedding being bleached-stained but I thought that we were finally moving onto a more effective treatment. The surgeon had cultured the wound and an infection was discovered. While I obviously was not pleased with this new information I figured it was just par for the course. I was placed on Bactroban Cream, a type of topical antibiotic ointment to treat the infection. In addition, the surgeon also instructed that we use a different type of dressing. The dressing that she recommended was something called Prisma. The intention of the Prisma is for the dressing to absorb any gross discharge the wound may be producing, it also has Colligen-like properties that in time would assist my body in closing the wound.
My surgeon decided that she was going to take me off of the Prisma because while it was helping, it was not giving us the desired results. Her next plan of attack made me incredibly upset because, you guessed it, she put me back onto the Dakin's solution, to be changed three times a week all over again. The solution that firstly was not what my wound should have been treated with and secondly was setting me into an emotional tailspin. I was devastated that we were in my opinion taking yet another step backward. I was yet again stuck having to deal with this Dakin's solution staining everything it came into contact with. The only positive about using it this time was that the risk of damage to the surrounding tissue was taken into account so we were using a skin barrier to protect it.
I was by this point feeling incredibly discouraged about the entire situation. I had had the wound for approximately a year and a half and aside from very minor changes it was not doing any better. The doctor kept recommending the same types of therapies that were just not being helpful. I had basically no quality of life, because it was drilled into my head that I needed to keep pressure off of my wound as much as possible. I figured that if I was going to ever get better that I should listen to the doctor so I basically put any sort of social life on hold. I had spent the past year and a half stuck at home in the Cliitron bed, aside from a very few family events that I felt it was important I attend. This was when I think I began to feel so discouraged about the situation that I just shut down. My nurse was trying to convince me that we were wasting time and that I was not going to get any better if I did not seek another opinion. Logically, everything the nurse was saying made perfect sense, except that I think I was numb to the situation. While I was existing I sure wasn't living.
My surgeon decided that she was going to take me off of the Prisma because while it was helping, it was not giving us the desired results. Her next plan of attack made me incredibly upset because, you guessed it, she put me back onto the Dakin's solution, to be changed three times a week all over again. The solution that firstly was not what my wound should have been treated with and secondly was setting me into an emotional tailspin. I was devastated that we were in my opinion taking yet another step backward. I was yet again stuck having to deal with this Dakin's solution staining everything it came into contact with. The only positive about using it this time was that the risk of damage to the surrounding tissue was taken into account so we were using a skin barrier to protect it.
I was by this point feeling incredibly discouraged about the entire situation. I had had the wound for approximately a year and a half and aside from very minor changes it was not doing any better. The doctor kept recommending the same types of therapies that were just not being helpful. I had basically no quality of life, because it was drilled into my head that I needed to keep pressure off of my wound as much as possible. I figured that if I was going to ever get better that I should listen to the doctor so I basically put any sort of social life on hold. I had spent the past year and a half stuck at home in the Cliitron bed, aside from a very few family events that I felt it was important I attend. This was when I think I began to feel so discouraged about the situation that I just shut down. My nurse was trying to convince me that we were wasting time and that I was not going to get any better if I did not seek another opinion. Logically, everything the nurse was saying made perfect sense, except that I think I was numb to the situation. While I was existing I sure wasn't living.
Friday, February 3, 2012
Some Progress
While I was happy to be home from the hospital I was not pleased with my situation. I yet again had to get used to different nurses coming into my house at least two times a week to change the VAC dressing and I also had to see the surgeon once a week so that she could keep an eye on my progress. While I tried to remain upbeat and positive that eventually things would all work out I was also working myself into quite a mess of emotions. I had to emotionally adjust to the wound VAC being necessary in the first place. While I was having a hard time with that the most difficult physical adjustment was trying to figure out how to sleep. As I've said I was on a Clinitron At-Home bed, which is filled with sand. My cousin once felt it an said that 'it felt like it is filled with a billion babies that are punching at you.' While that may sound funny I have yet to figure out a better way to describe how it felt. I figured that I would just have to relax and that eventually sleep would come.
While I was struggling to sleep I had to manage to fit in nursing visits and doctors appointments into my life. At this point the visits were rather stressful because the VAC was being very particular about how it was sealed. The nursing visits were scheduled to take a hour each time and there were quite a few that ended up taking two hours each. Finally one of my nurses said that a representative from the VAC company would be in my area and that she would like her to come to the next visit and hopefully she would have some suggestions to get it to work better. I agreed because I figured that if we could get the machine quieter that maybe I would be able to sleep. The representive came the next visit and showed us a few materials that we could use to get it to seal better. While they did in fact help they by no means made it silent.
During a subsequent doctors appointment I explained to the surgeon that it had been at that point a solid four weeks since I had slept properly and asked her if she could prescribe something for me to take temporarily. She said that I would need to go see my primary care physician for that. While I understood her reasoning I was not pleased with having to get out and go to another doctor, considering that is no easy task. See, I do not drive so all of these appointments needed to be scheduled around times when my family was available to bring me to them.
When I got home I called my regular doctors office and left a message for her to call me back and generally what it was about. I did receive a return call, but not from my doctor, but from her secretary. The secretary explained that the doctor would need to see me in the office to discuss prescribing something to help me sleep. While I was less than pleased, at this point I wasn't surprised so I went ahead and made an appointment to see her a few days later. During the appointment I caught her up on everything we were doing and all of the special equipment I was adjusting to and explained to her that I was having difficulty sleeping, partially due to noise and partially due to stress I assumed. She did prescribe a medication for me to take that she thought would help. Then she said that if it didn't help to call her back and that she would tell her secretary that with me this did not require another appointment. I left the doctor happy on both accounts.
That night I took the medicine hopeful that it would work. About half an hour after I took it I found myself feeling incredibly drowsy, so I turned off the light and the next thing I knew it was the next morning. Finally, I woke up feeling human it was the greatest feeling ever.
The following weeks consisted of a regular routine of nursing visits and doctors appointments. The wound VAC was working, slowly, but working none the less. My nurse was very pleased with the progress as was the doctor. While I was pleased that we were finally seeing results I was a little bit worried that we had now entered October and the wound still wasn't anywhere near the size it was prior to the nurse putting on the 'one week dressing'. The other thing that was weighing on my mind was that my brother was going to get married in a couple weeks. On one hand I was worried that I wasn't going to be able to go and on the other hand I was worried that if I did go and the wound VAC started to malfunction, that dealing with it in a public restroom would be difficult. I discussed my concerns with my nurses and they assured me that actually being that I was going to be vertical in my wheelchair during the wedding that the chances of the VAC causing problems were slim to none. Assured that it wouldn't be a big problem I went to the wedding determined to have a good time and just forget about all of the things that were going on in my life.
The first few months after the wedding consisted of doctors appointments and nursing visits that were pleasing everyone because the wound was responding nicely to the treatment. Until, those warning bells went off in my head again. One morning I was at the doctor's office and while she was pleased with the wound itself she was worried that I seemed to possibly be developing another one. I was worried when she said that but didn't choose to freak out at that moment. She explained that in her opinion the adhesive used to keep the wound VAC drape in place was tearing my skin when it was removed. I asked her where the second wound was forming and she told me that it was on my thigh. My thigh, which we never once applied the adhesive to. While I believed that I had another wound I did not at all agree with her on what had caused it. Somehow, she convinced me that she was right and I was wrong and that going off the wound VAC was the right thing to do. Instead of listening to my instincts and insisting on staying on it I allowed her to change the orders.
While I was struggling to sleep I had to manage to fit in nursing visits and doctors appointments into my life. At this point the visits were rather stressful because the VAC was being very particular about how it was sealed. The nursing visits were scheduled to take a hour each time and there were quite a few that ended up taking two hours each. Finally one of my nurses said that a representative from the VAC company would be in my area and that she would like her to come to the next visit and hopefully she would have some suggestions to get it to work better. I agreed because I figured that if we could get the machine quieter that maybe I would be able to sleep. The representive came the next visit and showed us a few materials that we could use to get it to seal better. While they did in fact help they by no means made it silent.
During a subsequent doctors appointment I explained to the surgeon that it had been at that point a solid four weeks since I had slept properly and asked her if she could prescribe something for me to take temporarily. She said that I would need to go see my primary care physician for that. While I understood her reasoning I was not pleased with having to get out and go to another doctor, considering that is no easy task. See, I do not drive so all of these appointments needed to be scheduled around times when my family was available to bring me to them.
When I got home I called my regular doctors office and left a message for her to call me back and generally what it was about. I did receive a return call, but not from my doctor, but from her secretary. The secretary explained that the doctor would need to see me in the office to discuss prescribing something to help me sleep. While I was less than pleased, at this point I wasn't surprised so I went ahead and made an appointment to see her a few days later. During the appointment I caught her up on everything we were doing and all of the special equipment I was adjusting to and explained to her that I was having difficulty sleeping, partially due to noise and partially due to stress I assumed. She did prescribe a medication for me to take that she thought would help. Then she said that if it didn't help to call her back and that she would tell her secretary that with me this did not require another appointment. I left the doctor happy on both accounts.
That night I took the medicine hopeful that it would work. About half an hour after I took it I found myself feeling incredibly drowsy, so I turned off the light and the next thing I knew it was the next morning. Finally, I woke up feeling human it was the greatest feeling ever.
The following weeks consisted of a regular routine of nursing visits and doctors appointments. The wound VAC was working, slowly, but working none the less. My nurse was very pleased with the progress as was the doctor. While I was pleased that we were finally seeing results I was a little bit worried that we had now entered October and the wound still wasn't anywhere near the size it was prior to the nurse putting on the 'one week dressing'. The other thing that was weighing on my mind was that my brother was going to get married in a couple weeks. On one hand I was worried that I wasn't going to be able to go and on the other hand I was worried that if I did go and the wound VAC started to malfunction, that dealing with it in a public restroom would be difficult. I discussed my concerns with my nurses and they assured me that actually being that I was going to be vertical in my wheelchair during the wedding that the chances of the VAC causing problems were slim to none. Assured that it wouldn't be a big problem I went to the wedding determined to have a good time and just forget about all of the things that were going on in my life.
The first few months after the wedding consisted of doctors appointments and nursing visits that were pleasing everyone because the wound was responding nicely to the treatment. Until, those warning bells went off in my head again. One morning I was at the doctor's office and while she was pleased with the wound itself she was worried that I seemed to possibly be developing another one. I was worried when she said that but didn't choose to freak out at that moment. She explained that in her opinion the adhesive used to keep the wound VAC drape in place was tearing my skin when it was removed. I asked her where the second wound was forming and she told me that it was on my thigh. My thigh, which we never once applied the adhesive to. While I believed that I had another wound I did not at all agree with her on what had caused it. Somehow, she convinced me that she was right and I was wrong and that going off the wound VAC was the right thing to do. Instead of listening to my instincts and insisting on staying on it I allowed her to change the orders.
Wednesday, February 1, 2012
It's All an Adjustment
My family and I had a temporary moment of panic when the Wound VAC first alarmed and then we attempted to solve the problem by patching the leak. See, the wound VAC uses negative pressure to help tissue regranulate from the bottom of the woundbed, therefore, making it less deep. While it does that it is also sucking away any discharge that the wound may be producing. In order for the VAC to properly do its job it must remain sealed. When I moved from my wheelchair to the bed I moved just enough to make the VAC loose it's seal. We were able to get it sealed enough so that the alarm would stop, but it was suddenly not as quiet as it had been. I decided to just deal with it being loud for the one night, knowing that visiting nurses would be coming the following day to check on the surgical site and also to do some instruction on the VAC itself.
A visiting nurse came the following morning to get me all situated and also to re-admit me into their service. See, once I was hospitalized they no longer were involved with my care, so I had to sign all of the paper work and learn about the company again, as is protocol. After we did all of that the nurse got down to the business of showing me and a family member how to set up the wound VAC just in case it should do anything dumb when a nurse wasn't able to come out and fix it.
The VAC works by packing the wound with foam which then helps the negative pressure get to the wound. The foam first needs to be cut to the approximate size and shape of the wound. The nurse cut the foam piece that she needed and then showed it to me. While I did want to know what was going on with my body I had avoided seeing photographs of the wound and although I had heard measurements in the past I didn't really 'get' just how big the wound was until I saw the piece of foam. To the best of my recollection, the foam was about eight centimeters wide. I had no idea at the time just how big that was until I saw it. Then the nurse called in my family members so they could see what to do. Well, when my family members came in and saw the wound they immediately had to leave the room. It was too much for them to handle. That in turn scared me, because while I knew it wasn't a good situation I had never seen those family members get so upset about anything like this before.
The days that followed were very noisy and I didn't sleep very much at all. Partially due to having to get used to the noises that the wound VAC made and also because I had to adjust to sleeping on the bed my doctor recommended. The bed that I was on is called a Clinitron At-Home bed. The bed is filled with a sand-like material that always moves. So that pressure is never kept on one part of the body for too long. In order to function properly it has to be set to a specific temperature. Well, as someone that is usually hot I hated that it best functioned at a very high temperature. The first few weeks home from the hospital were quite an adjustment for me, both emotionally and physically.
A visiting nurse came the following morning to get me all situated and also to re-admit me into their service. See, once I was hospitalized they no longer were involved with my care, so I had to sign all of the paper work and learn about the company again, as is protocol. After we did all of that the nurse got down to the business of showing me and a family member how to set up the wound VAC just in case it should do anything dumb when a nurse wasn't able to come out and fix it.
The VAC works by packing the wound with foam which then helps the negative pressure get to the wound. The foam first needs to be cut to the approximate size and shape of the wound. The nurse cut the foam piece that she needed and then showed it to me. While I did want to know what was going on with my body I had avoided seeing photographs of the wound and although I had heard measurements in the past I didn't really 'get' just how big the wound was until I saw the piece of foam. To the best of my recollection, the foam was about eight centimeters wide. I had no idea at the time just how big that was until I saw it. Then the nurse called in my family members so they could see what to do. Well, when my family members came in and saw the wound they immediately had to leave the room. It was too much for them to handle. That in turn scared me, because while I knew it wasn't a good situation I had never seen those family members get so upset about anything like this before.
The days that followed were very noisy and I didn't sleep very much at all. Partially due to having to get used to the noises that the wound VAC made and also because I had to adjust to sleeping on the bed my doctor recommended. The bed that I was on is called a Clinitron At-Home bed. The bed is filled with a sand-like material that always moves. So that pressure is never kept on one part of the body for too long. In order to function properly it has to be set to a specific temperature. Well, as someone that is usually hot I hated that it best functioned at a very high temperature. The first few weeks home from the hospital were quite an adjustment for me, both emotionally and physically.
Monday, January 30, 2012
Into the Operating Room I Went
The following morning I was brought down to have the surgery to figure out just how deep this wound really was. I was not thrilled with the prospect of having surgery but this was by no means the first time I had been in an operating room, so I sort of knew what to expect, or so I thought.
Typically before a surgery, the doctor will come in and talk to you and answer any last minute questions that you may have. I was just outside the operating room and had met a couple of the nurses that would be with me during the procedure and also the anestethesiologist. It was getting closer and closer to the time they were going to bring me into the operating room and the surgeon still hadn't shown up to speak with me. Finally, I requested to see her before the procedure. Talk about weird, never in all of the surgeries I've had, have I ever had to ask to see a doctor prior to a procedure. Word got to the doctor that I wanted to see her and she showed up. When she appeared it was like she was there as a favor to me. I found that to be completely unprofessional and it set off another set of warning bells, though I didn't choose to open my mouth and say I had a problem with it at all.
We went on with the procedure as scheduled and I woke up about an hour later, feeling spectacular. I was brought back to my room and was given lunch and was just told to stay on my side as much as possible. Although, the wound vac was supposed to be set up during the surgery itself, something had gotten screwed up with its delivery and so we would have to do that the next day in my room. I was okay with that being that I was told that hooking up the vac shouldn't be an uncomfortable experience.
Later, that afternoon the surgeon came to see how I was feeling and also to tell me that the wound wasn't as deep as she had first suspected. To say that I was relieved would be an understatement. That is when she told me that she wanted me to get a special mattress to sleep on. I freaked out, I am one that loves her sleep and to tell me that the way I was used to sleeping was going to have to change did not go over well in the least. She chose that moment to sit down and actually talk to me face to face, for the first time ever. She explained that the best way for the wound to heal would be if along with the vac for me to agree to get an alternating pressure mattress. Which while keeping pressure off the wound would also help to increase circulation. She explained that the special mattress wouldn't need to be forever just until the wound healed, I reluctantly agreed.
The following day, the wound vac was delivered and a bunch of nurses came into the room to put it on and also to explain to me and my family members what to do if it started making alarm noises once I was discharged. Putting it on, although time consuming, was not painful at all so again I wasn't too worried about having to use it. "Temporarily" was the word that I kept repeating to myself every time I remotely got upset about either the vac or the new mattress that by that point was already on the way to my house and being set up.
I was discharged from the hospital the following afternoon. I thought okay at least we now know that the wound is not as deep as we originally thought and now with the wound vac on it and a special mattress that it would heal relatively soon and I could move on with my life. When I got home and saw the monstrosity that was taking over my room I nearly lost my mind. I have a relatively small bedroom and the bed, oh yes it's a bed not just a mattress. was taking up a ton more space than my regular full sized bed had used before. I climbed onto the bed and as I did I immediately noticed that it was heated. I was not at all pleased with this information being that it was probably August at this point. The other thing that happened when I first climbed from my wheelchair to the bed was that the wound vac chose that moment to start alarming. If only that would be the one time my family and I would hear that sound.
Typically before a surgery, the doctor will come in and talk to you and answer any last minute questions that you may have. I was just outside the operating room and had met a couple of the nurses that would be with me during the procedure and also the anestethesiologist. It was getting closer and closer to the time they were going to bring me into the operating room and the surgeon still hadn't shown up to speak with me. Finally, I requested to see her before the procedure. Talk about weird, never in all of the surgeries I've had, have I ever had to ask to see a doctor prior to a procedure. Word got to the doctor that I wanted to see her and she showed up. When she appeared it was like she was there as a favor to me. I found that to be completely unprofessional and it set off another set of warning bells, though I didn't choose to open my mouth and say I had a problem with it at all.
We went on with the procedure as scheduled and I woke up about an hour later, feeling spectacular. I was brought back to my room and was given lunch and was just told to stay on my side as much as possible. Although, the wound vac was supposed to be set up during the surgery itself, something had gotten screwed up with its delivery and so we would have to do that the next day in my room. I was okay with that being that I was told that hooking up the vac shouldn't be an uncomfortable experience.
Later, that afternoon the surgeon came to see how I was feeling and also to tell me that the wound wasn't as deep as she had first suspected. To say that I was relieved would be an understatement. That is when she told me that she wanted me to get a special mattress to sleep on. I freaked out, I am one that loves her sleep and to tell me that the way I was used to sleeping was going to have to change did not go over well in the least. She chose that moment to sit down and actually talk to me face to face, for the first time ever. She explained that the best way for the wound to heal would be if along with the vac for me to agree to get an alternating pressure mattress. Which while keeping pressure off the wound would also help to increase circulation. She explained that the special mattress wouldn't need to be forever just until the wound healed, I reluctantly agreed.
The following day, the wound vac was delivered and a bunch of nurses came into the room to put it on and also to explain to me and my family members what to do if it started making alarm noises once I was discharged. Putting it on, although time consuming, was not painful at all so again I wasn't too worried about having to use it. "Temporarily" was the word that I kept repeating to myself every time I remotely got upset about either the vac or the new mattress that by that point was already on the way to my house and being set up.
I was discharged from the hospital the following afternoon. I thought okay at least we now know that the wound is not as deep as we originally thought and now with the wound vac on it and a special mattress that it would heal relatively soon and I could move on with my life. When I got home and saw the monstrosity that was taking over my room I nearly lost my mind. I have a relatively small bedroom and the bed, oh yes it's a bed not just a mattress. was taking up a ton more space than my regular full sized bed had used before. I climbed onto the bed and as I did I immediately noticed that it was heated. I was not at all pleased with this information being that it was probably August at this point. The other thing that happened when I first climbed from my wheelchair to the bed was that the wound vac chose that moment to start alarming. If only that would be the one time my family and I would hear that sound.
Friday, January 27, 2012
Meeting the Waste of Time
I feel that the wound was already infected before that one nurse decided to put the different dressing on and that by no one seeing it for a few days it allowed the infection to fester. Leaving me with a huge wound that had actually turned black.
As I had been instructed, I went to the wound care center the following week so that I could begin seeing the doctor that was supposedly going to heal the wound. The doctor came into the exam room and before she had even really introduced herself to me she began working on the wound, continuing to cut away the dead tissue. Her failure to introduce herself was the event that set off the first alarm bell in my head. While I understand that doctors are busy people I do not feel that it is in any way appropriate for a doctor not to take the thirty seconds and introduce themselves to a new patient.
While the doctor was lookiing at the wound is when she started asking questions regarding how long I had had the wound and what we were doing for it. I answered her questions and then was sent for an x-ray to make sure the infection hadn't spread into the bone. While I was waiting for the x-ray I was hoping that it hadn't progressed that deeply but something in my head told me different. The x-rays were inconclusive, which meant that she couldn't tell if bone was involved or not. If bone were involved without us knowing it would have been disastrous. Being that she was unable to tell through x-rays that meant she would have to bring me to the Operating Room to find out.
The surgery was scheduled for a few days later. I was admitted to the hospital the day before my surgery was to take place. During that time I saw a wound care nurse that suggested that something called a Wound Vac be put on the wound. When she first told me that I was sort of shocked, 'I'm sorry you want to hook me up to a machine and let the machine make it better,' I thought. Instead of panicking at that point, my somewhat of a nerd brain took over and I started asking for literature about this 'Vac' that they wanted to hook me up to. The wound care nurse gave me a large binder with a ton of information in it. When a family member came in to visit me later that afternoon he found me studying. After I had finished reading all of the literature I was all but certain that while this device may not be the most pleasant of experiences that it would probably be effective. At this point the little voice in my head that had been telling me that this doctor may not be a good match for me got louder. I requested a second opinion from a doctor that I trusted and had seen previously for various issues.
When he came in and looked at the wound he told me that yes surgery was going to be what I should do. Surprisingly I was okay with that answer. That is when I asked him if he would do it instead of 'my surgeon'. He said no, that he wasn't really into wound care and that I should stick to the surgeon I was already working with. I agreed, though somewhat hesitantly.
As I had been instructed, I went to the wound care center the following week so that I could begin seeing the doctor that was supposedly going to heal the wound. The doctor came into the exam room and before she had even really introduced herself to me she began working on the wound, continuing to cut away the dead tissue. Her failure to introduce herself was the event that set off the first alarm bell in my head. While I understand that doctors are busy people I do not feel that it is in any way appropriate for a doctor not to take the thirty seconds and introduce themselves to a new patient.
While the doctor was lookiing at the wound is when she started asking questions regarding how long I had had the wound and what we were doing for it. I answered her questions and then was sent for an x-ray to make sure the infection hadn't spread into the bone. While I was waiting for the x-ray I was hoping that it hadn't progressed that deeply but something in my head told me different. The x-rays were inconclusive, which meant that she couldn't tell if bone was involved or not. If bone were involved without us knowing it would have been disastrous. Being that she was unable to tell through x-rays that meant she would have to bring me to the Operating Room to find out.
The surgery was scheduled for a few days later. I was admitted to the hospital the day before my surgery was to take place. During that time I saw a wound care nurse that suggested that something called a Wound Vac be put on the wound. When she first told me that I was sort of shocked, 'I'm sorry you want to hook me up to a machine and let the machine make it better,' I thought. Instead of panicking at that point, my somewhat of a nerd brain took over and I started asking for literature about this 'Vac' that they wanted to hook me up to. The wound care nurse gave me a large binder with a ton of information in it. When a family member came in to visit me later that afternoon he found me studying. After I had finished reading all of the literature I was all but certain that while this device may not be the most pleasant of experiences that it would probably be effective. At this point the little voice in my head that had been telling me that this doctor may not be a good match for me got louder. I requested a second opinion from a doctor that I trusted and had seen previously for various issues.
When he came in and looked at the wound he told me that yes surgery was going to be what I should do. Surprisingly I was okay with that answer. That is when I asked him if he would do it instead of 'my surgeon'. He said no, that he wasn't really into wound care and that I should stick to the surgeon I was already working with. I agreed, though somewhat hesitantly.
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