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.
Showing posts with label patient experience. Show all posts
Showing posts with label patient experience. Show all posts
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.
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.
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. ***
Sunday, August 17, 2014
In a Holding Pattern
I waited a couple of weeks before I contacted my boyfriend’s urologist again and asked him for a recommendation. I got a response shortly after, saying that he did reply as soon as I asked him to but that also included contact information for a doctor. I read the email as being incredibly defensive but shortly afterward, realized that I could do nothing about the perceived tone that the email had. All I could do was take the contact information and choose to either contact a third opinion or just file it away for possible use in the future. My discomfort that I have in my back has not decreased even though I have greatly increased my water intake. I was told that increasing my water would help prevent the remaining stone fragment from getting any larger. Currently, I am drinking like a fish and waiting to see what my urologist says when I see him in a few days.
Although, I was confused about my wound care surgeon’s thought process, I did not contact him to question his thoughts about my toe. I have been monitoring it for about a month, hoping that something about its appearance would change, signifying that healing was happening. Nothing has changed in fact the throbbing is becoming more uncomfortable. I called the wound care center a couple of days ago and explained to the receptionist that I understood that a month was just a guideline but that I saw absolutely no physical changes in it and the pain was increasing and asked her what she thought I should do. After much discussion about my schedule and about which doctors and nurses where available when, we were unable to coordinate my availability with my wound care surgeon’s availability so an appointment was made with the other wound care doctor that I have seen before.
Speaking of my availability for a wound care appointment, I am unavailable because I am going to the city for the day to see a play and to have dinner. Ordinarily, I would be incredibly excited about this and though I am, I am somewhat concerned about my stamina. Since I have been discharged from my wound care ordeal, my stamina and ability to do ordinary things without experiencing horrible fatigue has been not existent. At first, I thought it was just because I hadn’t been trying to do much for so long that my body would just have to readjust, that doesn’t seem to be the case though. I don’t feel like it would take this long unless something else was causing it. I discussed this with my therapist and she suggested that I go to my regular doctor and at the very least get a blood test. I saw my doctor a few weeks ago and we decided to run some labs because perhaps some of my levels were a little off. It’s pretty ridiculous, but at this point I was sort of hoping something was wrong so that it could be taken care of and I could start feeling more like myself. I also, requested that we begin the MRSA nasal swab tests so that it can be clear in my medical record that I do not have MRSA. The reason that I want this in my record is because if I were to ever be hospitalized, I would need to be isolated which isn’t so much of a problem for me but it causes aggravation for my visitors. If I am in isolation, my local hospital requires that my guests wear gowns and masks each time they visit. I haven’t bothered with the testing for that before now because it never really bothered me until my dad also ended up hospitalized, during which time he was unable to visit due to isolation protocol.
A few days after my appointment with my doctor I received a phone call and was told that my Vitamin D level was very low and my vitamin B-12 level was on the low side. It was recommended that I begin taking both of those vitamins, to supplement my diet and to give it about a month and if I am not feeling much better to come back in. I have begun taking both of those vitamins and I am just beginning to feel a little bit better, then again I haven’t really done much, to “test” if I am actually responding. I guess I will find out in a few days, after I’ve been out and about all day.
Tuesday, July 15, 2014
What is Stopping Me From Accepting Good Advice?
I have spent approximately the last week pondering the steps I will need to take in order to help resolve some of the medical issues that I am experiencing. Several weeks ago, my boyfriend gave me the email address of his urologist and suggested that I get in touch with him and ask for his thoughts. My therapist echoed his suggestions and still the contact information only sat inside of my wallet. During the time that the contact information for my boyfriend’s urologist was “gathering dust” I was somewhat focused on the issue with my toe.
I went to the wound care center last week so that the problem with my toe could both be diagnosed and then hopefully a treatment plan would be decided upon. When I got to the wound care center, I told my surgeon what had happened and after examining my toe, he told me that I had a subungual (under the nail) hematoma. I told him that I was experiencing some throbbing with it suddenly, and that my discomfort was what prompted me to get it looked at. He said that he was going to remove the toenail to relieve some of the pressure. He then asked the nurse that was with us to get him the supplies he would need. Of course, I was not entirely thrilled with having my toenail removed but I figured that it was going to ultimately make me feel better.
When the supplies were brought in, after asking about my sensation, my surgeon started poking around the sides of my toenail and cleaning it up a little. When he got to one spot I said that it hurt. My surgeon then questioned where exactly my pain was and I pointed it out. That is when his plan changed and he said that he was going to leave the nail in place. I said something at that point along the lines of, “you are”? He said that yes he was going to leave it and that it was actually better to leave it anyway. I asked him how long he thought it would take for it to grow out and he said that it would probably take about a month. When I asked him what I should do about the discomfort, he told me that I should deal with it if I could. I left the appointment with no plans to follow-up and thinking that eventually it would heal.
A couple of hours later, my boyfriend and I were out having lunch and I found myself sinking into an emotional funk. I have a tendency to over-think things and sometimes my thoughts make a minor issue snowball. I told my boyfriend a little of what had gone on during the appointment and that I was confused because the surgeon changed his mind. My boyfriend did agree that it sounded a little odd to him to but that I could just wait the month and if things with my toe hadn’t improved then I could call and ask for another suggestion.
The next day I had an appointment with my therapist and filled her in on everything. Again, she suggested emailing my boyfriend’s urologist and explaining to him what was going on as far as my kidney pain is concerned and that I was emailing him in hopes that I would be able to draw on his experiences in treating patients with disabilities. I told her that it sounded like a wise decision and somewhat agreed to email him soon. I also told my therapist what had gone on the previous day at the wound care center. I told her that instead of leaving the appointment with a plan I left feeling even more unease than I had when I first arrived. I explained to her that in my experience with my wound care surgeon, he had rarely if ever changed his plan in the middle of actually doing something, as he had during my appointment. I also said that it seemed a little odd that he originally was going to remove my nail but then when he changed his mind about that he said it was better to leave it alone. My thought was, if it was better to leave it alone then why was his first instinct to remove it. My therapist agreed that it was a valid question. Being that I failed to question any of this during my appointment at the wound care center, she encouraged me to either call or email my wound care surgeon to just ask him if he would let me in on his thought process. I questioned if she thought I should get in touch with my surgeon immediately or if she thought I should wait the month and see how my toe was doing and get in touch only if the plan didn’t work. My therapist told me that in her opinion I could email him that day or the next day or really, “whenever, I felt like I wanted to feel better about things”.
A few days ago I got up the courage to email my boyfriend’s urologist. After giving him a condensed version of my story, and explaining that I had seen a second opinion that gave the suggestion that my pain was lingering due to my disability, I asked if he could give any thoughts on what was going on. I was surprised to get an email back within twenty minutes. He thinks that I just need to see an urologist that will pay more attention to what is going on and offered recommend one. Unfortunately, the doctor he was planning to recommend is approximately two hours away from my home. I responded, thanking him for offering to give me the name of someone and that I would take the information. I also, asked if he knew of someone that would be a little more convenient for me to get to.
I have not heard back from my boyfriend’s urologist regarding any recommendations but I am hopeful that I will hear something soon. I have not however emailed my wound care surgeon to inquire about his thought process yet. Part of my hesitation is possibly because of the intense trust I have in him and part of it is because I tend to shy away from confrontation, especially with people that I have great respect for. I realize, that asking to be let into his thought process is not confrontational; it is just that I have never really questioned his judgment before. I guess, I will need to think about things farther to decide how I want to proceed in both of these areas.
I went to the wound care center last week so that the problem with my toe could both be diagnosed and then hopefully a treatment plan would be decided upon. When I got to the wound care center, I told my surgeon what had happened and after examining my toe, he told me that I had a subungual (under the nail) hematoma. I told him that I was experiencing some throbbing with it suddenly, and that my discomfort was what prompted me to get it looked at. He said that he was going to remove the toenail to relieve some of the pressure. He then asked the nurse that was with us to get him the supplies he would need. Of course, I was not entirely thrilled with having my toenail removed but I figured that it was going to ultimately make me feel better.
When the supplies were brought in, after asking about my sensation, my surgeon started poking around the sides of my toenail and cleaning it up a little. When he got to one spot I said that it hurt. My surgeon then questioned where exactly my pain was and I pointed it out. That is when his plan changed and he said that he was going to leave the nail in place. I said something at that point along the lines of, “you are”? He said that yes he was going to leave it and that it was actually better to leave it anyway. I asked him how long he thought it would take for it to grow out and he said that it would probably take about a month. When I asked him what I should do about the discomfort, he told me that I should deal with it if I could. I left the appointment with no plans to follow-up and thinking that eventually it would heal.
A couple of hours later, my boyfriend and I were out having lunch and I found myself sinking into an emotional funk. I have a tendency to over-think things and sometimes my thoughts make a minor issue snowball. I told my boyfriend a little of what had gone on during the appointment and that I was confused because the surgeon changed his mind. My boyfriend did agree that it sounded a little odd to him to but that I could just wait the month and if things with my toe hadn’t improved then I could call and ask for another suggestion.
The next day I had an appointment with my therapist and filled her in on everything. Again, she suggested emailing my boyfriend’s urologist and explaining to him what was going on as far as my kidney pain is concerned and that I was emailing him in hopes that I would be able to draw on his experiences in treating patients with disabilities. I told her that it sounded like a wise decision and somewhat agreed to email him soon. I also told my therapist what had gone on the previous day at the wound care center. I told her that instead of leaving the appointment with a plan I left feeling even more unease than I had when I first arrived. I explained to her that in my experience with my wound care surgeon, he had rarely if ever changed his plan in the middle of actually doing something, as he had during my appointment. I also said that it seemed a little odd that he originally was going to remove my nail but then when he changed his mind about that he said it was better to leave it alone. My thought was, if it was better to leave it alone then why was his first instinct to remove it. My therapist agreed that it was a valid question. Being that I failed to question any of this during my appointment at the wound care center, she encouraged me to either call or email my wound care surgeon to just ask him if he would let me in on his thought process. I questioned if she thought I should get in touch with my surgeon immediately or if she thought I should wait the month and see how my toe was doing and get in touch only if the plan didn’t work. My therapist told me that in her opinion I could email him that day or the next day or really, “whenever, I felt like I wanted to feel better about things”.
A few days ago I got up the courage to email my boyfriend’s urologist. After giving him a condensed version of my story, and explaining that I had seen a second opinion that gave the suggestion that my pain was lingering due to my disability, I asked if he could give any thoughts on what was going on. I was surprised to get an email back within twenty minutes. He thinks that I just need to see an urologist that will pay more attention to what is going on and offered recommend one. Unfortunately, the doctor he was planning to recommend is approximately two hours away from my home. I responded, thanking him for offering to give me the name of someone and that I would take the information. I also, asked if he knew of someone that would be a little more convenient for me to get to.
I have not heard back from my boyfriend’s urologist regarding any recommendations but I am hopeful that I will hear something soon. I have not however emailed my wound care surgeon to inquire about his thought process yet. Part of my hesitation is possibly because of the intense trust I have in him and part of it is because I tend to shy away from confrontation, especially with people that I have great respect for. I realize, that asking to be let into his thought process is not confrontational; it is just that I have never really questioned his judgment before. I guess, I will need to think about things farther to decide how I want to proceed in both of these areas.
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