My visiting nurse and I called the wound care center that had opened in my neighborhood and explained that I needed to be seen for a second opinion and generally what had been going on. I was able to get an appointment the following week so we continued to treat the wound as we had been with the Prisma.
The day of the appointment with the new doctor I was optimistic that something would be done to help this wound. I went in and originally met with a nurse to give her all of the background information that she needed. The nurse looked at the wound and said that she saw what I meant about the edges being very thick and rolled and that she would be back with the doctor in a few minutes.
When the nurse came back in with the doctor we both explained to him what had been going on and for how long (25 months). When the doctor looked at my wound he completely agreed that the edges needed to be removed for anything to progress. I thought it was awesome that finally a doctor was being reasonable and seemed to have knowledge about how wounds heal.
He also mentioned that I may want to consider 'flap surgery' to close the wound. That had been mentioned to me previously, at the first wound care center. That surgery seemed pretty extensive and also by the time it was mentioned by the first surgeon, I no longer trusted her. So there was no way that I was going to consent to another surgery with her, especially one that extensive.
I explained that it sounded sort of extreme and that I wasn't too sure how I felt about it, but I most definitely did want to do something about the edges of the wound. That is when they explained to me that while the wound was surgical, they did not actually have a surgeon that worked with them so they would have to refer me somewhere else. When it came time for them to give me a referral the nurse gave me the name of someone that she knew and trusted completely. She said that he was very good and that she had confidence that he would be helpful. Until I was able to get to, what would end up being my third opinion, they explained that basically it did not matter what we used in the wound. They had some of the calcium alginate dressings there so they used that and sent me home.
I left that appointment feeling like I had maybe gotten to the turning point. Based on a new referral to a surgeon that this wound would be treated effectively and I could move on with my life. When my nurse came the following day to change the dressing I told her all about what had happened the day before and that I was given a name and number to call. She said that it was great that we had left the first wound care center. That is when I realized that the appointment would need to be cancelled. I was a chicken and did not want to call and cancel it myself so I asked my nurse to do it. It was done in about two seconds. After we cancelled the appointment a new one needed to be made with the surgeon I had been referred to. That was scheduled for the following week.
Showing posts with label rolled edges. Show all posts
Showing posts with label rolled edges. Show all posts
Monday, March 5, 2012
Tuesday, February 28, 2012
Edges Are Preventing the Healing Process
We continued to treat the wound as the surgeon directed even though at this point my nurse had absolutely no belief that the surgeon was going to be the one that actually would heal the wound. At this point I no longer trusted the surgeon even a little bit. After nearly two years this wound was still basically the same size it was when I began seeing her. I was upset about the situation but was emotionally too "stuck" to do a whole lot to help myself.
The wound care surgeon finally decided to take me off of the Prisma and switch me to a Calcium Alginate dressing that had Silver in it. The dressing is supposed to absorb the drainage from the wound and as that happens the dressing will form a gel which is supposed to keep the wound moist for optimal healing. The silver that is in the dressing is supposed to help protect the wound from a very wide variety of bacteria to hopefully prevent an infection.
None of these things that the surgeon was recommending were helping me so the visiting nurse said that she had a contact with a nurse that specialized in wound care and she would like to bring her to see me to see if she had any suggestions as far as what would close this wound. This was when I decided to do something that would potentially help myself and agreed that the wound nurse could come to the following visit with my regular nurse.
When the wound specialist came to my house with my regular visiting nurse she wanted some background information on what we thought caused this wound in the first place and also what we had tried to use to get it to heal on its own. We answered all of her questions and then she got down to the business of looking at the wound. When she saw the wound she almost immediately knew what the problem was. My wound had developed very thick rolled edges on all the sides.
The wound care nurse explained to me that what had happened was that the epithelial cells had migrated down around the wound edges, the edges were healed so my body thought that the wound itself was also healed. It was explained to me that the only way that the wound would heal is if we got rid of those edges so that the epithelialization of the wound surface could occur. She suggested that we begin using silver nitrate on the wound edges. She told me that basically it would "melt" away the edges of the wound to convince my body that it needed to continue to work to heal the wound. While none of this sounded like it was going to be any fun, I agreed that it made logical sense and I was willing to give it a shot.
My visiting nurse went ahead and called the surgeon to run the idea by her and to get the order so that we could get the supplies. While the surgeon did not seem to think that it was a necessary step she did not object to us giving it a try. The supplies were ordered and a few days later my nurse applied the silver nitrate to the wound edges. When she first put it on it stung for a minute, but it did not feel nearly as terrible as I was warned that it would feel so we went ahead with it for a few more of the nursing visits. When I went back to the surgeon for a follow-up appointment she saw the edges of the wound and flipped out because they "looked awful". I explained to her what we were doing and our thinking behind it. Although she had originally okay'd this treatment once she saw what it was doing she insisted that we stop it and got upset that we had started it "without her orders to do so". Being that the surgeon was so incredibly displeased, we stopped using the silver nitrate, even though my nurse and I believed that it was an ugly yet necessary step toward the ultimate healing of the wound.
The wound care surgeon finally decided to take me off of the Prisma and switch me to a Calcium Alginate dressing that had Silver in it. The dressing is supposed to absorb the drainage from the wound and as that happens the dressing will form a gel which is supposed to keep the wound moist for optimal healing. The silver that is in the dressing is supposed to help protect the wound from a very wide variety of bacteria to hopefully prevent an infection.
None of these things that the surgeon was recommending were helping me so the visiting nurse said that she had a contact with a nurse that specialized in wound care and she would like to bring her to see me to see if she had any suggestions as far as what would close this wound. This was when I decided to do something that would potentially help myself and agreed that the wound nurse could come to the following visit with my regular nurse.
When the wound specialist came to my house with my regular visiting nurse she wanted some background information on what we thought caused this wound in the first place and also what we had tried to use to get it to heal on its own. We answered all of her questions and then she got down to the business of looking at the wound. When she saw the wound she almost immediately knew what the problem was. My wound had developed very thick rolled edges on all the sides.
The wound care nurse explained to me that what had happened was that the epithelial cells had migrated down around the wound edges, the edges were healed so my body thought that the wound itself was also healed. It was explained to me that the only way that the wound would heal is if we got rid of those edges so that the epithelialization of the wound surface could occur. She suggested that we begin using silver nitrate on the wound edges. She told me that basically it would "melt" away the edges of the wound to convince my body that it needed to continue to work to heal the wound. While none of this sounded like it was going to be any fun, I agreed that it made logical sense and I was willing to give it a shot.
My visiting nurse went ahead and called the surgeon to run the idea by her and to get the order so that we could get the supplies. While the surgeon did not seem to think that it was a necessary step she did not object to us giving it a try. The supplies were ordered and a few days later my nurse applied the silver nitrate to the wound edges. When she first put it on it stung for a minute, but it did not feel nearly as terrible as I was warned that it would feel so we went ahead with it for a few more of the nursing visits. When I went back to the surgeon for a follow-up appointment she saw the edges of the wound and flipped out because they "looked awful". I explained to her what we were doing and our thinking behind it. Although she had originally okay'd this treatment once she saw what it was doing she insisted that we stop it and got upset that we had started it "without her orders to do so". Being that the surgeon was so incredibly displeased, we stopped using the silver nitrate, even though my nurse and I believed that it was an ugly yet necessary step toward the ultimate healing of the wound.
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