I had a visiting nurse the next day and told her that I was nervous that my wound had possibly opened again but that I was getting mixed signals from my body. When the nurse looked she said that it was still closed and that I should try to calm down, while still paying attention to what my body was telling me. I was happy to learn that it was still closed but was confused by where the drainage had come from. My nurse looked around the entire area of my wound and said that she did not see anything that looked like it had opened or bled. I was relieved that it still appeared to be closed. That is when my nurse told me that either she or my other nurse would see me a week later. Already they were starting the discharge process, which begins with them only seeing me once a week for several weeks. They do this so that we can be sure that the wound is fully closed and seems to be staying closed. I knew how this process was, based on what had occurred several months earlier and I was comfortable with the process, I just did not think that it was going to start so soon. I expressed to my nurse that I was nervous that no one was going to see it for an entire week and she assured me that everything looked fine and also said that she was really only a phone call away if I really felt that things were going wrong. Before she left she asked how my boyfriend was doing and verified that he was going to be seen at the wound care center within a few days.
The next day when my boyfriend came to my house he said that he had to listen to a voicemail because he had missed a call from the wound care center while he was driving to my house. He only listened to part of the message and then told me that he had to call to reschedule for later in the day. I asked to listen to the message and when I heard it I realized that he wasn’t being asked to reschedule for later in the day, but for the following week at a completely different time. I told him that that was what I understood it to be and though I was displeased, I knew he was the patient and so these decisions were his to make. Before he returned their call I told him that to me it did not sound like they were making the connection that we were together and that he should use my name, or at least tell them that I said hello so that maybe something would click in their heads. My boyfriend chose not to use my name or really do a whole lot of advocating for himself so that he would be able to be seen. I sort of overheard the conversation and was peeved that he didn’t say anything about being with me, because it sure did not sound like the wound care center realized it.
When my boyfriend got off the phone I asked him when it was rescheduled for and when he told me I was then even more positive that they did not know we were together just based on the day and time his appointment was made for. I told him that I was pretty sure he was going to get a different doctor than he was originally scheduled to see, my boyfriend disagreed but we both dropped the subject.
The next day was when my boyfriend’s appointment was supposed to have been and I needed to go to the surgeon’s office to speak to people about a different matter. When I was getting out of the car my boyfriend asked me if I could ask the office manager if she had any idea if the surgeon was going to be at the wound care center during the time his appointment had been rescheduled for. I agreed to ask, happy that he was possibly beginning to realize that things were maybe not as he first thought they were.
When I got into the office I was surprised to see my surgeon! I have been in his office quite a bit for reasons and I have never seen him there. When he noticed me he asked what I was doing there and then questioned what had happened with my boyfriend’s appointment. I explained the situation and then asked him if the rescheduled appointment was even going to be with him, he said that it was not. The surgeon then asked if my boyfriend needed to be seen that day and asked if waiting if he was running late would be okay. I said that yes he should be seen and that waiting was not a problem at all. The surgeon then, worked his magic and the appointment was made for a couple of hours later that afternoon. When I left the office and told my boyfriend, he was very happy that it had all gotten worked out.
A couple of hours later when we were about to go into the wound care center I asked my boyfriend if he wanted me to go in with him or if he would prefer if I waited in the waiting room. My boyfriend said that yes he wanted me to go in the appointment with him. While we were waiting in the exam room for the nurse to come in, I asked my boyfriend if he wanted me to do any of the talking or if he wanted me to be a silent observer. He said that I could do some of the talking. When the nurse came into the exam room she did the typical things that happen at a first appointment. My boyfriend and I explained to her how it had recently been treated and then we waited for the surgeon to come in. Admittedly, I was sort of amused by this point; I was not the patient, finally! I also sort of made a joke to the nurse that I was interested to see the surgeon actually do something because based on the location of my wound I had never actually seen him do anything.
When the surgeon came in he examined the wound and asked my boyfriend how he thought he had gotten it in the first place. The surgeon decided that he was going to culture it and also to biopsy it so that we would know if anything really funky was going on inside. The surgeon also said that he wanted my boyfriend to get his leg x-rayed before we left. All of that sounded like a good plan so the surgeon took a small tissue sample. When he took the sample, the wound began to bleed, I watched it but was not alarmed because I knew that good blood flow was a good sign for wound healing. The surgeon then cauterized it so that the bleeding would stop and told the nurse what type of dressing to put on it. He then told my boyfriend he would see him the following week but would call him sooner if the lab results showed anything that he would need to know sooner.
The nurse then came over and explained to both of us the type of dressing that she was putting on it and how often it would need to be changed. My boyfriend was not going to need visiting nurses so it was going to be up to him and to a lesser extent myself to change the dressings and monitor the wound. She was going to put a type of Hydrocolloid dressing on it and said that we should change it every three to five days and more often if the amount of drainage required it. The nurse then looked at the wound and realized that it had begun to bleed again. She held pressure to it and it slowed down, she then said she was going to place a small piece of calcium alginate just over the part that was bleeding, She then placed the Hydrocolloid dressing on top and while looking at the amount of drainage explained that that dressing would need to be changed sooner than in a few days. We left the wound care center certain that we were capable of handling it.
A couple of hours after we got back to my house we decided that the dressing should be changed. I took off the dressing and noticed that it was still bleeding from that one area but only a small trickle. I did not think much of it and so I just put a small piece of calcium alginate over that area and then put the dressing in place. Everything seemed to be going well until just before my boyfriend was about to leave, that is when we realized that a small circle of blood was on the floor. My boyfriend came over to where I was and showed me his leg so that we could determine how to proceed. When I saw that the dressing was saturated with blood and that it was coming out of all the sides I knew instantly that it needed to be changed. When I took off the dressing I was rather appalled by the amount of blood that I saw. The dressing that had been prescribed does not absorb exudate as much as it turns it into a gel. The bloody gel was sitting on top of the wound, I knew that it had to be removed so that I could both change the piece of calcium alginate and examine the area that was bleeding. I took a deep breath as I was putting on a pair of gloves and then carefully grabbed the gel like substance from the wound to dispose of it. After I did that I looked at the part that the blood was coming from and noticed that it was actually bleeding this time and not with just a trickle.
My brain clicked on almost immediately and I shoved a bunch of pillows under my boyfriend’s leg, hoping that the blood would stop if it were elevated. I also held pressure to the wound knowing that the combination of elevation and pressure usually makes bleeding stop. This had gone on for quite awhile and although I did not want to bother the surgeon I knew I was in over my head, so I sent him a text message explaining that it was still actively bleeding and that my boyfriend would only have one dressing left to last the entire week after I redressed it. The surgeon clarified which dressing he had prescribed. I answered his question and then explained that I had changed it once already but that this time the bleeding was worse. The surgeon then told me to use calcium alginate and then instructed me on how to properly apply direct pressure to get the bleeding to stop. I explained that yes we had calcium alginate and that we had used it before also. The surgeon told me, “no worries. It will stop”. The bleeding eventually slowed down considerably but did not seem to stop. When the surgeon sent me a message about an hour later asking if everything was okay, I explained that it had slowed down but never stopped but that a few minutes before his messaged me it had started to actively bleed again and asked him what he thought we should do. I explained that I had applied the dressing and it was saturated. While I waited for him to respond I called and left a message at the wound care center explaining that we were rapidly running out of dressings and questioned if we would be able to pick some up the following morning and to please call me.
Meanwhile we were now at the wee-hours of the morning and my boyfriend had fallen asleep! I was tending to his bloody mess while he lay on the bed snoring. I was not exactly happy with him at that moment but I didn’t really mind it all that much because there was really no logical reasons for the two of us to be awake the entire night. I eventually couldn’t help myself and fell asleep. I slept for about two hours and then woke up. About an hour after I woke up the surgeon replied to my text message and told me that I should wrap it with an Ace bandage over top of the saturated dressing. I woke up my boyfriend and asked him to get an Ace bandage so that I could follow the surgeon’s instructions. Shortly after I applied the Ace wrap I received a phone call from one of the nurses at the wound care center. I explained everything that had gone on the day before and through the night. The nurse said that she was going to get in touch with the surgeon and would call me back shortly. When she called back she explained that she would be at the wound care center for a few hours and that we could come in if we wanted.
We decided that we were going to go to the wound care center to get the wound looked at and also to pick up enough dressings to last the six remaining days until his next appointment. The nurse unwrapped the wound and we saw that it was bleeding the nurse then said that she was going to cauterize it. I explained that the surgeon had done that the previous day and it still bled. The nurse questioned that he had because he had told her that she should cauterize it when she saw it. I said that yes I was pretty sure he had, the nurse then said that she was still going to do it. When she did that the blood seemed to stop, finally! She then asked me what types of dressings I had in my arsenal at home and I named a couple. She then said that she was going to switch him to an Abdominal Pad Dressing (ABD Dressing) and was then going to apply an Ace wrap tightly on top of that. She told us that that needed to be changed on a daily basis and reminded us that she would be at the wound care center the following day if we needed her for anything. We left the wound care center glad that we had made the decision to get the wound looked at and hopeful that we wouldn’t have anymore drama before the next appointment.
Saturday, February 2, 2013
Sunday, January 27, 2013
Uncertainty
“My one purpose in writing is simply to provide a catharsis for my own thoughts. They worry me until they are set forth in words.” ---
H.L. Mencken
I usually only turn to this blog after I have the facts from my surgeon or one of my nurses. Today, however, is going to be a bit different. I have been going through a lot surrounding my wound and so today please allow me to use this to express my frustrations, fears, worry and joys.
Last week I had an appointment with my surgeon at the wound care center. Being that the previous week my surgeon had proclaimed my wound healed and my visiting nurses also seemed to agree I went into the appointment kind of feeling like I was going to be discharged, yet still sort of unsure about the situation. As a matter of fact, when I went in the nurse asked me if we had “sealed the deal”, in other words if my wound was closed. I told her that I thought so, I also told her about the communication that my nurse had received that caused me to be so incredibly cautiously optimistic the week before. The nurse understood why I had felt confused and when I told her the depth that was mentioned in the communication she told me that she was virtually positive that it was in fact an outdated communication, which I shouldn’t worry about.
When my surgeon came in and examined my wound he also said that it was closed and I was done, I was marginally more excited than I had been the previous week but was not anywhere near feeling the joy I felt the first time my surgeon had discharged me. Before I left the nurse and surgeon took a picture of my wound to document that it was healed and also to show me what it looked like. I never got to actually see that picture though because we got talking about another pressing topic that was taking over my life.
Several months ago I discovered that my boyfriend had a wound on his lower leg. He being a typical guy minimized it and was not at all concerned. I was worried though so I tried to encourage him to get it checked out if not by a doctor, at least by my visiting nurse. He refused and because I did not want to nag him I let the subject drop but only temporarily. Eventually, he agreed to let my visiting nurse take a look at it, he said it was because I was genuinely concerned but I personally think he just wanted me off his case. My visiting nurse, with me also being her eyes was sort of treating his wound off the record for a couple of months and then it healed.
Unfortunately, his wound did not stay closed. My boyfriend asked me if my visiting nurse would be able to take a look at it again, because this time it was draining. My boyfriend’s schedule however, did not mesh with when she was coming over so last week when he was with me; I offered to look at it. He allowed me to do that and once I did, I almost immediately said that it needed to be seen. I also recovered the wound, using calcium alginate to absorb some of the drainage and then covered that with a Tegaderm foam adhesive dressing. I then asked my boyfriend if he wanted me to call the wound care center to ask if he could be seen, ideally while we were both there later that day for my appointment. They were unable to fit him in that day but could schedule him for a week later.
All of this was on my mind during my appointment, so some of the time we were talking about my boyfriend’s wound and what I had done after I had seen it that morning. I explained what I had seen and then how I had covered it again. The nurse seemed to think that what I had done sounded like the right thing to do until the surgeon could see it. I then halfway jokingly asked her if she would kindly get some of this information out of my head, that I could not stop thinking. She chuckled and said no.
My boyfriend and I left the wound care center and as we were leaving I told him that I had been discharged but that this time I was really not going to tell anyone other then him at least until my wound stayed closed for awhile. I had decided this because I will never forget the shattered look on my parents’ faces when I had to tell them that it had reopened after seven weeks of being fine. When we got to my house I asked my boyfriend if he would take a picture so that I could see being that I never got around to seeing the one from the wound care center. I saw the picture and although I was still only cautiously optimistic I was happy to see it closed. A few hours later my visiting nurse returned my phone call and I told her that my surgeon said I was done but that they couldn’t get rid of me that easily because I was going to go back the next week with my boyfriend. My nurse was thrilled to hear about me but was disappointed to hear that my boyfriend’s wound had opened up again. She then told me that getting it seen was a good idea, not so much because of the drainage but because their could be an underlying cause of the wound. That was precisely my thinking also.
Two days later my visiting nurse came to my house and she was so incredibly happy to hear that my wound had closed that as soon as she walked into my room she turned on the music that was on her iPhone. She had decided that this visit was going to be a fun one. I was okay with that but also told her that I am trying to temper my joy with some realistic expectations, purely because I had become so devastated when it had opened. When she looked at the wound she also said that it was closed and then took a picture so that I could see it. The picture that she showed me was different from the one my boyfriend had taken just two days earlier. I calmly asked her what the darker part was and that it looked open to me. She said that a tiny part of it was open but that it had absolutely no depth at all and was not draining so she was still calling it healed and even decided not to cover it. When she left my brain started spinning. I was upset that it looked different in just two days and had no idea what to think about her not covering it again.
I did not have any drainage that I noticed for the rest of that day so I was sort of hoping that my nurse was right and that I was needlessly being paranoid. I spent the majority of the day in bed, this time because I had come down with a cold.
The day after that was when I began to get a really weird feeling that my wound had opened even more and was potentially draining again. I did not feel anything at that point so I tried to convince myself that my mind was playing tricks on me and that I needed to relax, especially because my cold was really making me feel crummy. I lounged in bed and when I wasn’t sleeping I was trying to zone out to the television. The thing that did pop into my head periodically was my boyfriend’s wound. His appointment at the wound care center was four days away and I was interested to know what it was going to be like to be on the other side of a wound care situation. That evening when I got out of bed I noticed something that may have been drainage coming from my wound, I was a little nervous but did not do anything about it. Again, my mind had been playing tricks on me and I was trying to convince myself that while I had the right to be concerned after all I had been through, I should also try to think positively.
Thinking positively is apparently not something I am very good at doing though, especially when I am stressed. That night, while having dinner my mother said something really funny and I started laughing so hard that my eyes started watering. Once that happened though the tears brought on by laughter turned to tears of stress due to being unsure about my wound and being concerned about my boyfriend’s wound. Of course my parents have no idea that any of this is going on so I was crying with a goofy grin on my face. It wasn’t that big of a deal but it did make me feel like a fool. Here I was having dinner with my parents; one minute laughing at my mother and the next minute crying about the uncertainty that was happening in my life. I am pretty sure that I will have a visiting nurse at some point tomorrow who will hopefully be able to tell me if what I noticed was actually drainage or if I really do just need to calm down.
H.L. Mencken
I usually only turn to this blog after I have the facts from my surgeon or one of my nurses. Today, however, is going to be a bit different. I have been going through a lot surrounding my wound and so today please allow me to use this to express my frustrations, fears, worry and joys.
Last week I had an appointment with my surgeon at the wound care center. Being that the previous week my surgeon had proclaimed my wound healed and my visiting nurses also seemed to agree I went into the appointment kind of feeling like I was going to be discharged, yet still sort of unsure about the situation. As a matter of fact, when I went in the nurse asked me if we had “sealed the deal”, in other words if my wound was closed. I told her that I thought so, I also told her about the communication that my nurse had received that caused me to be so incredibly cautiously optimistic the week before. The nurse understood why I had felt confused and when I told her the depth that was mentioned in the communication she told me that she was virtually positive that it was in fact an outdated communication, which I shouldn’t worry about.
When my surgeon came in and examined my wound he also said that it was closed and I was done, I was marginally more excited than I had been the previous week but was not anywhere near feeling the joy I felt the first time my surgeon had discharged me. Before I left the nurse and surgeon took a picture of my wound to document that it was healed and also to show me what it looked like. I never got to actually see that picture though because we got talking about another pressing topic that was taking over my life.
Several months ago I discovered that my boyfriend had a wound on his lower leg. He being a typical guy minimized it and was not at all concerned. I was worried though so I tried to encourage him to get it checked out if not by a doctor, at least by my visiting nurse. He refused and because I did not want to nag him I let the subject drop but only temporarily. Eventually, he agreed to let my visiting nurse take a look at it, he said it was because I was genuinely concerned but I personally think he just wanted me off his case. My visiting nurse, with me also being her eyes was sort of treating his wound off the record for a couple of months and then it healed.
Unfortunately, his wound did not stay closed. My boyfriend asked me if my visiting nurse would be able to take a look at it again, because this time it was draining. My boyfriend’s schedule however, did not mesh with when she was coming over so last week when he was with me; I offered to look at it. He allowed me to do that and once I did, I almost immediately said that it needed to be seen. I also recovered the wound, using calcium alginate to absorb some of the drainage and then covered that with a Tegaderm foam adhesive dressing. I then asked my boyfriend if he wanted me to call the wound care center to ask if he could be seen, ideally while we were both there later that day for my appointment. They were unable to fit him in that day but could schedule him for a week later.
All of this was on my mind during my appointment, so some of the time we were talking about my boyfriend’s wound and what I had done after I had seen it that morning. I explained what I had seen and then how I had covered it again. The nurse seemed to think that what I had done sounded like the right thing to do until the surgeon could see it. I then halfway jokingly asked her if she would kindly get some of this information out of my head, that I could not stop thinking. She chuckled and said no.
My boyfriend and I left the wound care center and as we were leaving I told him that I had been discharged but that this time I was really not going to tell anyone other then him at least until my wound stayed closed for awhile. I had decided this because I will never forget the shattered look on my parents’ faces when I had to tell them that it had reopened after seven weeks of being fine. When we got to my house I asked my boyfriend if he would take a picture so that I could see being that I never got around to seeing the one from the wound care center. I saw the picture and although I was still only cautiously optimistic I was happy to see it closed. A few hours later my visiting nurse returned my phone call and I told her that my surgeon said I was done but that they couldn’t get rid of me that easily because I was going to go back the next week with my boyfriend. My nurse was thrilled to hear about me but was disappointed to hear that my boyfriend’s wound had opened up again. She then told me that getting it seen was a good idea, not so much because of the drainage but because their could be an underlying cause of the wound. That was precisely my thinking also.
Two days later my visiting nurse came to my house and she was so incredibly happy to hear that my wound had closed that as soon as she walked into my room she turned on the music that was on her iPhone. She had decided that this visit was going to be a fun one. I was okay with that but also told her that I am trying to temper my joy with some realistic expectations, purely because I had become so devastated when it had opened. When she looked at the wound she also said that it was closed and then took a picture so that I could see it. The picture that she showed me was different from the one my boyfriend had taken just two days earlier. I calmly asked her what the darker part was and that it looked open to me. She said that a tiny part of it was open but that it had absolutely no depth at all and was not draining so she was still calling it healed and even decided not to cover it. When she left my brain started spinning. I was upset that it looked different in just two days and had no idea what to think about her not covering it again.
I did not have any drainage that I noticed for the rest of that day so I was sort of hoping that my nurse was right and that I was needlessly being paranoid. I spent the majority of the day in bed, this time because I had come down with a cold.
The day after that was when I began to get a really weird feeling that my wound had opened even more and was potentially draining again. I did not feel anything at that point so I tried to convince myself that my mind was playing tricks on me and that I needed to relax, especially because my cold was really making me feel crummy. I lounged in bed and when I wasn’t sleeping I was trying to zone out to the television. The thing that did pop into my head periodically was my boyfriend’s wound. His appointment at the wound care center was four days away and I was interested to know what it was going to be like to be on the other side of a wound care situation. That evening when I got out of bed I noticed something that may have been drainage coming from my wound, I was a little nervous but did not do anything about it. Again, my mind had been playing tricks on me and I was trying to convince myself that while I had the right to be concerned after all I had been through, I should also try to think positively.
Thinking positively is apparently not something I am very good at doing though, especially when I am stressed. That night, while having dinner my mother said something really funny and I started laughing so hard that my eyes started watering. Once that happened though the tears brought on by laughter turned to tears of stress due to being unsure about my wound and being concerned about my boyfriend’s wound. Of course my parents have no idea that any of this is going on so I was crying with a goofy grin on my face. It wasn’t that big of a deal but it did make me feel like a fool. Here I was having dinner with my parents; one minute laughing at my mother and the next minute crying about the uncertainty that was happening in my life. I am pretty sure that I will have a visiting nurse at some point tomorrow who will hopefully be able to tell me if what I noticed was actually drainage or if I really do just need to calm down.
Tuesday, January 22, 2013
Cautious Optimism
I’m sorry that this post has been delayed so long. Things got a little absurd and I needed time to process before they came out in a jumbled mess of emotional chaos. I think I am at the point where I can write somewhat coherently so here we go.
My visiting nurses continued to fill the wound with collagen of one form or another for several weeks after the surgery. It seemed to me that the wound was progressing, slowly but still moving forward. During a visit to the wound care center my surgeon mentioned maybe wanting us to change what we were using, just to jumpstart the healing again. He thought that we should maybe switch back to using the Hydrofera Blue. That was when he asked about how much drainage we were noticing and I told him that it was still heavily draining. At that point my surgeon decided not to put in the Hydrofera Blue because he felt that it might just plug the drainage in the wound and not let it escape. I agreed and went home with instructions to continue using Collagen inside of the wound and the same Tegaderm foam dressing on top of it that we had been using.
The visiting nurses and I continued following my surgeon’s instructions and we were seeing some progress. I was happy to hear that things were going well but was still taking most of the good news with cautious optimism, with an emphasis on the cautious. In the beginning of December I went to my regular appointment at the wound care center and when my surgeon probed inside the wound to see what the depth was he was very happy. Actually, it was one of the few times when I had heard him really “up” about how it was doing. After I laughed about his reaction he told me to just keep doing what we were doing and to come back in two weeks so he could assess my wound again.
During the couple weeks I was waiting to go back to the wound care center my nurses started to become more and more pleased with my wound. The drainage was starting to decrease and the depth started to become less. The next time I saw my surgeon he was also pleased and told me to keep going with the collagen and see him again a few weeks later.
After about a week I mentioned to one of my visiting nurses that I had been thinking. Me thinking? Wait a minute; this could either be really good or really bad. See, as I have said wound care was continuing to take over my life and once in awhile I found myself unable to get wound care out of my head. I mentioned to her that my surgeon was at one point considering changing to Hydrofera Blue but he was concerned about having too much drainage. Based on the fact that we were noticing the drainage had decreased and had been on the collagen for approximately nine weeks I was thinking about mentioning to him that maybe that point would be a good time to switch what we were doing. My nurse agreed with my thinking and told me that it couldn’t hurt to bring it up with him at the following visit.
A couple of days later I had another visit from a nurse, this time it wasn’t the one that I was super comfortable with, but the one that I had been taking almost everything she said with a grain of salt. I mentioned my idea to her and she also told me that mentioning it wouldn’t be a bad idea. That is also when she told me that she had received a communication from the wound care center about my wound. That sort of threw me for a loop because the nurses rarely if ever get communications about me. She then proceeded to tell me that the communication said that my wound had some depth that she was unaware of. What had happened by this point was that the opening of my wound had become so small, my visiting nurses were having trouble getting any instruments inside of it to measure the depth. Visually they thought it was doing well but they couldn’t really be sure. The depth that she told me seemed that it had to have been completely outdated but there was no way to be sure at that point because she didn’t have a copy with her to check the dates. I felt that the communication was outdated because I am all but certain that the number was not one that would have caused my surgeon’s excitement a month earlier. I was going to the wound care center two days later so I intended to mention both the weird measurement communication and my idea to switch to the Hydrofera Blue while I was there.
When I got to the wound care center the nurse took the dressing off and then didn’t really say much of anything. I also, didn’t bother to ask because I knew my surgeon would be in shortly. When my surgeon came in, before I had really even gotten a chance to tell him my idea about changing to Hydrofera Blue or to ask about the strange communication my nurse had received, he came over and examined my wound. Then he said something completely unexpected, “I’m calling that healed”. By then, my surgeon came over to the other side of the bed so he could actually see my face. I have to say I don’t think I gave him the reaction that he was exactly looking for because well frankly, I did not believe it. He asked me if it was something the nurses said that had me feeling a little unsure and I said yes, but before I really got to tell him what exactly she said, we got talking about other things. I think I was so thrown off by that news because I could not get the strange measurement from the communication that my visiting nurse had told me about out of my head.
My surgeon then told me that he wanted us to lay a piece of calcium alginate over top of the wound and then put a dressing on top of it, “just to absorb any drainage and to provide some more protection for it”. He told me to come back a couple of weeks later so that he could be sure. Due to a scheduling conflict I told him that two weeks was not an option so he could choose either seeing me the following week or to wait and see me in three weeks. He then said to come back the next week.
I left the appointment unsure how to feel. While I was happy to hear that my wound was supposedly closed I was also thinking about the times I had heard before that it was closed. The previous times I had gotten very happy very quickly and then it had reopened so this time around I was a little hesitant to get excited. Being that I was so cautious I decided to really only tell my boyfriend what my surgeon had said. I decided that because before when I had told everyone and their mother about it being closed it had reopened and the look on those people’s faces was too much for me to handle so I was going to keep quiet about it for awhile, this time.
Two days later when a visiting nurse came I explained to her what all had gone on at the appointment and what the wound care orders had been changed to. I also, told her that while I fully trust my surgeon while I believe HIM, I did not necessarily believe IT when he told me. She laughed and said that it sort of made sense to her, if that was how I “wanted to spin it”. My nurse then examined the wound and she said that it was doing incredibly well, that it had no drainage but that one part of it may still have been open. I was neither surprised nor upset upon hearing that. Mostly because I just didn’t get the “it’s done” feeling. She then dressed the wound and told me that the other nurse would be out to see me in a few days.
The next nurse that came was the one that I do trust and that I have always had a close relationship with so when she came in and I told her what was going on she had said that she would tell me what she thought. When she looked at it, she said that it is closed. I believed her but still was hesitant, she then said that she poked at it rather aggressively and that nothing happened. My response to this news was “eh, ok, if you say so; but I’m still not telling anyone yet. She laughed but told me that she understood why I was being so incredibly cautious this time around. Before she left, she asked me to call her after I see my surgeon to give her an update, which just happens to be tomorrow. Stay tuned.
My visiting nurses continued to fill the wound with collagen of one form or another for several weeks after the surgery. It seemed to me that the wound was progressing, slowly but still moving forward. During a visit to the wound care center my surgeon mentioned maybe wanting us to change what we were using, just to jumpstart the healing again. He thought that we should maybe switch back to using the Hydrofera Blue. That was when he asked about how much drainage we were noticing and I told him that it was still heavily draining. At that point my surgeon decided not to put in the Hydrofera Blue because he felt that it might just plug the drainage in the wound and not let it escape. I agreed and went home with instructions to continue using Collagen inside of the wound and the same Tegaderm foam dressing on top of it that we had been using.
The visiting nurses and I continued following my surgeon’s instructions and we were seeing some progress. I was happy to hear that things were going well but was still taking most of the good news with cautious optimism, with an emphasis on the cautious. In the beginning of December I went to my regular appointment at the wound care center and when my surgeon probed inside the wound to see what the depth was he was very happy. Actually, it was one of the few times when I had heard him really “up” about how it was doing. After I laughed about his reaction he told me to just keep doing what we were doing and to come back in two weeks so he could assess my wound again.
During the couple weeks I was waiting to go back to the wound care center my nurses started to become more and more pleased with my wound. The drainage was starting to decrease and the depth started to become less. The next time I saw my surgeon he was also pleased and told me to keep going with the collagen and see him again a few weeks later.
After about a week I mentioned to one of my visiting nurses that I had been thinking. Me thinking? Wait a minute; this could either be really good or really bad. See, as I have said wound care was continuing to take over my life and once in awhile I found myself unable to get wound care out of my head. I mentioned to her that my surgeon was at one point considering changing to Hydrofera Blue but he was concerned about having too much drainage. Based on the fact that we were noticing the drainage had decreased and had been on the collagen for approximately nine weeks I was thinking about mentioning to him that maybe that point would be a good time to switch what we were doing. My nurse agreed with my thinking and told me that it couldn’t hurt to bring it up with him at the following visit.
A couple of days later I had another visit from a nurse, this time it wasn’t the one that I was super comfortable with, but the one that I had been taking almost everything she said with a grain of salt. I mentioned my idea to her and she also told me that mentioning it wouldn’t be a bad idea. That is also when she told me that she had received a communication from the wound care center about my wound. That sort of threw me for a loop because the nurses rarely if ever get communications about me. She then proceeded to tell me that the communication said that my wound had some depth that she was unaware of. What had happened by this point was that the opening of my wound had become so small, my visiting nurses were having trouble getting any instruments inside of it to measure the depth. Visually they thought it was doing well but they couldn’t really be sure. The depth that she told me seemed that it had to have been completely outdated but there was no way to be sure at that point because she didn’t have a copy with her to check the dates. I felt that the communication was outdated because I am all but certain that the number was not one that would have caused my surgeon’s excitement a month earlier. I was going to the wound care center two days later so I intended to mention both the weird measurement communication and my idea to switch to the Hydrofera Blue while I was there.
When I got to the wound care center the nurse took the dressing off and then didn’t really say much of anything. I also, didn’t bother to ask because I knew my surgeon would be in shortly. When my surgeon came in, before I had really even gotten a chance to tell him my idea about changing to Hydrofera Blue or to ask about the strange communication my nurse had received, he came over and examined my wound. Then he said something completely unexpected, “I’m calling that healed”. By then, my surgeon came over to the other side of the bed so he could actually see my face. I have to say I don’t think I gave him the reaction that he was exactly looking for because well frankly, I did not believe it. He asked me if it was something the nurses said that had me feeling a little unsure and I said yes, but before I really got to tell him what exactly she said, we got talking about other things. I think I was so thrown off by that news because I could not get the strange measurement from the communication that my visiting nurse had told me about out of my head.
My surgeon then told me that he wanted us to lay a piece of calcium alginate over top of the wound and then put a dressing on top of it, “just to absorb any drainage and to provide some more protection for it”. He told me to come back a couple of weeks later so that he could be sure. Due to a scheduling conflict I told him that two weeks was not an option so he could choose either seeing me the following week or to wait and see me in three weeks. He then said to come back the next week.
I left the appointment unsure how to feel. While I was happy to hear that my wound was supposedly closed I was also thinking about the times I had heard before that it was closed. The previous times I had gotten very happy very quickly and then it had reopened so this time around I was a little hesitant to get excited. Being that I was so cautious I decided to really only tell my boyfriend what my surgeon had said. I decided that because before when I had told everyone and their mother about it being closed it had reopened and the look on those people’s faces was too much for me to handle so I was going to keep quiet about it for awhile, this time.
Two days later when a visiting nurse came I explained to her what all had gone on at the appointment and what the wound care orders had been changed to. I also, told her that while I fully trust my surgeon while I believe HIM, I did not necessarily believe IT when he told me. She laughed and said that it sort of made sense to her, if that was how I “wanted to spin it”. My nurse then examined the wound and she said that it was doing incredibly well, that it had no drainage but that one part of it may still have been open. I was neither surprised nor upset upon hearing that. Mostly because I just didn’t get the “it’s done” feeling. She then dressed the wound and told me that the other nurse would be out to see me in a few days.
The next nurse that came was the one that I do trust and that I have always had a close relationship with so when she came in and I told her what was going on she had said that she would tell me what she thought. When she looked at it, she said that it is closed. I believed her but still was hesitant, she then said that she poked at it rather aggressively and that nothing happened. My response to this news was “eh, ok, if you say so; but I’m still not telling anyone yet. She laughed but told me that she understood why I was being so incredibly cautious this time around. Before she left, she asked me to call her after I see my surgeon to give her an update, which just happens to be tomorrow. Stay tuned.
Sunday, January 6, 2013
Surgery Recovery and Miscommunication
After a quick stop at the pharmacy to pick up the prescription for pain meds, I went home to rest and await my visiting nurse who was scheduled for the next day. When my nurse came she asked how my pain level was and I explained that while I was sometimes uncomfortable, it was easily controlled with my prescription. She also, asked what exactly had been done in the operating room and what the orders were as far as the wound care itself was concerned. I explained to her that during the surgery the wound had been cleaned up back to healthy bone and then filled with antibiotic seeds and then a type of Prisma collagen was placed inside the wound. The collagen that was inside the wound and the antibiotic seeds would all start to be absorbed by my body as such the only thing that my nurse would need to do for the next few visits, would be to change the outer dressing and monitor the amount of drainage.
I saw my surgeon at the wound care center about a week later. During which time he added Promogran (another collagen) to the wound and explained to me that he still only wanted my visiting nurses to change the outer dressing and that he wanted to see me weekly. He needed to see me weekly so that he himself could add the collagen after it had been given a chance to be absorbed. That way not everyone was poking around inside the wound, therefore hopefully giving it the best chance to heal.
Following those instructions was going very well and my surgeon seemed pleased with the progress of the wound. A few weeks later, my surgeon explained that he needed me to skip a week with him so as I was leaving a made an appointment for two weeks later. When I next saw my visiting nurse I explained to her that I was skipping a week at the wound care center but that I had completely forgotten to ask what should be done about the collagen that was to be replenished weekly. My nurse told me that at that point it was fine because it had only been a couple days and we had time to get in touch with the wound care center before it would need to be changed anyway.
I called the wound care center and spoke with the nurse that had last been in the room during a visit with the surgeon to ask her what she thought we should do during the time I would not be seen by my surgeon. The nurse that I spoke with was one that although I do not have a problem with her per say, I do not feel like her and I communicate very well. When I asked her what I should do after the collagen was in for a week all she really said was that it “dissolves into the wound” I explained that I knew that already and then asked in what I thought was a different way that would maybe get me an answer. I even pulled out the big guns and used the word “replenish” in the sense of “what should we use to replenish the amount of collagen once this has been in all week”. The nurse continued to just tell me that my body absorbs the collagen but never really told me what to add once it had been in for the week.
When my visiting nurse came I explained to her that I had tried to get us an answer but hadn’t been very successful. She was frustrated by the lack of information but was mostly just amused that I had asked several different ways and still the nurse was unable to at the least reply with “I do not know, let me speak with the doctor and get back to you”. I was also amused so I laughed about it, with the intention of calling my surgeon a few days later for a straight answer. A few days later I found myself calling my surgeon directly so that I could get further instructions. I had no problem calling being that this was a completely legitimate question, however, I did sort of feel like a fool for not having asked him before I had left. When I spoke with my surgeon and asked my question he then asked me what supplies I had in my wound supplies box so that hopefully he could just pick something I already had. He was able to suggest using another kind of collagen and told me that kind should be changed a few times a week so the nurses could start filling the wound with that and he would see me the following week.
I saw my surgeon at the wound care center about a week later. During which time he added Promogran (another collagen) to the wound and explained to me that he still only wanted my visiting nurses to change the outer dressing and that he wanted to see me weekly. He needed to see me weekly so that he himself could add the collagen after it had been given a chance to be absorbed. That way not everyone was poking around inside the wound, therefore hopefully giving it the best chance to heal.
Following those instructions was going very well and my surgeon seemed pleased with the progress of the wound. A few weeks later, my surgeon explained that he needed me to skip a week with him so as I was leaving a made an appointment for two weeks later. When I next saw my visiting nurse I explained to her that I was skipping a week at the wound care center but that I had completely forgotten to ask what should be done about the collagen that was to be replenished weekly. My nurse told me that at that point it was fine because it had only been a couple days and we had time to get in touch with the wound care center before it would need to be changed anyway.
I called the wound care center and spoke with the nurse that had last been in the room during a visit with the surgeon to ask her what she thought we should do during the time I would not be seen by my surgeon. The nurse that I spoke with was one that although I do not have a problem with her per say, I do not feel like her and I communicate very well. When I asked her what I should do after the collagen was in for a week all she really said was that it “dissolves into the wound” I explained that I knew that already and then asked in what I thought was a different way that would maybe get me an answer. I even pulled out the big guns and used the word “replenish” in the sense of “what should we use to replenish the amount of collagen once this has been in all week”. The nurse continued to just tell me that my body absorbs the collagen but never really told me what to add once it had been in for the week.
When my visiting nurse came I explained to her that I had tried to get us an answer but hadn’t been very successful. She was frustrated by the lack of information but was mostly just amused that I had asked several different ways and still the nurse was unable to at the least reply with “I do not know, let me speak with the doctor and get back to you”. I was also amused so I laughed about it, with the intention of calling my surgeon a few days later for a straight answer. A few days later I found myself calling my surgeon directly so that I could get further instructions. I had no problem calling being that this was a completely legitimate question, however, I did sort of feel like a fool for not having asked him before I had left. When I spoke with my surgeon and asked my question he then asked me what supplies I had in my wound supplies box so that hopefully he could just pick something I already had. He was able to suggest using another kind of collagen and told me that kind should be changed a few times a week so the nurses could start filling the wound with that and he would see me the following week.
Sunday, December 16, 2012
Surgery, Weather, Pain and Secrets
For several weeks my routine consisted of nursing visits and appointments at the wound care center. Everything was pretty much status quo, until one day when I went to the wound care center and my surgeon probed inside my wound. He told me, that we would have to go back to the operating room, again. At that point I listened to what he was saying but I guess I blocked it out because shortly after I left I couldn’t really remember what he had said. I can only assume that, that happened because the news was so unexpected.
My surgeon’s office got in touch with me shortly after I got home and we were able to schedule the surgery for two weeks later. I was pleased that it was able to be so soon, but that was short lived. A couple of days prior to the day it was supposed to be, the office called me back and explained that we needed to reschedule due to a conflict in my surgeon’s schedule. I wasn’t exactly thrilled that it needed to be postponed but was relieved to know that we would be able to reschedule it for just five days after the original date.
While I was waiting for the surgery date to arrive I couldn’t help but hear the news about impending Hurricane Sandy. I was hopeful that all of the reports were wrong and that everyone was overreacting and that nothing would need to be rescheduled for a second time. Sadly, I got a phone call from the hospital the day before and was told that the hospital was rescheduling everything and so my surgeon’s office would be in touch with me to get it done as soon as we possibly could.
Finally, the day of the surgery arrived, without any further rescheduling. My boyfriend went with me, as per usual. Prior to the surgery, I met with my surgeon and the anesthesiologist and we determined that for this procedure I would undergo general anesthesia. I was not super excited about this prospect but when my surgeon explained that the time previously, I was so aware and in pain that he felt it limited what he could do. Once I heard that I differed to his judgment. The last thing I remember before waking up in the recovery room was getting a kiss from my boyfriend and getting a bolus of something that would “take the edge off” and relax me a bit before I got in the operating room.
When I woke up in the recovery room I verified with the recovery nurse that I did have general anesthesia, she told me that yes I had, although I was pretty sure I had based on the tell tale sore throat and the incredible grogginess that I was experiencing. Shortly after the regular recovery room I was moved to where I would ordinarily get something to eat and then would be discharged. However, things were a little bit different this time around.
When I saw my boyfriend and got a sandwich, my nurse asked me if I was in pain and I indicated that yes I was. This was in and of itself, strange to me because I have very rarely, if ever, experienced post-op pain due to this particular problem. My nurse then gave me a pain pill that had been ordered, just in case. I ate my sandwich and hung out with my boyfriend and waited for the pain pill to take effect. When the nurse came back to see how I was feeling after the pain medication I told her that the pain was still the same as before I had taken the pill. The nurse told me that she was going to call my surgeon to get further orders. She appeared shortly thereafter, and told me that he had said to give me the second pain pill but that I should not go home until he had at least come to speak with me. I took the pill and awaited his arrival. While I was waiting, I started to hear people say that it had begun to snow. I was originally just amused by the snow and did not think much of it. Until, I realized that it could cause difficulty when we tried to go home.
When my surgeon came back, he asked me how I was feeling and I explained that I still had the same pain as I did before I had even had the first pain pill. My surgeon then informed me that it was snowing and the roads were somewhat slippery and asked what I wanted to do. At that point, I asked him what he felt I should do as far as going home was concerned. He explained that with the combination of the weather and the fact that I still had some discomfort he would recommend staying overnight at the hospital. My surgeon also said not to worry about my boyfriend because the hospital would most likely be able to provide a cot so he could stay with me. I agreed that staying over was probably the best thing and my surgeon said he would make the phone call to get me a room. Before, he left he told me that he himself was not going to be at the hospital the next day but that I could take my time and not feel rushed to leave first thing in the morning. He also verified that I knew how to get in touch with him if in fact I should need him the next day.
After, I got settled in the hospital room it dawned on me that I needed to make at least one phone call. I had previously agreed to call my visiting nurse after the surgery so that she would know that it went okay and also to get a general idea of what the upcoming wound care orders were going to be. I explained to her that the surgery was finished but that I was going to stay overnight due to some pain, and also due to the slippery roads. My nurse told me to feel better and to keep her posted as to what was going on. She also urged me to call my parents to tell them that I would not be coming home that day.
I am generally a private person and tend to only tell one or two people about any upcoming surgeries that may be necessary. My parents, in fact only know about half of the surgeries that have been necessary on my wound. Of those, I would say that they have been told about half of only after they had already been done. This may sound weird or cruel, some may say that they are my parents and they have the right to know what is going on, while I agree with that in theory, in practice my opinion is different. I know my family and they do not handle this sort of thing very well and tend to panic, which makes me nuts. I feel that it is in everyone’s best interest, including my own to keep certain things from my parents. That being said, I did agree with my nurse’s opinion that they should know I wasn’t going to be home that night.
I took a deep breath and picked up the phone to call my parents to tell them that I would see them at some point the next day. They may finally be realizing that I am an adult, because the reaction was not anything like I expected it to be. Basically, they just questioned if I needed a ride home the following day or if I needed them at the hospital right then. Being that aside from being in a little bit of pain and the fact that my boyfriend was with me I assured them that I was totally fine and was really just calling so that they didn’t think I was hurt traveling home in a snowstorm.
I spent the next several hours catching up on some sleep, while periodically asking for more pain medication. I have learned through many years of experience, to ask for pain medicine before the pain really starts to hurt, so I tried to take it on somewhat of a schedule so that my pain level never really got difficult to control. By late the next afternoon, I felt like my pain was at a reasonable level and that I would be fine to go home with just a prescription from my surgeon.
My surgeon’s office got in touch with me shortly after I got home and we were able to schedule the surgery for two weeks later. I was pleased that it was able to be so soon, but that was short lived. A couple of days prior to the day it was supposed to be, the office called me back and explained that we needed to reschedule due to a conflict in my surgeon’s schedule. I wasn’t exactly thrilled that it needed to be postponed but was relieved to know that we would be able to reschedule it for just five days after the original date.
While I was waiting for the surgery date to arrive I couldn’t help but hear the news about impending Hurricane Sandy. I was hopeful that all of the reports were wrong and that everyone was overreacting and that nothing would need to be rescheduled for a second time. Sadly, I got a phone call from the hospital the day before and was told that the hospital was rescheduling everything and so my surgeon’s office would be in touch with me to get it done as soon as we possibly could.
Finally, the day of the surgery arrived, without any further rescheduling. My boyfriend went with me, as per usual. Prior to the surgery, I met with my surgeon and the anesthesiologist and we determined that for this procedure I would undergo general anesthesia. I was not super excited about this prospect but when my surgeon explained that the time previously, I was so aware and in pain that he felt it limited what he could do. Once I heard that I differed to his judgment. The last thing I remember before waking up in the recovery room was getting a kiss from my boyfriend and getting a bolus of something that would “take the edge off” and relax me a bit before I got in the operating room.
When I woke up in the recovery room I verified with the recovery nurse that I did have general anesthesia, she told me that yes I had, although I was pretty sure I had based on the tell tale sore throat and the incredible grogginess that I was experiencing. Shortly after the regular recovery room I was moved to where I would ordinarily get something to eat and then would be discharged. However, things were a little bit different this time around.
When I saw my boyfriend and got a sandwich, my nurse asked me if I was in pain and I indicated that yes I was. This was in and of itself, strange to me because I have very rarely, if ever, experienced post-op pain due to this particular problem. My nurse then gave me a pain pill that had been ordered, just in case. I ate my sandwich and hung out with my boyfriend and waited for the pain pill to take effect. When the nurse came back to see how I was feeling after the pain medication I told her that the pain was still the same as before I had taken the pill. The nurse told me that she was going to call my surgeon to get further orders. She appeared shortly thereafter, and told me that he had said to give me the second pain pill but that I should not go home until he had at least come to speak with me. I took the pill and awaited his arrival. While I was waiting, I started to hear people say that it had begun to snow. I was originally just amused by the snow and did not think much of it. Until, I realized that it could cause difficulty when we tried to go home.
When my surgeon came back, he asked me how I was feeling and I explained that I still had the same pain as I did before I had even had the first pain pill. My surgeon then informed me that it was snowing and the roads were somewhat slippery and asked what I wanted to do. At that point, I asked him what he felt I should do as far as going home was concerned. He explained that with the combination of the weather and the fact that I still had some discomfort he would recommend staying overnight at the hospital. My surgeon also said not to worry about my boyfriend because the hospital would most likely be able to provide a cot so he could stay with me. I agreed that staying over was probably the best thing and my surgeon said he would make the phone call to get me a room. Before, he left he told me that he himself was not going to be at the hospital the next day but that I could take my time and not feel rushed to leave first thing in the morning. He also verified that I knew how to get in touch with him if in fact I should need him the next day.
After, I got settled in the hospital room it dawned on me that I needed to make at least one phone call. I had previously agreed to call my visiting nurse after the surgery so that she would know that it went okay and also to get a general idea of what the upcoming wound care orders were going to be. I explained to her that the surgery was finished but that I was going to stay overnight due to some pain, and also due to the slippery roads. My nurse told me to feel better and to keep her posted as to what was going on. She also urged me to call my parents to tell them that I would not be coming home that day.
I am generally a private person and tend to only tell one or two people about any upcoming surgeries that may be necessary. My parents, in fact only know about half of the surgeries that have been necessary on my wound. Of those, I would say that they have been told about half of only after they had already been done. This may sound weird or cruel, some may say that they are my parents and they have the right to know what is going on, while I agree with that in theory, in practice my opinion is different. I know my family and they do not handle this sort of thing very well and tend to panic, which makes me nuts. I feel that it is in everyone’s best interest, including my own to keep certain things from my parents. That being said, I did agree with my nurse’s opinion that they should know I wasn’t going to be home that night.
I took a deep breath and picked up the phone to call my parents to tell them that I would see them at some point the next day. They may finally be realizing that I am an adult, because the reaction was not anything like I expected it to be. Basically, they just questioned if I needed a ride home the following day or if I needed them at the hospital right then. Being that aside from being in a little bit of pain and the fact that my boyfriend was with me I assured them that I was totally fine and was really just calling so that they didn’t think I was hurt traveling home in a snowstorm.
I spent the next several hours catching up on some sleep, while periodically asking for more pain medication. I have learned through many years of experience, to ask for pain medicine before the pain really starts to hurt, so I tried to take it on somewhat of a schedule so that my pain level never really got difficult to control. By late the next afternoon, I felt like my pain was at a reasonable level and that I would be fine to go home with just a prescription from my surgeon.
Sunday, November 18, 2012
Mysterious Measurements
I know it has been entirely too long since I have last written and I apologize for keeping you all waiting. Now, without any further delay is another update.
The weeks that followed the surgery seemed to be going very well. My visiting nurses were pleased with the progress and my surgeon was also rather positive. During each nursing visit, the nurses would measure the length, width and depth of my wound. My nurses would always keep me aware of the measurements so that I knew what was going on. Suddenly, one of my nurses got a measurement that was drastically different then it had been previously. I questioned and she measured it again, getting a slightly smaller number but still a depth that concerned me.
When the visiting nurse left I called the wound care center and asked to speak to the nurse there that I was most comfortable with. Who had been the last person to measure it besides my visiting nurses and my surgeon. I left a message and she called me back the following morning. When she called, I explained what was going on and that suddenly the depth was being reported as a centimeter more than it had been just two days prior. The nurse that I spoke to emphasized, that if I was uncomfortable and felt that my wound should be seen by my surgeon, I should definitely come in. The nurse was able to get me an appointment with my surgeon the following morning.
The next morning I went to my appointment at the wound care center so that my surgeon could look at my wound and make sure that nothing was going wrong. When I got there, the nurse that I had spoken to on the phone came into the exam room with me. First, she asked what my feeling was. I explained that one of my visiting nurses got a measurement that I felt was a very drastic change. I wanted to be sure that nothing was going very wrong very quickly, but that small part of me felt like I was being a little overly paranoid and wasting everyone’s time by making an appointment. The nurse immediately told me that I had nothing to worry about and that if I wasn’t comfortable I had every right to come in to get it checked. The nurse also took the time to explain, that there were many variables that could have contributed to a slightly different measurement. I told her that I knew that and that was partially why I was hesitant to come in, in the first place.
It was then that my surgeon came into the room. When he came in he questioned if this was an actual appointment that he had requested or if I had decided to come in for some reason. I explained that it was because a measurement my visiting nurse had gotten concerned me. When the wound was measured my surgeon got a slightly larger result than he had the last time I had seen him but nothing near what my nurse had gotten. I was relieved to hear that it was not measuring what my nurse was saying.
The next day I had another visit with my visiting nurse, this time the one that I totally trusted, not the one that was sometimes getting the wacky measurements. She had already seen the documentations in my chart that the other visiting nurse had gotten and so she began to question what was going on, almost right away. That was when I explained to her that I had gone to my surgeon the previous day because I personally was concerned. My nurse said that I had made a good decision because if things had changed that much that quickly that it would probably be something not so good. I agreed and basically told her that it was my thinking also. The nurse and I also discussed what had gone on when I was at the wound care center and that the measurements by the other visiting nurse were inaccurate. It was sort of ridiculous that the nurse that, though I did trust, I also sometimes had a personality conflict with was the one that had gotten strange measurements. I decided, that from then on, while I was going to listen to her opinions and suggestions I was going to take her measurements with a grain of salt, at least until she was getting them somewhere in the ballpark of what my other healthcare workers were getting.
Once I decided to only somewhat take what one of my nurses said seriously I was able to calm down and focus on what the other people were telling me. I had decided to side with the majority instead of with the one that was telling me scary numbers. All of this was going well for several weeks, until one day when I went back to have another appointment with my surgeon at the wound care center.
The weeks that followed the surgery seemed to be going very well. My visiting nurses were pleased with the progress and my surgeon was also rather positive. During each nursing visit, the nurses would measure the length, width and depth of my wound. My nurses would always keep me aware of the measurements so that I knew what was going on. Suddenly, one of my nurses got a measurement that was drastically different then it had been previously. I questioned and she measured it again, getting a slightly smaller number but still a depth that concerned me.
When the visiting nurse left I called the wound care center and asked to speak to the nurse there that I was most comfortable with. Who had been the last person to measure it besides my visiting nurses and my surgeon. I left a message and she called me back the following morning. When she called, I explained what was going on and that suddenly the depth was being reported as a centimeter more than it had been just two days prior. The nurse that I spoke to emphasized, that if I was uncomfortable and felt that my wound should be seen by my surgeon, I should definitely come in. The nurse was able to get me an appointment with my surgeon the following morning.
The next morning I went to my appointment at the wound care center so that my surgeon could look at my wound and make sure that nothing was going wrong. When I got there, the nurse that I had spoken to on the phone came into the exam room with me. First, she asked what my feeling was. I explained that one of my visiting nurses got a measurement that I felt was a very drastic change. I wanted to be sure that nothing was going very wrong very quickly, but that small part of me felt like I was being a little overly paranoid and wasting everyone’s time by making an appointment. The nurse immediately told me that I had nothing to worry about and that if I wasn’t comfortable I had every right to come in to get it checked. The nurse also took the time to explain, that there were many variables that could have contributed to a slightly different measurement. I told her that I knew that and that was partially why I was hesitant to come in, in the first place.
It was then that my surgeon came into the room. When he came in he questioned if this was an actual appointment that he had requested or if I had decided to come in for some reason. I explained that it was because a measurement my visiting nurse had gotten concerned me. When the wound was measured my surgeon got a slightly larger result than he had the last time I had seen him but nothing near what my nurse had gotten. I was relieved to hear that it was not measuring what my nurse was saying.
The next day I had another visit with my visiting nurse, this time the one that I totally trusted, not the one that was sometimes getting the wacky measurements. She had already seen the documentations in my chart that the other visiting nurse had gotten and so she began to question what was going on, almost right away. That was when I explained to her that I had gone to my surgeon the previous day because I personally was concerned. My nurse said that I had made a good decision because if things had changed that much that quickly that it would probably be something not so good. I agreed and basically told her that it was my thinking also. The nurse and I also discussed what had gone on when I was at the wound care center and that the measurements by the other visiting nurse were inaccurate. It was sort of ridiculous that the nurse that, though I did trust, I also sometimes had a personality conflict with was the one that had gotten strange measurements. I decided, that from then on, while I was going to listen to her opinions and suggestions I was going to take her measurements with a grain of salt, at least until she was getting them somewhere in the ballpark of what my other healthcare workers were getting.
Once I decided to only somewhat take what one of my nurses said seriously I was able to calm down and focus on what the other people were telling me. I had decided to side with the majority instead of with the one that was telling me scary numbers. All of this was going well for several weeks, until one day when I went back to have another appointment with my surgeon at the wound care center.
Friday, August 17, 2012
What the Heck is Going On?!
My MRI was scheduled for three days after I had the appointment at the wound care center. I was very happy that it was able to be done so quickly. The MRI was a relatively long test but painless. At this point, these tests have become old hat to me so I was not at all nervous about having it done. When the MRI was completed I was told that the doctor that ordered it would have the results in just a couple of days. I also requested that the results be sent to my surgeon so he would be aware of what was happening when he returned. Within a couple days of having the MRI, the doctor that I saw at the wound care center called me with the test results. The doctor told me that the MRI results did not show evidence of osteomyelitis (infection in the bone). I was incredibly happy to hear that because if bone infection were present then it would take even longer for the wound to close not to mention could be painful. After hearing these results, we discussed scheduling an appointment for the following day with my surgeon.
The next day I went into my appointment relieved that my surgeon whom I was incredibly comfortable with had returned. It wasn't that I was uncomfortable with the doctor that was filling in it is just that my surgeon had treated me for so long and had gotten good results so there was a certain comfort level there. At my appointment, my surgeon explained to me that when he saw the MRI results his opinion was different; than that of the other doctor. He felt that their was potentially something still going on and that maybe something inside had caused the wound to reopen, as such he felt that the best option was for him to bring me back into the operating room and look around. I agreed that what he was saying sounded logical and so it was decided that I would either see him the day of the surgery or at the wound care center in a few weeks, whichever came first. The surgery ended up being scheduled for a few weeks later.
The day of the surgery I was not at all nervous or upset about what had happened. I did have my "moment" of "WHY?!" for a little while after the initial appointment with my surgeon but, by the day of the surgery I was no longer upset. I had decided long ago, to try not too get upset about this wound anymore. I made the choice to just take everything as it happened and deal with it the best way we knew how. My surgeon came in and explained again, what he was going to do in the operating room. All of it sounded incredibly familiar. My surgeon said that he was going to go in the wound and clean out any bone that needed to be gotten rid of and then he was going to pack the wound with antibiotic seeds. He then packed the wound with Calcium Alginate and covered it with a dry dressing. The procedure ended up taking less than an hour and afterwords I was able to have some lunch and was sent home with instructions to stay off of it as much as I could for next couple of days.
My visiting nurse came to my house two days after the surgery so that she could change the dressing and monitor me for any sign of infection. She said that everything looked good and that she was not concerned. I continued to have visiting nurses for the next few days and met with my surgeon eight days after the surgery. My surgeon said that he was happy with how it seemed to be progressing and, to keep doing what we were doing as far as using the Calcium Alginate and a dry dressing on top. I have had several visiting nurse visits and have seen my surgeon one additional time since the surgery. I am currently, approximately three weeks post-op and I am being told that my wound is continuing to get smaller in size. I am hopeful that my wound will close again relatively soon so that I can once again fully participate in my life.
The next day I went into my appointment relieved that my surgeon whom I was incredibly comfortable with had returned. It wasn't that I was uncomfortable with the doctor that was filling in it is just that my surgeon had treated me for so long and had gotten good results so there was a certain comfort level there. At my appointment, my surgeon explained to me that when he saw the MRI results his opinion was different; than that of the other doctor. He felt that their was potentially something still going on and that maybe something inside had caused the wound to reopen, as such he felt that the best option was for him to bring me back into the operating room and look around. I agreed that what he was saying sounded logical and so it was decided that I would either see him the day of the surgery or at the wound care center in a few weeks, whichever came first. The surgery ended up being scheduled for a few weeks later.
The day of the surgery I was not at all nervous or upset about what had happened. I did have my "moment" of "WHY?!" for a little while after the initial appointment with my surgeon but, by the day of the surgery I was no longer upset. I had decided long ago, to try not too get upset about this wound anymore. I made the choice to just take everything as it happened and deal with it the best way we knew how. My surgeon came in and explained again, what he was going to do in the operating room. All of it sounded incredibly familiar. My surgeon said that he was going to go in the wound and clean out any bone that needed to be gotten rid of and then he was going to pack the wound with antibiotic seeds. He then packed the wound with Calcium Alginate and covered it with a dry dressing. The procedure ended up taking less than an hour and afterwords I was able to have some lunch and was sent home with instructions to stay off of it as much as I could for next couple of days.
My visiting nurse came to my house two days after the surgery so that she could change the dressing and monitor me for any sign of infection. She said that everything looked good and that she was not concerned. I continued to have visiting nurses for the next few days and met with my surgeon eight days after the surgery. My surgeon said that he was happy with how it seemed to be progressing and, to keep doing what we were doing as far as using the Calcium Alginate and a dry dressing on top. I have had several visiting nurse visits and have seen my surgeon one additional time since the surgery. I am currently, approximately three weeks post-op and I am being told that my wound is continuing to get smaller in size. I am hopeful that my wound will close again relatively soon so that I can once again fully participate in my life.
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