This post is delayed because I have been letting my thoughts simmer for a while. I had to really think about just how open and personal I wanted this post to be. I have decided that after writing so openly about my medical journey, that it would be unfair of me at this point to censor what has been going on with me both physically and emotionally.
My surgeon discharged me from the Wound Care Center on January 23, 2013. When he discharged me, I was happy that my wound was closed but also completely terrified that it would open again as it had previously. My visiting nurses continued to do weekly visits with me for approximately five weeks after discharge, to make sure that my wound didn’t open again. During that time I was still keeping the news of my discharge to myself. While a part of me was incredibly happy and wanted to shout it from the rooftops, another part of me was worried that if it opened again I along with my friends and family would be devastated and that was too much for me to think about.
During that time I was also regularly attending my boyfriend’s appointments at the wound care center so I was still incredibly submerged in wound care. My boyfriend was discharged from the wound care center on April 3, 2013 and since then his wound has remained closed. When we left his last appointment we figured that we could just get on with our lives again.
Unfortunately, getting back to our old lives would prove to be more difficult than I ever imagined it would be. My boyfriend seemed to adjust quickly, but that is probably because his wound didn’t have as great of an impact on his daily life. I however, have had more of a difficult time. First, I am incredibly paranoid about my wound reopening. No matter how many times my boyfriend and I check the area and see that it is still doing well, I cannot get the last time it opened out of my head, or the words that the surgeon said about its reopening could be related to osteo. Two weeks ago when my boyfriend was checking to see if the area was still doing well he told me that the wound was still closed but that something else had developed. I asked to see a picture so that I would know what he was talking about. What I saw was a hemorrhoid. On one hand, I was sort of grossed out by it but on the other hand, it was starting to put the pieces of the puzzle together. You may remember that I had previously seen a couple of streaks of blood after I have gotten off of the toilet but that my nurse had always said the wound was still closed. Suddenly, it seemed to me that the blood must have been coming from the hemorrhoid and that I had just assumed it was from the wound because that’s where my focus had been for so long. As ridiculous as it may seem, I was relieved to have a hemorrhoid.
My boyfriend was spending a few days with me last week and while we were having a discussion, without entirely thinking, I let it slip that I am really not transitioning very well at all. As much as my boyfriend is trying to understand, he is unable to put himself in my shoes. He said that he expects that I would be thrilled to not have to be stuck in my house any more. Logically, I get that he thinks that’s how I would feel but that really isn’t how I feel at all.
While, it is spectacular to be able to go out whenever I want to, it is also a really scary situation. I was basically stuck in my own house for the greater part of four years, unable to do much of anything. As such, it seems that I got used to being both inside and with being near only a handful of people at a time and also was very rarely by myself. Therefore, while he was here visiting, we had decided that we would be going out and doing things, partially, because it would be fun but also to try to get me out of my house. Due to his work schedule and my admittedly strange sleeping patterns he was more tired than either of us expected and so we did not really do anything for a couple of days. While we were discussing the fact that we had been stuck inside, I began to break down and try to explain that I was feeling like a prisoner in my own home and that it really stunk. As much as he tried to understand, he was unable to fully grasp what I was saying. He brought up the fact that nothing was stopping me from going out by myself and I did the best I could to explain to him that I had been with people for so long that being out of my house alone seemed daunting.
I find myself at this point wondering what I need to do to get myself out of this funk. It isn’t just that I am sick of being inside, which I absolutely am but I am also finding myself completely overwhelmed by large crowds of people. I think that it is because I haven’t been exposed to crowds in such a long period of time and that I will eventually readjust but wow, readjusting is really hard. This feels somewhat like a case of depression.
I have experience dealing with depression because I had it as a child and teenager, yet this case feels different in some ways. Depression when I was a teenager felt like I did not want to do anything at all, and it didn’t matter what I had planned for the day. In this case, I feel more stuck. Like I want to go out and do things and have experiences yet I am unable to actually follow through with plans. Maybe these feelings are rooted more in fear, than depression?
Monday, May 13, 2013
Monday, April 29, 2013
A (Happy) State of Confusion
The following day, when my boyfriend arrived he almost immediately checked to make sure that my wound was still doing well. We were both pleased when he told me that it was still closed and was beginning to look even better since we had started using the Zinc.
When my boyfriend and I went to the Wound Care Center for his appointment later that afternoon, the nurse was incredibly happy when she took the dressing off of his wound. She said that to her it looked closed and asked how long it had looked that good. My boyfriend said that it had looked that way for about a week and that it hadn’t been draining. I looked at his wound and was very pleased to see that it was in fact closed.
When the surgeon came in the room we spent a few minutes catching up because he had been away for a few weeks. He agreed that my boyfriend’s wound was healed and told him that he no longer had to keep it covered but that he should use moisturizer on it for at least the next several weeks. That sounded like an awesome plan. The surgeon then asked us what we were going to now with our lives being that neither of us needed to see him anymore.
At that point I spoke up and asked if he had heard that I was at the wound care center the previous week. I was surprised when he said that no he had not heard that and then asked me what had happened. I in turn was surprised because I thought that the nurses would have told him and also because I knew I had already blogged it and he previously told me that he was reading. I told him that the week before I was seen, my wound had opened and I had gotten really scared and wanted it checked. The surgeon then said that it was a very good idea to get it checked because it is always better to try to catch it at the beginning. I told him that that was exactly my thinking when I called to make the appointment. I also explained that it had closed by itself again before my appointment but that I went in because I was nervous.
The surgeon then told me that the nurse and doctor that had seen it the previous week must have been confident that it was actually doing well, or else they probably would have told him. I kind of assumed as much. The surgeon then proceeded to tell me that if it opens again I should definitely come get it checked because it “could be osteo”. I knew from previous experience that “osteo” relates to bone. I said that I would absolutely come back in if I were uncomfortable with how it looked. We left the Wound Care Center and began to live our lives again.
Things were going well for about a week when I suddenly got “that” feeling. The area was a little sore but it was mostly an emotional gut feeling that had me on edge. When my boyfriend came I asked him if he would please check and see if anything funky was going on. He looked and said that it didn’t look open to him but an area below the wound seemed to have formed a very small blister. I had no idea what to think of that news so I asked to see a picture. I saw something that may have been a very small blister but nothing was draining so I took the “wait an see” approach. On one hand I know that things need to be checked as soon as possible, yet I also didn’t have the horrible gut feeling that I usually get. We waited a few days and when my boyfriend next checked it he said that the blister seemed to have either popped or been absorbed by my body because it was gone but now that same area had a small piece tissue that had come off. We were unable to tell if it was just dead skin from a part of the blister or if somehow some of the scar tissue had sloughed off. We’re both rather confused by the situation but neither of us really feels like it absolutely needs to be seen. We are going to continue to monitor it to see if any other strange things happen, if so we will definitely get in touch with my surgeon.
When my boyfriend and I went to the Wound Care Center for his appointment later that afternoon, the nurse was incredibly happy when she took the dressing off of his wound. She said that to her it looked closed and asked how long it had looked that good. My boyfriend said that it had looked that way for about a week and that it hadn’t been draining. I looked at his wound and was very pleased to see that it was in fact closed.
When the surgeon came in the room we spent a few minutes catching up because he had been away for a few weeks. He agreed that my boyfriend’s wound was healed and told him that he no longer had to keep it covered but that he should use moisturizer on it for at least the next several weeks. That sounded like an awesome plan. The surgeon then asked us what we were going to now with our lives being that neither of us needed to see him anymore.
At that point I spoke up and asked if he had heard that I was at the wound care center the previous week. I was surprised when he said that no he had not heard that and then asked me what had happened. I in turn was surprised because I thought that the nurses would have told him and also because I knew I had already blogged it and he previously told me that he was reading. I told him that the week before I was seen, my wound had opened and I had gotten really scared and wanted it checked. The surgeon then said that it was a very good idea to get it checked because it is always better to try to catch it at the beginning. I told him that that was exactly my thinking when I called to make the appointment. I also explained that it had closed by itself again before my appointment but that I went in because I was nervous.
The surgeon then told me that the nurse and doctor that had seen it the previous week must have been confident that it was actually doing well, or else they probably would have told him. I kind of assumed as much. The surgeon then proceeded to tell me that if it opens again I should definitely come get it checked because it “could be osteo”. I knew from previous experience that “osteo” relates to bone. I said that I would absolutely come back in if I were uncomfortable with how it looked. We left the Wound Care Center and began to live our lives again.
Things were going well for about a week when I suddenly got “that” feeling. The area was a little sore but it was mostly an emotional gut feeling that had me on edge. When my boyfriend came I asked him if he would please check and see if anything funky was going on. He looked and said that it didn’t look open to him but an area below the wound seemed to have formed a very small blister. I had no idea what to think of that news so I asked to see a picture. I saw something that may have been a very small blister but nothing was draining so I took the “wait an see” approach. On one hand I know that things need to be checked as soon as possible, yet I also didn’t have the horrible gut feeling that I usually get. We waited a few days and when my boyfriend next checked it he said that the blister seemed to have either popped or been absorbed by my body because it was gone but now that same area had a small piece tissue that had come off. We were unable to tell if it was just dead skin from a part of the blister or if somehow some of the scar tissue had sloughed off. We’re both rather confused by the situation but neither of us really feels like it absolutely needs to be seen. We are going to continue to monitor it to see if any other strange things happen, if so we will definitely get in touch with my surgeon.
Wednesday, April 3, 2013
An Update and a Wound-iversary
Approximately nine days ago while my boyfriend was here I asked him to check my wound again, even though I knew I was going to the doctor in a couple of days. I wanted him to tell me what it looked like so that I was as mentally prepared for the appointment at the wound care center as I could be.
What he saw was somewhat of a surprise; the wound appeared to have closed again! Part of me thought he was joking I thought that it was crazy that it had closed after I had freaked out and made the appointment to get seen and began to think that maybe I really should try to calm down. I asked my boyfriend what he thought I should do about the upcoming appointment. I did not want to go to the appointment looking like a paranoid freak, with absolutely nothing wrong, yet I wanted to catch something before it turned into a bigger problem. While leaving the choice completely up to me, he encouraged me to go to the appointment regardless of the fact that it looked closed to us. At that point I began to relax and then came to the decision that I should definitely get the wound checked out because their was a chance that while it had closed on the surface but that it still had depth inside. I also realized that I would probably find it hard to calm down if it weren’t checked.
The next day I was surprised when my phone rang and displayed that my favorite visiting nurse was calling. I answered and she told me that she was calling because she wanted to know how I was doing, what I was up to and to tell me that she was kind of missing me because I had been discharged a full month from their service. I told her that I was okay but that I was a little unsure of how the wound was doing. I explained that it had opened the previous week so I made an appointment to go get it checked but then it suddenly closed so I was sort of unsure about what I should really do. After she told me that I could have called her and she would have come to check it when it was open, she said that I should get it checked at the Wound Care Center so that I would know that it had in fact closed from the bottom up. I explained to her that although I knew she would have come to my house without a problem, that I didn’t want her to because of my horrible timing of telling my family that I had been discharged. My visiting nurse said she understood my point because she remembered the look on my parents’ faces when she first started coming again after I had been discharged previously.
The next day was my appointment at the Wound Care Center and I went armed with the photo I had seen that caused me to make the appointment in the first place. When I went in the nurse that was there was one that I’ve always been comfortable with and so I explained to her that I may have freaked out for nothing but I would rather be safe and get it checked. I showed her the picture and she said that I was right; in the picture the wound was open and did warrant being looked at. When the doctor came in I then showed her the picture and told her that to me it looked so similar to the time she had seen it previously that I was nervous and so here I was. The doctor looked at the picture and completely understood my concerns. When she went to look at the wound she said that it looked completely different than my week old photo and that she felt like it was closed again. She asked what I had been doing to take care of it the past week and I told her that I was just keeping it covered. She suggested that I begin to use some Zinc ointment on the area to prevent it from becoming moist and potentially macerated. She also did some re-education on the strength of tissue after a wound heals. Although I knew all of what she was saying, I knew that hearing it again was probably not a bad thing so I listened while she talked and the nurse gathered the supplies so that she could apply the zinc.
When I left the appointment I told my boyfriend exactly what everyone had told me and what I would need to do. He was relieved that I again seemed to be okay. I have pretty much been taking care of it myself, save for the few times my boyfriend has been with me and things seemed to be going well. Suddenly, I realized that April 1st was rapidly approaching. Longtime readers may remember that April 1,2009 was when this nightmare started. I found it somewhat hard to believe that finally April was approaching and I was no longer a wound care patient. Part of me wanted to be excited by this but a more jaded part of me was still somewhat unsure that I was actually done with this part of my journey.
My boyfriend happened to be with me that day and as requested he checked and the wound still seemed to be doing well. We went on with our day and tried to move forward. I can’t speak for him but I was somewhat hesitant to mention what the date was because of the previous setbacks. Last night (Tuesday) I thought that I may have again noticed some drainage but I am not entirely sure. My boyfriend is coming over in the morning and he has promised that he will check to make sure that I am okay, prior to us going to his appointment at the Wound Care Center. He says that his wound is doing well and that he is only covering it to protect it but that he expects that his wound care journey is coming to an end. I honestly, hope that it is, but then where will we go from here? I wish that I were as confident in my own wound as he is in his but I’m still only remaining cautiously optimistic due to the many setbacks that this wound has caused me.
What he saw was somewhat of a surprise; the wound appeared to have closed again! Part of me thought he was joking I thought that it was crazy that it had closed after I had freaked out and made the appointment to get seen and began to think that maybe I really should try to calm down. I asked my boyfriend what he thought I should do about the upcoming appointment. I did not want to go to the appointment looking like a paranoid freak, with absolutely nothing wrong, yet I wanted to catch something before it turned into a bigger problem. While leaving the choice completely up to me, he encouraged me to go to the appointment regardless of the fact that it looked closed to us. At that point I began to relax and then came to the decision that I should definitely get the wound checked out because their was a chance that while it had closed on the surface but that it still had depth inside. I also realized that I would probably find it hard to calm down if it weren’t checked.
The next day I was surprised when my phone rang and displayed that my favorite visiting nurse was calling. I answered and she told me that she was calling because she wanted to know how I was doing, what I was up to and to tell me that she was kind of missing me because I had been discharged a full month from their service. I told her that I was okay but that I was a little unsure of how the wound was doing. I explained that it had opened the previous week so I made an appointment to go get it checked but then it suddenly closed so I was sort of unsure about what I should really do. After she told me that I could have called her and she would have come to check it when it was open, she said that I should get it checked at the Wound Care Center so that I would know that it had in fact closed from the bottom up. I explained to her that although I knew she would have come to my house without a problem, that I didn’t want her to because of my horrible timing of telling my family that I had been discharged. My visiting nurse said she understood my point because she remembered the look on my parents’ faces when she first started coming again after I had been discharged previously.
The next day was my appointment at the Wound Care Center and I went armed with the photo I had seen that caused me to make the appointment in the first place. When I went in the nurse that was there was one that I’ve always been comfortable with and so I explained to her that I may have freaked out for nothing but I would rather be safe and get it checked. I showed her the picture and she said that I was right; in the picture the wound was open and did warrant being looked at. When the doctor came in I then showed her the picture and told her that to me it looked so similar to the time she had seen it previously that I was nervous and so here I was. The doctor looked at the picture and completely understood my concerns. When she went to look at the wound she said that it looked completely different than my week old photo and that she felt like it was closed again. She asked what I had been doing to take care of it the past week and I told her that I was just keeping it covered. She suggested that I begin to use some Zinc ointment on the area to prevent it from becoming moist and potentially macerated. She also did some re-education on the strength of tissue after a wound heals. Although I knew all of what she was saying, I knew that hearing it again was probably not a bad thing so I listened while she talked and the nurse gathered the supplies so that she could apply the zinc.
When I left the appointment I told my boyfriend exactly what everyone had told me and what I would need to do. He was relieved that I again seemed to be okay. I have pretty much been taking care of it myself, save for the few times my boyfriend has been with me and things seemed to be going well. Suddenly, I realized that April 1st was rapidly approaching. Longtime readers may remember that April 1,2009 was when this nightmare started. I found it somewhat hard to believe that finally April was approaching and I was no longer a wound care patient. Part of me wanted to be excited by this but a more jaded part of me was still somewhat unsure that I was actually done with this part of my journey.
My boyfriend happened to be with me that day and as requested he checked and the wound still seemed to be doing well. We went on with our day and tried to move forward. I can’t speak for him but I was somewhat hesitant to mention what the date was because of the previous setbacks. Last night (Tuesday) I thought that I may have again noticed some drainage but I am not entirely sure. My boyfriend is coming over in the morning and he has promised that he will check to make sure that I am okay, prior to us going to his appointment at the Wound Care Center. He says that his wound is doing well and that he is only covering it to protect it but that he expects that his wound care journey is coming to an end. I honestly, hope that it is, but then where will we go from here? I wish that I were as confident in my own wound as he is in his but I’m still only remaining cautiously optimistic due to the many setbacks that this wound has caused me.
Thursday, March 21, 2013
Boyfriend is Doing Well, I Need to Relax and Await Answers
My boyfriend and I continued to treat his wound with the Bactroban ointment and a gauze pad and just as the surgeon predicted, it continued to do very well. When we went back to the wound care center the following week even I was pleased with how small it had gotten. The surgeon was also happy with its progress and told us that we should continue using the ointment for a week and then after that just to cover it to provide some protection, by that point it would probably be closed. The surgeon said that he wouldn’t be able to see us for a few weeks but to make an appointment for three weeks later. We made the appointment for three weeks later and left.
It has now been a little over eight weeks since I have been discharged from the wound care center and approximately three weeks since my visiting nurses have stopped. I am still diligent about making sure that I do not stay in one position for very long and still periodically have my boyfriend check to make sure that my wound is closed. It was still closed after seven weeks so I decided that my dad’s birthday was when I was going to officially tell him the good news. I wrote the dates that I had been discharged, in his birthday card. He was incredibly happy to hear that I had been discharged, and while I suspect that he knew already, he did not say anything. My family and I were just starting to adjust to me being fully discharged when a few days ago I started to get a bad feeling.
I cannot explain what I felt, other than to call it a “gut feeling” I feared that my wound had reopened. I tried to remind myself that I had had that feeling before since I had been discharged and each time my wound had remained closed so I was probably just overreacting. When my boyfriend was here two days ago, I asked him if he would please check for me because I was really nervous, because the day before I thought I may have seen a little bit of drainage in my clothing.
As soon as my boyfriend saw my wound he said, “Yeah, it’s opened”. I was not surprised by what he said but I still needed to see it for myself. He showed me a picture of it and sure enough, a tiny portion, the same part that had opened previously was open again. I took a minute to just stare at the photo in disbelief that this had happened again. I was so upset that I could hardly form coherent thoughts to have a conversation with my boyfriend. At that point, admittedly I got a little more emotional than I usually do; all my boyfriend could do was hold me.
After a few minutes I needed some insight from someone that was a little more removed from the situation so I sent my best friend a text message. Explaining that it was open again and I had no more coping skills left and needed her suggestions. After she got over the initial shock, she suggested that I call the wound care center and see if someone could see me. She also told me that I should try to relax and zone out and forget about things for a while.
I was really upset that my wound had reopened; I also could not believe that it had happened just a few days after telling my family that I was fine. I realize it was just a coincidence but I couldn’t help but think that my making the announcement had somehow caused it to open again. By that point, I knew a decision had to be made about whom I was going to call. I decided to take my friend’s advice and call the wound care center and explain the situation. I did not want to call my visiting nurses because I knew that if one of them appeared it would instantly cause drama in my family and I could not put them through that again. When I called the wound care center the receptionist originally thought I was playing an early April Fool’s joke on them, once I explained that I was serious she began to check the schedule to see what could be done about getting me seen. She was able to make an appointment for me for the week before the surgeon comes back, with the doctor that I had seen when he was out of town before. She then asked me to hold on while she spoke to the nurse that I was most comfortable with at the wound care center. When she came back to the phone she told me that the nurse had suggested I just cover the wound with a clean dry dressing until I could get to the appointment.
My boyfriend covered my wound with one of the few dressings I have left, a Tegaderm Foam Adhesive and we just tried to relax and not worry too much. I go back to the wound care center next week so I am just trying to remain positive, until I get told just what is going on; if the part that reopened is just superficial or if it has depth and will therefore need more treatment.
It has now been a little over eight weeks since I have been discharged from the wound care center and approximately three weeks since my visiting nurses have stopped. I am still diligent about making sure that I do not stay in one position for very long and still periodically have my boyfriend check to make sure that my wound is closed. It was still closed after seven weeks so I decided that my dad’s birthday was when I was going to officially tell him the good news. I wrote the dates that I had been discharged, in his birthday card. He was incredibly happy to hear that I had been discharged, and while I suspect that he knew already, he did not say anything. My family and I were just starting to adjust to me being fully discharged when a few days ago I started to get a bad feeling.
I cannot explain what I felt, other than to call it a “gut feeling” I feared that my wound had reopened. I tried to remind myself that I had had that feeling before since I had been discharged and each time my wound had remained closed so I was probably just overreacting. When my boyfriend was here two days ago, I asked him if he would please check for me because I was really nervous, because the day before I thought I may have seen a little bit of drainage in my clothing.
As soon as my boyfriend saw my wound he said, “Yeah, it’s opened”. I was not surprised by what he said but I still needed to see it for myself. He showed me a picture of it and sure enough, a tiny portion, the same part that had opened previously was open again. I took a minute to just stare at the photo in disbelief that this had happened again. I was so upset that I could hardly form coherent thoughts to have a conversation with my boyfriend. At that point, admittedly I got a little more emotional than I usually do; all my boyfriend could do was hold me.
After a few minutes I needed some insight from someone that was a little more removed from the situation so I sent my best friend a text message. Explaining that it was open again and I had no more coping skills left and needed her suggestions. After she got over the initial shock, she suggested that I call the wound care center and see if someone could see me. She also told me that I should try to relax and zone out and forget about things for a while.
I was really upset that my wound had reopened; I also could not believe that it had happened just a few days after telling my family that I was fine. I realize it was just a coincidence but I couldn’t help but think that my making the announcement had somehow caused it to open again. By that point, I knew a decision had to be made about whom I was going to call. I decided to take my friend’s advice and call the wound care center and explain the situation. I did not want to call my visiting nurses because I knew that if one of them appeared it would instantly cause drama in my family and I could not put them through that again. When I called the wound care center the receptionist originally thought I was playing an early April Fool’s joke on them, once I explained that I was serious she began to check the schedule to see what could be done about getting me seen. She was able to make an appointment for me for the week before the surgeon comes back, with the doctor that I had seen when he was out of town before. She then asked me to hold on while she spoke to the nurse that I was most comfortable with at the wound care center. When she came back to the phone she told me that the nurse had suggested I just cover the wound with a clean dry dressing until I could get to the appointment.
My boyfriend covered my wound with one of the few dressings I have left, a Tegaderm Foam Adhesive and we just tried to relax and not worry too much. I go back to the wound care center next week so I am just trying to remain positive, until I get told just what is going on; if the part that reopened is just superficial or if it has depth and will therefore need more treatment.
Saturday, March 9, 2013
What The Hell is Happening Now?
I know it has been a long time since my last post. I apologize; it is just that my boyfriend and I do not live together and I haven’t actually been able to see his wound in person very often.
His wound was doing incredibly well; it was appearing much smaller and had no signs of infection. Just as I was beginning to relax, he threw me a curve ball. He sent me a text message two weeks ago on the day that he had an appointment at the wound care center. He told me that when he woke up, he discovered a blood blister directly above the wound and asked me what he should do to cover it because he was worried that the dressings he was using would cause it to pop. At first I thought he was just messing with my head and trying to get a reaction out of me by claiming to have a blood blister so I told him to prove it. Minutes later I received a picture of what in fact was a blood blister.
I took a breath and picked up the phone and called him. I asked what size dressings he had, hoping against hope that he had one that would be big enough and loose enough to cover the entire wound, including the blood blister, without being so tight that it would pop. Of course he did not have any of the type of dressing that I wanted him to use. I told him to just carefully cover the wound itself, avoiding the blister as best he could and then get to my house as soon as he was able so that I could put a more substantial dressing on it prior to his appointment that afternoon.
When he arrived at my house about an hour later I looked at his leg and saw that he had a weird shaped blister, more like one large one and then a small one directly next to it. The smaller one appeared to have ruptured but the big one was still intact and the primary wound did seem to be doing very well. I then loosely covered the entire “situation” with 4x4 gauze, knowing that it would be sufficient until his appointment a couple hours later.
When we got to the wound care center we told the nurse that the wound had been doing well until that morning when a blood blister was discovered. The nurse uncovered the wound and told us that the doctor would be in soon. We waited and when the doctor came into the room we explained what was going on and my boyfriend’s thoughts on what caused the blister in the first place.
The surgeon then said that he was going to test the fluid in the blister to make sure that it wasn’t showing any bacteria that would need to be treated. He poked a tiny hole in the blister with a small needle and aspirated some of the fluid. He then said that the wound should continue to be treated the same way we had been, with the Bactroban ointment and just a small piece of gauze to cover. He said that if the culture came back showing anything that needed to be treated he would call to let us know but that he wanted to see him again in two weeks.
My boyfriend took care of his wound for himself for almost the entire two weeks and kept telling me that he thought it looked like it was doing well. I was happy to hear that he thought it was fine, but I was also a little bit nervous that he would minimize it if things weren’t going well. I hoped though that he was aware of just how quickly things like this can go downhill and would at the very least tell me if it began to change. Two days before his appointment at the wound care center I asked if I could please see another picture, so that I could reassure myself that he really was “fine”. My boyfriend sent me the picture he had taken that morning and I was disturbed by what I saw. When I had last seen it in person, I noticed that the blister appeared to be flattened out and was looking more callous than blister. The picture he sent me showed even more of the dark calloused area. Admittedly, I flipped out when I saw the picture. In hindsight, I realize that most of my reaction was caused by not being able to clearly see what was going on. My boyfriend tried to explain to me that it “wasn’t that bad” and that it was only the blister that looked “kind of gross”. I wanted no part of his explanation and shut down the conversation. Not the best idea in that situation, but being that nothing could be done about his wound at that point, it was really not worth it to discuss it anymore.
A couple of days later we went to his appointment at the wound care center and I explained to the nurse that I personally hadn’t seen it in a few days but that I did not feel comfortable with how it looked. The nurse took the dressing off and said that the blister had flattened out and was now a callous. I took the opportunity to look at the wound in person for the first time since I had flipped out about the picture I had seen. When I saw the wound I was happy to see that it was not nearly as bad as it had appeared in the picture. When the nurse left I told my boyfriend that it was not as bad as I originally thought, but that it still, “wasn’t pretty”. A few minutes later the surgeon walked into the room and when he looked at the wound a really funny look appeared on his face. His face seemed to say, “What the hell happened, what do you want me to do about that and how am I supposed to work with that” all rolled into one facial expression. He then asked when it had become calloused and I stopped laughing so that I could tell him that it had begun about five days prior. The doctor then began to scrape away the calloused area and when he did he was pleased with how it looked underneath. He said that he was also really happy with how the primary wound looked. The doctor told us to continue treating it the same way we had been and that he wanted to see the wound in a week. My boyfriend and I left the appointment happy with how things were going and admittedly I personally, was still somewhat giggly because I still had the look of the doctor’s face in my head.
His wound was doing incredibly well; it was appearing much smaller and had no signs of infection. Just as I was beginning to relax, he threw me a curve ball. He sent me a text message two weeks ago on the day that he had an appointment at the wound care center. He told me that when he woke up, he discovered a blood blister directly above the wound and asked me what he should do to cover it because he was worried that the dressings he was using would cause it to pop. At first I thought he was just messing with my head and trying to get a reaction out of me by claiming to have a blood blister so I told him to prove it. Minutes later I received a picture of what in fact was a blood blister.
I took a breath and picked up the phone and called him. I asked what size dressings he had, hoping against hope that he had one that would be big enough and loose enough to cover the entire wound, including the blood blister, without being so tight that it would pop. Of course he did not have any of the type of dressing that I wanted him to use. I told him to just carefully cover the wound itself, avoiding the blister as best he could and then get to my house as soon as he was able so that I could put a more substantial dressing on it prior to his appointment that afternoon.
When he arrived at my house about an hour later I looked at his leg and saw that he had a weird shaped blister, more like one large one and then a small one directly next to it. The smaller one appeared to have ruptured but the big one was still intact and the primary wound did seem to be doing very well. I then loosely covered the entire “situation” with 4x4 gauze, knowing that it would be sufficient until his appointment a couple hours later.
When we got to the wound care center we told the nurse that the wound had been doing well until that morning when a blood blister was discovered. The nurse uncovered the wound and told us that the doctor would be in soon. We waited and when the doctor came into the room we explained what was going on and my boyfriend’s thoughts on what caused the blister in the first place.
The surgeon then said that he was going to test the fluid in the blister to make sure that it wasn’t showing any bacteria that would need to be treated. He poked a tiny hole in the blister with a small needle and aspirated some of the fluid. He then said that the wound should continue to be treated the same way we had been, with the Bactroban ointment and just a small piece of gauze to cover. He said that if the culture came back showing anything that needed to be treated he would call to let us know but that he wanted to see him again in two weeks.
My boyfriend took care of his wound for himself for almost the entire two weeks and kept telling me that he thought it looked like it was doing well. I was happy to hear that he thought it was fine, but I was also a little bit nervous that he would minimize it if things weren’t going well. I hoped though that he was aware of just how quickly things like this can go downhill and would at the very least tell me if it began to change. Two days before his appointment at the wound care center I asked if I could please see another picture, so that I could reassure myself that he really was “fine”. My boyfriend sent me the picture he had taken that morning and I was disturbed by what I saw. When I had last seen it in person, I noticed that the blister appeared to be flattened out and was looking more callous than blister. The picture he sent me showed even more of the dark calloused area. Admittedly, I flipped out when I saw the picture. In hindsight, I realize that most of my reaction was caused by not being able to clearly see what was going on. My boyfriend tried to explain to me that it “wasn’t that bad” and that it was only the blister that looked “kind of gross”. I wanted no part of his explanation and shut down the conversation. Not the best idea in that situation, but being that nothing could be done about his wound at that point, it was really not worth it to discuss it anymore.
A couple of days later we went to his appointment at the wound care center and I explained to the nurse that I personally hadn’t seen it in a few days but that I did not feel comfortable with how it looked. The nurse took the dressing off and said that the blister had flattened out and was now a callous. I took the opportunity to look at the wound in person for the first time since I had flipped out about the picture I had seen. When I saw the wound I was happy to see that it was not nearly as bad as it had appeared in the picture. When the nurse left I told my boyfriend that it was not as bad as I originally thought, but that it still, “wasn’t pretty”. A few minutes later the surgeon walked into the room and when he looked at the wound a really funny look appeared on his face. His face seemed to say, “What the hell happened, what do you want me to do about that and how am I supposed to work with that” all rolled into one facial expression. He then asked when it had become calloused and I stopped laughing so that I could tell him that it had begun about five days prior. The doctor then began to scrape away the calloused area and when he did he was pleased with how it looked underneath. He said that he was also really happy with how the primary wound looked. The doctor told us to continue treating it the same way we had been and that he wanted to see the wound in a week. My boyfriend and I left the appointment happy with how things were going and admittedly I personally, was still somewhat giggly because I still had the look of the doctor’s face in my head.
Wednesday, February 13, 2013
Learning to Relax (in more ways than one)
It has now been approximately three weeks since I have been discharged from the Wound Care Center. My visiting nurses are still seeing me once a week and they are confident that my wound is really closed for good this time. Their confidence is great; I am just waiting for my mind to catch up to it. I am still incredibly nervous that it may open again. I am trying to strike a balance between being aware that the wound has opened in the past, yet trying to adjust to having my life back to normal. I still regularly make sure that I’m not seeing any discharge and also, asking my boyfriend to check to make sure that it is closed between nursing visits. When my nurse came yesterday she assured me that it is closed and then warned me that the next visit may end up being my last. Apparently when she told me that I had a terrified look on my face because she immediately said that she really does only live a couple of minutes away and that it was okay for me to call her if I really felt that something was weird after I was discharged. She said that she would either come out to check the wound if I was really upset or if I was just mildly concerned she said she might just try to talk to me and try to get me to calm down.
My boyfriend has said that it is okay with him if I post a few of the pictures, so though I chose to keep my wound pictures private, I will share his.
Boyfriend's wound picture taken approximately September 4, 2012
After the visiting nurse and I treated it for a few weeks, it began to look too dry:
Picture taken October 16, 2012
Picture taken mid October, after treating with Hydrogel
Picture taken late October 2012
Picture taken early November 2012
Everything after that seemed fine until I saw it again in late January 2013. That is when I told him that it needed to be seen.
What my boyfriend's wound looked like in mid/late January
Photo from the first time the wound care center saw the wound (January 30, 2013) after it had been treated with Calcium alginate and a Tegaderm Foam Adhesive
Taken at wound care February 6, 2013 after having daily ABD dressing changes
Photo taken approximately February 8,2013 after Bactroban ointment
Taken February 9, 2013 after continued Bactroban
Calm down seems to be a recurring theme in my wound-life because when my boyfriend left to go to his house last week I was a little bit worried that he would have to take care of his wound without me. I was confident that he is not incompetent and could change the dressings without a problem, but I was worried that he would minimize it if he suddenly weren’t doing as well. That paranoia lead to me regularly asking him to text me pictures of his wound so that I could stay as up to date on its progress as possible. I am getting ahead of myself though, last week at my boyfriend’s appointment at the wound care center he was told that the culture results had come back positive for MRSA.
The surgeon therefore prescribed Bactroban Ointment an antibiotic to treat the infection, which my boyfriend was to apply to the wound bed once or twice a day when he changed the dressing. When the surgeon examined the wound itself though, he said that he thought it appeared a little smaller. I concurred (as if my opinion actually matters. ha-ha) that it did seem to be a little better than it had been, at least since the last time I had seen it.
My boyfriend is continuing to treat his wound himself at home and is periodically updating me on what he thinks is happening. He goes back to the wound care center next week. The surgeon said the he had a feeling that treating it with the ointment and just a small gauze pad would get it going in the direction we wanted it to go in. Hopefully, the surgeon is correct. Currently I am waiting for my boyfriend to visit so that among other things, he can show me a picture of my wound again so that maybe we can drill it into my head that it really is closed.
I know I am bordering on ridiculous with my level of paranoia about my wound; it is just that I cannot get the previous time that it was closed out of my head. I was so incredibly happy and relieved that it had closed (after 3+ years) and then absolutely devastated when it opened after six weeks of it being closed and living a normal life, once again doing what I wanted to do without having to worry about a wound.
My boyfriend has said that it is okay with him if I post a few of the pictures, so though I chose to keep my wound pictures private, I will share his.
Boyfriend's wound picture taken approximately September 4, 2012
After the visiting nurse and I treated it for a few weeks, it began to look too dry:
Picture taken October 16, 2012
Picture taken mid October, after treating with Hydrogel
Picture taken late October 2012
Picture taken early November 2012
Everything after that seemed fine until I saw it again in late January 2013. That is when I told him that it needed to be seen.
What my boyfriend's wound looked like in mid/late January
Photo from the first time the wound care center saw the wound (January 30, 2013) after it had been treated with Calcium alginate and a Tegaderm Foam Adhesive
Taken at wound care February 6, 2013 after having daily ABD dressing changes
Photo taken approximately February 8,2013 after Bactroban ointment
Taken February 9, 2013 after continued Bactroban
Calm down seems to be a recurring theme in my wound-life because when my boyfriend left to go to his house last week I was a little bit worried that he would have to take care of his wound without me. I was confident that he is not incompetent and could change the dressings without a problem, but I was worried that he would minimize it if he suddenly weren’t doing as well. That paranoia lead to me regularly asking him to text me pictures of his wound so that I could stay as up to date on its progress as possible. I am getting ahead of myself though, last week at my boyfriend’s appointment at the wound care center he was told that the culture results had come back positive for MRSA.
The surgeon therefore prescribed Bactroban Ointment an antibiotic to treat the infection, which my boyfriend was to apply to the wound bed once or twice a day when he changed the dressing. When the surgeon examined the wound itself though, he said that he thought it appeared a little smaller. I concurred (as if my opinion actually matters. ha-ha) that it did seem to be a little better than it had been, at least since the last time I had seen it.
My boyfriend is continuing to treat his wound himself at home and is periodically updating me on what he thinks is happening. He goes back to the wound care center next week. The surgeon said the he had a feeling that treating it with the ointment and just a small gauze pad would get it going in the direction we wanted it to go in. Hopefully, the surgeon is correct. Currently I am waiting for my boyfriend to visit so that among other things, he can show me a picture of my wound again so that maybe we can drill it into my head that it really is closed.
I know I am bordering on ridiculous with my level of paranoia about my wound; it is just that I cannot get the previous time that it was closed out of my head. I was so incredibly happy and relieved that it had closed (after 3+ years) and then absolutely devastated when it opened after six weeks of it being closed and living a normal life, once again doing what I wanted to do without having to worry about a wound.
Saturday, February 2, 2013
A Different Side of Wound Care
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.
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.
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