WOUND CARE

The last few days have sort of normalized regarding wound care for the MEAT FLAP.

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Nothing has changed. It looks the same as the first day I removed the dressings to take a peek. The only difference I could see was a greyish creamy matter at one end of the opening. Any changes, to me, are to be regarded with suspicion and concern for more potential complications.

I had put in a call to a resource referred to me by the bedside nurse after my procedure called “Wound Care Clinic”. She listened patiently to Matt’s description of what the surgeon told him to do to care for the incision, then she said, “There are better ways”, like in this whispery, far-off, mystical tone.

“Better ways,” Matt and I repeated looking at each other. Huh. She wrote the contact name and number down on my discharge instructions, and away we went.

Then, after a few days of this seemingly ridiculous routine of Matt performing his interpretation of what the doctor instructed him to do each morning and evening, we decided we needed to see this Wound Care specialist.

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Florence Nightingale

Today Matt and I went to the Wound Care Clinic at Legacy Good Samaritan Medical Center. The nurse, Sue Wilson, was like a refreshing breeze. She was the Florence Nightingale of Good Sam. She kept reaching out to put a tender hand on my wrist or hand, to express reassurance, that she was truly sorry that I’d had to endure the disease and procedures that I had, and she wants to help as many patients as she can take the complication out of their post operative wounds. There were a number of patients waiting to see her in the lobby.

She listened to Matt regale the story of Dr. Childs and the meso-rectal envelope and the stoma-gone-wrong to the hernia “blow-out” and repair surgery, then the instructions that Dr. Tseng had given to care for the “meat flap”.

Florence, I mean Sue, proceeded to lay me back on the exam table and examine the unbandaged wound. “Well, it looks great,” she said, mildly impressed. “It’s a clean cut, consistent color; it’s been well cared for” (I gave Matt a high-five later). Then she warned me she would clean and poke around to inspect it, that it may hurt. I noted that I don’t really feel hurt with this one. Apparently, in ostomy sites, which this was, nerves are damaged and it’s common that people will not feel pain. (That was our first ah-ha moment. That’s why I did not need my pain meds much after the surgery!)

Then she cleaned inside the wound, and to our surprise, a 5-inch long Q-Tip slid easily into a channel under the skin about 2 inches (Ayayay!). That’s where the infection track went. An infection leaves a trail, like snails do! (Another ah-ha.) Or at least like a train track.

She noted the measurements; how deep the tissue was, how long the incision, how far the channel went…

She then introduced a product that is seaweed (kelp?) -based. It looks like angel hair in a bag. With this, instead of packing with gauze, it helps the tissue stay nourished and it absorbs wound drainage. The name… blah blah, it’s a new one, …KALTOSTAT. Then she loaded brown paper bag of water-proof bandages that I can wear while showering, some Q-Tips, adhesive protection spray (to make it easier to remove the adhesive bandages from my skin) for me to take.

 

The Last Ah-ha

Now, naturally, I think, Matt and I have been gravely concerned about the cleanliness and preparation of our at-home exam table (the bed) and countertop, hands, etc, to avoid any possibility of introducing a whole new infection to the area. Rightly so. When you cut your finger, you use alcohol, hydrogen peroxide, cotton balls, Neosporin, band-aids for protection, you name it, on the wound to keep it from getting infected. And if you don’t? It gets infected! And the infection gets worse and worse until you do it right for long enough that it heals up.

In this case, that’s not necessary, it turns out!

Sue said, “You can change your dressings every 1-2 days, and if you shower every day, just let the water run over the wound” (??!?). Yeah; just shower like you normally do, and don’t pay any special attention to the incision (?!?!). Soap and water will not hurt anything, it will be good for the cut to be irrigated by the water (!!?!).

Gah? Totally counter-intuitive, no? I knew that the surgeon just knew something we didn’t or he would have given WAY more specific care instructions. So weird.

Other than that, I feel more energy. Kombucha, green tea, lots of fresh turmeric root, ginger, garlic, water… kind of what I usually do, just more of it. I introduced wine last night for the first time in over a week, and I maintain a strict regimen of ice cream after dinner. I can exercise (walking and not too much upper-body stuff), watch Matt work/play out in the garden. In the next few months we will be eating from home-grown bounty!

Anyway, that’s the short story (ha ha) of what’s been up the last few days.

STITCH INFECTION REVISITED

Infected sutures from my prior surgeries are creating a complication today.

My next surgery happens tomorrow morning.

Let’s back up.

The 3 weeks of antibiotics prescribed to me took care of the infection in my hernia area for a few days. Then it came back. GRRR! Well, I had to expect it would happen that way, as it was foreseen by the fates. So, less than a week after the antibiotics ended, a pimple formed where an old one was. Then over time a redness appeared in the hernia scar itself and grew to a large pimple and opened up again. Ok, we’ve got to take care of this. Now.

My hernia surgeon is not on my new insurance plan, so I scheduled consultations with two alternate surgeons to get their opinions. Their opinions were in agreement on the approach to clean out the sutures and mesh from the hernia repair, thank goodness, and I scheduled a procedure for tomorrow! Rest assured, it should be a minor procedure. My surgeon wants to put me under, so he can really get under the skin and make sure he understands the problem and gets rid of all infected material. Ok, I don’t really want to be aware during that. Very likely that he won’t replace the mesh.

The hernia may not come back, but it could. It could come back tomorrow or it could come back any time in the future. Then it can be repaired – again – at that time. But tomorrow it will be an in-and-out procedure. I will come out of OR (the operating room), then once my vitals prove stable I can go home, probably mid-afternoon, then back to business the next day. Ok, I can deal with that.

The surgeon who provided the second opinion cautioned, a full fix on this hernia could take “a while”. Yeah, I kind of figured. It’s quite amazing how complicated these hernias can be to fix. You could have a handful of surgeons review the same situation, and have a handful very different opinions on how to fix it. There are lots of material and technological options for surgeons to use, and there are a lot of body types among patients. Every patient will respond differently to a chosen treatment.

So, it seems to be a moving target.

Wishes of luck will be appreciated! I will update here once I am out.

STITCH INFECTION

From a gastrointestinal hold-up to… a stitch infection?

By Friday I was on the phone with the doctor again, the skin had turned red with a burning soreness from which I could not escape. She said the stitches need to come out. My next appointment with her wasn’t for five more days, so she called in a prescription for antibiotics, and said, if it doesn’t get better, she will meet me over the weekend to remove the stitches. At that moment, all I wanted was pain relief, so I began the antibiotics… along with more Ibuprofen.

By the next day I felt somewhat relieved, so Saturday was just a regular day at home; resting, reading, cooking, chores… By evening Matt and I were preparing dinner, and we were working out a disagreement. Matt was feeling I have been inattentive recently toward him, and I pointed out that I have not expressed to him how much pain and discomfort I have been tolerating, nor my secret concerns that my health would get worse before getting better.

Matt suddenly looked at my stomach intently and asked, “What’s that wet spot on your shirt?” Immediately I thought, Oh no, what now? I lifted my shirt and from the reddened skin and stitches oozed a mucous substance.

Oh my poor body!

As with so many times before, I had no idea what to make of this. Both Matt and I have been feeling worn out from these mysterious and worrisome episodes. Matt’s expression had softened and now showed severe concern. He got up and wetted a tissue with alcohol and rubbed the fluid away from my stitches. I vowed to call Dr. Childs the next morning.

After communicating the symptoms over the phone, Dr. Childs gave two options, I could drive in and have the stitches removed immediately (she was already at the office on a Sunday morning), or since it was not an emergency, I could wait and drive in Monday morning. I said, “I’ll come in now,” thank you. Yeah, let’s get this dun!

The good news is, Dr. Childs confirmed that the fluid was draining “as it should”, this happens, not to everybody, but is very common with soft tissue surgeries. The seroma, as it is termed, will have to drain and heal on it’s own time.

Whew! Stitches out, seroma relieved. Now I have a patch on my belly that absorbs seroma fluid. Because gauze pads are expensive, the doctor recommended feminine mini-pads will work just as well at a lower price. So be it, a mini-pad on my abdomen and daily flushing with a syringe of water (yuck!) will do just fine.

Today: Relief = comfort = concentration = happy Michelle = happy Matt!

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