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Posts Tagged ‘Wound Packing’

The past couple of days have been quite bad Still’s-wise; today is slightly better but I think that’s down to me switching back to my regular Tramadol rather than the Prolonged Release form I had been trying out.  That didn’t seem to keep the pain away enough at all.

Since waking up on Wednesday, there has been a lot of joint involvement – my left arm joints suddenly felt a lot worse, with the elbow even more restricted than usual, both knees felt painful, tight and stiff as if there was fluid in the joint (there may be, just not as severe as when I was a teenager and they swelled up like footballs), plus my right hip is extremely wince-worthy painful, meaning I can’t lift that leg on its own and have to take stairs etc. one step at a time.

It really isn’t looking promising for the Orencia / Methotrexate combination. I’ve now had two doses of the 15mg Mtx and that is the only thing to have changed – funny then, that I feel worse. Still extremely tired and so I’m giving myself rests in the afternoon and going to bed earlier again; I figured that my body was working over time to heal this open wound after all, so I will listen to it.  Hopefully, after my infusion and Rheumy visit on Thursday (expecting to need some joint injections), I’ll have much more energy for New York. Besides, I’m so excited that I’m sure I will run on adrenaline alone.

I’m no longer too concerned about my wound and travelling.  The nurse was very pleased with the progress it had made and reduced my clinic appointments to twice a week. The rest of the time I am to change the dressings myself and she has given me everything I need to do so. I’m getting used to it now and can even remove and replace the packing myself, it’s not too bad now I know what I’m facing. Plus the wound itself has improved so much that it is no longer the bottomless pit that it seemed at first; it’s amazing how the body works to heal itself.

I’m surprised that it hasn’t ever really been painful – of all the things that are going on with me at the moment, that is the least of my pains.  The Hidradenitis itself is more painful, especially this second site in my left groin. It is nothing to look at really, just two pin-prick sized holes where it has channelled to the surface, but I nearly jumped through the roof when they swabbed it the other day, whereas I haven’t flinched at all with them poking and prodding the open wound.  Obviously I’d love for it to clear up itself, but at the moment I’m okay with the possibility of needing the surgery again, but I would like to get an idea of the scarring first.

Anyway, that’s everything for now. There isn’t much I can do until I see my Rheumy really, except maybe ask the GP about some different painkillers again.  Looks like I’m back to waiting around for things to improve; it just can’t happen fast enough.

L

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Yesterday was the first day since my surgery that I didn’t see the nurse to repack my wound and change the dressing. She had said previously that the wound would heal better the more time we left the packing undisturbed, hoped to move on to alternate days, and that if I felt everything was in place and not too soaked, then I could give Sunday clinic a miss.

Everything looked fine when I got up to check early on Sunday morning and it didn’t take much persuading for me to climb back into bed for a much-needed lie in. By lunch time however, things started to soak through the dressing a bit; it’s only blood but the thing is, as well as being a little bit messy, my sensitive nose can smell it and that makes me feel dirty so… The nurse had given me spare dressings, aquacel, saline irrigation, gloves and pinny – the whole kit! – just in case this were to happen and I felt brave enough to give it a go myself, which is what I did.

I followed the instructions she had given me to make sure myself and the area were sterile and set about removing the dressing.  I had only caught brief glimpses of the wound up until this point and so was a bit nervous about what I’d find underneath. I figured it was something I needed to face though, it’s my body after all. I have to admit that it was a bit bigger than I had expected but nothing I couldn’t cope with. I wasn’t brave enough to remove and replace the packing though so just cleaned the edges and stuck a clean dressing over the top. I was so relieved to get the thing on as I’d been worried the packing would fall out, that I’d have no choice but to poke some more in!

It seems that keeping the packing in was the right thing to do anyway, because when I went to the clinic this morning the nurse said that it had done really well with that extra day of being untouched; whereas the tape was just filling the wound beforehand, it was now coming above the surface, which feels like great progress! So we made the decision that we would leave replacing it until my post-op appointment on Wednesday morning. Again, I have the kit to sort things out myself if needs be, but hopefully I won’t have to.

The bleeding is normal by the way, just the body trying to heal itself as the nurse told me. I managed to take a quick picture for anyone interested in seeing what the surgery involves. I’ve no flash on my camera phone so it is quite dark and not gory, but if you really are squeamish this is your warning not to look!

The wound is located in my left groin/top inner thigh; I’m not sure of the actual measurements. The surgeon removed all the infection and the scar tissue, where tracts or sinuses had formed and my body had tried to heal repeatedly. The wound couldn’t be stitched because of the risk of trapping infection inside; if the body heals from the surface layer down than a cavity remains and is perfect for reforming abscess. This way, the body heals from the bottom upwards, meaning nothing gets trapped inside and the area is replaced with healthy tissue. I can’t imagine what the scar will be like, but I doubt I’ll be wearing bikinis for a while!

L

A week after surgery - the packing is still in place here.

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There hasn’t been much to report since the surgery on Friday; I’m still on bed rest mainly, so as to keep my legs raised and help the healing process. The wound is currently repacked with Aquacel or Kaltostat every morning and then redressed, meaning a daily drive to the local clinic. It’s not the nicest experience, having someone prodding around in an open wound, but I had visions of it being much worse and I’m pleased to say the pain is only mild.

The first nurse I saw told me not to look, that they’d taken quite a chunk out of my thigh, so I didn’t. However, yesterday the nurse somehow managed to stick the dressing onto the wound itself, meaning that it peeled away and gaped every time I sat on the loo, giving me no choice but to face it. I made sure that the nurse this morning stuck the patch well and truly over the wound and taped it down doubly, as not only did it make me feel queasy seeing the gaping hole, but I was also worried about it being contaminated. I have had a wound infection in the past and it wasn’t nice; thankfully, this one is looking nice and pink, which I have been told is a good sign that it is clean and healing well.

I am not allowed to shower so am having good old fashioned flannel washes twice a day and my boyfriend washed my hair for me last night. He’s also looking after my little furbaby, Jasper, as I’ve been told to keep away from pets for a while; I’m sure I will have a very sulky bunny by the end of it. I think both of them will deserve a treat by then too, especially considering how close my squeamish bf came to passing out during the first dressings change.

Still’s -wise, everything is pretty much the same and being kept stable by the Prednisolone and painkillers. Tonight I am to make a couple of changes to my medication; firstly is to switch to Modified release Tramadol capsules, which I only need to take twice a day and should give me a more steady level of pain relief. Secondly, I need to double my dose of Methotrexate to 15mg.  This is still a lot less than I took when I reacted badly to it, but I’m still feeling a bit hesitant  – the ‘hangover’ side effects have gradually faded over the past weeks and now I have a feeling it will be like starting over, if not worse.

But that’s being negative and only time will tell.  I have to know that I’ve given the Orencia the best chance of success before giving up on it; this could be just the boost it needs.

L

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