Too much to really say in a status update so thought I would write as a blog entry.
First and foremost I must say that all the doctors and nurses were AMAZING at Brackenridge. This was probably one of the best experiences to date as far as staff goes. The ER is always a nightmare, but again, all the staff was excellent.
I don't know what I would have done also without my dear friend which happens to be an attending OB doctor at Brackenridge and was on call all weekend. She was my voice and put the fear of God into any other intern or resident involved with my care.
So let me explain. Everyone knows I am a skinny girl. Well I had a bony area on my tailbone for YEARS that the skin never ever broke or anything, just got red now and then. I am only on it when I go to bed at night and even then, no more than 2-3hrs at a time. So I was getting physical therapy and it was mentioned in passing. They said they could come bandage it as a preventative to getting a wound. GREAT! (I thought)... So they came 2x a week and put this special bandage on it. Well, every time they would come it would be a different nurse (mostly LVNs). I was always told I could shower with the bandages on; as it was too hard for my mom to get them on correctly. Well one day the head nurse came (he was an RN) and he put the wrong bandage on and well I showered... 2 days later... took off the bandage and it had leaked and macerated my skin (broke it open).
We have been fighting this wound ever since. It always looked pretty superficial but kept scabbing over. We discontinued home health because Mom was so pissed at what they had done she thought we could get rid of it ourselves. We treated it daily with topical antibiotics, peroxide, you name it. Some days it looked better, but never seemed to fully heal. This has been there almost a year. My horrible hospital stay in February made it worse. Since then, I would say over the last 2 months we noticed it was "weeping" some bloody fluid. So we were not sure where to go so I contacted my nurse (one that did my dressings right) and she said the home health care had just hired a guy that specialized in wound care.
We loved him, he is from Louisiana and has a pretty strong accent. Pretty nice to look at too, and STRAIGHT lol! but very married. He is hilarious and good at what he does. He knows his wounds. Well come to find out, he said my wound was much worse than we thought. He said at least stage 3, possibly stage 4. This freaked us out. Well he treated it for 2 weeks with ointments to try and debride the wound--this means to rid it of all necrotic (dead) tissue and "clean" the wound because apparently it can't heal unless that tissue is removed. Well everything he did didn't work. It may have gotten SOME better, but not near what I should have. He told me I would have to go to a wound clinic.
Well I started feeling sick a couple of days before going to the wound clinic (which was in Cedar Park-the closest one to me). I went, saw the doc which was a general surgeon and he decided he wanted to debride some of it. He cut a small area out, but it was deep. He cut all the way down to muscle, that is how bad the wound was. He was worried about a condition called osteomyelitis which is basically infection in the bone. With wounds that deep that won't heal, sometimes it is because the bone is infected. Especially seeing as how right on the other side of the muscle he cut down to was my sacrum (the sacrum is basically the top part of your tailbone). Osteomyelitis can be VERY serious and life threatening. The next step without treatment is sepsis (blood infection) or spread to other connecting bones/tissues. Since the sacrum is attached to the spine... this was especially worrisome because obviously your spine goes to your brain.
So he ordered an MRI and some blood tests. I won't go in to all the details about that mess as we had serious issues with the Cedar Park hospital getting the MRI done. Anyway, by this time I was fighting pneumonia and had just got on a new regimen to try to stay out of the hospital. I was missing; going on 2 wks of work. I ended up getting the MRI done on Friday the 19th and the wound clinic wanted to put a wound vac on the wound. This is a device that does exactly what it sounds like... it vacuums out any fluid out of the wound and promotes healing by creating more blood flow also. By this time I was on the back end of the pneumonia and showing improvement. I was so happy to get the MRI done, I had the wound vac in place, and was gonna start back to work on Monday the 22nd and expected to not hear anything on my results until the following Thursday with my next wound clinic appointment. Well Friday night at about 10:30pm... I am sitting in front of my new iMac and jamming out to music... was finally feeling well... the phone rings. Dad brings me the phone and yelled at me to turn down the music. I was thinking, "who could this be?" Well it was a doctor. My primary doc's doctor on-call. He tells me he received the MRI and spoke to the radiologist and that I had osteomyelitis in my sacrum and coccyx (tailbone). He says "You need to go to the ER and start IV antibiotics tonight".... "what?--can't it wait until Monday?" "not by my recommendation, this is serious and could be life threatening and you need antibiotics ASAP"...
So there went my happy times... mom, dad and I discussed it in length and cried a bit, and also put in a call to Dr. Shapiro, my pulmonologist so he could be aware and also oversee anything relating to my respiratory state. Seeing as how I was still coughing from the residuals of pneumonia. He said I should go to the ER the following morning. I insisted on going to University Medical Center Brackenridge Seton because they are a higher level of care than the hospitals around here, and Dr. Shapiro does rounds there. The only problem is that it is a charity hospital and so the ER is always filled with crackheads and homeless. Dr. Shapiro said the ER would be a mess on a Friday night.
So mom and I got there around noon on Saturday. We sat in the ER for almost 8 hours! Got in to an ER room quick, but after that we just waited and waited. I got an idea and called my dear friend Diana that I did the ballet with. I had forgotten she is an attending OB doc there at the hospital. I thought she would probably want to know what was going on. Well ... she happened to be on-call and came to the ER to see me. The timing was perfect as an ER intern came in to talk to me. My friend was in regular clothing so he thought she was just any other "friend"... he began asking me questions. He forgot to ask one important question and she spoke up and said "Are you allergic to any medications?" He said, "good call!" ... she said "yeah, I am OB attending here at Brack"... boy his whole demeanor changed!! hahaha! He had come in a bit cocky. She said in a joking (yet not joking way) "I will be watching you!" It was hilarious and pretty awesome to know someone with that much power that you can honestly say is your friend.
Right before we went to our room, we met with a really nice plastic surgeon that said she would come see me the following day. That she wasn't convinced by the MRI that I had osteomyelitis! She said she would need to surgically look at it and debride it.
I finally got into my room with two IV ports, one in each hand, by about 8pm. Mom and I were starving and dad brought us up KFC. I wasn't about to eat the hospital food. I had missed dinner anyway.
The next day, Sunday, I saw my friend sitting at the nurses desk and could see that she was looking over my charts. She then came in, this time all in full doctor's coat and all. Right after she was there for a bit, the plastic surgeon came in. My friend asked if she could stay for the procedure. Boy was it a procedure!! Something that would typically be done in an operating room, and even under general anesthesia. I was blessed because this wound has never hurt me... I can't feel anything in that spot at all hardly. Well she gave me a shot of lidocaine and epinephrine to control bleeding and I didn't even feel that!!
Well basically the wound is the size of a bit bigger than a quarter in diameter. She cut the whole wound out!! It was full of dead (necrotic) tissue. She tried to pull it out without using a scalpel but it had been there so long it was fused in there hard. She cut all the way down to the bone. She did some swabs of the tissue to culture and shaved down/off some of the bone, and sent some of that for biopsy. The great news was that in all of the tissue or bone she saw NO visible signs of infection anywhere. She said the bone will because very brittle and looks discolored. She said all the bone was very healthy and now that she got the dead tissue out, all the tissue left was bleeding and red which is good as all that's left is healthy tissue. My friend agreed everything looked good. So then the wound vac was put back on and the hope is that it will close up the wound, at least mostly. I am not sure how long I will have to have it. Finally I got the hospital to let me go home Monday because really I wasn't doing anything there I couldn't do at home. Jacob, my wound nurse, changed my vac yesterday. My friend wanted me to send her a picture with each change. I saw it for the first time since it was operated on... it is DISGUSTING!!! So bad I won't even share... and for those of you that know me... know I have no shame with almost anything! It is a big open nasty wound and you can see the bone... it's pretty scary. I have an appointment at the Cedar Park Wound Clinic next Thursday and Jacob will be changing my bandaging 2x a week. I pray I don't need any other surgical intervention to close this. They were saying if the vac doesn't close it they may do a skin graft or create a skin flap to close it. Blech!
So there ya' go! I got back to work yesterday and it felt so good!
I will try to keep up with posts better so I don't have to write novels. (I know I always say that!)
We have been fighting this wound ever since. It always looked pretty superficial but kept scabbing over. We discontinued home health because Mom was so pissed at what they had done she thought we could get rid of it ourselves. We treated it daily with topical antibiotics, peroxide, you name it. Some days it looked better, but never seemed to fully heal. This has been there almost a year. My horrible hospital stay in February made it worse. Since then, I would say over the last 2 months we noticed it was "weeping" some bloody fluid. So we were not sure where to go so I contacted my nurse (one that did my dressings right) and she said the home health care had just hired a guy that specialized in wound care.
We loved him, he is from Louisiana and has a pretty strong accent. Pretty nice to look at too, and STRAIGHT lol! but very married. He is hilarious and good at what he does. He knows his wounds. Well come to find out, he said my wound was much worse than we thought. He said at least stage 3, possibly stage 4. This freaked us out. Well he treated it for 2 weeks with ointments to try and debride the wound--this means to rid it of all necrotic (dead) tissue and "clean" the wound because apparently it can't heal unless that tissue is removed. Well everything he did didn't work. It may have gotten SOME better, but not near what I should have. He told me I would have to go to a wound clinic.
Well I started feeling sick a couple of days before going to the wound clinic (which was in Cedar Park-the closest one to me). I went, saw the doc which was a general surgeon and he decided he wanted to debride some of it. He cut a small area out, but it was deep. He cut all the way down to muscle, that is how bad the wound was. He was worried about a condition called osteomyelitis which is basically infection in the bone. With wounds that deep that won't heal, sometimes it is because the bone is infected. Especially seeing as how right on the other side of the muscle he cut down to was my sacrum (the sacrum is basically the top part of your tailbone). Osteomyelitis can be VERY serious and life threatening. The next step without treatment is sepsis (blood infection) or spread to other connecting bones/tissues. Since the sacrum is attached to the spine... this was especially worrisome because obviously your spine goes to your brain.
So he ordered an MRI and some blood tests. I won't go in to all the details about that mess as we had serious issues with the Cedar Park hospital getting the MRI done. Anyway, by this time I was fighting pneumonia and had just got on a new regimen to try to stay out of the hospital. I was missing; going on 2 wks of work. I ended up getting the MRI done on Friday the 19th and the wound clinic wanted to put a wound vac on the wound. This is a device that does exactly what it sounds like... it vacuums out any fluid out of the wound and promotes healing by creating more blood flow also. By this time I was on the back end of the pneumonia and showing improvement. I was so happy to get the MRI done, I had the wound vac in place, and was gonna start back to work on Monday the 22nd and expected to not hear anything on my results until the following Thursday with my next wound clinic appointment. Well Friday night at about 10:30pm... I am sitting in front of my new iMac and jamming out to music... was finally feeling well... the phone rings. Dad brings me the phone and yelled at me to turn down the music. I was thinking, "who could this be?" Well it was a doctor. My primary doc's doctor on-call. He tells me he received the MRI and spoke to the radiologist and that I had osteomyelitis in my sacrum and coccyx (tailbone). He says "You need to go to the ER and start IV antibiotics tonight".... "what?--can't it wait until Monday?" "not by my recommendation, this is serious and could be life threatening and you need antibiotics ASAP"...
So there went my happy times... mom, dad and I discussed it in length and cried a bit, and also put in a call to Dr. Shapiro, my pulmonologist so he could be aware and also oversee anything relating to my respiratory state. Seeing as how I was still coughing from the residuals of pneumonia. He said I should go to the ER the following morning. I insisted on going to University Medical Center Brackenridge Seton because they are a higher level of care than the hospitals around here, and Dr. Shapiro does rounds there. The only problem is that it is a charity hospital and so the ER is always filled with crackheads and homeless. Dr. Shapiro said the ER would be a mess on a Friday night.
So mom and I got there around noon on Saturday. We sat in the ER for almost 8 hours! Got in to an ER room quick, but after that we just waited and waited. I got an idea and called my dear friend Diana that I did the ballet with. I had forgotten she is an attending OB doc there at the hospital. I thought she would probably want to know what was going on. Well ... she happened to be on-call and came to the ER to see me. The timing was perfect as an ER intern came in to talk to me. My friend was in regular clothing so he thought she was just any other "friend"... he began asking me questions. He forgot to ask one important question and she spoke up and said "Are you allergic to any medications?" He said, "good call!" ... she said "yeah, I am OB attending here at Brack"... boy his whole demeanor changed!! hahaha! He had come in a bit cocky. She said in a joking (yet not joking way) "I will be watching you!" It was hilarious and pretty awesome to know someone with that much power that you can honestly say is your friend.
Right before we went to our room, we met with a really nice plastic surgeon that said she would come see me the following day. That she wasn't convinced by the MRI that I had osteomyelitis! She said she would need to surgically look at it and debride it.
I finally got into my room with two IV ports, one in each hand, by about 8pm. Mom and I were starving and dad brought us up KFC. I wasn't about to eat the hospital food. I had missed dinner anyway.
The next day, Sunday, I saw my friend sitting at the nurses desk and could see that she was looking over my charts. She then came in, this time all in full doctor's coat and all. Right after she was there for a bit, the plastic surgeon came in. My friend asked if she could stay for the procedure. Boy was it a procedure!! Something that would typically be done in an operating room, and even under general anesthesia. I was blessed because this wound has never hurt me... I can't feel anything in that spot at all hardly. Well she gave me a shot of lidocaine and epinephrine to control bleeding and I didn't even feel that!!
Well basically the wound is the size of a bit bigger than a quarter in diameter. She cut the whole wound out!! It was full of dead (necrotic) tissue. She tried to pull it out without using a scalpel but it had been there so long it was fused in there hard. She cut all the way down to the bone. She did some swabs of the tissue to culture and shaved down/off some of the bone, and sent some of that for biopsy. The great news was that in all of the tissue or bone she saw NO visible signs of infection anywhere. She said the bone will because very brittle and looks discolored. She said all the bone was very healthy and now that she got the dead tissue out, all the tissue left was bleeding and red which is good as all that's left is healthy tissue. My friend agreed everything looked good. So then the wound vac was put back on and the hope is that it will close up the wound, at least mostly. I am not sure how long I will have to have it. Finally I got the hospital to let me go home Monday because really I wasn't doing anything there I couldn't do at home. Jacob, my wound nurse, changed my vac yesterday. My friend wanted me to send her a picture with each change. I saw it for the first time since it was operated on... it is DISGUSTING!!! So bad I won't even share... and for those of you that know me... know I have no shame with almost anything! It is a big open nasty wound and you can see the bone... it's pretty scary. I have an appointment at the Cedar Park Wound Clinic next Thursday and Jacob will be changing my bandaging 2x a week. I pray I don't need any other surgical intervention to close this. They were saying if the vac doesn't close it they may do a skin graft or create a skin flap to close it. Blech!
So there ya' go! I got back to work yesterday and it felt so good!
I will try to keep up with posts better so I don't have to write novels. (I know I always say that!)
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