Sunday, April 10, 2016

How I Became an Uncertified Wound Nurse

Okay.  I have started many a post the last few months and...never finished them. They were just too depressing. I don't love complaining and, when I started this blog, I did not intend for the state of my health to be the central theme.  I began "Little Momma, Big World" thinking I would be writing about my riveting (ha!) adventures in mommy-hood and marriage, but I have penned very few posts about either.  The fact is, my life is dictated by my health or lack thereof - which is fine, as I don't know life any other way.

Perhaps I should rename my blog to Mommy with an Ostomy.  Hmm.

For the select few who read my ramblings, I must inform you that a month ago, I wrote a very depressing post about continued complications from my surgery last December.  I didn't end up posting it, much less finishing it, because I've jumped on my Crohn's soapbox a couple times using this medium, and I really do not want to portray my outlook on life as one big autoimmune injustice.

However, I will write this post until the end.  I will post it because today, for the first time in a long time, I had a wonderful doctor appointment.

I think when you grow up with any sort of chronic illness, "good" doctors' appointments are typically few and far between.  It started with my pediatric gastroenterologist: diagnosis of Crohn's at seven, followed by my Indian doctor looking pensive as pill after pill did not work.  The bad news continued, after a three-to-four year period of not growing (At all. Whatsoever.), with my endocrinologist combining growth hormone with chemotherapy and wondering why I still wasn't growing.  "You will probably never hit five feet," I was told.  For some reason, I'll never forget the elevators shutting on me as my parents and I left that dismal appointment.  Years of being told by doctors I needed an ostomy, or that time I experienced severe anaphylactic shock to the only tried and true Crohn's treatment of the time.....all these memories make good doctors' appointments so sweet, so uplifting.

Back to the main story.

On October 1st, I had an appointment to check my rectal wound with my colorectal surgeon.  She took one look at it and sighed.  "We've done all we can, and nothing has worked."  Dr. Galandiuk is a very even-keeled, soft-spoken, and frank woman.  The dismal look on her face triggered the tears the I had been trying so hard to swallow down. "I think it's time for a wound vac."

Until two years ago, getting an ostomy was my absolute paralyzing fear: life as I knew it would end if I had a bag of poop on my beautiful abdomen.  Since my surgery last December that left me with a gaping wound where my b-hole used to be, the words "wound vac" have chilled me to the bone.  In short, it's a suction device that would be constantly attached to me by a tube and a piece of foam in the actual wound.  It sucks out all of the crap, promoting healing and closure.  That's all fine and dandy but who wants to walk around with a tube in their butt?? The wound vac is about the size of a lunch box, so you can't hide it either.  Because of the location of my wound, the wound vac placement would be very precarious and could easily fall out.  Not to mention, insurance doesn't like to cover it (I mean, really??? Like I'd do this if I didn't need it?!)  A wound vac is my greatest fear.

When Dr. G broke the news, I became desperate.  As I ferociously blinked back my tears: "Please, is there anything else I can do?  I just got a second job and, and, I have a two year old, and I just don't, it's not the right time."

The woman knew I needed a semblance of hope.  She looked at me for a minute, then: "Let me see if there's a plastic surgeon here.  Dr. Tobin does these great tissue flap surgeries and maybe he could do that for you."  I sniffed.

For those who aren't in the medical field, having another doctor from a totally different practice and field just "come over" to see a patient (who doesn't belong to them) is a bit unorthodox.  Typically, an official consult is called and you're typically waiting a few weeks to a few months before the other doc ever sees you. Yet, a mere half hour passed and both Dr. G and this plastic surgeon showed up in my exam room.

I held my breath, literally and figuratively, as he inspected me.  He stepped back and said, "Well, you're not a contender for a tissue flap surgery."  I began crying again, as I'm apparently wont to do around doctors.  "However, I've worked with thousands of wounds in my career.  I've found that packing it with a dressing soaked in Dakins solution [essentially Clorox] works well.  Most surgeons would have you change it twice a day, but I've found the most success with changing it four times a day."

I thanked him profusely for his alternative solution.  This is what I was going to do.  He left as quickly as he came, and I was left with Dr. Galandiuk.  "You can try this.  I must say, the wound vac is probably your best bet."  Despite the gravity with which she told me this, she left the choice to me.

It's worth noting that I have never been trained in wound care, and, despite working in a hospital for two years, I have most certainly never dressed a wound.  Sure, I've seen it done, but I never took notes on technique or anything.  The first dressing was the worst.  It was excruciating to put in, and the pain inflicted by later removing it was actually unbearable.  Not to toot my own horn, but I've been in a lot of pain throughout my life and I like to think that because of it, I have a high threshold for pain.  The hurt I inflicted upon myself while pulling that dressing out (un-medicated) went against every bodily instinct in me.

After a few days, the pain morphed into discomfort and I was able to walk (albeit, you could probably tell something was literally up my a-s-s).  A week passed and I was a wound-dressing champ: one change in the morning, two at work, one at bedtime, like clockwork.  The dressing became practically unnoticeable. I liked having it.  What?

This brings us to one month post-depressing appointment.  November 5th, I anxiously walked into the exam room.  "So," Dr. G starts, "how do you think it's going?"

"Well, I made a conscious decision to not assess the progress of the wound, because I figured the hope that it will get better clouds my perspective."  No reason to get my hopes up, if they might easily get dashed anyway.

She inspected me.  "This is extraordinary," she said.  "Your wound has shrunk quite considerably!  I don't think you'll need a wound vac."  At this, my mom's eyes welled with tears.

I could only muster an incredulous, "Really?!" 

I was then sent to my plastic surgeon. "This is remarkable!"  His beady eyes lit up.  "The healing that has happened in just one month is rather miraculous.  Let's not tamper with what's working.  Proceed with the dressings, and I don't think you'll need a wound a vac!"

My mother mentioned to him how many people had been praying for my healing.  To most doctors, a statement like this has a nice sentiment, but the lack of science involved doesn't lend prayer a lot of merit.  "It's healing up well," he agreed. "But just because you have faith doesn't mean it's smooth sailing," he warned.

I suppose my story is a long-winded way of saying I obviously don't expect God to deliver. Despite my prayers, and all those praying for me, I fully went into that appointment not expecting the amazing news I got.  I pray, sure, hoping that something good will happen. Ultimately though, my poor health over the course of my whole life has proven Dr. Tobin's statement true, right?


We're basically promised in the Bible that life won't be easy.  Our trials, however, many might they be, do not preclude the Great Physician from working miracles.

He heals the brokenhearted
and binds up their wounds.
Psalms 147:3 NIV


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