Monday, November 23, 2009

On the Brink of Vacuuming

I thought about the title of this post and thought things like "update on the wound" and "wound status" probably wouldn't be too enticing in the blogrolls of my fellow bloggers where I'm listed. Better to tease the potential reader with the title above.

Anyway, now that you're here... I'm back in the blog world with an update on Skip's wound.

We went on 4 successive Thursdays to the local wound clinic for debriding by a plastic surgeon. This is the process of removing slough and necrotic (aka dead) tissue from the wound to leave a nice, healthy wound bed, providing a good site for healing (FYI - do NOT go to Wikipedia to look up the definition of debriding unless you have a strong stomach. The photo accompanying the article is gruesome.). The second visit wasn't the most fruitful debridement because Skip's blood sugar was out of control (she has Type II diabetes) and they were very restrained as a result. They also sent us off to the Emergency Room after the appointment. Fortunately, Skip's blood sugar was returning back to normal in the ER so nothing further was required; we still have no idea why it was so high that day as the problem has not recurred, fortunately. The 3rd and 4th visits were very effective and the surgeon announced last Thursday that we could begin the vacuum wound treatments.

The device arrives tomorrow morning and the wound nurse and the nurse in charge of Skip's case are coming for the initial setup. From there on, nurses will come and change the sponge in the vacuum 3 times a week. We'll still need to visit the wound center every other week for a while for a check-in on progress and such. The projected time for healing is 4-6 months. Yikes!

Now that we're transitioning into the healing stage for the wound, the next thing to work on is Skip's environment to ensure such a horrible thing as this monster wound never occurs again. A Roho cushion for her wheelchair has been held up because the company that sourced her power chair are having issues getting Medicare to pony up the $24,000 for the chair and won't get the cushion until that's resolved. I'm not quite sure what the status is on the bed air mattress. We'll check in on that when the nurses come tomorrow. In the meantime, Skip is sleeping on her side (she's been sleeping on her back for years) and is spending afternoons when her aide isn't here lying down. She's changing her position through tilt and recline on her chair throughout the day.

I just checked in with Skip. The pain today is "so-so." Some days it spikes way up, some days it's moderate, but it never seems to go away. I'm looking forward to a pain-free day for Skip.


steve said...

BR's alternating pressure pad has been an ass saver. The original pad we had sprung a slow leak, so the pad wasn't inflating to the proper pressure, and a wound started forming almost overnight. Only the bout with incontinence over the summer and associated Depend usage did more damage to the butt skin.

Can't say enough good things about the Roho cushions. Both BR and my mother use them and are very happy. They even make one for toilet/shower chairs that will likely be on the Christmas list.

Good luck with Medicare. If you are successful, let us know how. It seems their standard limit on power chair expense is around $4000.

Cranky said...

Steve - glad to hear your compliments re the Roho cushions. I may purchase one on eBay since the Medicare issue continues.

As far as the wheelchair goes, the salesguy that worked with us on it said Medicare does approve more expensive chairs with greater functionality if medical necessity can be proved. As far as I can tell from the Medicare denial papers, it appears the folks that sourced us the chair didn't submit the paperwork in good order.