We made the Monday, Wednesday, and Friday wound care appointments this week. I missed the Monday appointment because I was working, so someone else took her. I’ve been taking pictures of the wound to compare visit to visit; I had Amanda get a picture of it for me. She said the doctor was going to take one on his phone to show her what it looked like, and she was like, here, take it on mine! It looked good and was healing great, especially the bottom, which has filled in completely. I made it home to make the Wednesday appointment, and it looked good then as well. But there is a hole or tunnel per se at the top that is deep the doctor was concerned about.
The doctor wanted to put collagen and silver cept, an antimicrobial gel, in the hole. So they made a paste from the crushed bone and silver cept to put in the cavity. He had the tech make the foam that goes over the wound shaped more to also go in the hole. He also mentioned that he’d likely discontinue the wound vac, stating that it didn’t seem to be doing much good now.
I made a quick trip out Wednesday night and got back late Thursday night, so I was able to make the Friday appointment. When they removed the vac bandage, I immediately said the hole was bigger! It didn’t look good compared to the previous visits, too. The hole seemed bigger and looked white all around the hole. Turns out the discoloration was from the collagen paste, and the hole just seemed more significant. After I compared the current picture to the old one, I could see that it was bigger, but I didn’t think it was much smaller, though.
The doctor was literally scratching his head as he was deciding what to do now. He could tell I was a bit perturbed by how it looked. It has been looking so good at each appointment until they put the paste in there. He decided to DC the vac for now but wanted to put another gel in the hole. I was full of questions, so he was talking directly to me and addressing the issues I would bring up. I noticed this because I always appreciate it when doctors assess both of us. He later apologized to Amanda, saying he was the kind to speak with one person and bad about talking to two!
The new bandage has a silver flannel-looking mat over the hole, then gauze and paper tape. My next question was, could she take a shower, to which he answered no. I could see Amanda was not happy about that. But the new dressing couldn’t handle any water on it. The nurse who put the dressing on was female but didn’t have any regard for the size she made it. It was cockeyed and stuck up high on Amanda’s chest. I knew she would like it when I was how it was done. Correct, I was; she was fuming mad as we walked to the car!
We were sent with supplies to change the dressing if needed. The drainage amount, which had been minimal with the vac, was hard to gauge so the doctor wasn’t sure how often we’d need to change it, if at all. To calm Amanda’s nerves, I told her when we got home, I could change it out. Since it was fresh, just leave the silver patch over the hole intact just swapping the gauze and tape out for much smaller and straighter ones. She was happier without the big vac to tote around now. They did say to keep it charged and bring it along with our supplies to the next appointment, just in case. That appointment will be on Monday, which we’ll leave and head straight to Houston for follow-ups.
We also had to see our primary to get a refill on Amanda’s pain meds. She’s backed off using them a bit and likely won’t need much more, but with busy days ahead, she didn’t want to change it. The pain with pain meds, pun intended, is that we have to go in for a physical visit to get it refilled. This appointment was pushed back like our last; the doctor wasn’t back yet. I knew it would be a while when I saw the doctors leaving while we were sitting in the parking lot. Once we saw him, he must have needed a break because he just sat and talked for a while. By the sound of the other rooms, his visits would be filled with babies and toddlers, so maybe he did need a break!
I’m currently in Alpine and will get back late Sunday; then, I have a union meeting I need to prepare for and attend in Del Rio on Monday morning. Amanda had a friend lined up to take her Monday morning. Then I’d pick her up, and we’d head to H-town, but with the wound not looking the best, I wanted to be there for the appointment, too. This will be a quick one-night stay in Houston. We will see the transplant team, cardiologist, infectious disease, and surgeon all in one visit. This is the perk of being a transplant patient: all the doctors come to you. Sometimes, it feels like we’re 90 or nothing! I wish this would be a two-night trip, but our budget says to skip the extra night and go to work.