Friday, 1 April 2011

Frustration City

Went back to hospital yesterday to get Violet's pressure sore dressing changed and checked.

I had noticed the side of the dressing looked red and told the ortho surgeon who said that was normal. When we finally got in to see them, the nurse said that is not normal and that her whole foot was suggestive of Osteomyelitis (Bone Infection) so she was sent down for x-ray and we awaited the results.

Surgeon said it looked okay. The sore is very very close to the bone. He was advised by the same nurse to put a VAC dressing on it for 2 weeks at least. He thought that would be a good idea, so we were sent home with that attached to the pressure sore, with a few metres of tubing and a noisy machine to help heal her sore quicker.

Went back today to get the VAC re-dressed and on cleaning her sore, it started bleeding. They applied pressure for 10 minutes and it wouldn't stop, so they decided no VAC dressing today as it would continuously drain blood from her foot and went back to the old solosite gel and dressing.

I asked them to do a bone scan to rule out the bone infection as it doesn't normally show up on x-ray when it's in the early stages. They would not do it. So, we were sent home until Monday when we go back for them to check it again and put VAC dressing back on.

He even said today that he would be taking her off the AB's on Monday. I will not be doing that though, as her foot is still so red, swollen and sore that infection is still obvious and that's not just the pressure sore, it's her whole foot.

I am so annoyed and frustrated they will not listen and do the bone scan, as I have been right every other time! Think it will be time for a second opinion soon. I decided to go to her G.P on the way home and he has organised a bone scan, soonest I can get her in is Thursday.

Just given this surgeons past history of being wrong just about everything, I am not willing to sit and wait for the infection to be chronic before he decides on a bone scan.

For those of you that may be interested in seeing her foot now, here is the link to the photo on photobucket.


Alison said...

Oh Sarah - how awful for Violet. What an ordeal this has turned into.

What is a VAC dressing? It sounds like a vacuum bag attached to her foot???

I'm hoping and praying you get good news from the bone scan. How is Violet coping with everything? She has been through so much now.

Big hugs to all of you.

The Henrys said...

HUGS to you and Violet. Stay strong and follow your instincts. You have been right every time so don't let them stop you!

Belinda said...

Sarah, sending you both my love.

Hoping there is no bone infection.

Things have to turn around for you guys! I am hoping so!


Missy said...

Have they done anymore swabs of the wound? I would want to know that the antibiotics that they are treating her for are the right ones(culture and sensitivity).
DONT take her off the antibiotics at all. If she still has an active infection she needs antibiotics. Is Violet having any temps at all? Gosh I am just hoping she doesnt end up with Osteomyelitis.

Sarah the other option maybe to push for is hospitalisation? I know neither of you would want it, but maybe having her in hospital for IVAB's, wound care etc may be a better option for this wound. I am suprised they have not admitted her in all honesty.

Have they debrided it or is it doing that on its own now? They normally do surgial debridement of the dead black tissue when it is extensive tissue destruction or infection but most likely under anaesthetic.

How is Violet coping with the cleaning of the wound? It must be painful for her.

I am thinking of you all, especially Violet...glad you went to your GP..push for everything you can.

Missy said...

Just had a look at the pic...the wound looks nasty but good to see no black around the wound edges.
It is easy to see how red her foot looks, keep an eye on the heat and redness and how far it extends up her foot and leg, which could really indicate a deeper infection.
Yep it looks yucky I am sorry to say.
I am so heartbroken Violet has to deal with this (and you too) Like I said, if it gets to much, talk to your GP or DOctor and tell them you want her admitted for treatment, as you just cant do it at home anymore.

Sarah said...

Missy, They have surgically debrided it on Monday as I asked them to do it as it wasn't doing it naturally as they had hoped.

They did this with her awake and screaming on Midaz and Nitrous.

It was still very black until they debrided it. Now it is open it has turned yellow at the top and smells.

I have asked for her to be hospitalised to get IV AB's pumping thru her but they have not let her.

She screams when cleaning is done and especially on Friday once it started bleeding.

Sarah said...

Did a swab last Tuesday and nothing came of it, which surgeon found hard to believe.

I am going to ask for another one tomorrow when she goes back.

No temps as yet thankfully. Was wondering as she is on a super high dose of AB's at home if this woud disguise temp. She is on Nurofen, Pandol and Morphine still too, the pain has been full on.

Di said...

Sarah, that is so awful. I can't tell you how sorry I am to read that you and Violet are having to go through more complications.
I really really hope that the weekend has been brighter and that you get some better news at your next appointment.
Thinking of you both.

Missy said...

Okay,I am glad you asked for it to be debrided, as if it hadnt happened naturally, then it was certainly time to get in their and get rid of that necrotic tissue.

Yes it is possible that the nurofen, panadol and AB's are holding things at bay, but I guess if she ends up with a nasty infection, those temps will hit a high regardless.

I was wondering if they would do a GA for debridement or not..poor little love.

Are you giving her some morphine etc prior to your cleaning sessions? Make sure she is dosed up prior to any wound cleaning to help with the pain.

Cant believe there is no infection present? Wow..that is awesome if it is the case, as it means you have kept the wound very clean.

Her latest pic has her foot looking so red and angry looking.

Having a wound with a odour is not fab, as it normally indicates an infection. It is certainly quite sloughy looking.

Basically the signs of a wound infection is;pain, heat, oedema(swelling) redness and exudate(fluid coming out of wound.

Signs of a systemic infection, so when its gone beyond the wound; elevated temp, malaise and elevated leucocyte count.

So it may be worth getting a full blood picture as well for VIolet, although I am not sure how cooperative Violet may be with that.

Thinking of you all

Sarah said...

Missy, Thanks so much for your info!

Haven't been giving her any pain relief before, they used to and it didn't seem to make much difference (Midaz) but I also want them to see the pain she is in still, so they can see what I am on about...even though they can see clearly that it is angry and looks infected.