The Mechanical Maggot

Tuesday, April 14, 2009 — It’ll be a week tomorrow since they put the Wound-Vac on, and I have to say, it’s been a better week, overall, than the previous one.

When I left you last Wednesday night (or early Thursday morning, to be more precise), I was awash in pain from the newly-applied Wound-Vac. I’ve had two dressing changes since then, Friday and Monday. Both times, it’s very tough the night of the treatment: burning, aching, throbbing, pretty much all night. (Or, as I remarked Monday, trying to keep my mind off what was happening in my southwest corner — “Reminds me of Throbbie Burns, the famous Scottish poet!”) But most of the next day it’s increasingly better; some pain the second night; all pretty good the third day, but then I have it done all over again.

Visible Improvement!

What is remarkable, though, is that it is making visible improvement! The floor of the crater in my leg appears to be rising, the walls appear to be moving in just a little bit. Yesterday Emily said it looked “terrific.” To me, it looked like hamburger, and I said so; but apparently, what they’re looking for is “that red beefy look.” Ugh! More red, less yellow and gray = good.

Changing the Canister: Yikes!

Sunday night I had to change the plastic canister in the machine myself. That was a bit scary! It’s actually quite an easy business: the tissue that is suctioned up through the sponge and passes through the clear tubes is bloody, but it attaches to the gel that’s contained in the canister. Therefore, the material in the canister is reddish, but gel-like in consistency, instead of sloshing liquidly around in there. When the canister is perceived by the machine to be full, an alarm goes off (beep-beep-beep, not clang-clang-clang) and the little computer screen flashes “CHANGE CANISTER NOW”.

This happened around 6:00 p.m. I opened the zippered compartment wherein sits the canister; it didn’t look particularly full. I would have guessed 1/3 to 1/2 full. But the alarm was beeping and the order was flashing, so I scrambled around looking for a new, sterile canister pack in the several cartons-within-a-huge-carton that contain my supplies. The canister box was, of course, in the bottom. The change went off without mishap — it’s just snap it off, snap the new one in, throw the old one away. I was surprised there were no special instructions for disposal. Apparently it’s okay to just toss it in the trash.

Good Features of the Wound-Vac

So, after a week’s experience, there are definitely some things I like about this process and some things I dislike very much. Here are the positives:

• It does the job quickly, efficiently, and relatively painlessly.
• It’s possible to carry out most daily activities while wearing the shoulder pack, even though it’s pretty inconvenient. I can drive, for example, and cook, and feed the cats. To work at my desktop, I take off the shoulder pack and put it on the floor.
• It’s not uncomfortable to sleep with it. I plug it into the special battery charger and place it beside me on the bed. I thought the cats would hate it, but they don’t even seem to notice it.
• It doesn’t make a lot of machine-like noise. It does, however, make a rather nasty slurping sound every so often, as it pulls the bloody goosh up the tubes. Several times I’ve been about to make a snide remark at a cat or the Beloved Spouse, based on this sound and what I thought might have just taken place; but I’ve been wrong each time.
• I am allowed to interrupt the suction therapy a maximum of two hours a day. That’s a lot more than I need, really.

Not-So-Good Features

And here are the negatives:

• It weighs about 4.5 pounds, which is a lot for sore shoulders to tote around. I’ve taken to wearing the strap cross-body, messenger-style. Not much of a fashion statement, but it’s much less uncomfortable.
• Although the computer screen does have a screen-protect button to prevent screen settings from being changed inadvertently, it is not well protected by the flap that covers it. Several times a day, I find that the “THERAPY IS OFF” or that the Screen-Protect has been removed, simply because a touch or two on the flap has changed things.
• To take a shower, I have to: (a) turn off the machine;  (b) clamp off both tubes and disconnect the connector; (c) wind the lower tube once around the leg and tape it to the skin, so I won’t step on the clamp; (d) encase the whole lower leg in a plastic garbage bag, tying the closures and taping all the way around with special tape, to prevent any water getting on the compression bandage; (e) keep the leg out of the way of the water, as much as possible, while performing my ablutions.
• The time allotted before the “THERAPY INACTIVE” alarm goes off is only ten minutes. Ten minutes is not nearly enough to carry out the above activities; so from ten minutes after the start until I’m in shape to reattach the connector, I have to listen to that annoying beep-beep-beep until I feel like smashing the machine.
• There is no good way to contain the clear plastic tubes inside the pack. This means that, even if I coil them up under the flap and stick down the Velcro, they will be drooping out within minutes. And this, in turn, means that all that bloody goosh that should be kept personal and private is on view for the whole world to see, as it makes its slow way from my leg up to the plastic canister. I really dislike this feature! In fact, I dislike it so much that I actually wrote a letter to the manufacturer today complaining about this and suggesting they simply add a strip of Velcro, or two, under the flap, so the patient could coil up the tubes and secure them by looping the Velcro strip through and sticking it at the top.

On the Way to Healing!

From all current indications, if things continue to improve at this rate, I’ll be Wound-Vac free in three or four weeks. Sounds like forever, but hey — a week’s already gone. You can get used to almost anything. I’m planning to go to Boston at the end of May, through the first week in June. The occasion is (ostensibly) my 50th Reunion at Radcliffe/Harvard; but the truth is, I want to spend some time with my daughter Sarah and her husband Chris, not to mention Johnston (5.5) and Hayes (almost 3), and this is a great excuse. They live just outside Boston, no more than spitting-distance from Cambridge. I would love to be able to go with just an ordinary gauze dressing on the leg. We shall see.

Thanks for reading — Betsy