What’s Going On Here, Anyway?

Wednesday, April 8th — The compression bandage felt pretty good on my poor leg, at least compared to what it had undergone on Wednesday, Wednesday night, and part of Thursday, till I became a Maggot-Free Zone. Emily did some more picking and tweezing and sluicing, during which I talked fast and dug my fingernails into my knee to keep from whining. The rinsing with sterile water was again rather soothing, but I kept anticipating that it might hurt. Hence the fingernails-in-knee trick. After a while, Emily (assisted by Jenna this time) noticed a lot of bright-pink crescents in my right knee area, some of them just barely oozing. “What in the world are those?” she wondered, no doubt imagining some weird rosacea-like rash. “Just my way of not screeching in pain,” I replied. They did look rather unusual.

A Misty, Moisty Experience

This time Emily used something called, appropriately, “MIST.” It’s a small machine that sprays a fine mist of sterile water on the wound from pretty close down, and delivers ultrasound waves through the spray. The ultrasound apparently helps break up any remaining necrotic tissue, getting it ready for either another round of maggots or — preferably — a Wound-Vac. All I felt, however, was this nice cool mist of water. That’s my favorite treatment so far.

And then it was more gauze pads, and LOTS more compression bandages, and the trick with the sandal straps to make my suddenly-huge foot fit into the shoe. I got a mini-description of the Wound-Vac from Ryan, and it sounded pretty manageable. So I went off home fairly happy, and looking forward to a few weekend nights of rest without any Residents in my leg.

“Anybody Left In There? Hmmmm?”

By Sunday, however, I was wondering if perhaps they hadn’t overlooked a single feisty maggot when they were tweezing around in there. I had a mental picture of this enormous fellow, left all alone at the Buffet by his less fortunate compadres, just gorging himself silly on what necrotic tissue was left. I thought probably that when Emily took off the dressings on Monday, there was going to be a maggot the size of a piece of popcorn, just totally stupefied by all that overindulgence. As she was unwrapping my leg, I told her about the fantasy, and she remarked, “Oh, that couldn’t happen. He’d have suffocated by now; they can’t get air through layers of compression bandages.”  Oh, terrific: so I’m going to find a DEAD maggot the size of a piece of popcorn in my wound? Wonderful! I thought.

I cannot express my joy when not a single maggot of any size whatever, dead or alive, was revealed under the Silvercel.

So the verdict on Monday was a cautious “It seems to be making good progress. Most of the dead stuff is gone, and you can see some healthy flesh along the edges here and there. Let’s not do more maggots, since you had so much pain with them. Let’s order a Wound-Vac for you, and we’ll put it on for you and show you how to use it on Wednesday.”

A Treat for the Poor Neglected Shoulders!

I celebrated by stopping by Seaside Chiropractic on Tuesday and having Dr. Klein do a sitting-up adjustment of my spine and some work on my shoulders, the way we used to do it before I graduated to the Moving Tables. I tell you, I’d been getting all kinds of complaints from the shoulders, who were used to being the focus of attention up to recently. Now, all of a sudden, it was What are we, chopped liver? It’s been two weeks, and where’s our adjustment? What does a body part have to do around here to get some attention — grow an ulcer and get worms?? When is it OUR turn again?  They were very happy when we left Seaside. I was pretty happy too, because I really miss my three weekly sessions and how great they make me feel. And I love when Roseanna takes me into one of the offices for a Game Question, and then ends up asking me about my life instead. She is such a terrific listener, she could be a therapist with no problem.

By the way, David Klein and Roseanna are pretty well running the office on their own these days. Itha went back to school (for osteopathy) and Jenny left, so Mama Bear and Papa Bear are multitasking like I’ve never seen before. Hope neither of them has a breakdown any time soon.

Eau de Rot: It’ll Never Sell

Tuesday night, not only was the leg under the compression bandage starting to burn and ache again, but (and this worried me) there was a faint smell coming from under the bandage. I noticed it at night, under my freshly-washed and sweet-smelling comforters. It made me very uneasy, because I am one of those crazy-clean people who keep the body-lotion and fragrance companies in business. I do NOT want to go around smelling like a week-old corpse and have people edging politely away from me when they get too close.

When the dressings came off, sure enough, it was very rank. Emily wasn’t quite as happy this time as she was on Monday. I certainly hope this Wound-Vac thing will make a noticeable difference, and fast, too. While the maggots only debride the wound, that is, they clean away the dead tissue, the Wound-Vac does some debridement and also promotes healing in two ways: by drawing the edges of the wound together, and by suctioning tissue up through a special sponge place on the wounds. This encourages granulation, which is defined by MedicineNet as “That part of the healing process in which rough, pink tissue containing new connective tissue and capillaries forms around the edges of a wound. Granulation of a wound is normal and desirable.”  As a matter of fact, the surgeon, Dr. V., had mentioned using a Wound-Vac for a few weeks after the surgery (which was not performed).

Wound-Vac, Just Like It Sounds

Comprising the special sponge, which is cut to fit the wound and placed over or inside it; special plastic “drape,” or tape, that provides a vacuum-sealed closure around the sponge; a suction device on top of that, that will pull the leftover dead tissue up through the sponge; a clear flexible plastic tube through which the tissue will flow to a plastic canister, attached to the small machine that is carried in a shoulder pack. The whole thing is computer-controlled, and can be battery-operated for eight hours. After that, you have to charge it.

I’ve never seen so many tubes and wires on one machine. My poor Beloved Spouse was down on his knees for ages, trying to attach an adapter so we could plug it in near the bed. Presumably, when I have to get up in the night, I’ll just detach the cord temporarily. The pack with the machine in it weighs a couple of pounds, but it’s not unmanageable.

I’m hoping everything is going all right with this 24-hour suction business. I don’t feel the suction, but I do see the stuff moving up the clear tube to the canister. And unfortunately, I’m having enough pain with this that I can’t fall asleep. So what better to do at 1 a.m. than catch up on my blog?  Hmmmm?

If it’s still this painful tomorrow morning, I’ll call and make an appointment to see Emily tomorrow instead of Friday. There’s a sort of strange sense of deja vu here — just like last Wednesday night, when I knew something was wrong, and had to remove the maggots halfway through their work order. I hope this is a healthful, healing pain, and not a something’s-wrong-again pain.

I’ll let you know tomorrow. Thanks for reading, and thanks for being interested in this kind of stuff. Takes a strong stomach… they say the Golden Years are not for wimps, and I’m beginning to believe that! — Betsy