Yep, it’s official, it can be healed. The nurses brought their resident expert with them today. The first thing I learned is that terminology in general use is so tightly focused in their field as to have effectively lost its original meaning.
Take “necrotic” – it simply means dead – dead tissue in a medical context (in the context of Tory politicians it’s the tissue between their ears). However, in the context of lymphoedema it is tightly tied to one specific type of tissue found in wounds.
This must surely cause confusion when they discuss patients with, say, GPs, and it could be dangerous to the patient if there’s misunderstanding.
Anyway – long story short – I have a new dressing, an impermeable hydrocolloid pad that seals the wound, and its Aquacel Ag dressing, and keeps it moist.** This – as I’ve been saying all along – promotes healing, and he feels, as I do, that healing is possible (though he had a minor sulk about my refusing compression. They are obsessed with bloody compression but clearly, as in my case, there are other solutions, but the fact that these can only be accessed by a patient who is strong-willed enough to stand up to the buggers and make them think outside the box is, frankly, fucking disgraceful.
**I don’t think my lesions are seeping enough to wet the Aquacel pad – we’ll see. If not then we’ll revert to wetting it first with normal saline solution. As always, my leg, my call.
And, in my view, compression should be the treatment of absolute last resort – not the only one they can think of. I’ve been in compression twice. The first time the pain was intolerable, and I removed it. The second time, at the hospital, they wrapped up an infection – the stink was a give-away. And if there is one no-go area in compression, it’s that you do NOT compress an infected leg.
In addition, the other leg sprouted a small lesion at one dressing change, a bit smaller than a 20p coin, just above my instep. Three days later, it was the size of my hand. At that point I called a halt, had all the compression removed, and I have no intention of going near it ever again unless every other avenue for treatment has been explored first.
By the way, the dried-out dressing I complained of in this post was dismissed as rubbish by the expert – the dressing, that is, not my complaint. I was tempted to make an issue of it, but as it felt pointless – at least we’ve moved on now – I let it go. I won’t forget it, though!
So, Mr. Expert examined my wounds, pronounced them clean and dry, and free of infection. The recent swelling is, apparently, normal and the result of the body increasing lymphatic flow to the area to try to heal it. Stimulated, no doubt, by last Tuesday’s outing. I’d still be happier without it – I’ve had enough swelling to last several lifetimes over tha past year – but at least this is beneficial.
Allegedly. Considering what massive damage increased lymphatic flow caused last year I’m still not entirely convinced, but we’ll see.
He also said that, as there was no infection, I didn’t need the Aquacel Ag, with its antibacterial silver – which is where I disagreed.
I accepted that I didn’t have a current infection, but given the almost unbreakable cycle of infection and re-infection last year, culminating in MRSA and 10 days of i-v antibiotics, with a mass of wrecked veins to show for it, I insisted on carrying on with the Aquacel Ag in order to remain infection-free, to which he agreed, rather grudgingly.
And that’s where we left it.
The important thing, for the immediate future, is not to let the nurses screw it up!
And I’m sorry if those of you reading this are nurses and are offended, but I have almost a year’s experience of this bunch, and their urge for what’s cheap, or, as with compression, what they’re familiar with, rather than what’s right for me!
Finally, right now I’m getting a lot more pain than normal after a dressing change – it seems to be one of those days when morphine doesn’t work. Mind you, I do wonder, in this situation, which isn’t uncommon, whether it’s not working or if it is working and the pain is so severe that what I’m feeling is just a fraction of what it could be. I have no way of knowing.