New rules sort of apply here – The View from Bed Three. No photos.
Surgery is looking more attractive by the day. Nurses arrived an hour late this morning, no explanation, no apology and – even worse – no supplies. AGAIN!
So I had to raid my hidden, only to be used in the direst emergency stash, meagre though it is. Or was – it’s now gone. And I had to construct a usable dressing by combining 3 separate items. It works, but it shouldn’t have to happen!
And, I’m sorry to say, there was a lot of anger – mine. When they say, at 11.00 “We’ll be there in half an hour” and still haven’t shown up by 12.30 a phone call at some point isn’t an unreasonable expectation, not least because when leg ulcers are exposed to the air they become even more painful than normal. And trust me, normal is something you do not want to experience. As it was I was sat here wetting it down with Prontosan wound wash to keep it moist.
I know lack of supplies isn’t the nurses’ fault, and I made that clear, but I do hope that they report back just how bloody furious I was at this apparently endless fuckuppery.
Someone is doing a piss-poor job. I don’t know if the problem is one of funding – hey, I’m just one of the many patients who are suffering, and we’re clearly not important enough to be kept informed – or plain, old-fashioned, incompetence but, as I said previously, part of my job in a previous life was ordering supplies for a shipyard medical centre, and running out wasn’t just a capital crime (well, almost), it simply wasn’t allowed to happen. The Community Nurse service should be no different.
It puts patients at risk (I, for example, have no more dressings, yet mine will still need changing over the weekend**), and it puts nurses at risk from violent patients who are terminally pissed off (and they’re not always tattooed thugs – little old ladies with walking sticks can be dangerous too).
**OK, I’m nothing if not resourceful (not to mention modest ), and as long as I have my Aquacel Ag bactericidal dressings I can build on that and cobble up what I need from scratch – I need a sterile absorbent pad – I have lots – a sterile impermeable membrane so that it doesn’t either leak through or, worse, dry out and weld itself to the wound which, as well as pain, causes damage when it’s removed, which I’ll have to make, and find a way of securing the whole assembly to my leg in such a way as to not cause more damage. The proper dressing, even the improvised one described below, is adhesive, the DIY version won’t be.
I’ve done all this when the ulcer was the size of 2 5p coins. I dare say I can still do it now it’s the size of my hand, though it does increase the risk of infection.
But – I keep coming back to this – I shouldn’t bloody well have to!
And what about the patients who are too ill, don’t have a stash, or the initiative, to fend for themselves. What of them? Are they expected to keep dressings in place until the decay? Or infection sets in? Today the nurse brought me a handful of Aquacel Ag – that’s the bactericidal pad that’s applied directly to the wound. These are normally topped with an impermeable hydrocolloid pad, or an absorbent foam pad with an adhesive border. The nurse had nothing.
I had three of the latter, small ones from when the ulcer was small, two of which I combined into one larger pad which was just barely big enough (stretching “big enough” to breaking point), the nurse sitting watching, “so I can see what you do,”. I actually devised this combination of products months ago, and got it approved by the nurses, and it was clear that the idea was novel which, to be honest, I find worrying. I find it hard to believe I’d come up with something the pros hadn’t, but that did seem to be the case.
On a different note, something is going on with my GP. He’s being helpful. Today I got my second 6-month supply of hydrocortisone. And last week I got my Oramorph early, without so much as a token gripe.
He seems to have given up arguing with me.
Then, on Wednesday, there was the possibility of surgery offer out of the blue. Last time I mentioned it he just wouldn’t talk about it – flatly refused. So what’s changed?
Can it be that, as with my COPD, I’m much worse than I think I am? Which really wouldn’t surprise me given the severity of my pain, which also now extends from toes to hip. Today’s nurse was all in favour of the surgery too, and the nurses are against amputation on principle, normally.
I do know I’m profoundly weak again. If the surgery is to go ahead, I’ll have to be able to get around on one leg and crutches for a while. I’ve just tried – I can’t – I simply don’t have the strength. Not even to move the couple of feet to transfer from bed to wheelchair.
Something has changed that I don’t know about, that’s for sure, and I have a horrible feeling that this weakness is just the tip of a rather large iceberg. The research I’ve done and the information I’ve downloaded since my “promotion” to COPD Stage 3 suggests I’m seriously screwed from almost every perspective, and that such severe weakness isn’t unexpected as a result of poor oxygenation.
And as far as I’m concerned, heart failure is still in play.
On that note I’m off to bed.