amaya at lake

amaya at lake

Tuesday, December 18, 2012

Wound care appointment

     Today we had our appointment at the wound care department at Redlands Community Hospital. I was anxious about our appointment; nervous, curious, hopeful and optimistic. After a thirty minute wait to register the nurse came out and took us back in so that we didn't have to wait any further. That was great, because Lidie was worn out and getting squirrely. We went back into a room that looked like a recovery room after surgeries. Just beds and curtains. We were the only ones back there so that was nice. The nurse was very kind and told Amaya she would be getting a lot of attention since she was the only patient there today. The nurse looked at Amaya's heel and asked some questions. She said it was a pressure wound and the best way to let it heal was removing any pressure. We have been told that before and have tried to do that. At this point its been over nine months since she's had it and I'm ready for it to heal, for good.
   When the doctor came back to check Amaya out he also had many questions (about the surgery, why she had it, how she got the bed sore, when, what did it look like, did it change, etc). He said it looked like a stage two pressure wound and took a picture to document it and to measure its size. He pushed on it and asked Amaya how it felt. She said it was sensitive and hurt when they pushed on it. He drew a picture for me showing the bottom of her heel. The bone sits then there's a fat pad underneath it then the skin. He said that part of her fat pad is gone. She's had fat atrophy. He said he wants to refer her to see a plastic surgeon to see what he recommends. He thinks that a surgery might be needed to replace the fat. I asked where the fat would come from and he said that's what we would have to ask the plastic surgeon. He said that possibly fat could be moved there or new fat inserted. He wasn't sure, but said the plastic surgeon there was great and would help us. But it would have to be a surgical procedure. Ugh. 
   He said that if they had seen it sooner they could have done something more, but at this point that's all hindsight. He said when the blister was there they could have popped it. Because he said that the fluid in the skin was putting pressure on her heel and caused it to spread and for the fat tissue to disperse and for the consistency of her skin to change. He said that now she has no cushion on that part of her foot to absorb the pressure when she walks. I told him about how she's modified her walk (walking on her toes more) and that it gets sore the longer she walks. He said that might be because of the bedsore. He said at this point there's no ointment or anything like that, that he could prescribe to help it heal. He and the nurse brainstormed things to put on the heal now to help it from putting pressure on it. Since she's so small they didn't have much, but went and asked one of the physical therapists to come look at her. The therapist and the nurse looked in catalogs for something that could help Amaya. I was very grateful for their help, and kindness. 
   He wrote us a referral for the plastic surgeon, then gave us some "conservative" options to try in the meantime. The nurse wrapped Amaya's heel with some cushiony material and a special tape. He is requesting a boot for her to wear all day (she can remove it for physical therapy). It will help protect the heel from any more pressure. In the meantime they gave us a cushion to wear at night and some of the cushiony material and tape to tape her heal for daytime. Hopefully she'll get it within the week so that it can start to help her soon. He wants to see how her heel responds to having no pressure. Does it heal? Does the fat come back? We have to wait and see. He's hoping there will be some change in three weeks. We have an appointment to return in three weeks. At that time he will take another photo of the heel, measure it and see how it is doing. 
    After mentioning another possible surgery the doctor asked how Amaya handled the last surgeries. Mentally, emotionally, psychologically? How was she doing at school? Is she happy and doing okay? I told him that she did really well. She healed well, worked hard, and continued to go to school throughout it all. 
    By the time we got out to the car I was in tears. Overwhelmed with frustration, filled with sadness, and a general sense of worn-out-ness. Frustrated with Lidie's fit during the entire appointment, mad at myself for calling Josh out of work to help me, angry with the heel not healing, frustrated with the idea of having to see another specialist, and dealing with more referrals. Sad and frustrated that Amaya has to have another thing to have to wear, and another possible surgery. Sad and desperate for a break, for all of us. Disappointed that there is no ointment that can fix this heel now. I was hoping we would get a shoe insert or something simple like that.
     So any prayers or good thoughts or kind words that you have please send them our way because this momma is worn out. And I can't bear to have to explain to Amaya that she will need another surgery. Let's hope that boot helps. 
Lidie waiting in the lobby. This was just before she lost all her patience and started getting super fidgety and throwing a fit for the entire time we were at our appointment (about an hour and a half). I was so desperate I asked Josh to come be with us to help take care of her because I was having such a hard time trying to parent her and listening to all that the doctor was explaining to me. Thankfully the doctor was kind and patient. 
I found this picture on my phone. I had let Lidie play with it in hopes that it would distract her and keep her busy. No luck. Here's a visual of how crazy Lidie was getting. She was so close to the doctor (who was sitting close to me trying to show me a drawing and talk to me). Lidie sandwiched herself in between us and kept moving and throwing a fit and almost kicked the doctor several times. Ugh, super embarrassing.  
Here's Amaya laying on a bed while they examined her. 
On the ride home there was a rainbow that helped brighten our day.
Here's what the tape on Amaya's heel looks like. 
Here she is doing her physical therapy homework before bed. She has the pink cushion on her heel that the wound doctor gave her today. She said it felt like a cast. She's going to be sleeping with it on until she gets her boot. 
Here's a close up of it. It's a lot nicer than the towels we use to wrap around it. 
Here's another shot of her doing PT homework.  She did four exercises before bed. 
     Here's a picture of what the boot looks like that they are ordering for Amaya. We're hoping the insurance will cover it because it cost ninety dollars. And I'm really hoping she gets it soon because the doctor wants her to have it as long as possible before her appointment with him in three weeks. The good thing is that she'll actually be able to walk in it. The doctor said they usually don't let adults walk in them because they break them, but she should be okay to walk in it. 

No comments:

Post a Comment