Wound care and failed states in Africa
So last week was a mixed bag for my wound care. On Monday, my legs were itching like crazy, so I took off my compression bandages at lunch just before I had my appointment, had a full shower, and went to my appointment. My wound-care nurse was NOT happy with me. Literally, it was off for about 20 minutes, and in her view, was long enough to completely undo all the compression up to that point. Hence my brain being kicked around that this is my new normal and I’ll never be able to take them off for life. Not completely rational, perhaps, but there it is.
On Wednesday, we changed the bandages, things were looking really good for my small wound / gash on my left leg (we started treating it just in case it got worse), and we increased the compression on my right leg from 20-30 units to 30-40 units of compression. Basically? We used a wrap that squeezes the leg more when it contracts. The goal was to see if I could tolerate it.
I couldn’t. By that night, it had to come off, my leg just hurt too much with the higher compression on. So on Thursday, I called the clinic to see if I could get in. But I never heard back (they’re not sure what happened with the message as they never got it nor is that usual, even though I was coming in Friday anyway, and they felt I should have got a call…me too, to be honest). So on Friday, with only one wrap still on my good leg, I attempted the infamous “shower with garbage bag over it” technique that didn’t work worth a damn. The top seemed pretty sealed, but alas, no, when I got out, there was water pooled in the bag and my toes were soaked. Ergo, if water comes in from above, and reaches my toes, you can bet everything in between was soaked. I cut it all off so I could get the leg dry, and had it rebandaged at my appointment. It was a new nurse, and she didn’t beat me up about having removed it Thursday or Friday, all par for the course, and I was in a pretty subdued “life sucks” mood anyway, so I was likely giving off a “don’t crap on me” vibe.
On the positive side, things were still progressing, the left leg looked healed so no need for any more wound care on that, not really, just the compression bandage. And the right leg? There was still one small area that needed to still close, but the rest was “closed” with new skin having formed. From looking down on the wound from above, i.e., upside-down, the wound looked like a map of Africa and Niger was still an open wound, Algeria and Chad were states in transition, and the rest of the continent was poised for recovery. I had no idea what was happening in a little area near Madagascar, but then again, nobody ever does.
The big news? I could move to three-day care instead of every other day. So Monday, Thursday and then, exciting isn’t it? Valentine’s Day. Maybe I’ll show my leg some love, although after each appointment of scraping and peeling off dead skin or scabs, I already have the red roses covered. My wounds always look very angry with me.
Today was my new appointment, so in I went. The Rx from the doctor’s office for custom socks has still not arrived, so I had to call again. Not a giant deal, but it delays again my referral to the place that will actually do the custom socks in time so that when the wound care is over, I can just use them at home. I phoned around town to try to get proper cast covers for my bandages so I can shower more easily (we used them before for Jacob when he was doing serial casting) but ended up having to buy them online from Amazon. I ordered two, one for each leg, and they’ll be here tomorrow. Great! But then my appointment removed the bandages from my left leg entirely and so now I only need one for my right leg. Grrr…She gave me a tube sock to cover the left leg for now, open-toed, but still doing basic compression (around 10-15 units, over-the-counter grade). And my right leg? Niger is still a war zone, but Algeria and Chad show signs of transitioning to recovery. The Northern coast experienced Tropical Storm Tweezers today to get rid of skin that failed to grow, and that was a new level of fun. My wound showed me the redness of its love again.
So, definite progress, at least physically. Mentally? Not so much.
I’m coming to grips with it a bit, but we were out on the weekend as Andrea wanted to go tobogganing at our friend’s place in Manotick. They even got to try out this Finnish kick-sled that looked like a bit of fun to try. But I couldn’t do any of it. I can’t afford to fall, for one thing, or even bang my leg on something. Plus, I’m wearing bandages that make it hard to even get my regular boots on while having a thin cover on my toes (i.e. VERY cold), and I can’t even put my big warm boots on with the wraps still on. So I had to drop Jacob and Andrea, and go do something else for an hour.
When I’ve missed out on some activity in the past, even if it was semi-health related, there was always a combined “failsafe” for my mental side that the reasons were either at least partly choice (I was choosing for mental health reasons, for example, knowing I COULD do it but it was a bad idea to push myself that way right then) or temporary (my knee was sore from something else, or my back was out and needed chiro), and often a result of having done something else earlier in the week.
This time? It’s not temporary, it’s not choice, and it’s not a result of some trade-off of another activity earlier in the week. Just as with my stupid decision last summer to jump off a dock and almost permanently injure my calves and knees, there’s a degree of disability here that prevents me from doing what I want to do. I really wanted to try the kick-sled. Ironically, I didn’t even have to address the question if I was too heavy for it or might damage it, because it wasn’t even an option to consider, not while protecting my leg from future damage.
I’d like to think that I’ve worked too hard already, although that wording doesn’t feel right. It’s not hard work, it is just time and energy devoted to having my legs wrapped and then sitting. So it is more like I’ve invested too much time in the current healing process to risk a new injury that will set me back.
What will I think a month from now? Will I have some basic compression socks that look okay and I’ll think it’s no big deal? Will I adjust to it like my CPAP machine where I was thinking, “Okay, for the rest of my life, this is my nighttime”? But I know it helps, so I use it every night, no big deal. I’m better with it than without, most of the time. I do, still, occasionally sleep downstairs or take a nap without it. In the right position, I can sleep just fine without it, albeit not sustainably. So I take a break. But if I go to the cottage even for a weekend? I take the machine. I know I’ll sleep like crap without it in another bed. I do the work because the benefits are immediate and I can see them.
Will the benefits of compression socks motivate me somehow? Will I embrace it the same way? Or perhaps it is something that I’ll simply tolerate because I have no choice. Time will tell.
In the meantime, I’m down to one leg wrapped and I can take the sock off my left leg tonight. Progress of a sort.
