I see an island!

One of the things I just love about wound change days is all the new things we see and learn.  Seven days a week is an IV drip for antibiotics and the medical term for what they're treating is osteomyelitis.  Here's a link to elaborate more.  http://www.medicinenet.com/osteomyelitis/article.htm  I'm just thankful for the medicine and the times in which we live.  I think sometimes, not on purpose, we just get wrapped up in the day-to-day, we take for granted the medical marvels we have at our fingertips to save lives. 

Now wound changes are Monday, Wednesday, Friday.  I'm seeing the benefits of this in that the skin graft has more "undisturbed" time and you see more results after a couple of days of being wrapped up.  Debriding the skin graft and surrounding areas is really important right now.  As dried lymphatic fluid, scabs, or dead skin are removed the new skin underneath has a chance to grow.  Unless the tissue is really visibly ready to be lifted off, normally the nurse will get a new washcloth, wet it with warm water, and wipe and massage the site until dead tissue lifts off. The graft itself is just amazing.  We couldn't figure out why, despite the graft, there's still such a definite difference in how the leg looks compared to the other leg.  The third TRACS surgeon, Dr. O'Herrin, who has not been involved until now but saw the leg for the first time last week, reminded us that they can graft skin, but the leg will have to fill out with fat, which is completely normal.  So, there's no fat between the grafted skin and the new tissue.  Makes perfect sense. 

Today there was a new surprise on the tendon that didn't get grafted--if you can look closely, you will see a white spot in the center of the granulation that has covered the tendon on top.  A couple of months ago I learned the term "epitheliazation", which is the growth of new skin cells.  That white spot on the center of the granulation covering the tendon is called an "epithelial island".  It is the creation of new skin dead center in the middle of the granulation.  This open tissue is too small for a skin graft and the surgeon is perfectly happy with letting the wound cover naturally.  This epithelial island is going to grow outward towards the edges of the wound.  The outer edges of the wound have epitheliazation along the edges and are growing inward toward the island.  In a matter of a couple of months this will be covered. 

The IV antibiotics seem to be doing the job killing the staph and pseudomonis in the bone.  The foot looks better, isn't red.  Right now some areas around the foot and leg are being treated extra-gently with a pinkish cream that was used all throughout the treatment to protect the skin, but months of tape from the wound back and the pressure points as Mike rests his foot on pillows have worn out and cause blisters and the nurses are REALLY good about covering them with the ointment.

When this all commenced on August 1, the amazing surgeon came out of the OR after nearly two hours of surgery that first night to tell me what had happened.  I knew this wasn't going to be a simple fix, and as I listened to what she was telling me, although I was relieved for her compassion and care and surgical skill, all I could say was, "We don't have insurance."  I explained our predicament and his having to resign from the prison after his last knee surgery.  "That doesn't mean we will stop taking care of him and treating him."  I do not think I've ever seen a more caring face on a person, ever.  She truly feels that her mission in life is to heal and a month ago she got to some into a wound change, surprising us, and she teared up to see how well Mike was progressing. 

In the early days of this we were both blessed and, frankly, appalled to have been granted "charity care" status and know how precious that gift is.  Mike and I have been discussing this and we will be putting our post-treatment efforts into fund-raising for this amazing hospital.  It's small, but Consumer Reports named Salem Hospital the safest hospital in Oregon.  To look at the campus of buildings you would never guess there are so many individual clinics and so many people that live to give to you.  The current economy has created low funds in the charity care account and we will be launching an effort to reach out to the most philanthropic individuals and corporations and asking them to make donations to the charity care account.  With more and more companies laying off and reducing workers, insurance will be harder and harder to come by and our hospitals will face huge hardships.  Mike and I aren't independently wealthy, but it takes no wealth to write a letter and share our story and show them firsthand how this hospital saved Mike's life and changed our lives for the better.  They need wheelchairs and walkers.  Mike would like to try to find a company that makes hospital beds for big and tall people.  At 6'10", his biggest challenge was to get comfortable in a bed made for the average-sized person.

Should the Lord tarry, this will be our commitment to a hospital that made a commitment to us to heal my husband.