Thoughts From A Tired Soul

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Today called for a full bowl of plump wine seeds.

My good friend crossed over at 8:30 this morning. She was in grave condition and this was a blessing really. They had thought a few weeks, who knew it would be only days.

The frozen wine slushies will have to wait until later...

I'm disturbed and in need of assistance from someone familiar with biology and/or medical knowledge. My sister sent me a photo of a bedsore on her hip that when I left the hospital 2-weeks ago was only about 1/2 inch around and 1 1/2 - 2 inches deep.

I put it in a spoiler on purpose because it is not for the squeemish...I'll take it down if it's deeply forbidden. However, I've researched hundreds of pictures and asked numerous sources, after which learning it is not mersa, and negative for gangrene at this point, yet this darned thing is growing rather than healing. The docs claim it's not the flesh-eating bacterium...but, it sure looks like it's growing when healthy tissue should have it shrinking...It's near the incision point of her hip surgery. That healed wonderfully, but this monster hole doesn't have far to go and raw bone will
 
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If it’s turning black at the periphery, that’s necrotic tissue. For any number of reasons, she is not getting sufficient blood flow to the area to sustain the tissue, and to heal.

Is there no opportunity for a wound vac?

The width is what it is, but JFC, how do they allow it to get to 5cm depth and not change course? Packing with saline seems nutty...why introduce water to an environment like that?!

Honestly, this is beyond my knowledge—I know lots about wounds, and I’ve seen quite a few :eek: , but when you get to that depth and you add necrosis, that’s beyond the scope of my studies, witness, and experience.

Is she on any heavy-hitting beta-lactam antibiotic, or vancomycin?

Okay, I’ll just straight-up say that I am freaked out because I don’t have the knowledge to know if that is an emergency or not, so in my cluelessness, I’m siding on freaking out.

I would be asking a fuckton of questions.

I’m so sorry, @Sandie33 :(

Damn,
Ian
 
I'm so sorry to hear of your good friend's passing. Sounds like she was a tough cookie to have all that was wrong going on and didn't raise a fuss.
Wine slushies, that's a new one on me.

Also, a huge thank you for the spoiler/warning Sandie! I choose not to look at it & would be of no help there anyway.
 
Has there been consult with:
  • a wound care specialist?
  • an infectious disease specialist?
  • a hospitalist?
  • a patient advocate?
Via my Mom,
Ian
 
Has there been consult with:
  • a wound care specialist?
  • an infectious disease specialist?
  • a hospitalist?
  • a patient advocate?
Via my Mom,
Ian
All of the above, except the house doc rather than a hospitalist, as well as the cardiologist are involved. She's back in the nursing home setting now. The team there has been trying to navigate her ugly disposition. It's quite difficult now because they've had to lower her serequel and mood stabilizer meds because they are messing with her heart electrodes as well as she's gained water around her lungs again.
I asked if they could give local anesthetic before the cleaning her wound but her nurse told me that wouldn't be effective to stop the pain and a baby dose of pain killer dalaudum, (spellings aren't the best for me), is given before they start digging.
From the questions I've asked and googling pictures and definitions, the hip is a Stage 4 pressure sore and can take months to years to heal completely in a nonambulatory situation like hers.
Is she on any heavy-hitting beta-lactam antibiotic, or vancomycin?
augmentin I believe is the oral antibiotic
Balactim something or other is the cream they're putting in/on
The packing is soaked in the saline because it has to heal from the inside out, which it is not doing

Okay, I’ll just straight-up say that I am freaked out because I don’t have the knowledge to know if that is an emergency or not, so in my cluelessness, I’m siding on freaking out.
Thank you to you, and to your Mom for trying to be helpful. 'freaking out' is for her and my neice too. I'm concerned because of her having had the gangrene...thinking she still does.

I would be asking a fuckton of questions.
I have been doing just that with limited answers. Her nurse is helpful. My sis had to have her left foot and shin removed for a similar 'sore' she developed during home care, and it went on for months. They determined at that time she had both wet and dry gangrene when she was admitted after her hip surgery. She has another sore on her right heel. It's not as gruesome as the one on her hip though as it's still closed but deeply discolored.

I’m so sorry, @Sandie33 :(
Thank you again for trying. I'm flabbergasted the home care possibly let the foot one cause the amputation, the hip one is same side; can they amputate clear to her pelvis without creating a larger dilemma I wonder?

It's a mess any way I try to approach it.
 
I'm so sorry to hear of your good friend's passing. Sounds like she was a tough cookie to have all that was wrong going on and didn't raise a fuss.
Wine slushies, that's a new one on me.

Also, a huge thank you for the spoiler/warning Sandie! I choose not to look at it & would be of no help there anyway.
Wine slushies are a refreshing summer drink. They are watered down wine mostly once the slushed ice starts to melt.

Thank you for the setiments, she was one tough lady. I've since found out she didn't want a funeral so we all will be giving her a celebration of life luncheon any way.

I'll end up taking the picture down. I was upset and emotional earlier but that wave has about ran out. When I'm at a loss I tend to reach out for help and then double think a retract. Doubt has always interfered throughout life for me. It interferes with my intuitive hits...almost like static.

My gut reaction to my sis's picture was more than a knee jerk that ain't good reaction. Instead, I had to ask my neice if she'd seen it without the packing. She had and it is deep enough to see cordings...that's when I decided that ain't good and started talking with the staff.

We girls have had skin complaints over the years, but nothing like this.

Then there is the mental and cognitive issues that has surfaced in the sis and my instinct still says that if she is too weak to finish rehabilitation and get back home it's only a matter of time for her passing. I don't believe she'll survive the nursing home as a patient long.

I just don't know. In taking things as they come I'm grateful that it is easier to be grateful for the experience and let her and her daughter decide and me simply advise when asked. ;)
 
a baby dose of pain killer dalaudum, (spellings aren't the best for me), is given before they start digging.

Likely Dilaudid (hydromorphone). Suitable...it’s a heavy hitter. In my experience, the only thing better is fentanyl (Duragesic).

augmentin I believe is the oral antibiotic

Splendid, but this perhaps will require another prong.

She has another sore on her right heel. It's not as gruesome as the one on her hip though as it's still closed but deeply discolored.

What’s the protocol for her repositioning? I’m surprised a stage 4 isn’t necessitating an inpatient trip. I hated repositioning when I was near-paralyzed, but I complied, because I knew the potential cost of the alternative.

can they amputate clear to her pelvis

Yes.

without creating a larger dilemma I wonder?

Given the situation, highly unlikely.

It's a mess any way I try to approach it.

No doubt.

*hugs* (if you accept)
Ian
 
*hugs* (if you accept)
Yep, I'm a hugger, firm believer they are big medicine. I appreciate the talk. It has helped to calm me and get my ajna pointed in a more solid direction, thanks Ian. :D
repositioning
Getting her to comply is the issue. I did talk her into ABS padding around the wound site to see if she's more comfortable. With the fluid building up it's a crap shoot to roll her.
Dilaudid (hydromorphone).
that's it.

she has a severe reaction to it.

If she gains anymore weight, the neice told me they will take her back to the heart institute. Fluid in her chest is what caused the CA both times. If she codes again the docs are prepared to call it.
 
With the shocks of the last few days and a drizzling rain this is a good morning for contemplation.

I had bought several plants and have been trying to get them in the dirt while navigating all the other 'commitments' a day brings. I realized last night that I bought Lysimachia Goldi thinking it was another exotic ground cover. It's the same Creeping Jenny that I've been planting for the last three years. :tearsofjoy: Each nursery I've bought it at had a different tag in the pot as it's identity.

Oh well, I'm in love with it's little elfin cupped leaves. Perhaps that's why I keep gravitating to it. I have been building little areas in the flower gardens so the sprites and fae have happy little places.

My neighbor told me I'm nuts for thinking they all exist. I laughed and tried to explain that until someone proves they do not exist I'll continue to believe they do. After all, there has been many times I've caught a movement from the corner of my eye while working in the yard and thought to myself was it really what I thought I saw or was it just wishful wistful thinking?

I say wistful because there was a time in my younger years when my imagination provided me with all I needed to keep myself happy.

I knew at a young age others would not provide that for me.

Yet again, I get on a roll to empty out the good, the bad, and the wonder, and Dad's alarm sounds and all that gets stuffed back to answer the call of caregiver.

Deep down I feel unacomplished at this point in life. I begin something and it sits as unfinished as I feel.

Others, especially family, do not realize that I have things I want to do too. I don't sit around twiddling thumbs waiting for them to call. My stepsister is actually pissed at me because she has been wrapped up at the county fair for two weeks, texted me ten minutes before tuck-in time for Dad, and because I couldn't talk then she's put out. :tearsofjoy: wtaf?

She has no clue that for almost two hours prior I had been redirecting Dad between pj's and street clothes that he was not 'going home'. He does this quite a bit between wanting to go home and will I give him a ride to work. Just recently my younger sister had to catch and redirect him back to the house because he had said fine he'll walk if she won't take him.

So my stepsister really needs to get over herself.

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I'm playing in the mud today. :P
 
:<3::<3::<3::<3::<3:
That is deserving of a five heart rating John ;)


I'm making spaghetti boulganaise ... life smells good. :p

There'd better be a very special place in heaven for you Sandie, or I'll be having words with the authorities up there :D

Ah! I can almost smell what you are cooking over the internet. Never stop shining and living my friend!

:<3:
 
my day ...

Mean sister calls ten minutes before 8 demands to speak with Dad. Dad not up, told her yesterday after 10 am best shot. Hangs up. Calls back at 8, demands to speak with Dad. Get him up, nope, hangs up. Calls back at 10, demands to speak with Dad. Carry phone to Dad. Hello. Can't hear you. Dad hangs up. :tearsofjoy: I call sister back, round 2, Dad hangs up. She calls back. I talk to her relay to Dad .... wait for it ...

Dad, "Hang up." oh my.

Get Dad up, morning routine done. I go out to mow. Belt on mower breaks after two laps in yard. Shit. I just paid $300+ to have mower serviced front to back. Waited 5 damn weeks. Check bill ... wait for it ... belt replaced. hmmm.

Push mower won't start.

Brush hugger won't start.

Grab light weed wacker, string gone. Younger Sister..."forgot to tell you." How is everything with Dad. FU.

Call 83 year old neighbor lady, who talked me into buying weed trimmer, she helps get string off because younger sister had tossed away the directions that were in same zip bag as string.

No clue, don't bother me, at fil's picnic, will call Dad later. wtf.

Get string loaded, battery fully charged, go over to neighbors to hang heavy flower pots for her in exchange for her helpfulness. Get rhubarb blondies as treat thanks.

Pick up the mf string trimmer, whack about an 8 inch one swipe path, battery dead. Look closely ... wait for it ...
String jammed.

Absolutely done in that moment.

Could have thrown the biggest Sissy fit however, said a loud thank you to the universe for stealing giving me a prime day off. Reckon I wasn't supposed to get any yard work done on the only fekkin day it hasn't rained in the 6 day stretch.

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lmao :p
 
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Saw this yesterday, recollecting it caused me to laugh out loud, even while Dad was in the dentist lol :P

Then, while held up in traffic, because the road crew is still working on our beautiful new road ... I thought of @Asa and her new babies...oh the training phases ♡. I recall the last pup I had survived many jalapeño sky raisins...me, not so much. ;)
 
Dad at the dentist ... oh gosh what a time.

One plus, he found out momma don't play! Lately that's how I feel, like a mean mom.

Dad has not been taking care of his teeth. I pointed out around Christmas time, that the same one and a half bottles of mouth wash hadn't been touched since September, then again in Marchish, I pointed out to Dad and my sister that the mouthwash and toothpaste hadn't been touched. The toothbrushes I've bought are mia.

At Dad's visit the technician had to do some x-rays. He managed to get his top plate out but not the partial on the bottom. He hasn't had it out in so long that the technician had to use a dental tool to pry it out!

Blood everywhere with her scraping and picking. Dad toughed it out saying it didn't hurt. Squaked a bit when he found out he had to have his remaining teeth removed and would be getting new top and bottom plates. It is going to be close to $5,000 with extraction and new build. wtf!

My gut instinct tells me he will end up not using them because of the brain disease.

After repetitively telling the technician he has dementia she finally backed off the rapid fire questions of chastisement.

Why is it so difficult for others to understand that cognitive impairment is just that ... the inability to comprehend at an advanced level. I finally snapped at her and asked that she give him a moment to think and respond.

Geeish. We wouldn't badger a kid like that ... or would we?

I drove to the next stop in our errands thinking what a wonderful parent I've become. :P
 
Then, while held up in traffic, because the road crew is still working on our beautiful new road ... I thought of @Asa and her new babies...oh the training phases ♡. I recall the last pup I had survived many jalapeño sky raisins...me, not so much. ;)

:<3yellow::<3yellow::<3yellow:

Between the jalapeno sky raisins and the noxious weeds, my two have had hives a few times. In over 25 years of raising puppies, I've never had one that eats everything in sight. Now I have two. LOL I also got hives for the first time. It's been exciting. LOL
 
So today was the eye exam for Dad. Last time, a year ago, he had a terrible time reading the lines and letters. Today, with some coaching that they were ALL letters he did much better.

Z, C, E, and H were morphed into 5, 3, 3, 4's
I told the doc I was going to play that straight box and see if we got rich, lol :P

So now, armed with a new prescription, we head to pick out a new, albeit unfashionable, pair of spectacles for Dad. :D
 
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