During my first week, I went to the clinic two days in a row. I saw Jeannine, the main nurse both days. Seeing me two days in a row was mainly to see if I could withstand the Unna Boot, aka the soft cast, put on my foot. For one day, it was tolerable. My next appointment was five days away. I have to admit, that it was miserable the entire time.
It wasn’t that it bothered the wound so much, but it triggered very painful plantar fasciitis. This is a heel ailment caused when the plantar fascia ligament that connects front and back of the foot becomes inflamed. One trigger is wearing different shoes that have little or no arch support, which seems to be why I’m suffering from it this time around. I haven’t been able to wear my normal shoes because of the location of the wound. I had plantar fasciitis 22 years ago when we went from wall-to-wall carpeting to hardwood floors. Evidently, heels don’t like major changes.
Right now, I’m taking Tylenol to control the pain of the wound. But it doesn’t even touch the plantar fasciitis. However, elevating the leg does. After having my leg elevated for about 10 minutes or so, the pain in the heel goes away. But it returns whenever I put weight on my foot, no matter what kind of shoe I’m wearing or what kind of surface I’m on. So, I spent as much time as possible with my legs elevated the past several days.
Another problem wearing the soft cast was taking a shower. I was not to get it wet. So, I used a kitchen-size trash bag with lots of duct tape to seal it. Because a plastic trash bag is slippery, I put on one of the hospital socks with non-slip nubbies on the bottom to prevent slipping. I thought I had my lower leg sealed off from any water penetration, but not so. I thoroughly enjoyed taking a shower after several days without. But afterwards I realized that in spite of my efforts, the cast had gotten damp. I tried drying it. But it didn’t work.
I then removed all three layers, which had all gotten damp—not sloppy wet but damp. Even the wound had gotten damp. Just in case I had to remove the cast, Jeannine had given me a pad to cover the wound and tape to secure it. The good news was that my next appointment was only a few hours after removing the cast.
At the appointment, Jeannine looked at the wound carefully and determined that it appeared no better but no worse. According to her notes, “Conservative sharp debridement was provided (8 sq cm), using sterile forceps to remove necrotic tissue/debris from wound bed and buildup of barrier film (applied at last visit), and dead skin was removed from around the wound.” She also used the Debrisoft pad (like a cat’s tongue) and saline solution.
It hurt much more this time even with the lidocaine gel. Not sure why. Jeannine has a gentle––but, as I discovered––determined touch. She keeps trying until she gets it.
This time, after treatment, I was not fitted with the soft cast from toes to knee.
She put a moist, fairly thick piece of a blueish/purple foam rubber looking object to cover the wound. It’s called Hydrofera blue protective dressing. She then wrapped the leg in a stockinette and then two layers of Turbigrip compression stockinettes. This set-up did not trigger my plantar fasciitis nearly so badly. And the next day, my heel felt nearly normal. Don’t know how long it will last. But I’m immensely enjoying the lack of serious pain!!!
And every other day between March 22 and 28, I get to play nurse. Jeannine sent me home with a whole bag of goodies—everything I will need to change the dressings and clean the wound. While I enjoyed playing nurse to my dolls as a kid, as an adult with me as the patient, I’m a little apprehensive.
On Thursday, I did treat my wound. I assembled everything I would need and then washed my hands with antibacterial soap really well. Then rolled up the three layers of stockinette stockings like she showed me, before removing the bandaging. I thought I was ready, but I had to stop three times to get something I needed. I stopped to get my directions, then my glasses so I could read the directions, and then scissors to help remove all the bandaging.
I washed my hands again before cleaning the wound first with special sterile gauze pads dipped in saline solution and then with a special wound cleanser. Before rewrapping, I spread a special lotion to protect surrounding skin from damage from discharge. Then I placed the moist, blue Hydrofera protective dressing before wrapping the cotton candy type wrap around and around my ankle before pulling down the three layers of stockinettes. After cleaning up, I elevated my legs and think I did all right as a nurse. I did learn that preparation is all important. Next time, I’ll have a checklist of everything I’ll need before I start.
I’ll keep you posted. The fun continues!