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PostPosted: Fri Jan 09, 2015 5:30 am 
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Gallant Game
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Oh wow, what a cliffhanger "Stay tuned for the next episode ...."

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PostPosted: Fri Jan 09, 2015 11:41 am 
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Poor Mr. Winglet. I have read his adventure and I feel sorry for him. I hope that he will be doing okay in the next few days.


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PostPosted: Fri Jan 09, 2015 12:11 pm 
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Winglet wrote:
At the first day of an indication of infection, Mr Winglet chose to do nothing. He's an adult, and despite my suggestion to him (on more than one occasion) to have it dealt with that day, I can't force an adult to attend a doctor.


Stubborn creatures sometimes, aren't they? I find that "We need you to look after yourself, for all of us," works on Mr Shairlyn. ;)

Everything is crossed for Mr Winglet's speedy recovery!

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PostPosted: Fri Jan 09, 2015 8:59 pm 
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Old Mother Goose
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shairlyn wrote:
Winglet wrote:
At the first day of an indication of infection, Mr Winglet chose to do nothing. He's an adult, and despite my suggestion to him (on more than one occasion) to have it dealt with that day, I can't force an adult to attend a doctor.


Stubborn creatures sometimes, aren't they? I find that "We need you to look after yourself, for all of us," works on Mr Shairlyn. ;)


Nice thought... comments in that vein to Mr Winglet don't have the same result as they do on Mr Shairlyn. :roll:


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PostPosted: Sat Jan 10, 2015 2:47 pm 
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Old Mother Goose
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Mr Winglet has been home since last night, and slept well. He's very pleased to be home, and the dogs are very pleased he's home, too. One of them accidentally stood on his wound last night... OUCH ! RDNS came this morning to do a dressing change, which went well. Lovely bloke who was happy to answer our curious questions & who also did a quick & painless dressing change. Tomorrow we get a different RDNS nurse, and Mr Winglet is seeing our regular GP for a dressing change on Monday, followed by daily visits to our regular GP clinic for their nurse to do the dressing change. By next weekend I'm planning to help him to do them at home.

I've taken him out to brunch at our favourite local cafe as a treat, and he's exhausted now. He's lying on the lounge watching cricket... and I expect he'll fall asleep shortly. He's too tired to regale of you the details of his last couple of days in the hospital, but he will when he's feeling up to it. He did manage to find out a bit about the new neighbour in his room before he was discharged. A more mature bloke, who had gone to meet someone at a shop to buy something, and the person that he was meeting attacked him for no apparent reason. He was knocked to the ground & has no hearing in one ear, no sense of smell & a fractured skull. The attacker was "helping police with their enquiries" last Mr Winglet heard before being discharged.

Mr Winglet relaxing on the lounge with his sympathy chook & sympathy dog.
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The infected hand just before we headed to hospital (and the other hand as a comparison).
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The wound as it stands today (taken during the dressing change this morning - all clean & healing well).
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PostPosted: Sat Jan 10, 2015 3:51 pm 
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he looks happy to be home.
i think rigorous application of dogupressure for a couple of days is required.

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PostPosted: Sat Jan 10, 2015 9:14 pm 
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Gallant Game
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:thumbs: Colour coordinated sympathisers

Is that Miss Elwood?

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PostPosted: Sat Jan 10, 2015 9:16 pm 
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Old Mother Goose
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Smallflock wrote:
Is that Miss Elwood?


Indeed. That is the benevolent leader herself.


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PostPosted: Sat Jan 10, 2015 9:53 pm 
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That looks very sore. I'm glad he is on the mend.

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PostPosted: Sat Jan 10, 2015 9:58 pm 
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Mr Winglet looks very well cared for with his sympathy chook and dog , hope he feels much better soon , and his hand improves quickly.
Gotta love a blue chook named Elwood :thumbs:


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PostPosted: Sun Jan 11, 2015 9:05 am 
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Old Mother Goose
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7 January 2015... one day post-op... Ketamine trial for dressing changes.

If you recall, due to the agony involved in trying to the first dressing change, the pain management team & surgeon signed off on ketamine to be administered to make it painless. He still had the wadding in the wound, pulled out a few centimetres, and the hand re-wrapped to go on with.

Mid morning the nurse arrived to advise that she was there to inject the ketamine.... into his stomach. Two issues with that. One, Mr Winglet said to her that he thought it was going to be a liquid for him to drink, and two, Mr Winglet told her that there is "No way on God's green earth" that they were going to inject him in the stomach. She told him that the injection won't hurt, and that it's just like a diabetic injecting themselves in the stomach. Mr Winglet pointed out to her that he doesn't have diabetes, so that means nothing to him. She offered to do the injection in his leg, which was not an issue at all, and she could get on with that without further ado. He'd been told it will take about 15 minutes to kick in, and that the effects would last about 2 hours. 15 minutes went by... nothing. Another 5 minutes or so & the nurse said she'd try to remove the wadding anyhow, perhaps thinking that he was not being accurate in his assessment of the effects. She attempted to pull it out a little at a time, Mr Winglet is screaming, cursing & yelling his guts out in agony. The vast majority of it came out in one go as Mr Winglet pulled his arm away in pain & she had hold of some of it with her plastic tweezers. She tried to pick at the last few bits, accompanied by a symphony of swear words at high volume & much wincing by her patient. It took her a number of minutes & the total wadding removed was about 10 centimetres long. After it was all out, and Mr Winglet had time to settle after this attack on his hand, she offered up the immortal words, "It's quite deep. Is that bone?". Luckily Mr Winglet had not yet eaten his lunch. She put a pad over the top of the wound & went away. Mr Winglet was rather relieved & figured he'd be left in peace for at least several hours.

About 20 minutes later, she returned. "I have to repack it". NOT what he was wanting to hear. His response, "Oh, that's just f#*&ing fabulous". She soaked a piece of wadding in some sort of liquid (saline, we think). The wadding was about the same size as the piece that had been removed. She managed to get about half of it in, accompanied by her patient yelling, screaming, cursing, moaning, whinging, grimacing, wincing, sooking, apologising and generally making it clear that the entire ordeal was extremely painful to him (these are all Mr Winglet's dictated words). At this point one of the other nurses RAN into the room and said to her, "Just STOP. Some of the other patients think you're torturing him". Apparently they could hear him across the entire ward. The nurse that ran in was the same one that had first attempted removal of the wadding. So they stuck another external pad over the wound, having cut off the wadding that they hadn't been able to stuff inside him. They then left him alone. Another reprieve, but with the constant angst of wondering what was going to be inflicted upon him next. Mr Winglet said to his neighbour in the room, "Sorry about all the carry on." His response, "No worries. Sounds really painful". Followed by a short pause and, "At least you scared 'em off".

Later in the afternoon, at the next shift change, his new nurse came back with more ketamine & told Mr Winglet she needs to remove the packing again. The packing was supposed to be changed three times a day, and so far they'd managed it once (partially) and it was now more than 24 hours since the surgery. He told the nurse that the last lot of ketamine had made no difference & she informed him that they've doubled the dose... and that she's going to inject it into his stomach. "No. You won't. You can inject it into my leg." With the double dose, she had to administer two injections. There was another nurse present, who had hooked him up to a heart monitor, and who had put an oxygen measuring doo-hicky on his finger. He didn't really pay much attention to being hooked up at the time. The injections went fairly smoothly. About 15 minutes later he was, and I quote, "as high as a kite". The nurse who had injected him then uncovered the wound (removal of the top dressing has never been an issue.. it's always been about the internal stuff), and then had him look away (not the first nurse to suggest this to him). He did as he was told (as he generally has been throughout his stay). She started to chat to him, "So, what do you think about..." & whilst Mr Winglet was distracted by what she was saying she pulled the wadding out in one fell swoop. The pain was immense, with Mr Winglet's comment of, "F#&*ing OW !", followed up with, 'The ketamine may have got me off my face, but it did nothing to dull the pain." The nurse said, "That's it ! I'm not repacking that. The doctors will have to sort out something else." A wave of relief went through Mr Winglet & he settled back into his bed, his wound still not repacked & another pad over the top.

He was left alone, in terms of the dressing changes, for the rest of the night. IV antibiotics were changed, and he was fed, watered & checked on, but no-one went near the wound.


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PostPosted: Sun Jan 11, 2015 9:35 am 
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Old Mother Goose
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8 January 2015... two days post-op

About 8:00am, the team of doctors tending to his care appeared by his bedside on their usual morning rounds, plus some of their minions (Mr Winglet's description). Previously each visit had been about three doctors, but this morning there were about seven. The surgeon began with, "Ah. Mr Winglet. This is the patient that has been refusing to have his dressing changed". Mr Winglet responded, "That's a bit harsh". His surgeon said, "Don't worry. That's just our jargon". Mr Winglet was not fully sure whether or not to believe him. The surgeon removed the pad to have a good look at the wound & was most pleased. He said it won't be packed anymore due to the amount of pain that it's caused Mr Winglet & that it just needs the dressing over the top to be changed every day & a change to stronger antibiotics. One of the other doctors (we think from the pain management team) suggested, "What if, instead of packing it, we put a wick in there, coated with gel." This was suggested as it would be easier to pull out of the wound. The surgeon said, categorically, "No. We're not putting anything in there. It hurts him too much". Mr Winglet supported this option with, "Yeah ! Listen to him. Let's do what he says !"... pointing to the surgeon. The earlier comment about jargon was now entirely believed & Mr Winglet could finally relax, knowing that no nurse or doctor was going to go poking about in his hand. He (and others) could poke around the wound, on the thumb & fingers, on the mound of Venus... all with no pain or discomfort. Poke anything inside the wound, and it was another story. His morning nurse, the same lovely lady who had managed to distract him the evening prior to get the piece of wadding out with "relative" ease, was in the background listening carefully. She told him she'll be back later & it was good to know that she'd heard the certainty with which the surgeon said to leave the insides alone.

Around lunchtime Mr Winglet had a visit from one of the senior pain management team doctors, who told him, "I'm here to discuss your pain management options". Mr Winglet told her, "No need to worry about that. The surgeon & I have come to an agreement. He won't let people stick things in my wound, and I won't yell at them". Her response was rather pleasant, "That's fantastic. I'll go give your drugs to someone else". Mr Winglet let her know that the ketamine, even at the double dose, didn't do anything for the pain even though the higher dose had him off his face. It was then that he found out from her that they wouldn't have increased that dose anymore, as he had been hooked up to the machines that go "bing" because of how dangerous that quantity of ketamine is. That put a small scare into Mr Winglet, to say the least. She said that the next options, had he still needed wadding changes, were looking like laughing gas or going back under general anaesthetic for each dressing change.

The rest of the day Mr Winglet had to suffer with laying in bed & watching cricket until he had me visit in the evening after work, as has been the regular routine each day whilst he's been there. On arrival, I took him for a spin in a wheelchair down to the hospital cafe & to have a brief wander into the atrium that protects the hospital from the weather. It was a stinking hot, humid night, and he hadn't felt any normal weather for days, so I had him walk into the atrium just to feel the heat from outside before returning to his room. I left about 9:00pm. He chatted to people by phone & on FaceBook until about 10:30pm. As his next lot of antibiotics were due at midnight he figured he's stay awake & watch TV, rather than nod off & have to be woken from a slumber. The rather officious nurse on that night told him at 12:30am, in a rather matronly tone, "You HAVE to turn your TV off & go to sleep !". His response, "Well, I would, but I've been waiting for you to come & give me my next lot of IV antibiotics, which were due half an hour ago". With no apology, she mumbled something under her breath & went to fetch them. Same nurse, earlier in the day, had walked into the room & looked into his face & said in the same harsh tone, "Did you know you've spilled some water here?". Mr Winglet was able to look her back in the face & respond, "No. I haven't spilled anything. One of the other nurses did". That was also met with no apology, something mumbled under her breath, and her leaving the room. Perhaps she should try improving her communication? Or consider another career. She'd earlier given Mr Winglet's new neighbour a hard time, when he'd pulled out his canula attachment to make his way to the toilet. The man is slightly concussed, with a fractured skull, so is probably not in a clear-thinking state & likely not fully cognitive about his actions. Despite this she told him off rather curtly & hustled him back to bed in a huff. I do so hope that she improves, for her own sake as well as the patients. Nearly all the other nurses we could rate as very good to excellent, so it's sad to have one so poor at her interactions with patients.

He slept reasonably well that night, having been told that he'll be discharged the next day & knowing that there would be no more poking & prodding at the insides of the wound.


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PostPosted: Sun Jan 11, 2015 9:41 am 
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Phoenix
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Oh dear , thats sounds like an awful ordeal for Mr Winglet :hug

Maybe a local anaesthetic might be the key to a less stressful and painful dressing change......


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PostPosted: Sun Jan 11, 2015 10:14 am 
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Old Mother Goose
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angelcake.... Local would not be good for the wound three times a day, plus the agony of putting that in his hand would likely be as bad as doing the change of wadding. Him being able to feel his hand was an important part of knowing how it was going. The nurses would check for sensation each time and, on the plus side, the pain inside the wound means that the nerve endings are doing well... no fun for Mr Winglet, but he is expected to get full use of his hand back & anything (like local anaesthetic) that might have meant not knowing how it was going would not have been helpful in the longer term. It was considered by the pain management team, so was on the table. Just not the best option, as it turns out.


9 January 2015... time to go home !

He was discharged in the morning, and there is a transit lounge to wait in for your ride home (me) so that the bed is freed up. The transit lounge closed at 5:30pm, and if you can't be collected by then there's always the cafe area to wait in. With visiting hours going to 8:00pm, the cafe stays open for a while in the evening, allowing for a pleasant place to wait if needs must. Being a good citizen of the hospital, he was out of bed & happy to sit in a chair in his room before they finalised the paperwork to get him to the transit lounge. This meant that the nurses had more time to sort out the bed ready for the next patient. There's always plenty of patients waiting for a bed, so he was happy to do this. He couldn't leave the ward until the infectious disease team came to see him, and once they gave him the all clear he said goodbye to the nurses on the ward & headed off with his bag of belongings. The bag contained important things he'd asked me to take in, like his phone charger.

He spent the afternoon in a recliner chair in the transit lounge, watching cricket (can you see a theme?). About 5:00pm he thanked the nurses in the transit lounge (the same nurses that assisted him between ED & surgery when he first arrived) & toddled off to the cafe area to await his carriage (me). I collected him a little after 5:30pm, and he had that look of excitement a child gets as we drove home, as he watched all the day to day things that he'd missed out on for several days. Things like traffic, people walking their dogs, the Melbourne trams. The weather was perfect to collect him, with the heat & humidity dramatically reduced since the worst days prior. He could feel the warmth on his face, and seemed oddly pleased about that. Getting in & out of the car was difficult, but manageable without him needing any assistance.

We came home & he had a very light & small dinner, followed not long afterwads by him getting reacquainted with his bed & pillow. Off to bed at 8:00pm & slept quite solidly through the night. The dogs were both thrilled to see him home, with Gemma (the nearly 13 year old) back to her old self. More playing & being bolshy, rather than her moping & quiet behaviour without him here. Cleo (the 9 year old) ran straight past him when I let her outside. Then the penny dropped & she spun around & just about had kittens in her excitement at seeing him. Later in the evening she managed, despite attempting to be delicate, to stand directly on the wound, resulting in a "whimper" from Mr Winglet. They can be rather demanding of him, but he's managed to keep them calm enough, and to give them some pats & facerubs, that they've been better than expected when we needed that most.

Gemma, as you can see from the photo above, has been by his side non-stop since he's returned home. When I had to put them in another room with the RDNS here, she was frantic to get back to him. They get put in another room irregularly, but often enough that they may have a little whinge and/or an initial bash at the door, but will generally stop when told firmly once to settle down (from the other side of a close door). Gemma wouldn't listen & was quite distressed, needing multiple times to be told to pull her head in. I'm sure that she thought he'd disappear & she'd never see him again. It doesn't help that she's starting to show signs of cognitive decline, which may further be upsetting her each time she's separated from her favourite person. Cleo, the younger of the two dogs, clearly missed him, but doesn't have the same life experience & forethought to consider that anything might happen other than what is happening "right now". She's happy he's home, and back to her normal behaviour.


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PostPosted: Sun Jan 11, 2015 10:33 am 
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Old Mother Goose
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Thanks everyone for your kind words... on the RDNS paperwork, it lists something about "change dressing" & then in brackets, in very large letters (DO NOT PACK). We like that. :thumbs:

grabby,
Dogupressure is occurring throughout the day & night, and doing him the world of good.

Smallflock,
Well spotted. The colour coordination extends to Mr Winglet's hair.
Here, we like to refer to his hair colour as "blue roan" (the same colour as Gemma, our English Cocker Spaniel in that photo).

Chicken07,
Although it looks less than ideal, it's not sore at all & doing very well.
He can touch it quite a bit around the opening without even a flinch.

angelcake,
Elwood had a blue sister, Jake, who is no longer with us. I'm glad you get the reference.


IN OTHER NEWS:
Elwood was chosen to be the chook representative indoors the other day as she is supremely confident, and I felt best positioned to cope with the strange environment. She did an excellent job of making Mr Winglet smile, by bokking at him to explain how bumblefoot can be managed if he avoids walking on the wounded limb & continues to keep it clean & take the appropriate antibiotics as instructed. I sprinkled some dessicated coconut on Mr Winglet's arm as a thank you to Elwood. She was very appreciative & picked up the little pieces deftly. Mr Winglet even smiled... this from the man who used to (and still does) refer to them as "fecky feathered peckers".


Last edited by Winglet on Sun Jan 11, 2015 10:37 am, edited 1 time in total.

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