Progress of open wound

crissyb222
on 12/1/11 9:25 am - IL
I'm more of a lurker on here but right now I sure could use some support. On Oct 4th I had a panni removal with tummy tuck. A few weeks later I developed Necrosis and the wound was opened up in 3 different places. I have a home nurse come check it once a week and my daughter packs it once a day. The surgeon says it's healing good but it will take a couple months. A wound vac is not an option for me. I lost my insurance as of Oct 31st and according to the company I don't qualify for patient assistance. My problem is that the skin below my belly button seems to be loser than it was after surgery. Will it get tight again when the wound is closed and healed ? Or am I looking at a revision ? The only answer I get from the surgeon is it's going to be fine...define fine. Also, the wound still burns when changed. Also it aches real bad below my incision, down my thighs and to the knees. Tylenol doesn't help at all. Has anyone ever had this ? I'm hesitant to ask the Dr for more pain pills as he was reluctant to give me a refill the last time I saw him. I only took 1 before my bandage was changed and occasionally before I went to bed if I did alot during the day. If this doesn't get any better soon I'm going to call the office. I'm miserable....
Lizzy25
on 12/1/11 10:07 am
 I'm so so sorry you're still in pain! That sounds awful. 

So what kind of wound care are you doing specifically? Are you packing it with wet-dry dressings, special dressings, silver sulfadiene, bacitracin? I've been using this wound dressing gel recently on my bellybutton and it has seemed to help more than what I was doing before. It's called Amerigel and I got it off Amazon for $20. It is commonly used in pressure ulcers and chronic wounds. But definitely keep following your doctor's orders. Just thought I'd throw that out there because I'm packing my belly button every day too. 

Your loose skin underneath the belly button could be a couple of things: 

-it could be that right after surgery you had more swelling, so the skin seemed tigher, and the swelling is going away now so it seems looser

-your skin could be stretching out. My PS warned me that weight loss patients have lost all elasticity in their skin so they frequently need revisions after plastics because their skin can't 'bounce back' and will stretch after the surgery. 

-depending on how deep the wounds are how far apart the skin has pulled, maybe it's due to the skin being open and it will tighten back up after the wounds have closed themselves. but this is kind of unlikely unless they're truly gaping. 

Regardless of the cause, you just have to wait and watch. (I know, I'm always being told that by doctors and I hate it!). Stressing about it now won't change the outcome later. You might need a revision, you might not. First priority is to get those wounds healed up! 

The wound will probably still burn for as long as it's open, but you can see that as a good sign because dead flesh doesn't register pain, so at least you know it's living tissue! I'd be more concerned if you didn't feel anything at all. 

You should definitely get the pain addressed. Being in constant pain will (and probably already has) cause depression and anxiety and will slow your healing. If he says no, describe your symptoms and how you're being careful with your pain medication. You presumably don't have a history of drug addiction or prescription abuse. Offer to let him talk to your doctor or pharmacist to verify this. Maybe you could compromise by having him give you something that's not a full-on opiate but stronger than tylenol. Like tylenol-3 which is stronger and has a little bit of hydrocodone but isn't as strong as vicodin or percocet. 


Big hugs!!! I will keep you in my prayers! 

"The greatest challenge to any thinker is stating the problem in a way that will allow a solution." -Bertrand Russell
5'9 HW: 297 GW: 160 CW: 161
Lizzy25
on 12/1/11 10:13 am
 Ok I just peeked at your recent pics and your wound is way bigger than I was picturing, it could very well be that your looseness is because of the size of the wound. You might need a scar revision at the very least once it's all healed up, but honestly the tissue itself looks very healthy, it's nice and red and looks like it has a great blood supply. You barely have any cellular debris or exudate, I think if you keep taking care of it the way you have you'll heal up great. 
"The greatest challenge to any thinker is stating the problem in a way that will allow a solution." -Bertrand Russell
5'9 HW: 297 GW: 160 CW: 161
crissyb222
on 12/1/11 7:12 pm - IL
Lizzy, I agree with both you and Denise. I'm going to call the office today and explain to them I'm still in pain and need something stronger than tylenol. I don't have a history of drug or prescription abuse so I don't know why I'm worrying so much about it. I used to love my Dr and we had a very good patient Dr relationship. Now I dread going to see him. The last time I saw him I was whining and telling him how miserable I am. He comes back with " I don't want to hear it. I warned you this could happen being I was a former smoker{ I quit before my tummy tuck in Oct). You're going to have to be strong and get through this." What happened to his compassion and great bedside manner ? It went out the window. I'm so dissapointed in him. I trusted him and I feel like he let me down. Thank You Lizzy and Denise for your advice and support. I've read your posts and I know it's been hard for both of you too. This too shall pass....when I don't know.
waitinggame
on 12/1/11 11:27 am - Bowie, MD
First, I have to extend a huge hug to you. You poor thing. No one deserves to have to contend with a wound issue like that. 

Next, I say you go to your doctor, slice open his scrotum, turn the skin inside out, then kick him in his man parts (sorry to the men reading this!). After doing that, ask if he'd like a Tylenol to help his pain. Seriously, I'm appalled that he'd even hesitate to give you quality pain control given the extent of your wound issue. I mean honestly, there are times I have a small paper cut or a hang nail that causes me significant discomfort--I can't imagine how badly your wound could hurt. I also can imagine there is some serious nerve disruption going on and who knows whether that might cause referred pain such as what you describe to your thighs and knees.

I'm with Lizzie--you must get your pain under control. You must be stressed beyond belief both from worry and pain. You need to get some relief of your discomfort so your body can direct its energies to healing.

Please do not be afraid to advocate for yourself about the pain meds. If you show them that you are hesitant to ask for meds, they'll treat you as if they have reason to worry. Trust me on this--I used to work for a doctor and the patient's that came in hemming and hawing (not sure what that means or how it's spelled, but you know what I mean!) about needing meds or those with excuses and stories about why they needed their meds vs. just saying they were still in pain and needed a refill often got cut off. Just go in and confidently say that you are suffering and you need something stronger than Tylenol to help you. I'd really question a doctor that sees the seriousness of your wound and doesn't offer help. 

I hope you are soon feeling better. I promise I will not again utter a complaining word about spitting a stitch or any other wound related issue after seeing those pics. You are a trooper!  

Sending healing thoughts,

Denise

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun. 

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane


                    ButterflyCenturyCard-5.gif picture by barbccrn

 

*6.5 lost preop

crissyb222
on 12/1/11 7:34 pm - IL
Denise....you're too funny. The scrotum thing actually made me laugh. I've been so overwhelmed with the things going on in my life and going through this was just the last straw. I'm definately not a trooper right now. I'm depressed and cry alot. I'm even on antidepressants...go figure. I'm really starting to question my Dr. I'm very dissapointed with the aftercare I'm getting from this. I'm sure we will get through this bump in the road...right ?

Thanks for the support,

Christine
waitinggame
on 12/1/11 9:35 pm, edited 12/1/11 9:38 pm - Bowie, MD

I call these times in our lives "Blips on the Radar of Life", because in the big picture of our lives, this will be but a moment in time soon to be forgotten. Much like any trauma, the painful memories ease with time--if not no one would ever have more than one child!! I've had some pretty heavy "life" stuff going on recently too and I am also struggling to handle it all. I think antidepressants are God's way of saying he wants us to be happy. That, and wine. LOL!

Much like the issue with the pain relief, and although I know it is easier said than done, I'd go in to see him and say something like, "Earlier in this process you seemed so positive and supportive, but last time I was here you almost seemed to be angry with me." Have I done something to upset you?" That way it isn't accusatorial and anyone with a heart should feel terrible for making you feel that way. Worst he says is, "Yes. I don't like your whining. I told you this could happen. Blah, blah, freakin' blah." Then you can say, "Well, I don't think that expressing my concerns about an incredibly serious medical condition constitutes whining and I need kind caring and support right now." Or he may say, "No, I'm not angry. Why?" Then you can tell him it's just that the last time you were there he said he didn't want to hear your complaints and that made you feel worried to express further problems and given what you are going through, open communication is critical. At least it might make make him stop and think about how he is acting and hopefully he'll back the hell up, apologize for making you feel badlly and get on to the business of supporting you both medically and emotionally.If not, there is always the scrotum slicing route! LOL! My doctor makes me feel so much more relaxed and confident about my process every time I see him. Granted, he may be blowing smoke up my slightly more firm rear, but for now I'll take it! Granted, I still hate my saddlebags and he may not be so warm and fuzzy when I hit him with that, but for now he is getting me through my tough times very supportively.

Hang in there. This too shall pass and all that hokey stuff. Just keep popping in here. Everyone is great. For some things go very smoothly. For others like us recovery is more challenging, but everyone here will offer you a word of encouragement and a virtual hug when you need one.

Try to have a good weekend sweetie!

Denise

Edited to add: I'm about ready to offer to come with you to your next appointment!! I've always said that after my mom passed due to medical negligence I wanted to be a patient advocate--this might just be the start of a new career for me! :) Relax and take good care of yourself this weekend!

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun. 

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane


                    ButterflyCenturyCard-5.gif picture by barbccrn

 

*6.5 lost preop

crissyb222
on 12/2/11 9:51 am - IL
I just wanted to let you to know I did call the office today and the physcian assistant called in a refill for Norco. I took one and am feeling much better...oh what a relief it is !! As far as the aching legs she says it's the nerves reconnecting and is normal.

Thanks for all your support

Christine
Laura in Texas
on 12/1/11 9:57 pm
Wow. Did that open all at once or did it get progressively worse? I had a small opening in my incision at the 4 week mark (about 1/2 inch). If it had opened longer than an inch, my surgeon was going to staple on either side so it did not get any wider. I've never seen such a big opening here. I am so sorry!! I think your surgeon should have done more to help you.

Laura

Laura in Texas

53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)

RNY: 09-17-08 Dr. Garth Davis

brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco

"May your choices reflect your hopes and not your fears."

crissyb222
on 12/2/11 9:31 am - IL
I developed necrosis and it got infected. I had another surgery to debride it and that's when he decided to open the incision up. He didn't like the way it was healing. I have 2 smaller open wounds on both sides near the end of the incision. He tried his hardest to get me a wound vac but seeing as I no longer have insurance and couldn't get assistance from the company I have to let it heal on its own. I have a home nurse come out once a week to check on it. My daughter wet-dry packs it every day. It is healing nicely but it's going to take a while.
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