Sunday, November 9, 2014

Pressure Sores

Before it gets too far away from when it was noticed (by me), I'd better now mention that Pam returned home to Mildura on the 13th October with many open pressure sores (also called bedsores) on her lower legs, ankles and feet.  There was also one beginning to form on her right elbow.
On the very day of our return, I noticed a plaster bandage having been applied to her right ankle - but immediately above it, there was a huge hole - no doubt painful for Pam - that MUST have been there when the ankle was bandaged, but wasn't treated... makes me wonder!
Anyway, I haven't even been able to see all of the wounds - and when I saw this one, I called the District Nurse straight away to please come and check them all, however many there were.  The District Nurses now come every Tuesday and Friday - and I have only so far seen one other sore at the bottom of Pam's left heel.  It's healing now but is still the size of a 2-cent coin.
Apparently, Pam knew she was developing bed sores while she was at Westhaven, but she didn't tell me at the time because she didn't think they were "that bad".  Pam has SIX pressure sores, but they're all now bandaged and so far, I've only seen two.
I'm a bit annoyed!  Pam had no such sores when she left for her holiday.  But not only did she get the bedsores, she had a nightie taken (presumably for washing, even though that was my job), and was never returned.  A simple $6 tube of lip-balm also went missing and I had to go and buy another one.
Now, my poor Pammy feels as though she may not be game enough to go away again.  These pressure sores may take months to heel, so I'm afraid I feel a bit the same way.
Well, that was yesterday.  This morning I took this picture of what Pam (and I) have to put up with for the next month or two.  These 'boots' were fitted to Pam just days after we arrived home - almost a month ago...
I change Pam's knickers every morning - you can imagine the fun I have getting them over these (without hurting Pam).  Pam was only at Westhaven for six full days - yep, SIX days only!
This morning (11th) it occurred to me that MS itself may have attenuated the intensity of Pam's perception of pain.  This may have something to do with her not mentioning it to me.  MS stops her from seeing her injuries and probably muffles and confuses the pain signals as perceived by her brain.  I'll make further enquiries as to this...
I have just gotten Pam out of bed and showed her this blog on the way to her lounge chair.  In regard of the theory expressed in the previous paragraph, Pam announced that her legs are both numb - well nearly numb; she can still feel SOME pain.  So it seems that in this bizarre way, MS may well be, at long last, useful (!)
It's now 2:55pm on the 11th and the District Nurse has just left having treated Pam's bedsores yet again.  I helped her and at last saw all six.  Most are healing well and only two (the ones in the top photograph) now still require iodine antibiotic.ointment.
I'm starting to take all this as a nasty learning experience.  In the normal run of things, I take hard-learned steps to ensure Pam doesn't get bedsores.  I clearly erred in thinking that that was going to be the case with the staff at Westhaven - that's a big organisation, with lots of different people involving themselves in Pam-care.  But I'd say many of them were acting ill-informed because communication between them was clearly insufficient.  I visited Pam every day we were there, sometimes several times per day - but it didn't even once occur to me to actively look for bedsores.  Poor Pam couldn't know she was getting them because of her MS and I should have looked for them.
If we do any trips away again, and if it's to Melbourne, I'd consider Westhaven even yet, because Pam's mother is resident there - but I'd have to get their agreement that I would be allowed to inspect Pam while she's in their care and that they act on any criticisms/suggestions I might make.

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