8/05/2008

inside-out


[Note: for my more gentle readers, you might want to skip this post and enjoy yourself some kittens instead. Seriously.]

Remember that game we played as kids, Operation, where you'd have a pair of tweezers and you'd attempt to pick out a body part from your surgical patient without hitting the sides of the hole? Each time I look at the wound in my leg that game comes to mind.

In order to get out all of the various channels of infection that were in my leg, the surgeons had to cut down deep into the soft tissue--in some places they went down about 5-7cm deep. In doing so they cut through various layers of stuff--dermis, fat, muscle, etc. Then they left the wound totally open so it would heal from the bottom-up rather than from the top-down or from the sides filling in. Leaving it open allows for the wound to be cleaned twice daily to flush out any residual infection. Then the hole is packed with clean wet gauze to absorb any yuck and so prevent it from closing prematurely. It's also pretty damn painful.

I am no stranger to nasty wounds. Not only have I lived with this festering infection for four months, I've also dealt with the healing wound of my amputated right leg, which was pretty nasty-looking for a long time (think Frankenstein).

But for some reason I've been completely flummoxed by this one. Looking into the wound makes my head spin and my stomach lurch. I think it's the cross-sections of each layer that affect me so strongly--they are slick and wet and they move. As my muscle flexes I can see it from the inside. I can see my own nasty fat. The edge of the wound has become sort of hard and dry like the way bologna looks after a few days when you forget to seal the plastic wrapper closed all the way.

When I was discharged from the hospital my docs assumed that I could change my own bandages. What they didn't know was that I'd only had one slim glimpse of the wound and had refused to look again. Fortunately John was on hand to do learn how to do the cleaning, packing, and bandaging. But this wound is going to take months to heal and I can't expect to John to always be there to manage this task for me. I feel it's time for me to be able to dress my own wound.

But the honest truth is that I sucked at the Operation game. When I was a Bio major the only lecture I even walked out on was when were were viewing surgical slides (I went into the parking lot and dryheaved). As much as I am fascinated with the human body and it's functions, as much as I am not grossed out by blood and poo and just about anything else ooky and bodily-related, this seems beyond me. It's not just the pain, it's even bigger than that.

Quite frankly, I am embarrassed about my squeamishness. In an attempt to get more acquainted with my wound, I had John send me some of the digital photos that he's been snapping daily so we can note any changes in color, shape, discharge, etc. I played with one of the images in photoshop, trying to take control of it and make it be something that I could get used to. No matter what I did--changing colors, saturation, fuzziness, etc, I couldn't make it into something that I was comfortable with.

It's my own leg and I'm completely scared of it. Why? I don't know. It's not a rational response, for sure. I want to get over this, and I keep telling myself that I am brave and strong and I can do it. Any advice?

16 comments:

Deborah said...

No advice. I dread the possibility of a big surgery, because I take months to heal from little ones -- my most recent mole removal surgery took six months to fully close. Something about iron, I think.

I'm just so sorry you are going through this. While it's cliche, the phrase that has resonated with my husband and I recently while dealing with something particularly stressful has been: Sometimes the only way out is through.

I prefer detours.

P.S. You have a great husband.

Deborah said...

And you are brave and strong, that much is abundantly clear.

Vajra said...

Like Deborah, I've got no advice, except love yourself as you are: beauty, wound, nausea, everything. You are so amazing to undergo yet another ordeal with such grace. Gee, I'd surrender to torture if they took away my credit cards, so all I can say is you are a great teacher as is your body. Just hang in there.

Bored in Vernal said...

Hi Jana, I don't know if I can give you any advice, but I really can't believe how brave you are. I have been reading your blog and thinking about you a LOT because when I found out you had to have an operation on your leg, I imagined how hard it must be. I have read your article about your amputation when you were a girl, and I can't even fathom how hard it must be to have to be put to sleep knowing that your other leg was being operated on. This kind of thing has to be extremely traumatic to the mind. It is no wonder you don't want to look at the wound. Please be easy on yourself and know that you are ALREADY brave and strong.

Tanya Sue said...

Hi Jana, with all of my medical crap I have found curiousity gets me through it. What everything looks like enthralls me. I think if you can find a way to be curious about what it looks like, that will help. I also think once you get past the "holy crap what did they do to me?" it will get easier to see and handle. Just be patient and know it is ok to be somewhat grossed out by it. At the same time, it is your body and the layers are amazing.

From my surgeries I have seen my ligaments look like torn in half, and what they look with a bone graph creating a new one. I have seen what my ovaries are like when they are ovulating. I never cease to be amazed at the human body.

Your amazing body figured out a way to make sure you knew there was still an infection, instead of letting the infection take over your body. Your body did things to make sure you knew there was something you needed to pay attention. That is amazing! Your body knew how to get your attention in order to get this problem addressed.

Penny L. Richards said...

Your reaction really doesn't seem irrational to me. Humans should be at least a bit upset by the sight of our own bodies opened up, pulsating--it's a vivid sign that something bad has happened, or is happening, and that we'd better treat it very seriously. Which you are!

I don't have any advice, but if it helps to know "this reaction is perfectly understandable; my body is telling me something important, and I'm listening," then do that, eh?

Penny L. Richards said...

Hehe, it looks like Tanya Sue and I were posting at the same time, with similar ideas... ;)

sarah k. said...

I got nothing. But my ears are ringing a little. I think I may be one of those "gentler readers". I wish they had those Wonder-Woman underoos that I had as a kid. I would find your size and send you some. I don't think my son's "Man of Steel" ones could be convincingly doctored to read "Woman of Steel". But you surely must be. And your sweet John is a prize.

John (with an h) said...

That totally reminds me: Bologna sandwiches for tomorrow

Ms. Moon said...

I was taking care of a friend of mine who had been shot in a burglary. She had an exit wound in her shoulder which needed irrigating several times a day which meant unpacking and packing- like yours. It was so hard for her and not especially fun for me either, but we got through it more easily when we decided to name the wound. I think we named it Ethyl. It just seemed easier to say, "Honey, time to tend to Ethyl," than it did to say, "Time to clean your WOUND."
A tiny thing. But she is fine now and got a beautiful tattoo of a bluebird over her scar.

Melissa said...

I have no advice. I'm 2 months out after an arthroscopic surgery and I had the same reaction as you did.

And from what it sounds like my arm was NOTHING like your leg.

Hang in there and remember to be kind to yourself...

Zhoen said...

In surgery, we drape the incision site, disconnect it from the whole person, which makes it easier to see as a thing, not a wounded and suffering being. Maybe get some medical drapes, an opaque garbage bag, tie it around, make it a kind of ceremonial, apart from life.

Working in surgery took some mental gymnastics, not to get ill, not to recoil. Prepping and draping are, I think, not just for sterility.

jana said...

ms. moon: I totally love the idea of naming my wound! And I have a friend who's promised to do the tattoo thing with me if/when I'm ready for it. First things first, though--I have to get this thing healed! :)

zhoen: good ideas--I've basically done this with my daily dressing routine and it seems to have helped a lot. I use a freshly-laundered towel as a "drape" (it's also a handly place to put the ooky bandages and stuff in the process of dressing the wound)

All: the docs say that it's healing fairly well--there's just one corner of the wound that's sort of festering. We're going to try some different antibiotics (again) to see if that will help with that particular area.

Anonymous said...

I had a syst that had to be opened and the had to be packed. It was on my lower back so I never really got to look into it, but it to about two months for it to heal enough for them to go in and cut the "Walls" of the hole out... only to be packed for more months. It was the worst ordeal I have ever been through and I remember screaming as my mom put the gauze in. It was also embarassing because if I wasnt careful the dressing would leak and get all over my clothes. But, after a bit, I became hardened to it or something, and either I got used to the pain or it got better. It does get better. The pain anyways.

Heidi said...

As with all things, this too, shall pass.

I wish you the best of luck. You've been brave and courageous so far, and I have no doubt you'll continue to be so.

Remember: Just because you're being brave doesn't mean you aren't scared shitless at the same time ;)

Muriel said...

Hello Jana,

I came across your blog via Dooce (I'm an avid reader of hers, she's a great person). Once I started reading your entries, I was very touched and emotionally flabbergasted.

I contracted cancer in 2005 at the age of 20, but didn't have an amputation of my entire leg, just a toe actually (from nodular melanoma). When they opened my leg to test lymphnodes, I also contracted infection after infection.

Technically, the open wound "healing" process didn't apply to me because they couldn't find anything in my leg to clean out. So I would contract an infection, receive antibiotics, go home, contract another infection, receive OTHER antibiotics, and so on. It was miserable, as I'm sure you know.

But, my wound wasn't pretty. My amputated toe wasn't pretty. And my husband (fiance at the time), was taught to clean and dress everything. He also took pictures to keep track of any changes, as well as document for my own benefit. I couldn't look at either wound site.

Anyway, I'm thankful I had my beau, and I'm thankful you have yours. I saw that you were able to clean your wound and congratulations!

It's amazing what we can actually go through...

PS. My link is to a blog I will publish soon, but it's empty now.