2nd opinion at Brigham and Women's

Well we got there and that place is crazy. Not sure if normal hospitals are like a million floors tall like that, but our home hospital is certainly not. We got very lost trying to find wound care. We FINALLY found it and went in, filled some paperwork and then I got called in. I explained everything to a Physician Assistant, and she took off sponge (holy pain, that thing was stuck to the whole side and had to be pretty much ripped off). In just 24 hours, the odor had returned and was stifling. We told the PA about the wound vac break we had taken this weekend and how everything had actually been going great then, and she said sometimes you need to take breaks from the wound vac for healing. Anyways, she had mentioned them *maybe* doing a culture, since the hospital sent me back with no records of any of those. Then we waited for the dr forever....and when he came in, he was very in and out. He said that he thought that our home hospital was doing a sufficient job and that we could our wound care with B&W, but that he didn't see why since in his opinion, they would do the same as them. I asked about the dying tissue and he said that this was probably already dead from the first infection (which I still don't understand bc they keep debridding it to the healthy stuff over and over again). Everyone keeps telling me that, that the dead stuff was already there. Its frustruating. I asked about the bacterias and cultures and he said they would only do them if I had pus coming out, and the brown drainage didn't count as pus. I asked if this was all normal then, and he said no, it was not normal, but neither is my wound. And that my body is reacting to the major abdominal trauma its been through, but its not surprising to him. So all in all, that was how it went. I kept crying a bit, bc I was just so frustruated to be hearing the same thing again. He asked if I had a plastic surgeon working with us, and I told him not that I have met/been told of. He reiterated that my drs appear to be doing the best they can with this type of wound and that it would just take time. The dr left and PA recommended that I might want to stop breastfeeding, bc my body is putting a LOT of effort into that, and its most certainly hindering my wound healing. Of course, breastfeeding is the one and only normal thing I have left after all this, and I am not ready yet (and not sure if I will be) to just throw in the towel with that. That kinda REALLY upset me...after all we have been through. She said that she would send a fax to my dr that they recommended a wound vac break from time to time. And that was that. I was a wee bit upset about all this, but I kind of figured this was how it was going to go. So we went to pick up our van from valet, and they said it would take 15 min. I just wanted to get in the car, but it never came. Doug went back 3 times to check on where it was. One hour later, they finally found the right people to get our van. They were looking in the wrong lot (since our 12 passenger van was in the oversized lot I guess-not where they were looking). Very frustruating.


We called our visiting nurse and she came over at 5pm, bc they didn't put wound vac back on and I needed the dressing changed. I honestly think she is the ONLY one that really gets this. She does TONS of wound vac changes and she says they never smell like mine...she was surprised that they were so laid back about the smell. All weekend she did the Dakins solution, and everything actually started looking better, there was no smell, drainage had gone back to pinkish-which is great, no spreading of dead area the whole time, in fact Dakins got rid of some of the dead stuff in there, and in 3 days wound shrunk by a couple cm. After 24 hours of wound vac back on, the smell came back with a vengeance, drainage was turning back to brown, and the dead area had now spread in size. We are all in agreeance that the wound vac doesn't seem to be doing anything positive for me at all right now, and visiting nurse said to make sure I talk to dr about this tomorrow before surgery. I am hoping I will see him, last time I didn't see him before or after the surgery. I don't want this wound vac back on me after the debridment...I really think it might be what is causing all my issues-don't know the science of why it might not be working, but this definately proves it to me (and nurse). She said talk to dr and have them switch me to dressings (Dakins if there is a smell, saline if there is not a smell). So hopefully I can talk to dr tomorrow before surgery and hopefully dr will agree to give me a break from the wound vac, give it a week of dressings, and see how my wound does with that. Wish me luck.

All in all, I was really bummed about 2nd opinion (although I was really expecting it to go that way), but maybe this weekend/visiting nurse experiement with vac off/dressings on has helped us come up with another potential solution to breaking this nasty cycle. Gosh I really hope so...I just need catch a break one of these days/weeks/months.