Friday, I made a trip to Pittsburgh to go back to the wound center at Ohio Valley General Hospital where I went back in 2006. It was a very good reminder of “good” versus “bad” medical care and why I have my leg today.
The woman at the check in was there when I went there before and she remembered me. The woman that took me back to the room also remembered me. She did the vitals and took pictures.
The next person slightly threw me because when I made the appointment, I was told that I was considered a new patient now and I would have to see a nurse practitioner before seeing the doctor. She said a name that I did not know. The NP that came in the room said she remembered my face. It took me awhile to place her but she had a different name than I was told would be seeing me. Once I heard her name, I knew exactly who she was.
I was very impressed that the NP recognized that a diabetic can have an infection without a fever. Sadly, a lot of medical people don’t understand that and insist that you don’t have an infection because you don’t have a fever. When I told her that I was impressed that she knew that, she said that they see it all the time there.
She called my PCP’s office to get copies of the labs that I had in March and June. I had a full panel of stuff in March and only the A1c in June. When they faxed the labs, my albumin levels were in range but on the low side. She recognized “optimal” range and not just lab range. Your albumin levels reflect your nutritional status and if that is low, it will hinder healing. Another plus for her! The first wound center I went to here tested things and although mine was very low (below lab range) they never once suggested a protein supplement. When I started going to this wound center in 2006, they recommended ProSource – that did not mess up my BS. She gave me the information for the place that I ordered it from before. I know that I don’t eat right because there are so many things I can’t eat because of the gastroparesis and now food allergies.
When the doctor came in, the nurse that was with him was the nurse that worked with the doctor when I went there before, so I also knew her. The doctor cleaned it up pretty good and took all the black off. The NP had measured it and was able to stick a q-tip in to see how far it went. Both the NP and the doctor mentioned undermining/tunneling – that is when it starts spreading underneath the skin and it makes a tunnel. Although he cleaned the top part off pretty good, he felt that I should be taken to the OR to open it up and clean it out there. He said they could do that there but they can control the bleeding in the OR better.
He asked questions about being sick or anything. I told him that I had what I thought was a stomach bug and then shortly after that, when I couldn’t get my BS down and had practically tripled the amount of insulin I was using and was still over 200. When I said that I normally use about 35 units total per day, he asked if I was a Type 1. On Thursday my blood sugar also went up and although not as high, I hadn’t been able to get it below 140 both Thursday and Friday.
He asked me if I would be able to stuff something in it. I said that I wasn’t sure, but I would try and if I couldn’t, my sister could help me – she is a nurse and said she could help with dressings if I need her to. There is a strip that has medicine on that they stuff into wounds – we did that when I had the other one. He asked if I used Dakins solution before. I asked if that was the bleach stuff and he said yes. I did not use it myself, but they did use it when I was in the hospital there. He said they can do that two ways – either a prescription to get it or a recipe to make it. I told him that I am not Betty Crocker so the prescription would be better. He also gave me a script for an antibiotic.
He wanted me to see one of the podiatrists there to open it up in the OR. When we discussed seeing that doctor, he said that he was only there Monday mornings. I said that was fine as long as it was late morning. He asked what I meant by late morning and I said after 10:30.
He would like me to get one of the special boots but said because they expensive he wanted to make sure that is what the podiatrist wanted also before ordering it.
When I went to check out, the woman making the appointments wanted to set it up at 8:45. Going to Pittsburgh during rush hour makes it a three hour trip, not a two hour trip. I said I could not get there at that time and needed later. She told me that the way the computer works, she had to use the first open time slot. She said that she would watch it and keep moving it back as it filled up but she would not be able to put it in later than 10. I told her to check with the doctor to see what he wanted me to do because I can’t get there that early. I don’t want to make an appointment for the wrong the wrong time and end up getting charged because I don’t show up! She came back and typed something in the computer and wrote 10:30 on my slip.
I really hope that is not true how she has to do it because that offers zero flexibility for patients. I won’t be able to see any of the doctors that are only there in the mornings. When I go back, I will bring that up with one of the nurses and the doctor. That would be an issue if I need to follow-up with him after the surgery.
After I left there, I had to go over to the hospital to get an x-ray of my foot. They asked when the last one was done and I haven’t had one done since I fell down the stairs over a year ago.
After I got home Friday night, I just started to cry. It was a combination of fear of what will happen and anger at myself for trusting a doctor that did not deserve that trust. I knew that something wasn’t right but I continued down the path of trust and kept going back. I could kick myself now for doing that. I just hope that no permanent damage was done.
Needless to say, I am very glad that I made that trip and my only regret is that I did not do it sooner. When I called my sister after I got home, she said, “You should have listened to me months ago!”
I added two more pictures at the bottom of the page with the running pictures. I put one from the morning of my appointment on October 5th and one from the morning after he took off all the dead skin. You can see those here or at the top under Diabetic Foot Wound and 2012 Diabetic Foot Ulcer.