As promised...

Here I am in all my uniformed glory! I just had my last clinical yesterday...we were the only group incredibly lucky enough to have a Saturday clinical! Sense the sarcasm? It actually was fine and now it's over so no harm, no foul. And it was actually probably the coolest day I had all semester. We got to see two dressing changes on some pretty crazy wounds. This may gross most of you out, so heads up. The first one was a patient who had their small toe amputated on Tuesday. So I'm thinking ok, no toe, no big deal, it will be stitched up, maybe a little drainage, no problem. Wrong! First, let me preface by saying this patient had diabetes and lots and lots of circulatory problems, their arms, hands, calves and feet were pretty bruised and red and such and such that comes along with poor circulation. So, as the nurse was unwinding the bandage, the first thing you could see were some stitches on the side of the foot, ok, not bad. Well it all went downhill from there! When the entire bandage was removed there was a big gaping hole where the toe should have been and also on the side of the foot. It was like nothing I had ever seen! And boy did I look...kind of like a train wreck...it's all you can see and you can't look away. The more I looked the more I realized you could see a BONE in there and his fascia(meat) and other accessories were really dark and inflamed. I had to take a tiny step back and close my eyes for a second and clear my head. When I looked again, it was still there, bone and all. I'm guessing that the healing process will be kind of lengthy due to the circulation issues. The second was way cool too! This patient had to have 2 kind of major abdominal surgeries with 2 weeks of each other. The nurse wasn't really sure of all the details but the just is this....when you have to be cut open, sometimes the Dr. can choose to not sew you up(for many different reasons) and you have to heal by what is called secondary intention. This is when the edges of your skin are healed up on the edges, but not healed together. The underlying fascia is exposed and the wound heals from the bottom up. This takes quite a while. The patient's wound was about 8-9 inches x 4-5 inches. They said it had healed a lot since the surgery and was about half the original size. I thought it was going to be really gross, but it was definitely the coolest thing I saw in person all semester! It is amazing the things our bodies can do! The tissue was healthy and pink with no infection....and it's avascular so there is no feeling...the patient was very relaxed throughout the whole thing. And last week I had a patient with a gangrenous great toe....Gangrene is nothing I ever want. And I also got to watch a patient get dialyzed in ICU after open heart surgery! So lots and lots of stuff the past weeks and now I have to gear up for finals! 7 tests in 7 days! Have lots more to tell and will soon, but now I'm off to cook my weekly Sunday dinner for friends!