Day 6 - When is a pressure sore not a pressure sore

Monday 14th September 2009

Deb, the Ward Manager, popped into my room to say good morning and asked how I was settling in. I explained about my back and told her what had happened on Friday night/Saturday morning. She was appalled and said that if anything like that happened again, I had to tell her as that not how she expected her staff to behave or treat patients.

I was still in a lot of pain with my back so Paula and Karl, two staff nurses decided to phone the Pain Unit to see if any extra strength painkillers could be prescribed.

Kermit arrived again and explained more about the operation. He would remove the old hip and provided all the infection had been removed and he was happy with it, then a temporary hip would be installed. This would then be replaced with a permanent one in about six to nine months times.

If, however, there were still traces of infection then he wouldn’t run the risk of putting in the temporary hip.

“Infection loves metal”, he said, “so it will simply attach itself to the hip and we’re back to square one”.

“Don’t worry”, he reassured me, “you’ll be able to manage without a hip joint as there’s lots of muscle around the joint to support it”.

Antibiotic ‘beads’ would then be put inside the joint cavity to help get rid of the infection. They would remain in place for the forcible future.

“As there’s a lot of dead skin from the pressure sore, I’ll do my best to remove it and nip everything together. I’m good at plastic surgery”, he said, “however if there’s too much skin that needs to be removed, and I can’t stitch everything back together, then I’ll have to pack the wound open and you’ll need plastic surgery”.

“If that’s the case”, he continued, “then you’ll need a skin graft, probably taken from your thigh. I’m afraid what ever happens, you’re talking a lengthy time in hospital”.
“Will that be weeks or months”, I asked.
“It’ll be several weeks”, he replied.
“So I will be home for Christmas”.
“Oh yes”, he smiled.

Later that day there was a knock at the door. “Mrs Harper”.
“Yes”, I replied.
“I’m Andrew, the Microbiologist. Can we have a chat”.

Andrew started by asking what had happened so I explained.
“Why do you think it was a pressure sore”, he asked.
“What else could it be”, I enquired.
“To get a pressure sore the skin needs to have pressure on it constantly. A couple of hours during the night isn’t going to give you a sore. You mentioned that you had a graze on your hip. We suspect that your pressure sore was actually the infection. Because of the graze on your hip, it had found a way to get out”.

He continued by explaining that the infection was quite severe so a strong doze of antibiotics would be required. I would continue on IV, as they were more potent, until the end then go onto oral on Wednesday. I would also be required to continue taking for several weeks after the operation.
“Do you drink”, he asked.
“Yes”, I replied.
“Would you like me to arrange it so you can have a drink whilst taking them”.
“It would be nice, but not the end of the world it you can’t”, I smiled,
“I’ll see what I can do, though I can’t promise anything”, he said.