Monday 24th September - Graft review...

   Monday 24th September 2012 I woke up nervous! I was having my second skin graft reviewed today. The first one as I explained here, was traumatic first I was told it had taken then I was told it had completely failed, was massively infected and I needed another one as soon as the infection was gone. My burns consultant came to see me the day before and told me that if it had failed again I might be able to go home for a few days but then come back for another graft.
   Even though I had gone through ALL of this and one failed graft I still thought 'It wont be failed again, it wont happen to me'. I was given lots of morphine and sat up and my Vac dressing taken off, the curtain around my bed was shut and I had to wait for my consultant. My mom was texting me trying to find out what was happening, this was a BIG event. The outcome of this affected my future scarring, whether I could leave hospital, Operations...
   Eventually Mr V arrived with a bundle of medical students and junior doctors. A nurse came in to hold my hand while he looked at my back. It was silent for about a minute and then I heard him say 'where is the graft?..' I felt sick, completely devastated. After some discussion between themselves he asked them all to leave so he could speak to me privately. (something I really value in this consultant) He looked sad, he specifically chose to take over my care and knew what I'd been through and how much I wanted to go home. He explained that it had almost all failed again, I asked about having another but after a chat with my nurses and their colleagues they decided I had to stay in a few more days but we'd treat the burn with dressings soaked in beta-dine again and try and avoid another graft. I was happy because I wanted to go home and couldn't face another gruelling skin graft operation but it meant my scarring would be worse. It also meant that again my body had failed to accept its own skin, it may be silly but that in itself is hard to accept.
   Now I had to have the dreaded staples out again, I was going to attach a photo of a similar graft but thought you may prefer just the staple instruments for less gore!

I wont ramble on about how much having the staples out hurts again but Just think - big full thickness burn, open wound, actual staples being pulled out...The only benefit to having such a severe burn is that it has burnt through everything including nerves so I could only feel the ones around the edge being taken out not the ones imbedded in the burn!
DRIVE SAFE, George xxx

 

Wednesday 5th September - 10th September Ups and DOWNS...

  It may read as though I'm skipping days throught this blog, I'm writing it from a diary my mom kept whilst I was in hospital to keep track of what happened when, for the solicitors.
  These were a stressful few days (everyday was but these more so...). On Wednesday the 5th September DAY 18 in hospital, my Vacum dressing was removed from my back (full thickness burn and graft) again. Once again this happened out of nowhere for me as a team of doctors, students and a consultant came into my room and talked about me to eachother while my nurse came in as fast as possible to try and get down what they were doing, so that I would know and so it would also be in my notes! They made me sit forward for this which was marginally better than being rolled but I had to hang on to my nurse to hold myself up and it killed my back, my pelvis, my legs everything. The removal itself hurt a lot, they peeled it off pretty fast but the thing is completley, air and water tight so it sticks pretty hard. They peered at the burn and muttered to themselves that it didnt look good 'here or here' but was probably 80% taken. That means 80% of the skin stapled onto the burn had survived and was doing well. They re-dressed it with a fabric dressing and special pads. They also pulled the dressings off my head, shoulder and hip and left them open for the nurse to try and figure out what they wanted doing with them! That was the first time I had seen my shoulder and hip injuries and they were pretty nasty. They called it 'road damage' or 'road burns' and basically where I had been dragged 10m under a car the tarmac had ripped through my jeans and 100% leather jacket and basically dragged and rubbed big patches of skin off me. My hip skin was hanging off and so was stitched back on and I have large areas of scar tissue which were once essentially gaping holes. The same happened to my head, my helmet was driven over and ripped up at some point and my scalp was rubbed away to my skull on the right side. Hense the hair removal, LUCKILY my hair has grown back through some of the scar tissue on my scalp and so they can cut out the remainder of scar tissue and pull it together to create a straight line scar. Which if you'd seen my head in A&E should be absolutley amazing!
  On Friday 7th September my wrist was comfirmed broken. One of the first things I recall when I came out of the coma was telling the nurses my wrist hurt (I couldnt feel my lower body so it didnt hurt at that time) they told me it was probably just a sprain because they had done a full body scan...Nope 3 weeks later it was 100% broken and put in plaster! Meaning I only had one un-damaged are (my left arm).
  Monday 10th September was heartbreaking really. It was DAY 23 and I was told I may be able to be transferred to a nearer hospital if I carried on progressing well, I was desperate to go home and really hoping for that. I met Mr VN (Im not sure if Im allowed to use his full name so I wont!) this day, he is a very senior burns and plastics consultant, he's also a wing commander in the army and runs private plastic surgery clinics in london. He had been told about me and wanted to take over as my burns consultant. He looked at my back, didn't order someone else to take off the dressings and actually spoke TO me! Sadly he took one look at my back and was absolutley certain the graft had completley failed and that the wound was becomming extremley infected. He was furious that someone had looked at it and told us it was 80% taken becuase it was 0% taken. They told me I'd have to go straight onto antibiotics, have my back treated everyday and when it was clear repeat the whole skin graft procedure. I was completley devastated I couldnt believe any of this had happened and just wanted to go back and never leave the house that day. I still do.
 

Thursday 30th August Sitting in a WHEELCHAIR... meeting Gareth Gates...

   29th August was an exciting day! (not because I met Gareth) Two days after I had been sat up for the first time (and then remained flat for another 2 days) my physio's turned up with a wheelchair! Another thing I never thought would be exciting, but god I was happy! I had to use two physio's, a nurse, a banana board, a slide sheet and another nurse on stand by to get into the wheelchair but I did it! I had (and still do have) a special support cushion for my pelvis and my left leg had to be elevated because bending it even slightly was SO SO painful. Another thing people probably don't think about was all the attatchments I had! I had a catheter (pipe directly into your bladder continually draining) so they had to get me into the chair without catching it and then hang it on the side. I still had my first VAC box dressing attatched to my graft, so they had to unplug the box and switch it to run on battery, that then went in a bag on the back of the chair. I also had several canulars (needles into the vein for easy access with fluids, pain relief and antibiotics) one of which was attatched to my PCA of morphine (patient controlled analgesia) so that had to sit on my lap.
  So all in all I was looking pretty trendy with my bag of wee on the side and huge box of back fluid behind me. Did I mention the VAC makes noises as it sucks?!
   Anyway the physio's took me into the hall (first time I had left my room other than on my bed to theatre) and I had a feeble go at wheeling myself. Its hard to get used to (and i still had an undiagnosed broken wrist so it hurt). Then this receptionist, clerk person comes up and takes my handles and pushes me down the hall to meet Gareth Gates. What the hell? Now this blog may become world famous (very unlikely haha) so I will watch what i say, but lets just say I was a lot more interested in learning to move in a wheelchair! The military ward get a lot of famous visitors (something else I wont go on about but I dont think its fair on the other wards..)
DRIVE SAFE george xxx

Skin Graft Number One...

  Thursday 23rd August (My first full day on the military trauma ward) it is safe to say I didn't really know what my injuries were. I think I was told in brief detail but it didn't go in and they tend to just say things like 'you're very poorly' when you've been through something so severe and clearly wont be able to understand yet. Also at this point I knew we had been in a motorbike accident that a driver had hit us at the island but no idea that I had been driven over and dragged 10 metres and had no memory at all.
  That afternoon my mum went home to sleep and Joss (my boyfriend and the bike rider) and Rhianna (his sister and my friend) were with me when a woman came into my room. I remember this clearly - she did not introduce herself and she was with a few students, she said some crap and then said ''So we're getting you in for your skin graft tomorrow''. The minute she said that sentence I went into massive panic. I couldn't breathe I started asking what she was talking about that I had no idea I was having any operations and she said ''yes you need a skin graft on your back from where you were stuck to the cars exhaust pipe'' This is where consultants and doctors fail. I had NO idea I had been under the car at this point, NO idea I even had a burn let alone how severe, NO idea I was having any operations. Then she tried to claim it had been decided on friday (IMPOSSIBLE my accident happened on sunday 2 days AFTER friday). After waking up in ITU I was terrified of even falling asleep the thought of being put under was more horrifying for me than I can even explain.
  During this panic attack she just left and luckily my wonderful nurse Laura came in, I was in an awful state crying and screaming yet trapped in my body unable to move. She assured me that I had to give consent and so I could refuse but I really needed the operation, that waking up wouldnt be like in ITU (ive never had an op or even been in hospital before this).
   I didn't agree/sign to the operation until I was in the anaesthetic room, I pressed my morphine PCA the whole way down hoping i would fall asleep before they could put me under. The assistant in there was wonderful she held my hand and stroked my head like i was a vulnerable child. I didn't feel myself falling asleep next thing I new I was opening my eyes in recovery. I remember I couldnt move (combination of my injuries anyway and the general anaesthetic wearing off) but I managed to say 'thank you for looking after me' to the recovery nurse I felt so thankful and vulnerable.
  I had a Split Thickness Skin Graft because they can cover a larger area. The skin was taken from the back of my right thigh using what is essentially a peeler (which as a wound itself is so painful) and literally stapled over my burn (with a little more complexity!). I had a NPWT or Vacuum dressing placed over it, applying a vacuum through a special sealed dressing attatched to a tube and a container box. The continued vacuum draws out fluid (gross!) from the wound and increases blood flow to the area. I also had my shoulder, hip, chest and head wounds washed and dressed and my hair properly shaved to keep my head injury more safe.
 I'm going to attatch some photos of skin graft 'implements' and the NPWT dressings THEY ARE NOT ME THEY ARE EXAMPLES FROM GOOGLE hopefully they wont upset anyone!
DRIVE SAFE, George xxx

                Example of a vacuum dressing - this person has a knee injury mine was obviously on my back.

                                  Example of the box and tube attatched to you and the dressing.

                                   How the donor skin is taken for applictation to the burn/wound.