May 16, 2009
Last night I went to the ER for a dressing change that involves unpacking and repacking 2 newly drained abscess areas. As I arrived, the pain became sharp and shooting and I was not able to sit; no position was comfortable. We went through the normal check-in process with standard questions, BP check and an ID band and was taken back to an exam room.
Once into a hospital gown and a sheet, I laid down on the table with my head elevated and my knees bent. The doctor arrived and peeled the foamy tape off my abdomen, which covered almost my whole left side of my tummy .. from just above my belly button down to my leg, from hip to midline and it felt as though my skin was coming with it. Please excuse my graphic description .. but the upper abscess had purulent drainage (pus) that rolled out of it and completely saturated a 4 x 4 piece of gauze.
Now, just to be clear, I am able to handle a great deal of pain. Having lived and worked with migraines all my life, having given birth and had gallbladder attacks and surgery, I can take a lot. Even at the height of this abscess, the highest pain level was felt to be a 6. Last night upon arrival, my pain scale was a 7.
Here's the situation that unfolded that I want to ask for your opinion .. in a question I will pose later.
The doctor unpacked the two abscesses (one below the original one and one above it). The one above it was as sore as a boil and my pain level shot to a 10 .. would have said 12 but 10 it the top of the scale. As the doctor took tweezers and began to poke the tweezers and the 1/4 inch gauze into the abscess, I tried everything in my power to stay still and instantly began crying/sobbing with the very severe pain and asked the doctor to stop. I asked that he please give me something for pain or to anesthetize the area. He said there was not and he began again. This time, the extreme pain caused me to scream with pain (and I'm no screamer) .. and although I tried my best to lay still, I inadvertently moved my hands to the area of pain in a guarded fashion .. and begged him to stop and do something that I simply could not sit still with that much pain.
The doctor threw the tweezers and said let me know when I was ready and he'd be back in an hour and angrily left the room.
Not only was I sobbing from the pain, my feelings were hurt beyond belief. This pain was double the pain of the initial abscess and opening it up! I was left alone in the exam room with feelings of wanting to flee and yet realizing with MRSA, to do so could cost me my life. I felt such despair, aloneness, frustration, depression .. it was horrible.
About 7 minutes later, a nurse came in and basically treated me as a child and wanted to know if I was going to let the doctor finish. It felt condescending as he told me his 3-year-old child had had this done.
I again asked for something for the severe pain and informed him I had a high tolerance for pain; this was different. He said he would talk to the doctor and asked that I let the doctor finish. I explained I was and would continue to try and cooperate and that perhaps the doctor could exhibit just a little bit of compassion and professionalism; throwing an instrument and storming out of the room was simply not necessary.
The doctor re-entered the room and began again. I explained my high pain tolerance to him and told him I truly tried to lie still. He then asked if I wanted something for pain and I told him that is what I had asked for from the beginning. The previous session had let the upper abscess be packed twice so he felt it was enough. He worked on the lower abscess and while painful, it was most tolerable.
The doctor told me he did not cause this .. and I'm still wondering about that comment.
After that, he ordered a small dose of morphine that was given in my hip, I was bandaged and came home. The pain continued in the upper abscess, despite the pain med and shot .. and additional pain meds at 3:00 am. I was finally able to drift off to sleep at 4:00 am and awoke again with pain at 6:00 am.
So .. here are the questions.
1. Do you believe the doctor's actions were appropriate?
2. Do you see any reason the pain medicine couldn't have been administered first?
3. I am somewhat concerned of the extreme pain and the fact that I am still having pain today.
I was told to leave the dressing alone until Sunday and return at that time for a dressing change. The nurse also told me to continue with my antibiotics and be sure to take them. It felt as though they did not feel I was taking the medication as directed or that I was somehow not taking care of the dressings.
How infuriating it was since I have been setting an alarm and waking up in the middle of the night to be sure my medication is taken every 6 hours like clockwork and I've followed every instruction regarding my wound care .. like warm, moist heat packs every 4-6 hours.
I am quite nauseated and simply do not feel well so I am going back to bed. In fact, I don't feel as good as I did a few days ago. Am hot and going to go turn on the fan to cool down. Am trying my darnedest to get well and get back on the community. You have no idea how much I miss all of you ...