Mistake by Nurse - advice please

LaCrepescule

I really feel for you. I used to work in a GP practice and in the first instance I would write to the practice manager about your care. They will take this very seriously and do a thorough investigation. The nurse made a totally avoidable mistake and seems remorseful and they won’t want this to happen again.
I have no doubt they will wholeheartedly apologise and maybe this will be enough for you. In the meantime they’ll want you to get the right care. All the best.

I agree. I was always surprised that patients put up with so much without complaining to the practice manager who often didn’t seem to know what was going on…

I really feel for you. I used to work in a GP practice and in the first instance I would write to the practice manager about your care. They will take this very seriously and do a thorough investigation. The nurse made a totally avoidable mistake and seems remorseful and they won’t want this to happen again.
I have no doubt they will wholeheartedly apologise and maybe this will be enough for you. In the meantime they’ll want you to get the right care. All the best.

MayBee70

I bought some colloidal silver pre pandemic but never worked out how to use it so it's still sitting in the medicine cupboard unopened. The owner of a health food shop I used to go to swore by it.

Colloidal silver is something I've started using recently. I have been doing so by spraying a little bit of it directly onto the wound in question.

The nearest thing I've had to OP is I've landed up getting very minor burns and felt frustrated at the thought I'd have to run them under cold water for quite some time and then not sure that would do the trick quickly. So I experimented and ran them very briefly under the cold tap - and then sprayed them with the colloidal silver generously and both times realised the pain had stopped pretty quickly and they healed up well.

Guess this could be sorta akin to a burn type feeling in effect? Could be worth a go....

Today the swab result came in while I was there. It's pseudomonas again. (You and me both Cressida). Two large silver dressings used with a more absorbent sponge like backing. Antibiotics changed.
I spoke about the bandaging and dressings Cressida mentioned in her post. The nurse was very familiar with them. She wants to wait until I finish this new course of antibiotics to see how they have worked and then we'll revisit the dressing and bandaging situation.

It sounds to me as though x3 a week is insufficient. Surely if you were to have daily dressings you would not be expected to hike it to the surgery?

When I had a similar problem, but 100% better care before Christmas, one of the new GPs with an interest in wounds suggested applying a light steroid cream. I was dubious because of the weeping from both legs, but it was a minor miracle.

This getting old lark is not for the faint hearted.

The silver is very good at helping to fight the infection. That's its USP. Expensive but effective.

Of no use once infection had gone.

If there's one thing I've learnt from all this it's once you've gone past the sticking plaster stage don't even think of trying to treat it yourself. There are so many different dressing types and bandages that if you don't know what you're doing you can do more harm than good.

In my case, I'm not convinced that even the professionals have always got it right but I would still rather be under their care than haphazardly trying to treat it myself.

I bought some colloidal silver pre pandemic but never worked out how to use it so it's still sitting in the medicine cupboard unopened. The owner of a health food shop I used to go to swore by it.

Maybe the use of silver has helped and hopefully also the antibiotics are starting to work.

Glad the pain has eased a little but must be so uncomfortable being wet and not able to do anything about it.

Let us know how things are after the appointment tomorrow.

blue14

How are you feeling today ferry?
Has the dressing stayed in place?

I’ve been following this thread for a few days and hope that the pain is a little less and you are feeling better.

Hi blue,

Good & bad today. The dressing and bandage are just about holding. Definitely not so much pain.

The whole shebang though is soaking wet and my leg is uncomfortable and damp beneath the bandages and dressings. Wet bedding, wet trousers, ugh.

But at least I shall be going back tomorrow now that we've gone from twice a week to three times a week. I do rather wish I could have a district nurse as it's a bit of a mission getting out and about at the moment, but unless you're 100% housebound here, no chance. But it's worth the extra effort just for the feel of clean, dry (albeit temporarily) dressings and bandages!

Thanks for asking

How are you feeling today ferry?
Has the dressing stayed in place?

I’ve been following this thread for a few days and hope that the pain is a little less and you are feeling better.

Thank you, ferry , for the update.
All sounds just a bit more positive.

You've put up with this problem for so long.
I hope this is the beginning of the end for you.

Thank you for the update, ferry23

At least they listened and you're on antibiotics now. Silver can be good too for reducing bacteria, I remember having silver dressings many years ago for a difficult wound

You should get an ultrasound fairly quickly, I would have thought. Let's hope so. When I needed one last year, the appointment came within a week.

ferry23 make sure you research Viscopaste bandages thoroughly as they need to be put on by someone who knows what they are doing.

I can't remember what type of dressing was used by the practice nurses but do remember the district nurse used Kliniderm dressings which I was fine with.

Cressida, thank you for sharing your story - which has remarkable similarities to mine. I have been convinced that having the fluid collect in the dressing and then living with it like that until the next dressing change is not good. I know when there's a heavy discharge as there's a burning sensation. So thank you so much. I shall take this up with them on my next visit.

When I spoke about honey the nurse did say she probably wouldn't recommend it for me as it can badly irritate sensitive skin. I shall research Viscopaste bandages.

I'm sorry you too had a bit of a horrific time, but you have given me a lot of hope that healing is still possible. Thank you again.

I’m relieved that you’re on antibiotics. I was worrying about the risk of infection. So pleased that things seem to be moving forward in a positive way.

ferry23 you have all my sympathy as I've been there too. I have very little confidence in GP practice nurses & GPs with regard to shin wounds. Several years ago I had been treating a shin wound myself but it wasn't getting any better but wasn't getting worse.

My daughter insisted I needed to go to the surgery and get it looked at. That's when the nightmare began. The wound was leaking fluid so a dressing was put on to 'absorb' it and a swab was taken. Up to that point it hadn't been at all painful but that night the pain was excruciating. I had to go back every 2 or 3 days to get the wound dressed and day by day it was just getting worse. Right round my leg was now inflamed and painful. Another swab was taken and I was put on antibiotics. At one point a GP mentioned the possibility of sending me to hospital for IV antibiotics. Another GP mentioned arterial insufficiency.

The nurse who had been dealing with me went on leave and her replacement (a nurse from another site) realised that my leg was being 'burnt' by my own fluid collected in the dressings.
She used barrier cream to protect my skin and persuaded the GP to arrange for the District Nurse to treat me at home.

The infection turned out to be Pseudomonas which I must have caught at the surgery because it hadn't shown on the first swab.

My leg started healing then seemed to stop making progress. Honey was suggested and that made it worse. My leg became red and inflamed again. It looked like I had Cellulitis. Thankfully the nurse realised it was a reaction to the honey so stopped using it.

I was referred to Vascular Surgery but by the time I went to my appointment my leg was well on the way to recovery thanks to Viscopaste bandages.

One thing that came out of this saga is that I now have a diagnosis of lymphoedema in both legs. I've had problems with swollen legs for over 30 years but didn't know why. I now wear compression wraps which keep the swelling under control in my lower legs.

Let's hope things improve from now on Ferry!

That's good news. A relief I am sure to feel that you have been listened to.

Enjoy your curry.

Hello!

Today's medical update.

Back on antibiotics, silver on my leg today. Double size pad on top. Dressing changes 3 times a week now until I get appt. at the Vascular Unit. Started antibiotics when I got home - swab test results not back yet.

No wadding put on underneath bandage as she could see most of it had disintegrated and fallen off.

Stockinette again, but fastened with a different type of tape - can resort to the sports tape if all else fails and wrap crepe bandage around if it starts coming off.

Had a talk about medicinal honey and different dressings and the nurse took the time to explain all the why's and wherefores of them all.

They want a vascular ultrasound rather than just going to the wound clinic. I will look into the cost of having it done privately but of course if the outcome requires some horrendously costly treatment I may have to revert back to NHS.

I've been home almost 2 hours and at the moment it's comfortable and holding up - to the extent that I've been able to salvage some cooked chicken and a few veg from the fridge and chucked them in a casserole dish with a tin of curry sauce. I haven't been able to stand long enough to cook anything properly for a week so I was expecting to see and smell some dodgy bits in the fridge. I've had to throw some bits out but I think the curry in a hurry saved a bit of waste. I did have the forethought to but some singe portions of microwave rice and I know I've got some microwave poppadoms so it's a proper (ish) meal tonight. Hooray! A night without either a not particular appetising ready meal or cheese, crackers and a couple of tomatoes which was last week's menu.

I did, by the way, double check again about the use of tap water. I told her I didn't want my decision to stay away from anything else to hinder the healing process but she said it's not unusual these days to use tap water - they would never use it if there was any doubt whatsoever. The fact that anything else causes such long lasting pain negates another cleaning regime some extent.

As much as I'm fed up and frustrated by the whole sorry story, I do think they're listening and working with me. I think that when you're entirely on your own, with little or no help close at hand, it's impossible for anyone who isn't in that situation to completely understand how difficult it can be, both physically and mentally. I' m used to it but it does get you down a bit at times like this - so I'm hugely grateful to all of you for your kind and helpful responses and for bothering to read my long and rambling and posts!

So here's some to you all

Hi ferry - a lot of people here are following your progress, thinking of you and wishing you well.

Hope you had a good night and are prepared for the appointment today.

Please do update us after the appointment.

Stockinette just falls down, they've tried lots of it, not so much of it - everything really. Plus, as I said upthread, the discharge from the wound broke down the stockinette last weekend and it just started falling apart.

I'm really trying for continuity of care right now so that they stick to an agreed plan of treatment. That's why I've avoided 111 or A & E or the Urgent Treatment Centre as they don't necessarily have anyone really experienced in wound dressing on at the particular time you go there. The Urgent Treatment Centre completely changed the type of dressing when I had to go a few weekends back and I don't think it helped.

Bear in mind this has been going on for 7 months so there's not really anywhere I haven't tried.

It's a great shame there isn't a tissue viability clinic near you. My sister is a tissue viability specialist and they have a lot of specialist knowledge and experience of difficult to heal wounds.
I would also be wary of ringing 111 unless it's a real emergency because I've they just wok to a script and you need someone who will listen and look at your history.
I actually think your surgery sounds like they are properly on it now

Do they not use stockinette to secure the dressing?

Yes, I was trying to remember what they used on top of the dressings when I had an injury. It's a light support without being tight.

But getting back to the matter in hand.
Dear ferry23.
How about ringing 111 and tell them the whole thing.
And cry. As is appropriate.
You are not getting the right care.
Wish I lived near you. I'd drive you around until somebody somewhere did something sensible.

Do they not use stockinette to secure the dressing? YellowLine?

You can get extra large baby wipes from most supermarkets now.
Sometimes called all over wipes.
Price About a pound in lidl or aldi.
Might be cheaper than things aimed at elders or disabled.
Likewise puppy pads for seats.