Tag Archives: skin graft

Jul8

Fat toes and gashed elbows

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Monday 8th June

My weekly visit to the practice nurse saw us discussing swollen, fat toes and over-granulation of the skin. Hmmm, doesn’t sound too pretty! My fourth and fifth toe remain puffy and podgy, and are hypersensitive to touch. In between the toes, where it is warm, moist, and constantly under pressure, the friction of rubbing together, and the graft not taking, the skin remains red raw, and the scar tissue keeps on growing (the over-granulation). Bleurrgghh. The nurse says if it wasn’t for the skin graft, she would probably use silver nitrate to get rid of the excessive scar tissue. But, we’ll wait and see what the consultant says on Monday.

I now seem to have two differently sized feet; my left foot appears to be two sizes bigger than my right! Ha ha, not! When can I wear dainty, summer sandals? High heels?

Anyway, about an hour after returning from the surgery, my mum pops round on her way to the beach. She remembers that she came to see me to ask for a plaster for her elbow, as she had fallen up her steps, coming back from the town. It’s only a graze, she says. Upon closer inspection, I realise it is a rather nasty, deep looking gash. Off we go, back down to the surgery for my second visit of the day, to see the same nurse. Lots of local anaesthetic, three stitches, a SteriStrip, gauze dressing, padding, bandage and an arm stocking, and mum is ready to be driven back to our house, by my husband, for a therapeutic cup of tea. No beach today!

May31

Last week of May

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Two re-dressings of the foot, and the removal of the one over the skin graft donor site ~ long and protracted, but the skin on my thigh doesn’t look too bad!

Had a quick telephone conversation with the second Macmillan nurse who appears much more friendly, sensitive and ‘glass half full’ than the other doom and gloom, telling-off one! It was good to let her know my thoughts and concerns, and not be made to feel insignificant or guilty, or to be spoken to in a dismissive or condescending fashion!

May22

The day the cast came off

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Wednesday 22nd May

Again we arrive at the hospital in Plymouth way to early, but it gives us a chance to locate the correct ward, and on the way, requisition a wheel chair, to speed up my movement!

Handbag on lap, crutches clenched between my knees; this is the new, smooth way to travel!

The ‘Peel and Reveal’ session was carried out very expertly, and almost painfree, by a wonderful nurse. What my eyes were presented with at the completion was amazingly fascinating, and yet shockingly gruesome! The size of the excision was unbelievable; there was a great dented crater, my fourth toe looked as though it was standing on a stalk, and where was the skin graft skin? I think I was expecting normal flesh colour, but maybe a bit pink and puckered! The split skin graft had been turned into a mesh and stretched over the wound, with a number of stitches to keep it in place. Wow!

May21

Macmillan nurse phones again

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Tuesday 21st May, late afternoon

I’m on my way to the loo, hopping and shuffling, when the phone rings. The nurse wants to touch base, and see how Friday went with my trip to the hospital, what happened, what was said.

When I told her that the operation had gone ahead, I’d had a wider excision and skin graft, she was really taken aback. Oh, but, but, but . . . My case had only been discussed that morning, in the weekly meeting, by the Multi Disciplinary Team. They/she assumed I hadn’t had the operation, that I had just gone to Plymouth for a quick chat, and then come home.

I felt I was being told off for having the skin graft. I recounted to the nurse that my consultant said I could always have a delayed sentinel lymph node biopsy at that hospital, as they carry out the procedure there. No they don’t, she snapped. And then ended the conversation saying she had a number of calls to make further enquiries.

I felt as if I had done something wrong. It was quite upsetting.

It feels l am in a power struggle; my treatment action plan seems to be part of a game. Who is better qualified? Who has the greater clinical knowledge? I trust my consultant, and will listen to his expertise and advice. I really want my glass to be half full, rather than half empty. I think that there should be greater communication between the two hospitals. I would like continuity of care from supportive professionals. It’s not too much to ask?

May17

Operation two

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It’s Friday 17th May, and the alarm goes off at 4:10am. We are out of the house and on the way to Plymouth a little after five. The sunrise is beautiful; colouring the sky in pink, yellow and orange.

Due to the lack of traffic on the roads, we arrive at the hospital car park at 6:35am, far too early! The appointment was set at seven thirty. Twiddles thumbs.

Upon arrival  I didn’t know what to expect. I half imagined we’d be back on the road soon, after a quick chat. But it became clear that surgery was going ahead, and I was first in the queue. I spoke with nurses, the skin graft registrar, a fabulously jolly anaesthetist, and of course the wonderful plastic surgeon.

He really wasn’t happy that the Macmillan nurse had told me my results over the phone, and had also confused me with the order of events. My surgeon had wanted to speak to me himself about the melanoma. He asked how I felt, and there was genuine care and concern in his eyes.

He explained that the plan was to cut away a lot more tissue around the original wound site, slice a sliver of skin from my thigh, and magically affix it into place. I would then have a plaster cast set around my leg.

I went down to theatre soon after, monitors were placed here and there, bleeping that all was normal, an oxygen mask went over my face, and a thin needle introduced the anaesthesia into my system. I remember the eight, bright lights above me. zzzzzzzzz

Coming round, I couldn’t feel a thing, but I could see a fat, bandaged leg poking out from the covers. The nurses and doctors in recovery were amazing, so attentive, cheerful and professional. I was treated like a star!

About an hour and a half after coming round, I was discharged, and we began the drive home. Just before we left though, the anaesthetist popped her head around the curtain to see how I was doing, and to make sure everything was OK. She made a shape with her thumb and forefinger, to show the size of the new wound ~ it appears to be mahoosive!!

I spend a dopey afternoon in bed, taking the super strong painkillers at regular intervals. I now know I have to time it right to make a trip to the loo, ha ha.

May16

A phone call from the Macmillan nurse

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On Thursday afternoon, 16th May, the Macmillan nurse phoned whilst I was on the computer doing some school work. She had the results. As far as my back was concerned, the results came back negative, but they would probably err on the side of caution, and carry out a further, wider, deeper excision, at some point.

She then asked me if it was alright to continue talking over the phone about these results. There was something in her voice that told me it wasn’t going to be good news. And it wasn’t. The alien blob from my foot, was indeed a melanoma.

I couldn’t speak, I didn’t know what to say, nodding my head and tightening my fist until my nails dug into my palm.

I should be going to Derriford hospital tomorrow for a wide local excision with skin grafting. But she continued to tell me that I would probably just be going to Plymouth for a chat with my consultant, and then come straight home. It was unlikely that I would have the operation.

Continuing with her outlining of events, she said that the MDT had met the previous Tuesday morning, with my results appearing that same afternoon. It was probable I would be sent to Exeter for further surgery, but not until the team had met this coming Tuesday, and discussed their cases.

I would have a sentinel lymph node biopsy at the same time as the surgery on my foot, along with the skin graft. The biopsy meant injecting a blue, radioactive dye at the site of the wound, and then looking for an offending nodes that had turned blue. These would then be removed in the hope of stopping the spread of the disease. The nearest lymph nodes to my foot were those in my groin.

It was a long phone call, where she did most of the talking. It left me scared, confused, unsure, and made for quite a sleepless night.

What should we do?

Will the operation go ahead?

Will it be worth driving to Plymouth at all?

And what of the melanoma, what were the implications for me?

May15

Post-op #1 ~ more dressing of the crater

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Following on from Wednesday’s visit to the surgery, I was back there on Friday ~ no better, no worse ~ was the state of the infection ~ keep taking the pills!

On Sunday the district nurse came to the house to clean and dress the wound. As it was still a bit stinky, she advised me to go back to the surgery on Monday.

I’ve never visited the place, on so many occasions, in so short a time! Back on the Monday, as the infection was still present, I was put on another set of antibiotics.

The swabs that I had taken for MRSA all came back negative, so that was some good news!

My last visit to the nurse was on Wednesday 15th May, when it found that the infection had  cleared up, yay! All systems go for the skin graft operation.