The Days, Months after…

Sorry that this took longer than the others, it was harder than I thought to remember things and get a clear picture of what order stuff happened. I want to warn you that at the end of this post there are very graphic pictures, and if you can’t handle that, I’d stop after the words.

So, there I am in the emergency room in Alaska with nurses all around me asking me questions and working on things. They had my phone and were calling my parents to get approval for an Escharotomy procedure, which is where they cut down your legs to let the pressure build-up out so I wouldn’t lose my legs. Both my legs were cut from just below my knees to my ankles. As they were trying to get a hold of my parents, they were removing what they could off of me bracelets, shoes, clothing etc. They couldn’t get a hold of my parents so they got a hold of one of my older brothers and we chatted for a quick second and then they explained to him what happened and what I needed to happen. I was aware enough to know that they shouldn’t call my dad, he rarely answers his phone. The nurse got the go ahead from my parents and they did the procedure. After the procedure, I took a medical jet to Seattle’s Harborview Medical Center. I remember the flight; I was in and out of sleep, and the nurse on board kept me company and made sure I was comfortable.

I woke up in a room in Harborview and was laying on a table for a good couple hours while every so often, the doctors would come in and assess the damage done. At one point I remember a nurse coming in, and I really wanted to see my feet so I told the nurse that I was going to, she tried to stop me but I got up, saw them, and said “that isn’t good,” and just laid back down. During all this, my parents were on their way to Seattle and made it there later that day.

First and foremost, my spine had to be stabilized. I have a rod and screws fusing my T11, T12, and L1 together. I was eventually moved to the 9^th ICU floor, where I had seven major surgeries in 21 days. The whole goal was to get down to the 8^th floor and after that going home was possible. Because I’m type 1 diabetic, I had to have finger pricks every hour, that’s 24 pricks spread over 10 fingers. My fingers were swollen like an Oompa Loompa. The 21 days involved surgeries and a lot of sleep to prepare for the next surgery, as well as wound care. I had a blood transfusion because I lost a lot of blood. I have 6th degree burns around my achilleas/feet, 4th and 5th degree burns around my legs, and as well some 4th and 5th degree burns around my right arm. They placed cadaver skin on my debride areas to cover from infection and allowing the tissue to “declare” itself. Declaring means allowing time for the tissue to die or grow, skin is one organ that cannot be transplanted. Once the tissue declared, they placed Integra on my right arm and on my legs, but my feet weren’t quite ready for it. They used the Integra as a skin substitute to close the areas of my open wounds so it’ll stop the fluid loss and helps prevent infection. My legs were missing layers of muscle and the Integra also worked as a filler to normalize the shape of my legs and arm. Some tissue was used to help create a tendon by my Achilles but it failed. On top of the Integra, I had skin grafts taken from my entire back and left thigh to be grafted on my legs and arm. They stretched/meshed the skin so it could fit the areas that needed it. The skin grafts kind of looked like fish nets on my arm and legs. The grafts were kept on by about 300+ staples. The section where they took the skin from was covered and over a couple days that covering would harden and then be ready to be taken off because it’s healed. I was “watered” every four hours, the water kept my legs and arm from drying out and prevented infection. I remember it being very cold when that happened and just being in a constant wet feeling. I did eventually get a heated blanket to help counteract the cold. Since my feet were the most damaged, I had my toes amputated up to the second nub and my pinky toes are completely gone. My right foot went back and forth to being amputated off but it and my left foot were mostly able to be skin grafted except my Achilles tendon area. Along with the therapy, in-between surgeries, maintaining my diabetes, and learning about burns, I had a feeding tube that would change every couple days to see if I could feed myself enough food to get the amount of calories I needed to keep up healing. I had a central line in my neck that would move after a while to my arm but once they couldn’t get any more blood out of my arm, it moved back to my neck. Because I was such high risk for infection with my body open, everyone had to gown up, which you’ll see in the pictures.

What’s a skin graft and how does it work? A skin graft is where healthy skin is taken from a place on your body, which in my case it was my back and left thigh. They took a full thickness skin graft because my burns were so deep, it was stretched and put through a machine that makes small slits or holes in the skin. The stretched skin covers a larger area than an unmeshed sheet graft but leaves a permanent mesh pattern like fish nets on you. This allowed them to take from my back and thigh once instead of multiple times. The wound heals with the new skin filling in between the mesh and holes.

After the surgeries, the day to day was wound care and trying to walk as well as fighting infection. Wound care on the 9^th floor consisted of being in a room on a metal table where the water could easily drain. They’d soak the bandages and then remove them, once they removed the bandages, they’d clean them with a wash cloth to remove old medication. It was very cold and was always extremely painful. Even though I had pain meds in me, that couldn’t completely stop me from feeling the pain. Once they cleaned the burns, a team of doctors would come in and basically check them out. After they’d leave, new medication would be applied and I’d be bandaged back up. During one of the wound cares, they had to peel off my back-skin graft covering because it got infected. I didn’t think pain could get worse other than wound care, but peeling off the covering on my back was some of the worst pain I’ve ever felt. Once I made it to the 8^th floor, the wound care was different in that it was done on my bed and not on a metal table. The process was the same except I didn’t have to have the group of doctors come in and look. Every so often, wound care would take place in a medical room with that metal table. With my skin grafts being stapled on me, those staples had to be removed and that’s when wound care was in a different room. They took 300+ staples out one at a time and boy did I feel that. I remember that I had this lolly-pop I was sucking on that also had pain medicine in it and there were four nurses working on four different areas. As pain got increasingly worse in one area, I’d say “area A, B, C, or D” and the nurse for that area would stop to give me a break. Each day consisted of trying to walk and then once I learned how to walk again, consistently walking daily.

When I was given the green light to go home, it was sometime mid/late August. I remember waking up that day, my parents packed up the luggage, we signed the release papers, and I got wheel chaired out of the hospital.  A friend drove us to the airport and some random people switched seats so we could all sit together. I was given pain meds and my legs were across my parent’s laps. When I got home, I was welcomed by my friends and family at the airport and then mostly everyone came to our house after and we just chilled and had a good time. Being home helped my recovery. As I was home, I still needed my legs to be bandaged up and wound care was still done except it was on my bed and my mom did it. Since my Achilles were still open, I still needed one last surgery and it took place two or so weeks after I got home. I had another skin graft taken from my left thigh again and that was meshed to cover my Achilles. I stayed in the hospital for two weeks or so and during that time re-learned to walk. For some weird reason the new skin grafts reacted with my older skin grafts and I had blisters all over my feet.

Now that I was done with surgeries, I had to wear Tubigrip until my burns were strong enough to withstand compression garments. The Tubigrip provided some pressure to help with the blood flow and to lessen the scar tissue. Once my skin was fully closed and strong enough, I got fitted to wear pressure garments. These pressure garments provide pressure over the healing burns when they are durable to tolerate the shearing that occurs from the fabric against the skin. The compression minimizes the development of scars by interfering with the production of collagen and helping to realign the collagen fibers. It helps promote circulation of damaged skin, decreases extremity pain, decreases itching, and reduces thick hard scarring from accruing.

Now that I was back home from the hospital, every week I’d go to therapy a couple days out of the week to get my movement back in my ankles and stretch the Achilles out. It wasn’t my favorite nor most pleasant thing to do, but I had to do it if I wanted to walk on my own. I still had to do wound care daily. When it came to the therapy, we made goals so it was something to work towards. My goals were to be able to run, be able to drive my car, and walk so I could be in my brother’s wedding. Eventually I had enough therapy where I could do all that and I didn’t have to go anymore. The only therapy now was pretty much working out and making sure I got stronger.

The hospital stay was a lot mentally and physically. I don’t remember much of the details, just that a majority of it was painful and that I slept because as one of my nurses said, “If you’re sleeping, you don’t feel the pain.” The pictures below were documented during my entire stay and like they say, “a picture is worth a thousand words,” and I hope these pictures give a visual explanation of what I said above. As well, some pictures are from my last couple surgeries here at home. Again, if you can’t handle graphic pictures, I’d stop.

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