What’s happening. (Warning: might be a bit graphic)

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Finally, the vac dressing has been applied, or Negative Pressure Wound Therapy, to give it its proper title.  The picture above shows the pump which applies the vacuum via a tube attached to the wound.  The idea is to draw out all of the dead tissue that’s been hanging around the sore for a long time.  It’ll also draw the clean, healthy tissue to the surface, effectively closing the hole around the dressing over time.  At least, that’s how I understand the information I’ve seen about it.

MW is still confined to bed rest.  That’s six weeks so far and several weeks to go before she can start to put prolonged pressure on the area.  The downside of all the bed rest is the increased risk of other pressure sores. You try and get rid of one problem and others creep up to test us.  There are new sores/skin issues on the inside of both knees, her left foot (which occurred prior to bed rest), a blister on her upper buttock where the vac dressing tube has irritated the skin, and her right ear where she has to lie on that side to alleviate the pressure from the main sore.  MW’s got that many dressings in various places she looks like a patchwork quilt.

This whole episode is taking its toll on MW.  She’s considerably quieter recently.  I don’t know if this is as a result of having to spend so long in bed on her own or not.  I do my best to keep her spirits up.  As do the carers who help us every day.  (The carers who help us now….I can’t think of an adequate superlative to describe them.  They’ve been exceptional.)  MW’s also tired all of the time.  I know fatigue is a well-known symptom of MS, and that MW has more than her fair share of it.  But this seems to have increased even more recently.  I don’t know if it’s a side effect of the new dressing, of the pressure sore (any skin issue can exacerbate MS symptoms. I know, it baffles me too), or if it’s a result of having to stay in bed for such a large part of each day.  Maybe sleep begets sleep, if that makes any kind of sense.  I’ve got to be honest and say that things make less and less sense to me.

I’m also beginning to realise that MW can’t look after herself in the same way as she was once able to do.  She’s always been insistent on washing as much of herself as she could reach (which wasn’t much but independence is important).  I was happy to trust that she’d say when even that independence was no longer possible.  I guess she’s thought that she was still able to clean herself but I’ve discovered that’s not the case.  From a practical point of view, it’s not much of an issue.  It just means that I, and the carers, will have a little more to do on a morning.  From an independence perspective, it’s a considerable loss.

MW can’t manage her bowel as she once could.  She’s going and doesn’t know she’s going (without getting too graphic).  It’s very solid so it’s easy to clean up but hard to keep away from the pressure sore dressing.  I suspect a call to the MS specialist nurse is in order.  It’s a balancing act between ensuring MW’s bowel empties and not having it go everywhere.

Me?  I’m tired.  Actually, that’s an understatement.  I’m exhausted.  I could do with about a week’s sleep but I’m not going to get it anytime soon.  When this sore’s improved, I’ll have to have a break.  Maybe then I can start to think of the long term effects of these latest deteriorations in MW’s condition and independence.  Anyhow, that’s the situation here at the minute.

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