Two-Buck Wound Vac (update!)

In the weeks after my right kidney was taken out, I did some research on "wound vac" equipment. Wound Care staff told me it would accelerate healing by drawing fluid out of the incision site and promoting blood flow to the surrounding tissue.

I couldn't afford the $1000-$2000 weekly rental, and I wanted to see if there was a cheaper alternative. There were several writeups about Danielle Zurovcik and her inexpensive hand-operated vac. Her invention was tested in the field in the aftermath of the 2010 Haiti earthquake. The team was only there for ten days, so they couldn't test for quicker healing. But the dressing and negative pressure did keep wounds cleaner than a traditional dressing and allowed for less-frequent dressing changes.

Dr. Zurovcik followed this with a 2011-12 clinical trial in Rwanda. From there she was able to finalize the design.

Her invention is the first product from her new company, WiCare (Worldwide Innovative Healthcare Inc.), which aims to get medical devices to those least able to afford them. If I'm reading things correctly, that includes here in the States.

Anniversary Time Again...

Made it to another July 12, my second since the big Aorta Meltdown of 2010.

I started out with a 40% chance of making it 10 years with the dissection; wonder what the numbers are for the next 8 years?

I do feel a lot better than I did in the months after it happened. Still have the mobility issues, high blood pressure, swollen feet and lower legs, sensitivity to heat, and fatigue. Still got some memory and cognitive stuff that makes me wonder whether the high BP did some damage.

I'm 14 months past having a carcinogenic kidney removed--the culprit in most of my problems, since it was driving the high blood pressure that popped my artery.


Good thing I'm not dependent on Republican scum like Dave Dreier and his buddies in the house who voted for the 33rd useless time to "repeal" the Affordable Care Act. Dreier the Death-Panel Dirtbag apparently thinks "let them die" is a good approach to health care:

“While I don’t think that someone who is diagnosed with a massive tumor should the next day be able to have millions and millions and millions of dollars of health care provided, I do believe there can be a structure to deal with the issue of pre-existing conditions.”

All my treatments have totaled much less than millions of dollars. Maybe $200,000, maybe a little more. Maybe I should apologize to Dreier for the imposition; it took a lot of nerve for me to grow that tumor in my kidney without thinking of people like him and their desire to save medical expenses at any cost, even that of a life. I fed the damn thing, cultivated it. Should have named it David.

I've made it two years IN SPITE of fucking Republicans and their psychotic desire to kill off any sort of health assistance for people who can't afford it. The hospital was a huge help, with its Compensated Care program that handled most of my bills for the first 7 or 8 months. I made it into Florida's  Medically Needy Medicaid program only to have it jerked out from under me within 3 months (Governor Scumbag doesn't think kidney cancer and a torn aorta make me sick enough; but then, he doesn't think a huge tuberculosis outbreak rates keeping the state's only TB hospital open). For the last year, I've been on MediPass, going to a county clinic as needed.

Not much of a believer in karma, but I sincerely hope that every one of those useless, evil wingnuts has their fortunes reversed and they end up worse off than I am right now. They need to learn some humanity and some humility.

All in all, I'm doing well enough. I won't be running (or walking) marathons or much of anything physical (no lifting more than 30 pounds, no stress, and like that), but I've got busy stuff I can do. I'm surprised that I haven't spent much time being depressed (those few times have been when my knees or feet keep me trapped in bed...very dark thoughts, then). I can still pay my own bills and (most importantly) I can drive the X-11. I'd be in a really bad place, for lack of that one bright spot to focus on when shit gets dark.

CANCER CURED!!!!

...so says one Chris Collins, a noted medical expert genius moron running for Congress in New York.

Indeed, he says that because of all the amazing and expensive medical  breakthroughs in the last 10 years, "People now don’t die from prostate cancer, breast cancer and some of the other things."

Because of implantable defibrillators! Stents! Neural stimulators! Tricorders!

So he wants to kill off Obamacare. No one needs it, you see. Like me, 2 years ago this month. I had no idea that there was a bad-type carcinoma growing in my kidney, just waiting to metastasize and infect the rest of me with killer cancers.

If I'd had an implantable defibrillator, I NEVER WOULD HAVE CAUGHT CANCER! It's all my fault for not thinking ahead, you know.

So...why do I hate Republicans?

One Year Ago Today, I Cured Cancer!

Well, okay, I had help, and my part involved lying on a table while a surgeon poked around in my giblets and pulled out a kidney.

Yeah, okay, so I was unconscious and don't remember a damn thing for the 5 hours I was out, but all those medical people were depending on me to be there. Go Team!

In the past year, the Evil Evicted Kidney has made no attempt at contact, which is fine with me, since the little farker tried to kill me.

Life in a cage

Zoos are depressing. I don't like to see animals mewed up in cages. I understand why it's necessary, though, when a bald eagle has lost most of a wing, for example. It's the more humane choice.

Doesn't mean I have to like it, especially when I see myself in a cage.

For more than 18 months I've been trapped in a body that doesn't work right, relying on a handful of pills to keep my blood pressure from blowing out my aorta or popping arteries in my brain. I can handle most of the day-to-day crap, such as diuretics that have me running to the bathroom like clockwork and leave me thirsty as hell. If I don't take them, my feet and lower legs swell up.

I'm having trouble with the lost mobility, though. I fucking hate it.

From Day One after my aorta self-destructed, I haven't been able to stand for more than a few minutes at a time or walk more than a few hundred feet without having to sit. Something as simple as taking out the trash leaves me winded; going to one of the "big box" stores is such an ordeal that I won't go unless I can get in and get out quickly. Even then, once I make it back to my car I sit there wheezing and panting for several minutes--on a good day. On a bad day, it's the same, but I can barely move my legs to drive the car.

Forget about going to Fort Pickens or the others. That's the worst part. I haven't been back to Pickens since last February.

I've been trying to tell various doctors that there's a blood-flow problem with my legs, starting at waist level. They all tell me to exercise. "Take a walk around the block."

Around the block? I can make it to my friend's house down the street--on a good day. After 18 months, that's still as far as I can go before my legs give out. It's not getting any better.

I spent a few days last week visiting my nephew in central Georgia; we went to a little park called Dauset Trails, which has a modest zoo and meandering trails and boardwalks. I spent most of my time either sitting on benches and resting or walking--or tottering--to the next bench. I glanced at the otters, stared back at a pair of glowing green eyes in the dark black bear hideout, felt sorry for the eagle that could no longer fly, and concentrated on making it to the next bench along the trail. I ended up parking myself on the last one while the others went off to look at deer and antelope.

By the time we made it back to the car, I was ready to lie down and not move for a few days.

A couple of days later, we went to a big indoor flea market; my nephew had told me about a vendor who sells die-cast cars (Hot Wheels, Matchbox, etc.). I wanted to see whether the guy had any Johnny Lightning Citations. Just like at the Trails, I spent a lot of my time walking for a minute or so before heading for the nearest bench. I couldn't stand long enough to look through all the cars, but he didn't have a Citation. Also like the day at the Trails, I found a chair in the food court while the others went off shopping.

This shit is past old.

Nick of Time for the Kidney...

All the way back in January, Florida's Thief Executive was making noises about hacking away at the Medicaid Medically Needy program (the same one I and many other Floridians are dependent on for coverage) and privatizing Medicaid so that his buddies can make some money.

I signed up for it in January, got my Medicaid card in April, headed for the kidney surgery as soon as possible after that.

I got a notice that apparently I'm no longer "medically needy" enough, popped aorta notwithstanding. Coverage ends July 31. If I don't do anything, I automatically get signed up for a county managed care program on Sept. 1.

I got lucky, getting the worst of my medical issues out of the way (that aortic dissection could still kill me, or at least leave me paraplegic, if I don't stay on top of it). But I wonder how many people out there won't be so lucky when Governor Scumbag's hack-and-slash approach gets to them.

Considering what the bastards have done across the country, it's a wonder there are so many people who vote for Republicans.

As far as the kidney incision goes, it's gone from a gaping, scary looking hole in my belly last month to damn near closed. I've gone from daily Wound Care visits seeing them every 2 weeks; from a thick "maxi pad" bandage to the vac to a little bandage. It's starting to itch a bit along the top end and my belly's still striped from all the tape adhesive...and about all I really want these days is for this to be done so I can take a kayak ride before winter.

w000000t!!

The wound-vac came off this morning; the site's down to .6 cm long x .5 cm wide x .6 cm deep, significantly down from just under 2 weeks ago.

Now I'm down to a little scrap of Promogran, a gauze pad, and a 2" bandage.

The vac's a neat little device, but I don't miss being tethered to it by several feet of tubing. That was about the only problem I had with it, really. I'm sure as hell not going to complain.

No, instead I'm thinking of where I'll take my kayak first, once the incision's healed over.

Happy Anniversary?

July 12th marked a year since my evil kidney made its bid to kill me off once and for all.

The 12th also marked 2 months since I ended its nefarious plans once and for all.

It's been a hell of a year. I've still got the recliner, but haven't slept in the thing since sometime in August or September, whenever it was that I was able to sleep lying down again. It's just taking up space.

Not much else has changed; I'm still taking a half-dozen pills a couple of times a day to keep my blood pressure under control, the tear in my aorta is still a danger, and I still can't walk or stand past a certain point. I haven't had a migraine since December, though, which is a definite plus. I used to get crippling headaches at least once a month until I started taking the BP meds.

The doubled/blurred vision I was having until a year ago is gone; my left eye used to go blurry past 20 feet and I could feel some pressure in it.

The wound-vac is still attached like a remora to my belly, the incision ever shrinking, and my remaining kidney producing like gangbusters.

Vac Day 9--Impressive. Most Impressive.

I've been through 4 dressing changes on the wound-vac since I started using it June 28th.

Incredible. That's how I'd describe the effect.

In 9 days, the big incision site has closed up to the point where its about as wide as a pencil (compared to about an inch) and about the same length (a little under 2 inches).

There was a smaller one a little larger than a pencil diameter just below this one which used to be connected to the larger one by a "tunnel" where the skin mended while I still had staples there. This one's nearly closed, now.

The redness around the staple spots has gone down noticeably.

Word has it I'll be rid of the thing in another week.

The Vac's Installed.

I got approved for the Wound Vac as a charity case; the thing arrived via UPS yesterday. Big, bulky box, mostly filled with smaller cartons of foam dressings and catch-canisters. The unit itself is about the size of a stack of 6 DVD cases.

The first dressing got installed this morning. All it is is a piece of foam cut to fit in the incision (which is about 1" x 1" by 1-1/2" deep now) with a sheet of plastic "drape" over it, something like Saran Wrap with adhesive on one side. Once that's arranged, you cut a hole in the middle of the wrap, arrange the vacuum fitting over that, and hook the tubing up to the machine.

My belly's been mostly numb around the incision site from day 1, so there's no pain involved, but when the vac is first turned on there's a moment where the suction is noticeable. Outside of that, there's no noise or anything. About the only time I notice the thing is when I need to move around--now I'm tethered to it by several feet of tubing.

So now I've gone from Frankenbelly...




...to Vacu-Belly!


That looks a lot worse than it really is. The red marks are from the staples, which came out a month ago.

The Wound Care folks say this thing will have me healed up in about 2 weeks. It'll be about time--I've been aching to take a kayak trip up Bayou Texar, or even to take a simple shower.

Wound Vac.

I'd never heard of such a thing before, but the Wound Care folks are trying to get me set up with one.

It's not much more than a little vacuum pump that draws fluid out of an open wound. It's supposed to increase blood flow to the injury and help it close up. There's some question (see the link) whether it's even effective for non-diabetic treatment, but I was told that it could speed my belly's healing by a few weeks.

Medicaid doesn't cover the rental--and I can understand why: this little handy-dandy wonder of modern medical technology is a grand or two a WEEK. I'm working on the "financial hardship" paperwork for one of these, but in the meantime I went looking for cheaper alternatives and found a story about an MIT student who worked up a hand-operated device that costs...three bucks.

Three. Bucks.

Danielle Zurovcik was going to test her invention in Rwanda, but took 50 of them to Haiti at the request of Partners in Health in the wake of the 2010 earthquake.

Three. Bucks. (There's followup of the Haiti trip at this link.)

The basic design came from an accordion-style toilet plunger. There's a good picture of it at this link. That's pretty damn cool. "Heroes" tag goes to Zurovcik and anyone working with her on this gadget.

Icky.

I knew I'd end up having to change out my own dressing eventually. I already knew how it'd feel--the incision site's been pretty numb from the beginning, so dressing changes haven't been painful at all. Just creepy.

When the various nurses and doctors were doing their things, all I felt was a sort of tugging, but below the skin.

The Wound Care Center is closed on weekends; so is the Urology office. In a pinch I could hit the Emergency Room, I guess, but this isn't an emergency. It's just a folded piece of alginate carefully teased into the opening, a piece of gauze over that, and an absorbent pad taped over the whole thing to keep it together. The alginate absorbs whatever drainage there is from surrounding tissues.

Doing it myself wasn't as bad as I was thinking it'd be--and I knew it wouldn't be, once I got past the fear and squeamishness.

Only 3 to 5 weeks left....

Four to Six More Weeks.

I've been referred to the hospital's Wound Care Center; they're taking over from the Urology staff who were packing/repacking my slowly-healing belly.

It's not a crisis; there's no out-of-control infection or any other excitement. Just my big Buddha belly. A deep fat layer slows the healing process.

The Wound Care folks started in on me yesterday, taking pictures and using a long swab to map out the incision site, poking & prodding. I'm getting used to that--but these new nurses are using the same "When you do this yourself..." wind-up as the Urology people.

Nuh-uh.

I can sit through "Trauma: Life in the ER" and similar shows with no problem. I've seen blood flowing out of a guy, taking his life with it. I've seen a disarticulated knee joint, with the top of the man's tibia shining white and clean in the midst of the torn hamburger of the rest of his leg. I've seen bikers with both femurs snapped like matchsticks, their lower legs at odd angles. An old woman with emphysema who lit a cigarette, then tried to smoke with her oxygen mask. I was fascinated by all of it, watching the ER teams put these people back together, watching the montage of their recoveries. One of the most amazing accomplishments of humanity.

I can watch it on TV. I can't see me poking gauze into this hole in my belly. It's got to be done, whether I do it or not; the Wound Care folks say 4 to 6 weeks more, less if I load up on protein.

Talking myself into it isn't going to be that easy...I'm such a chickenshit.

I wish they wouldn't DO that!

Since I'm too chickenshit to repack my own wound, I've been running back once a day to the Urology center to let friendly non-squeamish nurses do it instead.

The day the last staples came out, it turned out that the 3-inch incision (used by the surgeon as a "hand assist" for the two smaller laparoscopic cuts for popping the bad kidney out) hasn't closed completely; there's an inch or so to go...and there's a small pocket in my belly at that spot.

The first "Hey! Uh...don't." moment came Wednesday when one doctor swabbed the incision to get a sample of the fluid that's been dribbling out for the past 2 weeks. I didn't feel anything, but I was watching as he ran the swab along one spot...then plunged the swab about 3" deep. He freaked out (quietly) and went looking for a doctor with laparoscopy experience; second guy told him it's fine, you see this sort of thing with "big guys" like me. The pocket's in the fat layer, not down in the muscle, and it'll just take a bit longer to heal up. But it's fine as long as I keep the area clean and change the packing and bandage (looks like a maxi pad).

Nobody did any poking yesterday, but this morning, a different doctor came in to look things over. This one stuck his finger in there to feel around (yes, he had a glove on...no glove, no love, right?) and while I didn't feel it, I could see what he was doing.

It's still creeping me out, 9 hours later.

At least it doesn't hurt. I'm looking forward to a weekend of no poking or prodding or doctors going belly-spelunking.

Staples are Out!

Tomorrow will mark three weeks since I willingly allowed myself to be opened up.

The last of the staples came out this afternoon, but I've got a way to go still with that incision. The nurses who popped the staples ended up having to pack gauze into my belly--about an inch worth of it hasn't closed up and there's still significant drainage.

No pain, but the gauze-packing felt weird as hell.

The doctor expected me to do this myself, after the first time. I don't think so. I'm as chickenshit as they get when it comes to doing stuff like that. I'll fearlessly dive into a complicated carburetor rebuild, rebuild an engine in my back yard, get shoulder-deep in oil and grease all day long. But blood and living tissue leave me queasy...especially if it's mine.

Bad Kidney, Dead Kidney

The biopsy's back; the Evil Kidney was cancerous. Fortunately, it was stage-1, meaning the cancer was enclosed and hadn't metastasized. Doc says there's a 5% chance I'll need to worry about that.

In the 2 weeks since the evil one was removed, all sorts of things have improved:

--My lower legs had been swollen since January, but the swelling's maybe 95% gone. That hasn't improved the walking issues, which are likely a blood-flow matter.

--My blood pressure's down to the point where I have to scale back my meds.

--I'm feeling a bit more energetic, but I still get worn out pretty quickly. Lots of sleeping and naps.

Speaking of which...

So What's Kidney Removal Like?

I don't know.

The whole thing seemed surreal to me right up until I woke up. I've never seen my own insides (aside from one CAT scan display), so the notion of something being removed didn't really mean a lot.

Once I checked in on the 12th, there was maybe an hour of paperwork and questions to answer before I was rolled to the Operating Room. It was maybe 9 a.m.

The staffers moved me to a narrow table and put a mask over my face, told me to breathe--




--then there was noise around me and pain and light and it was 2:30 p.m. And that was the surgery. No dreams, no darkness, just 5 hours passing unnoticed. It didn't feel like 5 hours, but it didn't just go by in a flash. It felt like time had gone by; I just hadn't been in it.

The only real pain came from the Foley catheter. That's not something I want ever again. At least that one went in while I was unconscious. I was wide awake for the second one.


Worst moments: by Saturday May 14, they were trying to get me weaned onto solid food. But for breakfast was the "clear liquids" diet: some sort of broth, tea, apple juice. That broth did a number on me and kept me nauseous for the next 3 days. Lunch was fried chicken, macaroni & cheese, a roll, and a slice of chocolate pie.

I could barely stomach the whipped topping on the pie, let alone look at the rest of the platter. I held on to that pie for another 2 meals (back on clear liquids) before giving up. I wanted to cry about that.

Then there's the first walk. Saturday, two horrible people dressed as hospital types made me fight my way out of bed and onto my feet. Took me 20 minutes to get that far--and it hurt every millimeter of the way, because none of my limbs belonged to me yet. Once I was propped up on a pair of wobbly legs...those horrible people made me walk across the room to the wheelchair parked at the door. That room was several miles across and trembled underfoot with every step.

That wheelchair was a throne, though. A conquering king's not supposed to fall or sag into the thing, though. I was rolled down to X-Ray, rolled back to that horrible miles-wide room...and those horrible people made me walk some more. The conquering king act didn't work with the bed, either: I sagged again.


Best moments: They tried solid food again Tuesday morning, the 17th. Two little strips of bacon, two pancakes, an 8-ounce milk. Smelled better than anything I've ever experienced before, and I would have cried over that, too, but I was too hungry. By this point, it had been a week since I'd had any solid food at all (2 days before surgery, I went on a "clear liquids" diet).

The first bite of bacon--a tiny sliver, the merest crumb--was the most exotic, near-orgasmic food experience ever. I savored it for a good 40 minutes, eating slowly and carefully, not wanting to have to go back on fluids again.

Sex has nothing on good bacon. No bread, mayo, or tomato needed.

Sadly, bacon will never be that good again.

Things that are Worse than Kidney Surgery.

Five days in recovery gave me plenty of things to think about. My room-mate helped me to find three things worse than the surgery or recovery.

He didn't make much noise or disturb things, so it wasn't him. Nope, it was a weekend's worth of Jim Carrey movies on some channel.

I got to see attempts at zany humor from a pathetically unfunny man, in three different starring trainwrecks: "The Mask" and two "Ace Ventura" flicks. Bleah.

Think I'd rather be zipped open again.

Home, after 5 days in the Slammer!

Yeah, it was really a hospital, but either way every minute is regimented and laid out for you. Being stuck in a hospital bed isn't any fun.

I'm short a kidney, but nothing feels different aside from the incisions, some bruising. The swelling's gone down a good bit, but it was never very extensive.

The single greatest pleasure? Sleeping in my own bed.

Sounds like a good plan right now, too.

Ouch.

Kidney came out with no unexpected trouble. I've got a 3-inch bestapled cut a few inches right of the navel and two really small cuts above that. Doc said he got some of the surrounding tissue, no signs of metastasis, and we're still waiting on the biopsy.

Recovery hasn't been fun; the Foley catheter they put in during the surgery prep was removed Friday morning (I think). They had to run another one maybe 12 hours later. The epidural I was on to numb things up was weakening my bladder nerves, so I wasn't going. This second Foley came out this morning. Now there's nothing tethering me to the bed but my own tired body.

The epidural went away Saturday, they got me up and semi-mobile the same day, and now I'm staggering along under my own power. Still weak as hell, tired.

Might be out as early as tomorrow, assuming I can start eating (pretty bad nausea--don't drink the broth, folks) and walking better.