Hey, Marg!

Discussion in 'The Watercooler' started by klmno, Jan 14, 2011.

  1. klmno

    klmno Active Member

    I woke up this morning to horrible looking skin around my neck and much of it peeling off and being very painful. I went back to the doctor in the box and now I have the bandages. I guess it has to do with the stage of healing or the way it's progressing because this dr told me to keep a dressing on it, changed daily, for a week now instead of leaving it open to the air. I wanted to let you know since this is what you suggested to begin with. I asked about the change in approach and the nurse told me that due to it being a scalding burn and the initial blistering, it needed air until the blisters were gone. I don't know but my clothes rubbing on it all week sure didn't feel good. The bandages preventing that sure helps even though it is still quite sore.
  2. susiestar

    susiestar Roll With It

    I am sorry you are still hurting. At least the bandages help. Going back to the doctor in the box was a really good thing to do!!! Infection is the last thing you want, esp having just gotten over a virus. I hope it stops hurting soon. Did they give you medications to help the pain so at least at night you could get some relief?
  3. klmno

    klmno Active Member

    She gave me a rx'd ointment, an antibiotic, and 2 types of pain medications on Mon.- one being vicadin and the other being less potent. She said I could take both together but being that it's been about 10 years since I took ANY rx'd pain medications, that would knock me on my butt. I have been taking the less potent one during the day and the vicadin during the evening. It takes it a couple of hours to kick in but seems to last about 12 hours. At least this is the effect it is having on me. The other one isn't very effective for pain and makes me a little drowsy. Either way, I'm still waking up in pain a couple of times each night. Part of that, if not most, was when I'd turn over or shift the bed covering and it would rub on the burn. This dressing should help a lot. It's uncomfortable when I turn my head or move too much because the tape moves, moving the entire bandage over the burnt area but it's not nearly as painful as clothes rubbing on it.

    I just got back from the pharmacy and ran to the store while I was out. I picked up comfort food and more logs for the fp. I called my boss early this am and he said just get myself well, the owner's rep is staying on this to make sure I follow thru with dr's orders so my boss really can't go on a tangent about it. He told me I could make up the time on Monday (fed holiday) and I'll get comp time on my next trip out of town so he'll consider the time off work covered. That's good. I did work Wed. & Thurs but once the skin really started coming off yesterday and continued thru the night, it was just too painful and looked disgusting. I didn't think there was any way in the world I could stand putting on clothes appropriate for work - it had no bandage on it at that point.
  4. Marguerite

    Marguerite Active Member

    The clothes rubbing - that's why they wanted you to strip down and not have clothing over it either. But if it couldn't be avoided, you should have had dressings. Preferably wet dressings, since the blisters had already broken.
    You also can often get conflicting advice from health professionals, in the same situation. For example, some say not to put ice on it; others say cold water only, but you can have ice in the cold water. My own experience - if you hold a block of ice onto a burn, sometimes the ice makes a good contact and cools the burn and sometimes it doesn't. We have cold compresses in the freezer (gel-type) and sometimes they're good, sometimes they're not. it depends on conductivity, and that depends on whether you have free water in the picture. It doesn't matter how cold - if you haven't got conductivity, you can't get the heat out of the burn, and tat is the main reason for applying anything cold. Even room-temperature water will take away heat, if it is free-flowing. But a burn holds heat, when the blister forms it ironically insulates the residual burn heat and makes it even more difficult to remove the heat.

    I hope you have wet dressings. If you don't, you could find that any delicate healing skin, or residual blister, will stick to the dressings and do more damage as you change them. You may need to soak them off as I suggested earlier.

    With my pile of dressings I was given - I just went and grabbed the bag (wish I could send it to you!). The wet dressings are thin, they feel like a single layer of paraffin-soaked gauze (only it's not gauze and it's not paraffin). I had to smear the cream (or honey, or whatever) on that packaged wet thin sheet and that would help it stick to my skin without having to use tape (which would have taken off adjacent skin - in my case, the radiation burn covers a huge area, but the focus area breaks down first). Sticking a dressing to a breast to make it stay put, is not easy. The wet dressing stuck mostly by itself. Honey especially would help a dressing hold, and you could use that plus the doctor's stuff. But put it on the dressing, not directly onto the skin. It doesn't hurt so much to put it on the dressing because all tat then touches the skin is the dressing and not your fingers. It also greatly reduces the risk of infection to do it that way around. You're still getting the cream/honey/salve on the wound anyway.

    I then put a dry gauze over the wet dressing. Because the whatever-it-is in the dressing was full thickness, it helped attach the dry dressing. I then used something stuck inside my clothing (such as a stick-on sanitary pad, panty liners, or in my case - nursing pads) to help hold the gauze in place. I wore a singlet top with a soft bra cup built in (it's a maternity nursing singlet, so I could get a larger one in my size - or what my size is now one side only. The other side is now two cup sizes smaller!), and because it was mid-winter, I used singlet top as my undergarment. It meant that my clothing was now firm on my body and therefore m=not rubbing. However, between the firm clothing, the gauze and the panty liner were holding the dressings gently but firmly against the burn with minimal movement. I also slept in this. I figured I could wash it afterwards. Or I could strip off, hand-wash it, toss it in the dryer and stay naked until I could dress again. But healing the burn became a priority and, frankly, I was not exactly working up a sweat at that time anyway, I was mostly resting quietly. It WAS right at the end of my radiation treatment, I was sleeping a lot.

    The first nurse who put the dressings on me, soaked them in sterile saline first. I realised when the second nurse helped me (the next day - my radiation treatment was still going, and it was every day - the radiation team would look at the wound and tell me to see the nurse before I left if they felt it needed attention) that those particular dressings should NOT be soaked. They are impregnated with a sort of gel (similar to water crystals you might put in the garden, or that are used inside sanitary pads to soak up moisture). That gel keeps the dressing moist but when you change the dressings you can be spooked because the gel can look like skin sloughing off and you can think you're worse off than you really are! Once i realised what it was, I was OK. It rinses off, or you can leave it there. The tube of stuff I was given by the doctor to apply, was also full of the same sort of stuff. It really was amazing stuff.

    OK, I just raided my dressings bag again. The wet dressings are called Atrauman Impregnated dressing. It might not be available, but your pharmacist or doctor could look it up and tell you what is equivalent. The gel I applied is called Solosite. The ingredients are caboxymethylcellulose (that will be the lumpy gel stuff left behind when I removed the dressings to change them) but it also has glycerin and allantoin in it. Glycerin - you can get a bottle of it form the pharmacist, it's really cheap, and impregnate something like a Telfa dressing with that.

    So in summary - wet dressing over the burn, right over the whole thing. If one dressing won't cover it all, apply more dressings like tiles on a roof. Load each dressing with gel or cream (or honey) first. Or see if you can get large enough dressings and cut them to fit if you have to. If you can't get the wet dressings I describe, find a source of Telfa (noon-stick) dressings but again, use the gel/cream/honey to stick it on like glue. Over the wet dressing, put a dry layer. It doesn't have to be anything special, it is padding plus something to help hold it on. Over that, put something firm to hold it all in place. It's on the front of your upper chest up to your neck, isn't it? In which case, wear a skivvy but pad inside the skivvy also, with stick-on pads. Make sure the skivvy is tight enough to hold everything in place without rubbing. Or if you have something else to hold it all in place without needing anything firm - great.

    If, after all that, you have bits of dressing showing everywhere (and sometimes I would find despite my care, dressings would slip and I would be leaving bits of gauze behind me where I walked!) then cover what remains with a gauzy scarf. You can then go out in public and not worry about people thinking you've been in a horrific accident.
    I had to go out every day because I had to report in to the Cancer Centre daily for my last weeks of radiation treatment. So I found ways to make it work, plus I had the advantage of getting some really good tips from other patients.

    Taking the pain killers - do without them if you can, but take them if you really feel you need them. I found that once I had everything held firmly but well padded, the pain greatly eased. Whatever worked for me dressings-wise and clothing wise during the day, I slept in at night too. I changed dressings twice a day and washed each time (carefully!). Wherever I went I carried my bag of dressings, gels, aloe vera leaf (picked fresh daily) and small jar of honey.

    It might take up to a fortnight, but your skin will recover especially if you can reduce any rubbing. Ironically it's the loose clothing that rubs more and does more damage. Tight is better (tight enough to hold gauze pads in place as padding).

    If you need to, print this post and take it to the doctor, see what she says. Or take it to the pharmacist.

    It is always difficult o dress a burn on an ambulatory patient, when the burn is on a large area or an awkward place to cover. If you were bedridden the dressing could just sit there. But as soon as you move, especially when you stand up, gravity steps in. That's when you have to deal with the practical side of "how do I treat tis, but still manage to get on with my life as best I can?".

    I hope this can help. The skin coming off - no surprise there.

  5. HaoZi

    HaoZi Guest

    I know it sounds weird, but one place you might find glycerin is in the section for constipation, as well as skin care. If you have a CVS nearby they have a 99.5% version for skin care.
  6. klmno

    klmno Active Member

    I'm using the non-stick type of bandage and yes, it takes 5 or 6, depending on the size, to cover the entire area. I'm using the rx'd ointment on the burned area right before putting the dressing on. I'm using as little tape on my skin as possible because I realized that a good deal of my pain thru last night was due to the position I was in when the nurse put yesterday's dressing on, then being flat on my back last night caused a lot of pulling and tugging on the tape and thus, the bandages.

    But one thing I am wondering about, there was a yellowish thick liquid when I took the bandages off this morning. I'm not sure if it was the ointment although when it comes out of the container and is first put on, it is white. Or if it is oozing from the broken skin peeling off. And then the next question if it is oozing, is it anything to be concerned about? What are the early indicators of an infection when it's a burn like this? It's odd to me but I noticed if I lean over so my chest/neck are parallel with the floor, I get a lot of pain in the burned area.
  7. HaoZi

    HaoZi Guest

    I think generally yellow is considered bad (unless it's the ointment). If it's green or edging towards green get thee to the ER.
  8. Marguerite

    Marguerite Active Member

    It could be the cream changing colour chemically as it reacts with the serum from the broken skin. Look at the wound and see how it looks. Is there a red area around the outside of the burn? Is it swollen? Does it look like it could be producing any coloured gunk? Check the label, what is in it?

    It sounds like you're using the Telfa pads, they're the ones that have a sort of cellophane look to them. They are a dry dressing which means you have to stick ten down with something. The cream can help, but the dressing pad itself is too think to hold itself in place that way, you need something else to hold it in place. Go carefully with the adhesive on your skin (from what you use to stick it on). Even micropore, supposed to be non-damaging, will take off my skin if I leave it in place for more than six hours.

    If the burn is doing OK, it could be doing anything from being raw and bleeding, to pale with new skin forming. If it's raw and bleeding, it can look quite dark, like fresh raw steak. That's OK. It's when you have a red area outside the burn and that red area is getting larger and is also painful and hot, that you need to worry.

    The stuff I was putting on mine (Solosite) is clear and gel-like, so it was fairly easy for me to be sure it was not pus.

    Try rinsing down between dressings change - irrigate with saline. Don't rub. Try to not even dab. Just lean forward and squirt saline over the area. Or if you can have a tepid shower or bath, gently rinse the area then pour clean water over (not bathwater) to give it a final clean rinse. Then see if there is any yellow stuff, or anything looking creamy at all, remaining.

    There is a kind of burn cream, I think it contains picrate in some form, which looks mostly white but will change to yellow on exposure to air.

    If in doubt, ask the doctor. If you can while rinsing, add a drop of ti-tree oil to the rinse water.

    You can buy sterile saline from the pharmacy but I make my own. I use filtered water, but it is going in my eyes (contact lenses). The formula is 0.9 g cooking salt, to 100 ml of boiled water. It can be difficult to measure 0.9 g accurately, so boost the quantity to a litre - 9 g salt per litre of boiled water. Bring it to the boil (microwave oven is good) in a glass jug, then pour it into a clean bottle which has been scaled with boiling water. Make a fresh batch every day. Don't use it until it cools. Do not use a metal lid on the container you store the saline solution in. This makes isotonic saline which is the same concentration as the salt water in your body. That means it is gentler than pure water on your body.

    I hope you continue to heal without complications.

  9. ML

    ML Guest

    Nothing to useful to add but wanted to say I'm sorry you're hurting. Love, ML