April Otwell
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A Step in the Right Direction…

12/26/2022

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Hey guys,
It’s been a long week, to be honest with everyone. Christmas is right around the corner and I’m nowhere near in the Christmas spirit. The majority of my problem with this time of year is that the last Christmas I spent with my mom wasn’t a pleasant memory. She didn’t know that it was Christmas Day on Christmas. She argued with me about the fact that it was Christmas. She commented suicide about three weeks later. I always have trouble with my mental health during this time of year but this year has been especially rough.
I have been extremely busy this week preparing for the holidays. I won’t lie I haven’t bought any Christmas presents this year, I haven’t been in the right mindset or had the finances to do a whole lot. For the last few years, I have been breaking myself to provide Christmas for the people I care about but I cannot continue to do so otherwise I’ll only drown myself.
Tuesday I went to Monroe with Jessica, Amy, and Mallory. Monroe is about an hour and a half drive from my house. This was my first road trip that was so far away from my house. I do OK sitting up in my chair as long as I’m not moving around too much, otherwise, my wound hurts something awful. I’m not a big fan of car rides right now with my wound. I was scared that the car ride was going to make it that long without hurting too bad. We ended up spending about six hours total away from the house. We went to Ross where I was able to find a few shirts and cute leggings that are my actual size and easy to get on. Everything that I own is really too big for me and extremely baggy.
The rest of the week was spent deep cleaning some of my house. Unfortunately, over the last six months, I have lost sugar gliders, so I am now down to only eight of them in their room. It makes me feel better to deep clean everything. I’ve had to set myself back away from the sugar gliders emotionally otherwise, losing as many as I have in the short span, would absolutely kill me. They know that I love them and that is all the comfort I can give myself. I honestly don’t know what’s happening to them. I will only drive myself insane if I try to figure it out.
Friday I went to wound care again. The morning started off really well, I felt normal as much as I could anyway. I got dressed in a new outfit that actually fits me better and took the time to make sure I was sitting in my chair well. It was 13° outside! I hate the cold. It was only us when we got inside the building so we didn’t have to wait in the lobby long. We weren’t as lucky when it came to not having to wait. The nurse did all of the wound dressing changes, measured the wound, and waited on the doctor while she set up the sound machine. It was 0.5 cm by 0.5 cm, and the depth is 1.5 cm but there’s a tunnel or undermining in the wound that’s at least 9 cm. This tunnel or undermine is what’s not healing but at a standstill. The doctor that I been seeing the last two times I’ve been to this wound care clinic was not there because of the holidays so I had to see someone new. It was a lady named Rachel. She asked me a few questions before using the machine to clean out the wound. After the wound was cleaned out she sat back down to talk to me about the muscle flap surgery. She told me that the clinic had received the labs from Cabrini Hospital, and everything looked fine. The next step is to meet with a surgeon. We are going to try to do a FaceTime appointment with the surgeon this coming Friday. The surgeon may end up needing me to have a more recent bone scan to make sure there is no infection before we do the surgery. She also told me that the muscle flap surgery is a very delicate process and that if this were to fail, another surgeon would never perform another muscle flap on me again. It’s extremely important that I am doing offloading of the area, getting my nutrition, and getting good night rest. She told me that they would send me to L-Tac in Covington, Louisiana for about six weeks which I already knew. Of course, being away from my house that long makes me upset, but I would much rather get healed or I can do things at my house instead of just being there in the bed all the time.
It does scare me a little bit, knowing that if this surgery were to fail with this pressure sore, there would be no other chances at a muscle flap surgery. If this is the case, if I were to get another pressure sore, I would have no other choice, but to let it heal on its own. Depending on the size of the wound, this could take months or even years to heal a wound like this. I’m going to do everything in my power to make sure that this surgery does not fail. I have to say that my nutrition is not the best so I have started to replace mom some of my drinks with a protein shake to make sure that I’m getting enough protein. When I was in the hospital back in September, my potassium levels were not the best in the world so I am trying to make sure that I eat enough greens so that my potassium levels stay where they need to as well. I’ve been on a really big salad cake since my long-term care stay in Cabrini.
On Christmas Eve I had a water leak from the water facet under the carport. The water hose had not been drained before the water got cut off and then the water froze. It popped off the top of the pipe. I honestly don’t know how long it was running when we found it but I’m sure the water bill will be higher than normal. We had to wait on someone to bring us some PVC glue so we ended up just turning the water off. The glue that Jessica brought at about 4 o’clock was not any good so she ran to town to see if she could find any more at Walmart or tractor supply. There was not any at either place so I ended up having to call my dad and he come out to my house at about seven or eight that night to fix the water leak. It didn’t take but maybe five minutes to fix.
Yesterday was Christmas. It doesn’t feel like Christmas to me this year. In a lot of ways it kind of reminds me of the last Christmas, I spent with my mom when she didn’t even know it was Christmas day. This is also the first Christmas that I’ve spent pretty much alone in two years. It was odd, to be honest. The day was not all bad. I got up in my chair because I refuse to spend Christmas stuck in bed and put my makeup on. I used to do this every morning just to make myself feel a little better about myself and I have to say that it worked today as well. I was able to put my makeup on without using my universal cuff which I have not been able to do for a very long time which makes me happy as well. Kelly came by for a few minutes to drop off Christmas gifts before she had to run to her parent's house. I got a really good-smelling candle, a set of Harry Potter pajamas, a new lighter, a CUTE little succulent sign, a peppermint shot glass, and a neck scarf. I got to bundle up and go sit in the sunshine for about thirty minutes before Jessica pulled into the driveway to do my wound care. While Jessica was here I got her to help me and Mallory with rolling out the empty glider cages to the carport. I hope that the German roaches that I’m fighting in that room will freeze. They are up in the metal cages. There are not but five cages in there now. It’s so odd to see that room so empty. I love my gliders and I’m sorry that things have played out the way it has for them. Once Jessica left we did a few other things around the house before putting me back in the bed.
Until next week…
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The Long Haul...

12/19/2022

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Hey guys,
There hasn’t been a whole lot going on this week around my house. I’m just staying in bed as much as possible so that the sore can heal and not get any worse. I’m so ready for this thing to be healed already. I do have to say that I do not just hate the bed after this. I’ll most likely start sleeping in my bed again once I’m healed. I’ve been doing it in my chair for about ten years without having any problems.
Friday I went to wound care to get the results of my blood test and to check on the wound. The night before I ended up going to bed around four am and then had to get up at seven to leave the house on time. I was a little tired but I have had less sleep than that and been fine. I was fine in bed but once I got in the chair everything started adding up and I cried. I couldn’t get comfortable, my right hand was hurting extremely bad and to top it all off my whole ostomy had to be changed too while we were running late.
Once we finally got there, we had to wait for about forty-five minutes to an hour. Last week wasn’t nearly as busy and we got in the back extremely fast. While we were in the waiting room an older lady in a wheelchair would not get still. The waiting room is very small considering that most patients are in a wheelchair so there wasn’t a whole lot of room. She kept making me nervous because she wouldn’t stop moving in the room full of people.
My name is called finally and the nurse leads us to a room, immediately get started on getting the wound prepped for the doctor. I showed this wound care clinic that it’s much easier and faster to do everything from my chair. When the wound was measured it was 0.4 cm by 0.5 cm and had a depth of 7.9 cm. That’s about the same as it was last week so there wasn’t any change. The doctor took forever to come in the room once the prep was done. The room was freezing! The clinic is attached to the hospital's air conditioning so it stays extremely cold. He came in with some good news; my kidney function is good and there’s no infection in the wound. He was a little concerned about my white blood cell count being elevated but I explained that I usually keep a urinary tract infection because of the in and out catheters that I use. He seemed happy with that answer and waved off the elevated white blood cell count.
I had hoped that I would be able to rush the surgery date but the doctor had other plans. According to him, he still wants to wait anywhere from two to four weeks to give the new treatment time to work before we go to surgery. Apparently, a muscle flap is the last option for sores like mine. He’s still waiting on the images and test results from the Cabrini hospital where I was discharged to check out the CT scan for bone infection. Once he receives the results he can schedule his test to check for infection in the bone. I’m assuming that it’s after all of these steps we can go toward surgery. I honestly wanted to cry because I’ve been dealing with this wound for three months now and I’m tired of waiting. It’s been the same depth since just about the beginning so it’s obviously stalled. I tried to explain this to the doctor and he understood. He told me that the ultimate goal is surgery but he has certain steps to take to get there. He took the ultrasonic machine that uses only sound and saline to clean out the wound and promote healing to the inside of the wound. The sound was not as loud and harmful as the last time but it still does not feel too good. I noticed this time that the gauze that he was pulling out was red with blood. He kept telling me that the machine used no blades while he was working.
On the way out of the office, we scheduled the next appointment for Friday. By the time that we got out of there the small amount of sleep was starting to catch up with Mallory and me. We got our pharmacy order, and a bite to eat at Dairy Queen and stopped by a vape shop before heading home. We didn’t go right home but stopped by Jessica’s just to chill there and get out of the house. We stayed there for about three hours just laughing and enjoying ourselves before we came home and I got put back in bed.
Sunday I was invited to a small Christmas party with Lil Mike and some other family at his house. It was very nice to get out of the house. I ate so much food that my belly hurt so bad. There were ribs, seafood gumbo, green bean casserole, potato salad, and homemade cheesecake. Everything was so good. I can see why I dropped so much weight once Jessica stopped cooking for me. I miss how things used to be and I know that’s my fault. If I could go back to fix our relationship I would in a heartbeat. All I want is to go back but I can’t and I have to live with how things are now.
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Here We Go Again...

12/12/2022

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Hey guys,
So I’m wanting to start writing a blog every week about how my week is going and other thoughts going on in my head as I go through a difficult time dealing with a pressure sore.
Pressure sores are common among spinal cord injuries and can take its toll on someone both physically and mentally. The best way to heal a pressure sore is to relieve pressure on the affected area. It can be difficult to relieve pressure completely depending on where the sore is located. My pressure sore is located on the lower left buttock. These types of sores develop when prolonged pressure is applied to an area so there’s no blood flow to the area and tissue starts breaking down. The amount of skin and tissue breakdown determines the stage of pressure so from I to IV. My sore is a stage IV because the wound is deep enough for the bone to be exposed.
Last week on 12/09 I went to the Rapides wound care clinic instead of the clinic in Cabrini because I was not happy with the lack of progress in healing. The wound has gotten smaller but it’s still really deep. These types of deep wounds have to heal from the inside out to heal correctly. The wound should be shallower and larger than deeper and smaller so that you can see the end of the wound bed. The opening of the wound is very small versus the inside so we can not see the bottom of the wound much. There’s so much that could be going on in the wound itself. The process of getting into the wound care center was fast; we waited maybe ten minutes before bringing us to the back. Once in a room, everything happened at such a fast pace from asking intake questions to getting everything set up for the doctor. There wasn’t any waiting, unlike at the other clinic. This one took in the fact that everything can be done in my wheelchair. It’s more comfortable for me not having to get in and out of my chair into a hospital bed and my chair lays out like a bed so there’s no reason that I have to be moved. The nurses were extremely warm and friendly which was not the case at Cabrini clinic. As soon as the nurses were done the doctor came into the room. My first impression of him was that he was cute, with a friendly smile and beautiful eyes. He introduced himself and asked a few background questions such as how long I’ve had the wound, what has been done to treat the wound, and has there had been any labs performed on the wound. Once he got into the actual wound itself, he agreed that it didn’t look just horrible. It measured out to be about 7.5 cm deep. He took a curate to the inside of the wound to check for infection. That was not the most pleasurable experience to have to deal with only lidocaine for the pain. I asked if he was cutting the wound because of the pain that I was experiencing and the doctor stepped back to look at me with a confused expression. I explained that I didn’t want to have to cut the wound back open because I’ve already been dealing with the wound since September. If he cut the wound open again that would only push back the healing I’ve done already and prolong the healing process. He understood where I was coming from and thought for a minute. Basically, he said that I really had two options with the type of wound and the location; either cut open the wound to make it larger or do a muscle flap surgery to repair and close the wound. He’s seen this type of wound in the past and those are the best options.
A muscle flap surgery is something that I have heard from other people with a spinal cord injury. From what the doctor said, I would have to be taken to New Orleans for a four to six-week stay in a long-term hospital. It would be similar to the floor I stayed twenty-one days in at the Cabrini Hospital. The tissue is going to require special care while it heals so that it doesn’t die. This could mean that I could be completely healed by my birthday or soon afterward. There’s a big process to getting surgery started but he agreed to go ahead with the necessary tests and paperwork for it. The first step is getting bloodwork and a CT scan with contrast to check for infection in the bone. He also changed from a wet to dry packing to a honey-based paste with a smaller strip of packing. He was concerned that the larger type of gauze was keeping the wound open, delaying the healing process, and potentially causing more damage to the inside of the wound bed. After we got done packing the wound, putting my clothes back on, and sitting me back up we were able to leave right away. The staff had already left the office so they said that they would call us to set up another appointment and to get the test done. While I was still in the office the nurses went ahead and drew the blood work. Overall this wound care clinic impressed me more than the other clinic. They seemed to offer more options for getting me healed, as well as had a friendlier atmosphere and listened to my opinion.
Other than the wound care clinic, the only other thing exciting that happened was getting the alternating pressure mattress that I ordered to help relieve the pressure and keep us from having to turn me so frequently. The air mattress is not very comfortable but it’s better than a regular mattress. I’m not so sure that I really like the mattress because I feel like I’m sitting on the hard bed frame. So my butt hurts all the time. I have gotten a couple of people to do what’s called a hand check to see if I’m bottoming out. A hand check is where someone places their hand under the air mattress and sees if a person’s buttocks are hitting the hard surfaces instead of being suspended in the air.
I have a lot of time to think being stuck in bed so, of course, I have so many things that I want to do but I can’t do them in this bed. I’m so ready to be healed. I have been on bed rest since September which is three months. The last time that I had to deal with a pressure sore of this nature I was stuck in bed for a whole year. I was only 17/18 when the last one happened, my mom was still alive and I could just put my life on hold for a year and heal. I don’t exactly have the option to just stop my life to get healed without falling behind on so much. For me, my mental health has a lot to do with the environment. I don’t like clutter or chaos and I’m a very OCD clean person. I like my house to be clean but I have a specific type of cleaning. I haven’t seen many people that clean as I do. If I’m being honest, cleaning is one of my hobbies as sad as that sounds because I don’t feel like I can’t rest or relax while there’s still something to be done. I don’t know why I’m like that, it makes me mad. I tend to notice dirt more than most people so I can tell when something hasn’t been cleaned up correctly. There’s so much I want to do in my house, in my career, and in life. I just have to get healed up first so that I can actually do them. I’m ready to start my classes back up so that I can finish the thirteen or fourteen more classes that I have left of my dual bachelor's degree in graphic design and psychology. It’s taken me longer than I wanted but I’m almost done. I don’t even really know what I want to do with my degree yet. Originally I wanted to become a licensed psychologist but that involves getting my master’s degree and my Ph.D. before I could even take the state test. I just don’t know if I’m up for that many years of more school and then left with a huge debt to repay. I have time to decide what I want to do but don’t think I haven’t thought about it already.
A lot is going on in my head so please just bare with me as I try to get them down on paper. Until next week…


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    Paralyzed from the neck down after an ATV rollover at 14, April Otwell is beating the odds the doctors gave her. She's a blogger, fantasy writer, college student, sugar glider guardian and spinal cord injury survivor.  She's even writing her first fiction novel!

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