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After much deliberation, delays, and just plain reluctance to submit myself to what I knew had to be done sooner or later, I finally jumped in and consulted a podiatrist about surgical correction of a hallux valgus ("bunion", to the newbies) and crossing hammer toe. They were affecting my gait and making shoes difficult to fit, so I bit the big one and went forth for a surgical date.
It was a flawless procedure and I recovered without a problem, going home approximately four hours after the procedure in a surgical dressing, big shoe and hobbling along on crutches. The pain was minimal that first week, managed only with some ibuprofen. I faithfully took my post-surgical antibiotic, and looked forward to my first post-op visit and dressing change, anxious to see the work that had been done.
It was after that first visit that things started to skew. My husband and I later compared notes because, admittedly, we weren't sure if we had missed something, or perhaps were mistaken with what we'd seen. Or rather, hadn't seen. While the doctor's MA had removed my dressing after donning gloves, the doctor poked and prodded the sites, even opening a small blood blister, without wearing gloves. He then blithely rewrapped the sutures and sent me on my way. That happened on a Tuesday. By Friday, necessitating a call to his office and scheduling an emergency visit, the surgical sites were red, swollen and supperating serous drainage. This time, I removed the dressing for him. Again, to my disbelief, he prodded around my toes without gloves before dressing it again, pronouncing it infected and probably my fault for messing with his dressing, and prescribing another antibiotic. See you next week. And this time, I spoke with his MA about her responsibility to remind the doctor about the principles of universal precautions and that, as a registered nurse, I would be watching very closely on my next visit to ensure they were strictly observed.
On my regular followup visit two weeks after surgery, the sites looked only a little better, but the doctor, gloved this time and somewhat more respectful, removed the sutures from my toes and carefully re-dressed the oozing suture lines, pronouncing them on the mend. Sure.
Two days later I sat in our military ER with a team of orthopedic docs puzzling over my body-wide pruritic drug rash (reaction to Cipro) and questionably recovering toes. The stuff still oozing from the suture scars was swabbed for cultures, I was given Zantac for the itching, the wounds were carefully re-dressed by a very affable and careful LVN, and I was sent home. My third post-surgical visit to the podiatrist, he was polite, attentive, WEARING GLOVES, and looking fearful as my husband and I related my weekend ER visit and pending wound cultures. The doctor carefully removed the fixator pin from my second toe this visit, and the site was dressed with a bandaid. And since the Zantac wasn't doing anything for my intense itching from the rash, he prescribed a short course of low dose Dexamethasone. I am, for the first time in just a little over a week, comfortable; the rash has resolved, my toes are healing with the usual post-surgical swelling, and I will be seeing him again in three weeks.
The lessons here? First, I definitely won't be going to him again for surgical correction of my other foot; and second; be my own vocal advocate so a SNAFU like this will never happen again. Heaven knows, I've been adamant enough advising patients to do the same. However, when you're actually in the arena, sometimes you don't see the bull charging at you. Believe me, I will next time.
Bonnie Pope has been a registered nurse for over 14 years. She has practiced as a med-surg pediatric nurse, outpatient clinic team leader and educational resource nurse, as well as a clinical nurse consultant. Bonnie is an Army veteran with 10 active years and 3 reserve years as a Preventive Medicine and Environmental Hygiene specialist. Currently, she is the full-time caregiver of a specially-abled young adult. Bonnie has been married for 34 years and has three grown children.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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