Overdoing the Medical treatment?

mountainannie

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Dec 11, 2003
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Ok.. so I fell again. Not the first time. More like the 6th or 7th. Not drunken walking. Just Dominican Walking. Or maybe because of the little thingies in my ear that are out of place but anyway.. has been happening to me for the 10 years that I have been here. Always Sober at the time. Always face first. Always hit my knees.

This time though, I really scraped it up bad.. (badly? in a bad way? ok, looks bad?) nothing that deep but a lot of surface, from the knee down to the calf, And then the bruise underneath. OUCH.

Ok thought I could deal with it. Soap and water. Ouch. neosporin. covered. Then in a day or so. Hyrdogen peroxide. ouch, of course, did not cover it.. then more neo sporin .. then tried to keep it open.

anyway, a week passed. And now the sides are red and I am not gaining

so I went to Clinic Abreu and they sent me to a surgeon.

Who now wants to put me under anesthesia to clean the wound, after the x ray, (he wants to check for any small breaks) after the blood tests after the lab test on the gunk from the wound comes back.

Does this seem reasonable? Seems like overkill to me.

but I have never had this sort of thing in the tropics.

(concerned a little since they said to come back tomorrow but the lab work won't be ready for three days and the doc should have know that)

ok. I know that you guys are NOT docs but would you share my concern?
 

rogerjac

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Feb 9, 2012
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sounds like overkill to me. some antibiotics should do the trick. but better safe than sorry. you need your legs. my recent experience I saw lots of overkill. the gringo treatment
 

Chirimoya

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Dec 9, 2002
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There's a good chance they want to squeeze as much money as possible out of the gringa. That's what happens when health is a business.
 

dv8

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Sep 27, 2006
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i call overkill. local anesthesia to clean the would i can understand if it's a deep gash oozing puss. but it does not seem like it? ask a doctor about cream containing antibiotic like fucidin. this is a first choice medicine for skin infections: Fusidic acid - Wikipedia, the free encyclopedia
maybe you need a shot of antibiotic or an oral dose. cephalexin, perhaps? but this is to be determined by a doctor. with mild infection local antibiotic is usually sufficient.

have you had your tetanus shot? did the doctor offer this? agua oxygenada is not the best choice for wound management, btw. it's ok to clean the cut once but prolonged use softens the tissue and prevents healing process.
 

mountainannie

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Dec 11, 2003
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yes, it was 3000 pesos, not on my insurance.. (have to get it reimbursed) just to see him. And really he did not do much except put cream on it. No tetnus shot. Just took goop for a sample.. (then sent it to the lab? to see if there is any bacteria in it? I mean duh? it is yellow white pus? Of course there is bacteria in it!! isn't that why they call it pus)

anyway.. the other doctor.. doctora.. who spoke English, said, that really that they had to clean out the infected skin, otherwise it would come back and not heal.

ok. well, frankly I was more worried about waiting around til 1 PM with nothing to eat but got them to agree to coffee with sugar and apple juice..

And this is all covered by my insurance so I do not care. He is arranging with another doc to get it covered .. (odd ususally the Abreu docs are covered)

But general anesthesia is always risky.

And the leg does really hurt.

And WHERE to go for another opinion, will they not send me on the same run around? I mean if you go to a surgeon, do they not recommend surgery?

But then, again, I would hate to have it really get worse.


words like "necrotic" and "gangrene" which i do not want to REALLy know the meaning of.. float in my brain.

the doc is in surgery now... i have his cell number *this never happens in the US..that I would have his cell

Should I just ask him if I can go to another sort of doctor to keep it clean and monitor it? Before we go for surgery? What kind of doctor should ask for? (superficial wounds and leg bruises? motoconcho leg specialist?)

It was the emergency room that sent me up to surgery.
 

dv8

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few questions:
is the area of the wound cold to touch?
does it hurt?
do you have a fever?

why general anesthetics? this is dangerous in itself and there is no call for it unless there is a deep infection. maybe try a different hospital? i'm sorry to hear that you are going through rough patch like this with your health...
 

mountainannie

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Dec 11, 2003
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ok.. I did look up "necrotic".. maybe that was a word I heard the two doctors using.. and then here evidently is the issue..

the wound debridement

http://www.medscape.com/viewarticle/459733_6

(I kept trying to google surgery for wounds and it always came up for surgical wounds which is not what this is.).. So I was relieved to see that indeed this is considered a standard technique for cleaning out dead skin and infection so that the wound can heal. That makes me feel better.

And, I am relieved that they did not suggest the good old fashioned way which is to find a certain type a fly which only likes the dead stuff and put them onto it.

ok.. maybe not quite so third world as that.

And he did us topical anesthesia ... and all that.

And they do say that the process is usually painful so anesthesia is recommended. Ok... So I am just going to call him about the bacteria tests.

And then get someone to go with me for the general anesthesia.

i guess that left alone, it could turn into something really serious..

*of course, if i had gone to the emergency room last week, right after I fell, instead of being embarrassed since I was sorta inhaling sobbing, and it did not look so bad.. and tried to do it myself... with my stupid GOOGLING and know it all.. NONE of this would have happened...

there is a reason they are called doctors.

and yes, I generally have been suspicious of them because of the money stuff but now i do have insurance and will be reimbursed so there is no reason to get so upset and i should listen to them.....
 

AlterEgo

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Jan 9, 2009
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I agree that you need to get this taken care of... but general anesthesia????? I just had two serious knee surgeries and neither required general anesthesia. Ask around about that.
 

malko

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Jan 12, 2013
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Seems like overkill.......

Mashed up garlic, seems to work for me, to ward off infection. Also wash with that round local soap, sold in colmados in packets of 6.jabon de cuaba lavador.

Also on another note, scars seem to mark more here, my wife complains about them all the time. Pure butter of cacoa does wonders ( not supermarket nivea type, the real thing. )
 

mountainannie

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Dec 11, 2003
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thanks for the sympathy.. Goddess knows that it has been one thing after another.. but really I am grateful, I mean EXCEPT for being psychotic, which, of course, is a helluva an "exception", I have been in very good health. No diabetes, blood pressure or anthing else. And grateful really.. I mean we all do begin to fall apart around 65 or so, like there is a warranty card. attached to each body. But with the ear thingge and the chiky,, ok.. minor, minor,, stuff compared to cancer .. or really even to CB's broken jaw!

So it does yes, sound like overkill but I will admit that the wound is seriously UGLY. And it is hot. And getting red around the outside. And just nasty looking on the inside. And takes up a half of my quite large front of the leg.

I guess the doc decided on general from the way I winced under the topical? AARGH,, you had KNEE Surgery under topical?

Anyway, I would not mind if I did not wake up from a general. That would be a good painless way to go. (It is not death that frightens me, it is PAIN!!,, i hate PAIN.. so maybe the general is a good thing)..

As for the garlic, .. and others have said .. honey...

these I am going to try RIGHT before I try the MAGGOT Therapy

Maggot Debridement Therapy - for wounds status of maggot therapy

Evidently, now covered by Medicare and Medicaid!

Called the Doc about the lab tests.. The Doctora answered, said no problem about the lab not coming back for three days, they do not need it before surgery (why not? one wonders) Is there another way, I asked? Not really, she said. This is really the best, and the fastest way for the leg to heal, by removing the dead and infected tissue.
 

dv8

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MA, general anesthesia should be last resort. many lower body surgeries are done using epidural or whatever that procedure is called when you are "paralyzed" from waist down. a dominican anesthesiologist who works in santiago told me few months ago that it is much safer to keep the patient awake and use different drugs to completely numb the pain. inquire about such options. 65 and healthy? you are not ready to go. think of all the articles you have left to write.
 

charlise

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Nov 1, 2012
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Let the wound (knee) soak in a mix of water and bleach (60/40) for 15 minutes 4-6 times per day. Will kill any germ that intend to move in.
 

BlondeJustice

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May 28, 2014
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In the general course of my life I have seen many wounds.. When all else fail yest the water/bleach can help. I'm concerned though about what type of infection it is. StaphA infections (flesh eating disease) can be deadly. Gangrene? Requires removal of the dead tissue surgically. But general anesthesia? I'd go for local freezing and at most a spinal block-the same one women in labour get. Good luck but do not procrastinate in getting treatment even if it means heading back to the U.S. (Canada).
 

Cdn_Gringo

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Apr 29, 2014
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General Wound Care (small cuts and abrasions):

Even before the bleeding stops, clean the wound well with soap and clean water

Stop the bleeding with pressure and a gauze pad or two or three... (do not let the gauze attach itself to the wound)

If the edges of the wound have loose or tattered skin carefully cut it away with sterile scissors. This will help speed scabbing and is easier to do while the endorphins are still coursing through your system.

Apply a disinfectant. I like 2% iodine, hurts but is very effective and wont cause further tissue damage like Hydrogen peroxide will and it sticks around working longer than alcohol.

Cover the wound with a band-aid or gauze dressing based on size of the wound. Change the dressing every hour until the dressing changes clean and dry.

Change the dressing and expose wound to air for 10-15 minutes every 4 to 5 hours for the first two days. (It's ok to sleep through the night, change first thing in the morning).

At each changing, inspect the would for expanding redness around the edges. If found, use a pen or marker and draw a circle around the outer edge of redness. At the next dressing change, if redness has expanded beyond the first circle, draw another circle to show your doctor the rate of spread. You need antibiotics. Get thyself to the clinic.

Keep the wound covered and dry until completely scabbed over then dressings are no longer needed.

The secret is clean, dry & covered.

If you slide off your Moto and have road rash up and down your arms and legs, you need medical treatment and preventative antibiotics due to the large area of exposure.

For scrapped knees, small cuts and other assorted minor wounds you should be able to treat yourself successfully.

POLYSPORIN and other over the counter creams & ointments often do more harm than good, because people use too much too often. These products are wet and do not allow the wound to dry. No drying, no scabbing. No scabbing, no protection from infections or insect infestations.

After receiving a home treatable wound, you should be at the disinfection stage (above) within 15 minutes for the best chances at stopping an infection. If the wound won't stop bleeding get yourself to the clinic for more specialized treatment.

Lymphatic fluid - a clear oozing fluid that often exudes from wounds long after the bleeding has stopped. This is a good thing as it flushes contaminants from the wound. This is the reason for frequent dressing changes for the first few hours hours until the dressing remains clean and dry.

To avoid an infection in the tropics, it is important to act quickly to clean and disinfect the wound. To do this, you need to have the supplies on hand. In your car, at home and in your suitcase if traveling. A good first aid kit is your friend and a friend to those around you. Remember to replace what you use so that you have it for next time.
 
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La Profe_1

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Oct 15, 2003
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Annie, I had to have my leg wound debrided here in Puerto Plata. First they told me general anesthesia, then the surgeon decided that no anesthesia was necessary because the tissue was already dead (I DID have gangrene and necrosis). Talk to them about the recuperation process. Because my wound was so massive, it took more than six months for the surgical site to close.

It might not be overkill, depending upon just how extensive the infection is.
 

Cdn_Gringo

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Apr 29, 2014
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Poor you Annie. If indeed infected, they are going to remove tissue until all the badies are gone. This could leave you with a wound much larger than you have now and as La Profe_1 says, it may be awhile before you are mobile enough to fall over again.

Next time, a lot less Neo if any at all, no H2O2 and more frequent dressing changes. Don't be afraid to disinfect twice if you feel it is warranted . Clean, dry & covered.

Good luck. Get well soon.

Sorry to hear of your difficulties.
 

william webster

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Jan 16, 2009
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Overkill??

On my last visit to Canada , esposa was suffering....

US prescribed about $2,000 of blood work

Cdn guy - much less

His comment was:
In the US, medicine is a business
In Canada, its a service

if its as suoerficial as you stated originally, good cleaning and bandages should work
but la Prof's warning is a genuine one

Only you can tell by assessing your wound how far to wade in to the treatment .