Month: September 2019

Maggot therapy…

Every once and a while a patient enters your care who presents with an unusual situation. I’ve been a nurse at some capacity for about 16 years (LPN-MN) and there are lots of things I have seen, but still many that I haven’t!

One thing I check off my list is maggots in a wound, and not there on purpose. Maggot therapy has been in medicine for a very long time. It’s intended usage is to utilize the maggots for wound debridement (link below). Of course, the maggots are sterile and a regimen of routinely replacing the maggots is important to maintaining a healthy wound healing environment. However, this particular situation (person, place, & time avoided to protect the identity of the patient) was due to poor hygiene and a reluctance to seek medical treatment.

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When an interesting case presents to the emergency department, news travels fast! Basically, when a patient is checking into triage, charge nurses are notified of specific situations to help facilitate an appropriate room/space for the patient, especially if they require some kind of isolation. The downfall to this kind of pre-notification, is the anticipation of the unknown, and as the nurse, now my brain is in full though process of “how do I care for this situation”.

On the day the patient arrived with the infected wound, I was made aware the patient would be coming to my assignment, I had an open isolation room. And before I even met the patient, I could feel myself reacting to the idea of seeing these creatures crawling and I was having a difficult time preparing myself to maintain my professionalism while caring for this patient.

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After learning the story of a battle with cancer, failure to seek treatment, and an underlying mental health diagnosis, the compassionate nurse in me found its way out to ensure an empathetic and professional approach to caring for this patient. It was certainly not the patient’s choice to have the wound get to this level of infection, nor did they intend for this path to their ultimate demise. But due to lack of insight to the disease process and inability to process consequences the patient found themselves in this situation and I found myself learning how to flush maggots from a wound.

Although I can whole heartedly say that I do not ever want to complete this task again, done & done! I can say that having had this experience allowed me to get to know this patient on a different level than expected and it helped me understand that although resources are available to people, they might not have the capacity to utilize them. What we gave this person was comfort care; however, our interaction was brief, and it is unknown how they will navigate the system from this moment forward. I can only hope, that the care I gave in that moment was more than just flushing those creatures out of the wound.

(https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-4362.1999.00770.x)

Have you experienced and unusual treatment or procedure? I’d love to hear about your experience! Feel free to leave a comment!

fullsizeoutput_1e3c Trudi

(personal information of the patient, place, or time has been kept confidential to protect the patients privacy, no HIPPA/FIPPA laws are intentionally broken)
(some images are obtained from google, no copyright infringement intended)

Sight seeing in Colorado…

The first summer we lived in Colorado, we were so excited to start exploring that great state! Well, me anyway, as my boyfriend is from Colorado and as a child had the opportunity to explore this amazing state!

One day in mid-August, we packed up our camping gear and headed south to explore the south end of the state. First stop the sand dunes…huh?

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Designated a national monument in 1932 by president Hoover, the sand dunes are the largest in North America. Sand blown into the San Luis Valley from dried up lake beds covers approximately 30 sq miles with some dunes as high as 750 feet and it is estimated there is 5 billion cubic meters of sand! There is evidence of human habits in the area dating back over 11,000 years. It was certainly a wonder to see these huge sand dunes settled up next to the mountain. The day we visited a small stream was running through the park and during the Spring run off this stream resembles more of a river. The cool water of the stream was relief to our burning feet after we had walked through the sun soaked, heat packed grain of sand! What an amazing experience!

 

After we had explore the amazing wonder of the sand dunes, we continued south to find a camping spot near Durango. Originally a mining town, DuranDSC_1614go has developed into a quaint little tourist town, offering tourists a historic downtown area, amazing restaurants, shopping, and entertainment. The Durango/Silverton railroad is a heritage railway known worldwide for it’s steam-powered trains and scenic route. Although while there we did not ride the train, we did manage to wander through the streets of this cute town. We camped just outside of Durango near the trailhead of the Colorado Trail. Our camping spot allowed us to be in nature but close enough to explore the area.

When one finds themselves this far south in Colorado, of course it’s logical to make the trek to the Four Corners. The Four corners monument is the only location in the USA where 4 states meet; however, it is said that the monument that we stood on is actually not 100% accurate on the map and the true “four corners” are located somewhere else! After driving through some amazing scenic desert and navigating our way to the monument, you bet we stood on the spot and took a picture! The area this monument is located on Navajo land but 6 government agencies have jurisdiction at the point of the monument to include: Navajo Nation, Ute mountain Ute Tribe, Arizona, Colorado, New Mexico, and Utah. Although to stand on the monument was an occasion, the whole experience was mostly anti-climatic. Many of the local shops at the site were closed for the season, it was incredibly hot, and there was no other services located near by, even finding food was difficult.DSC_1571

As we headed back north, we detoured to visit the ruins of Mesa Verde. These cliff dwellings were seasonally occupied by nomadic Paleo-Indians who arrived in the area at around 9500 BCE.

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We found it interesting to venture around the structures and imagine the purpose of each building. Our guide informed us that much of the structures have been reconstructed over the recent years as theft and tourism contributed to the decline in the structures integrity and overall appearances. The tour was interesting and informative; however, I felt it somewhat limited due to group size and the availability of space on the paths. I enjoyed learning about the ancient peoples and found it amazing how they carved their dwelling so far up the cliff walls!

 

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Onward to Black Canyon! The last national park on our travels had an amazing drive into the canyon! Although only 12 miles of the 48 mile canyon are

 

located within the park, the park is home to the deepest and most dramatic section of the canyon. The canyon is named “Black Canyon” as parts of the gorge only get just over 30 minutes of sunlight per day. We enjoyed our day hiking around the rim of the canyon and took in the sites of the amazing views from each lookout point!

 

 

Although we did not capture any video footage of our travels, Here’s a photo compilation of our adventure!

 

fullsizeoutput_1e3c Trudi