Cath Lab Digest

U ntil recently, my life was filled with endless pain and suffering. A chronic vascular insufficiency has kept me on a long, difficult path paved with the grisly and somewhat gruesome consequences of recurring stasis ulcers. Although my 30-year struggle has a somewhat happy ending, the healthcare industry needs to be more aware of patients like me and do a better job of providing the clinical and financial support necessary for our care.

My story begins when I was 16 years old. I had a severe reaction to prescription sulfa medicine that resulted in a 30-day hospital stay. After vigorous physical therapy, I was released, seemingly fully recovered. However, my good health was short-lived - several months later, I was bitten on the ankle by a fire ant. This bite caused my first stasis ulcer and the first acknowledgment that my vascular system was impaired.

Over the last 30 years, I have experienced a multitude of treatments and complications. I have taken coumadin, endured multiple blood clots, and been hospitalized for deep vein thrombosis. Several failed skin grafts were followed by 6 months of bed rest and 2 years in a wheelchair - all unsuccessful attempts to heal my ulcers. I have been treated at two wound care centers that involved trips to Shanes Hospital and Salt Lake City Teaching Hospital. I have undergone 8 weeks of daily IV antibiotic drips for staph infections, hyperbaric treatments, and countless prescription salves and balms. Home remedies were tried as well... to no avail.

The most painful treatment involved the Unna boot. I used this device for 12 months. The drawing effect of the Unna boots caused a painful burning from the wound site that radiated all the way up to my groin. This pain remained with me 24-7 - my only relief came when the device was changed. Each new application of the device started the whole painful burning process over again.

One frequently used treatment I grew to fear was the painful process of invasive surgical debridement. Caregivers would scrape my wound without using any topical or analgesic pain relief. My advice to clinicians: The next time you tell a patient, "This will only hurt a little," I suggest that you tell the truth. It hurts a lot. Imagine the feeling of someone using an instrument to scrape inside a painful open wound. Each pass of the instrument would grate at every exposed, vulnerable nerve ending. The excruciating pain caused by this procedure can last up to 6 hours after the treatment. My heart goes out to the many elderly men and women I witnessed over the years struggling to endure some of these same painful treatments.

Another menacing treatment for me was the zipper pressure stocking. The swelling in my legs caused the stocking to tighten around my calves like a vice grip and the metal zipper would become embedded into the sensitive flesh on the back of my legs. I sometimes wonder if the quality of my life was improved as intended when the treatments I withstood were far more painful than my wounds.

Because I lacked medical insurance throughout most of my treatments, insufficient financial resources, time spent on treatment, and the pain associated with these treatments created a variety of difficulties in my job and life. At one point, going for a walk with my daughter was a daunting task. Trying to maintain a job as a florist required me to stand for long periods of time. I once was fired for coming to work using crutches. Trust me, interviewing on crutches doesn't create a great first impression. During one of the lowest points in my life, I wasn't able to work, and my daughter and I had to move in with my parents for several years until I, literally, got back on my feet.