15. The first thing that hit me was the smell. It was like a sour mixture of week-long decaying roadkill and molten diarrhea after a Taco Bell binge.
“I had a patient who weighed in close to 600 lbs when they first visited my floor due to a fall. This hefty mass of flabby flesh returned weeks after their initial visit but had lost almost 200 pounds. Most people would think that’s great, but it’s not so great when the weight loss is due to dead tissue and malnourishment.
Not only was this patient a pain in the ass (and back) to turn, but they were also a contact precaution for unknown organisms and MRSA. So we had to wear a personal sauna kit that featured a plastic gown and a mask. The mask wasn’t required but was completely necessary.
Back to the reason for this story. Anyone who has medical background knows that pressure ulcers can turn into vile pits of doom. Well, this patient had far too many to count. The worst was on their sacrum, requiring the patient to be turned completely to their side. This required multiple people, as they were intubated and sedated. This wound progressively got worse through their stay of a week before passing. The last time I changed the dressing is what I’ll describe.
The first thing that hit me was the smell. It was like a sour mixture of week-long decaying roadkill and molten diarrhea after a Taco Bell binge. After removing the previous packing, you could see that the wound had become completely desolate of healthy tissue. In the coming moments, I contemplated my life and if I was coming back the next day.
When taking care of a large pressure ulcer, you have to pack the wound with dressings. This can usually be done with a long Q-tip. However, this was no ordinary ulcer. This was the ulcer that had a portal to the seven layers of hell. The wound had tunneled deep into the patient’s back, both upward and inward. While sticking my entire hand into this pit of despair, I had a brief moment of horror where I imagined my glove ripping and being exposed to the half-liquid/half-solid tissue inside. Luckily that didn’t happen, although another twisted event happened in its place.
As I reached deeper inside this person’s back, I started to feel something more rigid that the previously sloughy tissue. My eyes widened and I let out a small groan as my hand pressed against the hard spine of this patient. Yes, this ulcer had become so bad that it made its way through almost 6” of fat and muscle. I’ve seen it plenty of times in other areas of the body, but I don’t think I’ll ever forget the feeling of my hand sliding over each disk. Thinking back I probably could have grabbed the spine like a mortal combat finishing move but fuck that nonsense, I wanted out of the situation.”
