Update on Emily (pic below)

About a month ago, I decided to take Emily to the Wound Care Clinic at LDS Hospital. The ulceration just wasn't healing, it got infected again, and just generally looked nasty. Why LDS? Well, I called Primary Children's and all I got was the voicemail of someone who said they were the Wound Care Nurse. I Googled Wound Care and found that Lakeview in Bountiful and LDS had wound care clinics (as well as other hospitals).

Emily has now been seen at the clinic three times. I LOVE the people who work there... They are so nice. The first time we saw an APRN and the other two times we saw the physician that oversees the clinic. The first time we were given an oil based dressing to debride the ulceration. The next week they said they were going to debride it but decided to use silver nitrate on it instead. The ulceration is SO wide... The doctor's thinking was that it just didn't have the layer of cells that it needed to start forming new skin.

Anyway, the picture below was after the first silver nitrate treatment. It kind of looked like a big brown scab after he was done. We numbed the ulceration really well (I held gauze with Lidocaine on it for about 30 minutes) and then the silver nitrate was applied with a Q Tip. We were to continue using the oil based dressing. The first day after the nitrate was wonderful. She didn't cry at all during her bath or dressing change (I think because it wasn't open to air). Then the next day, there was a lot of discharge and most of the scab came off. We were pretty much back to square one.

Yesterday we went back to the clinic again. The MD did the silver nitrate again (which hurt a little more this time). We are now going to try going back to using the Biafene and then a foam hydrocolloid dressing over it.

Another challenge has come up... Emily is so sensitive to every tape we use. This last week we were using paper tape which is the least irritating of them all. You can see in the picture the redness on her skin where the tape was... We are using a skin prep before the tape but it hasn't really made any difference - her skin is even starting to break down in some area. Arghh... Yesterday instead of tape the doctor cut some holes in a stocking-like thing and put it over her like a shirt. It seemed to work okay but we will have to do some adjusting with where the arm holes go.

We are supposed to see Dr. Vanderhooft again a week from Monday. The last time we saw her (3 weeks ago), she was getting pre-approval to do the pulse dye laser on the ulceration. This somehow usually helps the ulceration heal really quickly. It is REALLY expensive, however, so they have to get the go-ahead from the insurance beforehand.


I called our insurance yesterday and they okayed one treatment. YEAH!!! Dr. Vanderhooft said that she normally does laser treatments on Wednesdays at the U, so hopefully we can do it this week. The laser treatment is not a guarantee - it can possibly make the ulceration worse. However, at this point, we're willing to try it. The ulceration is so big and now SO deep.


Emily is also now cutting her first tooth(we saw the top of it). Between the tooth and the sore, the poor little girl is pretty fussy. Thank heavens for Tylenol.