Budget Buster - ER visits for an abcess - no vacation for us - UPDATE P4

[princess barbara]

So sorry about DS- hope he's not in pain. I used to work for the visiting nurses. Have your pediatrician call or fax a referral to a VNA ( or a wound care center )asking for a wound nurse to come to your home. The nurse will then work with your insurance company to order packing supplies, gloves etc. and teach you how to do it. Then the VNA will sometimes follow up maybe once a week or so to monitor progress. It all depends on insurance coverage. Sometimes the nurse may sign off on the case if the wound takes a while to close. But you should keep in communication with your pediatrician if there are any changes for the worse in the wound.

 

[Granny square]

I'm so sorry! How scary for your son!

Pick a date and start planning another trip!

 

[rszdtrvl]

I went in to his Pediatrician's office and talked to a nurse, rather than call again. He now has a 1pm appt. to get his packing material removed/changed and a new bandaid put on.

They did reiterate that they didn't have packing material (his Pediatrician told the nurse that he was not even sure if it needed packing material, but from everything that I have read it is necessary) and I said that I would hunt some down.

After going to every pharmacy in our city and a neighboring city, I found some, which I will bring to the appt.

A $20 copay is much easier to deal with than a $500+ ER bill, especially for something so simple as a wound pack and bandage.

 

[lovemygoofy]

I went in to his Pediatrician's office and talked to a nurse, rather than call again. He now has a 1pm appt. to get his packing material removed/changed and a new bandaid put on.

They did reiterate that they didn't have packing material (his Pediatrician told the nurse that he was not even sure if it needed packing material, but from everything that I have read it is necessary) and I said that I would hunt some down.

After going to every pharmacy in our city and a neighboring city, I found some, which I will bring to the appt.

A $20 copay is much easier to deal with than a $500+ ER bill, especially for something so simple as a wound pack and bandage.

I'm not sure what you are buying as packing material but, depending on the size of the open wound, you should be able to buy the gauze and tape at walmart or even just walgreens. The gauze comes in squares and in a square plastic container with pull back papertop. You can also purchase the tape there, silk or normal tape. You don't need "special" items for the repacking.

 

[rszdtrvl]

I'm not sure what you are buying as packing material but, depending on the size of the open wound, you should be able to buy the gauze and tape at walmart or even just walgreens. The gauze comes in squares and in a square plastic container with pull back papertop. You can also purchase the tape there, silk or normal tape. You don't need "special" items for the repacking.

There is specific gauze that is used for packing. It is a thin gauze - only one layer, and is different widths. The one he has now is 1/2" wide. It comes in a brown bottle, and is 5 yards long. I am sure regular gauze can be used if you are in a pinch, but since I found it, I prefer to use the specialty gauze. The entire bottle was only $7, and should last for the duration of the wound.

Like this :
http://www.amazon.com/Gauze-wound-p...&qid=1346954116&sr=8-2&keywords=packing+gauze

 

[Hannathy]

that acts as a drain by sucking the infection out, they will leave a tail of it sticking out of the wound. Unless the abscess was incredibly huge he won't need this done long (if the DR flushed it really well and he is taking his antibiotic.)

But Good job in being persistent! I'm glad it all worked out.

 

[lovemygoofy]

There is specific gauze that is used for packing. It is a thin gauze - only one layer, and is different widths. The one he has now is 1/2" wide. It comes in a brown bottle, and is 5 yards long. I am sure regular gauze can be used if you are in a pinch, but since I found it, I prefer to use the specialty gauze. The entire bottle was only $7, and should last for the duration of the wound.

Like this :
http://www.amazon.com/Gauze-wound-p...&qid=1346954116&sr=8-2&keywords=packing+gauze

Ahhh I understand now. My mom's wound was quite long and deep and I had to use thin squar gauze(think layering type stuff) and that was what I was picturing in my mind. Sorry about that

 

[buckirj1]

Happy it all worked out. I'm glad the li'l guys getting better.

 

[rszdtrvl]

Sorry about that

No problem! I had no clue such an item existed. And yup. It is packed in there with a little "tail" hanging out. I removed his old bandage and a bit started to come out - maybe an inch of it. I freaked out, but was told that it was okay as long as some of it was still inside his skin (most of it was still there, but I am so high strung I freaked out anyway).

 

[Hannathy]

Don't freak out! What they are going to do is pull that strip out, irrigate the wound and then take a hemostat or tweezers and simply push that gauze in loosely to fill the cavity leaving some hang out, then put a bandage over it.
Depending on the wound they may or may not irrigate it, they may just change the packing. It will only take them 5 minutes.

 

[robinb]

Since you don't have to go to the ER to have the wound packed is your trip back on?

 

[rszdtrvl]

Since you don't have to go to the ER to have the wound packed is your trip back on?

Maybe.......


I did some peeking at that Southwest Visa thing with the $69 annual fee and 50,000 points after you put $1,000 on the credit card.

I am sure we will have more than $1,000 in medical costs that can go on the card, and the cost for 3 tickets is 38,520 points, so........ It is a definite possibility. I am not sure if DH will go for it, but it will save us $875 (minus the $69 annual fee) on airfare. Hotel is not too expensive, and we plan on getting the S. California passes (which have Universal Studios & Disneyland park hoppers on them).

We were hoping to go in February, during school Intermission. Or if not then, during Spring Break.

 

[Bob NC]

What a great thread. Dissers just saved the OP a ton of money.

I nominate this for Thread of The Day!!

 

[Bob NC]

Maybe.......


I did some peeking at that Southwest Visa thing with the $69 annual fee and 50,000 points after you put $1,000 on the credit card.

I am sure we will have more than $1,000 in medical costs that can go on the card, and the cost for 3 tickets is 38,520 points, so........ It is a definite possibility. I am not sure if DH will go for it, but it will save us $875 (minus the $69 annual fee) on airfare. Hotel is not too expensive, and we plan on getting the S. California passes (which have Universal Studios & Disneyland park hoppers on them).

We were hoping to go in February, during school Intermission. Or if not then, during Spring Break.

I work with a guy who had some unexpected medical bills last month. He has a balance of $3500 at one hospital and $1400 at another.

Yesterday he called one of the hospitals to ask some questions about his bill. Without his even asking they offered him a 0% interest payment plan with extremely low monthly payments. Not a loan, unsecured credit directly with the hospital. He's going to pay it off but he was suprised that BOTH hospitals offered this.

 

[rszdtrvl]

His Pediatrician looked at the abcess and said it is healing very quickly, and does not need to be packed anymore. He said that constant opening and packing of the wound would slow down the healing, and that all he needs is a bandaid on it unless it starts to show infection.

Change the bandaid after showering, and all is good!

YAY! And all of the hunt for the packing gauze was in vain, I guess. Although I did leave it with the doctor and told him that if he could possibly use it, that was better than us taking it home (the container was still sealed).

DS is a happy camper that he does not have a huge mound of gauze inside his back and on his back!

 

[Hannathy]

That is great news! And you found out for a lot less than an ER visit.


If the package was sealed you could have taken it back.

I'm glad it is healing fast, I didn't think it would take long. Just make sure he keeps it very clean.

I'm glad you got good news I was wondering how it went this afternoon.

 

[cyndik1111]

!st- let me say I am SHOCKED at how this whole thing was handled! Shame on your doctor's office and shame on your ER. I am happy it all worked out for you, but it stinks you had to handle so much of the leg work yourself.

2nd-
Keep a close eye on the wound. Sometimes, if some of the abscess wall is still in place, the abscess can fill back up again. (over days/weeks)

I rarely pack abscesses anymore. I usually open the wound in such a way that allows drainage while it heals. But the key is to flush it daily.

When your son is in the shower, have him turn his neck into the stream of water and let the shower flush it for him. It is not ideal, but it might help.

If it is still tender in 2-3 days, it might need to be rechecked. After an abscess is drained correctly, the area is much less tender. If it is healing correctly, there should be very little pain. Pain suggests it is filling back up. Not a big deal, but would need to be flushed again.

Packing simply keeps the wound from closing up and filling back up with the drainage that would have followed the packing out of the wound. This allows the wound to heal from the bottom up. Otherwise it leaves a pocket to fill back up. Antibiotics don't necessarily help. They have a hard time getting from the blood stream to the actual abscess. I rarely put people on antibiotics anymore- unless the skin around the abscess is infected too (cellulitis) But finish all the antibiotics. Just don't be falsely fooled that the antibiotics will take care of anything left in the pocket.

So the take home message here is
1) watch the wound/look for pain
2) get a new doctor for your son. He should be ashamed of himself for saying he could't help in the 1st place. Abscess care is basic basic medicine, taught in the first months of medical school rotations. And if it wasn't your doctor's fault, the office staff needs to be retrained!

Good for you for being your son's advocate. Unfortunately, with the state of health care, a patient needs an advocate to keep on top of things.

 

[stitchlovestink]

!st- let me say I am SHOCKED at how this whole thing was handled! Shame on your doctor's office and shame on your ER. I am happy it all worked out for you, but it stinks you had to handle so much of the leg work yourself.

2nd-
Keep a close eye on the wound. Sometimes, if some of the abscess wall is still in place, the abscess can fill back up again. (over days/weeks)

I rarely pack abscesses anymore. I usually open the wound in such a way that allows drainage while it heals. But the key is to flush it daily.

When your son is in the shower, have him turn his neck into the stream of water and let the shower flush it for him. It is not ideal, but it might help.

If it is still tender in 2-3 days, it might need to be rechecked. After an abscess is drained correctly, the area is much less tender. If it is healing correctly, there should be very little pain. Pain suggests it is filling back up. Not a big deal, but would need to be flushed again.

Packing simply keeps the wound from closing up and filling back up with the drainage that would have followed the packing out of the wound. This allows the wound to heal from the bottom up. Otherwise it leaves a pocket to fill back up. Antibiotics don't necessarily help. They have a hard time getting from the blood stream to the actual abscess. I rarely put people on antibiotics anymore- unless the skin around the abscess is infected too (cellulitis) But finish all the antibiotics. Just don't be falsely fooled that the antibiotics will take care of anything left in the pocket.

So the take home message here is
1) watch the wound/look for pain
2) get a new doctor for your son. He should be ashamed of himself for saying he could't help in the 1st place. Abscess care is basic basic medicine, taught in the first months of medical school rotations. And if it wasn't your doctor's fault, the office staff needs to be retrained!

Good for you for being your son's advocate. Unfortunately, with the state of health care, a patient needs an advocate to keep on top of things.

I just saw this and must say it is awful! we had problems with our local ER when I took my DH there with what appeared to be an infection/abcess. They immediately tossed him on heavy duty IV antibiotics and marked his leg for growth and admitted him. We requested a culture and biopsy and the only thing that was done was a culture for mrsa. he was treated for over 48hrs w/ heavy IV antibiotics and it continued to grow outside of the marrkings on his leg and we kept asking for a biopsy and were told it wasnt needed. Long story short and I'm leaving out TONS of details!! they finally did emergency surgery on his leg on a Sunday morning to remove the bacteria and left him with a gaping huge hole in his leg!!! Luckily a friend of ours was friends with someone who worked with wound vacs! That thing was a LIFE SAVER!!! DH had to wear it for 6 weeks but who knows how long it would've taken for that wound to close without the vac?! The vac definitely made the procee MUCH faster!!! But not once did the surgeon recommend it. He did sign off once the friend went in, and said yeah this is probably a good idea to make things faster for him! Yeah, thanks Doc!!


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[LauraR]

I just saw this and must say it is awful! we had problems with our local ER when I took my DH there with what appeared to be an infection/abcess. They immediately tossed him on heavy duty IV antibiotics and marked his leg for growth and admitted him. We requested a culture and biopsy and the only thing that was done was a culture for mrsa. he was treated for over 48hrs w/ heavy IV antibiotics and it continued to grow outside of the marrkings on his leg and we kept asking for a biopsy and were told it wasnt needed. Long story short and I'm leaving out TONS of details!! they finally did emergency surgery on his leg on a Sunday morning to remove the bacteria and left him with a gaping huge hole in his leg!!! Luckily a friend of ours was friends with someone who worked with wound vacs! That thing was a LIFE SAVER!!! DH had to wear it for 6 weeks but who knows how long it would've taken for that wound to close without the vac?! The vac definitely made the procee MUCH faster!!! But not once did the surgeon recommend it. He did sign off once the friend went in, and said yeah this is probably a good idea to make things faster for him! Yeah, thanks Doc!!


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Wow, OP's story and this story really illustrate how dysfunctional our health care system is. You see so many complaints from hospitals about being flooded with patients who could have their needs met elsewhere. Well, duh-oh, if you don't direct people to where they can find the appropriate treatment, like OP wasn't, then you create your own problem! It's ridiculous that patients have to become health care experts to avoid exorbitant costs and learn how to navigate the system. I just read an article in Money magazine about how medicare will cover rehab costs for patients who have been admitted to the hospital for 2 or 3 days, but many senior citizens have ended up having to pay for rehab themselves (thousands of dollars) because hospitals had them marked as "under observation" instead of "admitted"! This is for serious injuries like a broken pelvis.
Just glad to hear OP's son is healing fast!

 

[rszdtrvl]

I don't think the issue was his doctor, but his staff.

When I called, the receptionist talked to a nurse and then she told me that they don't do that.

A couple of days later, when I actually went in to the office, I talked to a nurse, who then talked to the doctor (I could hear her conversation with the doctor) and then came back to me. I could hear the doctor say that most of the time in that frame they don't need to be packed anymore, and that he wants to see the wound.

That is what should have happened when I called. I was getting a brush-off, I am aware of that now. When I called the first time though, I was still kind of in shock and not thinking clearly.

The good thing is that he is healing.

The wound looks disgusting, but I can see it is healing. It is nice and open, still draining, and does not look infected. My son does not have any pain - he said maybe a 2 on a scale of 1-10, and does not want any pain medication (Ibuprofen - the ER prescribed Oxycodone which we did use a few of right after the procedure). The doctor said to take his bandaid off this weekend and let the air hit the wound - let it drain naturally, either while he is sitting up or laying on his stomach. He does want us to keep it covered in the shower and to keep it dry though.

DS is in awesome spirits and is such a trooper! I am really proud of his maturity in this situation. He is turning into a wonderful young man (he will be 16 in December).

Again, thanks everyone for your advice. In times like these, it is good to have a lot of people thinking for you, LOL. I really appreciate your thoughtfulness and well wishes!