Wound Clinic Patient Makes Great Strides with D-H Care
When Diane Cochran was admitted to Northeastern Vermont Regional Hospital because of a mini-stroke she suffered at work, doctors noticed bandages on her feet and asked her what they were for. When she told them, they referred her to Dartmouth-Hitchcock's (D-H) Neurology Department and Alfred Barber, MD, to establish primary care. Dr. Barber immediately referred her to Dartmouth-Hitchcock Medical Center's (DHMC) Comprehensive Wound Healing Center.
That was in February 2014. Ever since, Cochran has dutifully been coming to the Comprehensive Wound Healing Center two to three times a week to treat her venous stasis ulcers.
The Comprehensive Wound Healing Center, established in November 2013, is an outpatient clinic located at DHMC, staffed by a specially trained team of physicians, nurse practitioners, physical therapists and certified wound care nurses. The Comprehensive Wound Healing Center offers specialized treatment of chronic and complex wounds by using the latest evidence-based clinical practice guidelines and best practice care pathways.
Lower extremity venous disease or venous stasis is the dysfunction in the valve pumping the fluid back up to the heart, causing pooling of fluid in legs, leading to edema/swelling, which leads to breaks in the skin/wounds.
"Venous stasis is when you have insufficient veins and incompetent valves in your legs. I started out with phlebitis – inflammation of the veins – and in 1987 I stopped having that and in 1992 I had my first ulcer on my foot," Cochran says. "The ulcers would look like swelling and redness and then break open into a sore.
"It's been about 20 years I've been bothered with ulcers and I've tried all different treatments. I did whirlpool therapy and oxygen therapy, kept my wounds wrapped – the whole bit – and then my insurance company refused to pay for the topical hyperbaric oxygen treatments, so I just stopped going to the doctor and continued to dress the wounds myself (wet to dry dressings using saline-moistened gauze over the wounds) for 12 years, until my mini-stroke forced me to do something about it," Cochran says.
Before being treated at the Comprehensive Wound Healing Center, Cochran says it was painful to walk, and she had to take 12 pain relievers a day. When she first arrived at the clinic, she had to be pushed in a wheelchair.
Today, Cochran says she can walk around with no problem, doesn't need to take any pain relievers and rides up to 10 miles a day on her stationary bike.
Since her time at the Comprehensive Wound Healing Center, one of Cochran's wounds has had a 98 percent reduction in surface area, and her other wound has had an 89 percent reduction.
"It's amazing the difference in how she gets around now," Meghan Hill, RN, BSN, CWCN, says.
Cochran travels an hour-and-a-half from Walden, Vermont, twice a week for her appointments with Hill.
"I don't think I've ever missed an appointment. If it's bad weather sometimes the doctors will say, ‘It's OK Diane, you can stay home and come tomorrow,' but I'm always here. I have a list of people who I can call to bring me here," she says. "I'm committed to this. I can't see stopping. I enjoy taking notes and tracking my care. I keep notes of everything we do. When you go through something like this for such a long time, you kind of need that to make sure you're doing everything correctly.
"My care is wonderful here. I like everybody, everybody is knowledgeable. I've had Meghan the longest, and I like that I can have her all the time. She knows my wounds, she knows when something is different – she puts up with me," Cochran says.
"Diane's like our family now," Hill adds. "She's pretty special."