Wounds and Healing

My son had a pilonidal cyst on his gluteal cleft. In plain English, that means he had an abscess on his butt crack. The abscess wasn’t his fault; it resulted from a defect in his skin—it overlaps in his cleft, making it susceptible to infections of the hair follicle sweat glands. In the past six months he has had three infections.  After the second one, we were referred to the UNC pediatric surgery clinic. The doctor there recommended we wait to see if the problem would not reoccur.

Well, at the end of the summer, the cyst came back.  So, back to the doctor and this time he recommended surgery.  He mentioned sort of off handedly that the surgery would leave an open wound and that we would need to pack it until it healed. I didn’t think anything of it. It would be no big deal.

The day of surgery arrived—October 18. I got up early with Alex and we headed down to the hospital. Alex was in good spirits and I took a photo of him in his surgery attire. Then they wheeled him away.  Two hours later he was back, groggy but aware enough to tell me the riddle he told the surgery team (or started to tell the team but went to sleep halfway through). The riddle goes: How far into the woods can you run? The answer: Halfway, after that you are running out of the woods.  Shawn and I took turns hanging out with Alex at the hospital, with Shawn staying with him overnight.

Saturday morning Alex was home. Before discharging him, the pediatric surgical resident showed Shawn how to dress the wound and sent him home with some supplies and written instructions.  We were to change the dressing for the first time that evening. That is when I got my first look at the wound.

I was shocked. It was much bigger than I had thought it would be—about two inches long and over an inch deep. It was huge. My first thought was: how is this ever going to heal and how can we do this?  Of course, we didn’t have much choice. There was no going back; the surgery was over and now we had to care for this wound or it would become infected and he’d have to have another surgery.  We were deep into the woods now. Our only option was to go forward.

We gloved up and read the instructions.  The first step, remove the old dressing and inspect the wound.  We were told that we needed to check the wound at least twice a day for signs of infection (that would be red swollen tissue and pus and a bad smell). If we saw signs of infection we were to call the doctor immediately or bring him down to the clinic.

The second step was to wash the wound with normal saline. Normal saline is the medical term for sterile salt water that is exactly the same saltiness as our bodily fluids, like blood and tears.  The saline needs to be sterile, purified of all contaminants.  We used prefilled syringes of normal saline and spurted a stream of it into the wound, letting it wash away excess blood and gunk that had built up.  It used to be that doctors would recommended other fluids to wash wounds, things like hydrogen peroxide or rubbing alcohol. But medical science has come to recognize that it is more important to keep the wound clean and let the body heal itself than introduce harsh fluids to the area.  Hydrogen peroxide and rubbing alcohol do more damage than good. 

The third step was to repack the wound. We were to take a piece of gauze, wet it with normal saline and gently pack the wound. The important thing was to insure that the two sides of his wound did not close before the wound could heal.  It has to stay open—vulnerable.  It needed to heal from the inside out. If it closed before that happened, it would fester and become re-infected. Alex would have to have another surgery and we would have to start all over again.

The final step was to dress the wound. This means taking a clean square of gauze, rolling it up and taping it into place over the packed open wound. The purpose of the dressing was to soak up any blood or fluids that might leak out of the wound as well as to protect it.  This was the easiest part, although after we ran out of tape from the hospital we used some tape that was too harsh on the skin and needed to find better tape.

Over the course of the past two weeks we have changed Alex's dressing at least twice a day. It has given me opportunity to meditate not only on this wound and how it’s healing, but on other kinds of wounds—those seen and those unseen, physical and emotional and spiritual wounds that many of us have suffered during the course of our lives. Here are some of my thoughts on wounds.

Know Your Wound and Get Help.

It matters what kind of wound you have and you may need an expert healer to help you understand your wound and teach you the proper way to care for your wound.  With Alex’s wound, I was beyond my first aid training. Looking at the gaping hole in his backside left me feeling powerless and adrift.  Without the doctor’s instructions and the two phone calls I made to the pediatric surgical resident on call for clarification, I would have floundered and Alex’s wound would not be doing as well.  I took their instructions on faith, hoping that the doctors knew what they were talking about. While it is true that some injuries and wounds can be sutured up and heal quickly, this was not the case in this instance. 

 We need to triage our emotional and spiritual wounds as well. This may include going to an ecclesiastical leader or seeking counseling from a mental healthcare professional, someone expert enough to know what kind of wound we have and what course of healing we need to take. Of course, the ultimate healer is God. I cannot say how many times I have turned to God in fervent prayer seeking help for an injury to my spirit, or prayers seeking aid for a loved one who was wounded in some way. 

With our daughter Arianna we sought help from all three—our bishop, therapists and God. Just like when I saw Alex’s wound for the first time, at first I felt overwhelmed by the size and scope of her injury. And I thought, how can this ever heal?  But it did. So many people reached out to us, helped us and helped Arianna come to understand her wound and helped her heal from the inside out. Prayers were heard, blessing were given and received.  There were days I prayed all day and night for help. Help came.

Inspect

 The first step in wound care is to inspect it regularly for signs of trouble. Wounds can make us vulnerable to other problems and we need to be watchful while we heal for those signs.  Watchfulness is important—not only of ourselves but also for those we stand in stewardship over.  If we are watchful we can call for help before things get much worse. 

It is easy in this era of smart phones and social media distractions to forget to take the time needed to be watchful. We seem to have forgotten what it means to closely inspect ourselves and those in our care.  It’s easy to get caught up in work or school or our social lives and forget to really look at ourselves, to see if there is something festering away inside of us.  These past two weeks have helped me realize that I need to make time for introspection and self-examination.

Cleaning the Wound Daily

I find it interesting that the liquid recommended for cleansing wounds is normal saline—the same fluid as tears. In many ways, I believe our tears are healing.  We need not be afraid to cry, to allow ourselves to let the tears flow.  Normal saline also has the same saltiness as blood. And it must be pure, without impurities.  

I believe the atoning power of Jesus Christ is the normal saline of our spiritual healing. Jesus is the great healer. With his blood willing shed for us, we can be healed of even the deepest wounds. Because he suffered he understands our suffering and pain. It’s the great miracle of the condescension of God, to come to earth and live with us and suffer like us.  In this way Christ matches our saltiness. And he is pure—the only pure one.   As Isaiah said, “with his stripes we are healed.”  Revelation 1:5 makes more sense to me now. "Unto him that loved us, and washed us from our sins in his own blood." 

Remaining Vulnerable

Sometimes, to heal properly, we need to keep a wound open. That seems counterintuitive.  Our instinct is to close it up and slap a bandage on it and hope it goes away.  That is often the case with superficial cuts and clean incisions.  We can stop the bleeding, clean the wound, slap on a bandage and it will better in a few days. 

Then there are other types of wounds, wounds that go deep, that have been caused by infection.  They could be like Alex’s wound, caused by cutting out an abscess. Or they could be the infection caused by years of suffering in an abusive relationship, or addictions that have infected our minds and imprisoned our spirits. These take time and extended care. These need us to open up and become vulnerable.

With Alex’s wound, we keep it open by packing it with gauze we have wetted with normal saline. This way, the edges of the wound stay open but in a way that promotes natural healing.  And in many ways I have found this a perfect metaphor for how remaining open and vulnerable promotes healing of our emotional and spiritual wounds. 

When we sent our daughter away to wilderness therapy, we also began family therapy sessions. My husband and I would go every Thursday to the Duke Family Studies Center to meet with a therapist and talk about the wounds in our lives.  By learning to open up to each other and to our daughter, we were able to heal the breach in our relationship and become a much closer and loving family. We also sought out loving friends and family for emotional support. They allowed us to share our fears and anguish with them.  These friends helped us tremendously.

Protect

The last step in our instructions was to dress the wound—to protect it.  Although remaining open and vulnerable is important to healing, it is also important that you protect the wound from further damage and prevent debris from entering.  That is true of our invisible wounds as well.

With Arianna, we made deliberate choices to not share or open up to everyone we knew. I have family members who we felt would not be helpful. We sent our daughter to the wilderness and then to a therapeutic boarding school and cut off all communication with her ex-boyfriend’s family to give her and us a protected space to heal. We protected ourselves by giving ourselves time and space away from old stressors.

It is really important that we don’t minimize this last step. We could follow with exactness the previous instructions, but if we don’t protect the wound while it is open it will get infected again. And we don’t need to apologize for taking action to protect ourselves and those we love from people and places that are harmful to us, even if those people then accuse us of not being good Christians. Believe it or not, I have had that accusation thrown at me. It didn’t give me a moment’s concern because I knew I was doing what I needed to help myself and my family heal.

Patience

The last thing I have learned (so far) is patience.  It takes time for deep wounds to heal. And during that time we need patience to deal with the pain and frustration that often accompanies feeling out of sorts. Alex has had his grumpy moments these past two weeks.  At times not only has he had a pain in his butt, but he was one. In our world of instant messaging and instant video, we often want our healing to be quick and painless. 

It is not.

It took our daughter months for her to gain the insights she needed. It has taken me years to learn some of the important lessons God wanted to teach me, lessons that came as the result of healing deep wounds I received as a child.

In Conclusion

In those first moments, when we finally get a grasp of the extent of our wounds we can feel discouraged and hopeless.  We might feel the way I felt looking at the hole in my son—how can this ever be healed? And yet, I believe with every fiber of my being that we can be healed and made whole.

For me, the great source of healing is my faith in Jesus Christ, as I have mentioned above. There is a scripture found in the Book of Mormon that relates to how Jesus Christ heals us.  In these verses the prophet Alma relates a vision he has had of the Savior and his atonement.  He says:

And he shall go forth, suffering pains and afflictions and temptations of every kind; and this that the word might be fulfilled which saith he will take upon him the pains and the sicknesses of his people. And he will take upon him death, that he may loose the bands of death which bind his people; and he will take upon him their infirmities, that his bowels may be filled with mercy. . . that he may know according to the flesh how to succor his people. (Alma 7:11-12).

To those who do not share this faith, I would say there is still cause for hope. Find help.  Seek out people who have been through similar experiences.  Seek out professional help that is caring and will help you learn how to care for your wound and create a healing environment. Protect yourself and your loved ones from those influences and people who would harm you. And remain open to the healing power God has given each of us.