ok, so I'm not a doctor … but for an long as i was in the ICU and as many nurses as i ran through, I don't think I'm too far off by calling myself somewhat of a 'burn expert'.
here's what i like to think of as the 4-step process for burns:
Step 1: 'The Thick White Gooey Layer' (aka Eschar)
This is the layer you see in a lot of my early photos. It's basically dead skin that's piling up on top of you're healthy skin, and will eventually either peel or kind of just disintegrate off… in the doctor's opinion the faster the better! I actually still have a couple areas that have a tiny bit of eschar (pronounced: 's'-char) left, and not real thrilled about it seeing how i have a check-in at the hospital tomorrow. You can't force it off either. It just comes off when it's ready.
In fact, it's when these areas don't come off after about 10-14 days that the doctor's really begin to lean towards skin grafting. At the 10 day mark i had a few small areas of eschar left, but decided to take my chances and attempt to nurse my skin back to health on it's own by forgoing surgery/grafting for the moment. Initially when I was admitted to the ICU they wanted to graft my entire stomach, thigh, and part of my hand - but miraculously within 10 days I was down to just a few small concerning areas. The doctor's had very mixed opinions on me forgoing surgery, but I felt strongly about the fact I'm young, healthy, and active... and seeing how far my skin had come over the first 10 days I wanted to give it a bit more time. If it turns out that within a couple more weeks my remaining skin isn't coming back on it's own I'll revisit the idea then.
Step 2: 'Little Bumpy Patches' (aka Budding)
You can see this pretty clearly in a lot of my photos.. the little pink/red bumpy clusters. It's a great sign, it means the eschar has gone, and your hair follicles & nerve endings are coming back in … hooray! It's exciting and painful at the same time. Seeing how your nerve endings are exposed taking showers and changing bandages can be less than pleasant. Oh, and sleeping… yea, sleeping blows. But in the end it means you're on your way to new skin, which makes the doctors, nurses, and myself very pleased. Yay for little buds!
Step 3: 'Smooth Pink Skin'
At this point, your wounds are closed, there's no more bleeding or sloughing of tissue, and you're just left with discolored pink/red/purple skin. It's great because you don't hurt for the most part any more, the pain is behind you, but it sucks because now things turn into a bit of a waiting game. It could take anywhere from 8 months to a year for your skin to go back to 'normal' or as normal as it's ever going to get. You'll see a lot of my stomach is at this point now. In fact, I don't even have to cover those areas on my stomach or my hand with bandages any more. I just use Lubriderm on my hand and ointment on my stomach. Once all the other areas catch up (hopefully the next week or two), I'll just be using Lubriderm/cocoa butter for the next few months multiple times a day to keep the areas moisturized. Moisture is key to healthy new skin, and minimal scarring.
Step 4: 'Normal Skin'
I suppose I shouldn't use the term 'normal', like… what does normal even really mean? But, essentially this last phase is when your skin reaches it's peak of healing. Typically doctors say it takes 1 full year for you to recover from a burn of this nature, which also means no sun for me this summer (moment of silence for all the exotic caribbean vacations i had planned) *le sigh*.
As of right now my skin is mostly a mix of step 2 & 3, with just a bit of step 1 still lingering.
Hope this helps you decipher my photos, as well as helps anyone going through something similar prepare for what's to come. The nurses really didn't lay this process out for me so clearly, and I wish someone would have. Live & learn.
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