BANDON - A certified ostomy and wound care nursing specialist, who is one of only a half dozen in Oregon and one of 4,000 in the world, is now working at Southern Coos Hospital & Health Center in Bandon.

Susan Johnson's field of expertise includes three subspecialties - wounds, ostomies (surgically created openings for the discharge of body waste) and incontinence.

Johnson said she began providing chronic wound care to patients about 10 years ago in Southern California because she saw a need. A chronic wound is one that doesn't heal within six months.

“Where I was working at the time, there really wasn't any nurse in the hospital that really understood how to take care of chronic wounds, so I became interested in the specialty,” she said. “I saw different kinds of chronic wounds, which were not being well managed.”

Some people might believe all that's needed for proper wound care is cleaning and applying or changing bandages to a laceration, but the 53-year-old nurse said it's not that simple.

“Wounds come from a variety of different causes and simple wounds that are taken care of right away tend to heal quickly. But then there are wounds that just don't heal,” she said. “It's like being a detective. You have to understand what kind of wound it is, because every wound is cared for differently.”

Johnson added that variables such as diabetes complicate the healing process, and that a person's age also can delay healing. Diabetes is the most common cause of chronic wounds and the medical community recognized a need for wound-care nurses because of that trend.

“The process begins with knowing the history the patient and what caused the wound,” she said of her specialty. “Then you could pretty much fix it.”

For example, if a patient has a wound on his leg and vascular testing reveals poor circulation, then treating the circulation problem also will hasten the healing process, Johnson explained.

Wound care has become more complicated, with thousands of wound-care products on the market.

“There are different types of gauze and topical ointments, which can be very confusing,” she said. “The key is determining what type wound is it, then understanding what kind of products are available and what they will or won't do for the patient.”

According to Marvin Heskett, Southern Coos' Specialty Clinic office manager, every facility should have a nurse with Johnson's qualifications for treating diabetic, burn or trauma wounds. Heskett added that patients with an ostomy need a specialist who will assist them with proper medical care, and with the maintenance of their medical products.

Johnson said her “second job” is to educate patients regarding ostomy, infection or cancer of the colon and then to assist them in choosing the best options to help lead a normal life.

“What's different in a smaller community is that there may be no support (after an ostomy),” she said. “It's a life-altering surgery. There's no getting around that.”

Johnson said that since the word has spread about her arrival at the clinic, a colostomy support group formed and meets on the second Tuesday of every month at the hospital.The third classification of Johnson's specialty certification - incontinence - is a hidden problem, due to patient embarrassment. It may be caused by a variety of reasons, some of which are not difficult to diagnose or treat.

“Stress, urge, diabetes, neural muscular injury or disease - all could cause incontinence,” she said. Sometimes it's easy to diagnose and fix, such as a bladder infection.”

“Patients are very embarrassed to talk about it, and some won't share it with their own physicians,” Johnson said. “It's probably the most under-diagnosed condition.”

She said treatment can consist of seeing a neurologist, proper exercise, medications and sometimes altering the diet.

With Johnson's presence now known to the medical community, doctors, clinics and hospitals from outlying areas are referring patients to her. She also has been accepted to an wound-care program at Columbia University.

Johnson is happy to be in the area. She said she loves the rivers, beaches and the ocean that the Oregon Coast offers its residents,

“I love Bandon.” she said. “People have treated me very well here, and I have patients tell me they are very happy I am here.”