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Thread: Stage IV wound

  1. #1

    Stage IV wound

    In July I went to the Dr., he sent me to a wound nurse to determine the extent of the Pressure Ulcers. It took four sessions of debriding to get all of the dead tissue. The wound is on my hip and turned out to be an oval shape 3.5” by 3” and 2.33” deep (exposing the bone) This is determined to be a stage IV wound.

    I have been confined to bed for the last 4 months. I have a vacuum pump, having the dressing changed three times a week. I am also required to use an air mattress that inflates in different places to allow for pressure relief. At this time I go to the wound clinic once a week and the county nurse comes for the other two dressing changes.

    I have made two trips to Iowa City Hospitals for reviews to receive flap surgery. My first trip to Iowa City in September, revealed no bone infection, but my protein levels were very low 2.5 Album. The surgeon told me I needed this level to be at least 3.5. My second appointment one month later my protein level had improved to 2.9. Still very low but improved enough for the surgeon to schedule a surgery January 4, 2011.

    My appetite has improved so I now eat well and am following the dietitian’s instructions and am eating at least 120 grams of protein a day. I am able to get in my wheel chair for 2 hours a day, to do my bath routine, and get food. It surprising how quickly 2 hours pass. My mood is I would say varies I have way too much time to think, which is dangerous for me. I try very hard not to play the poor me game and am doing well.

    I wanted to see if I am doing everything I can. To tell you the truth I have a very difficult time asking for help. I am sure it is why I got in this situation in the first place.
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  2. #2
    Senior Member lynnifer's Avatar
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    Did they test your iron levels ... reasons for non-healing (diabetes, thyroid)?

    It sounds like you're doing everything proper. I had incredible luck with the wound vac at first, then it plateaued ... I think you'll find if they use that after surgery, it will be like super-human healing. I thought it was!

    I asked to be on antibiotics before and after surgery.

    Chin up. It sucks to be where you're at ... can't do anything ... takes forever to heal .... bad thoughts start creeping in. You're not alone there!

    Hope you have something to keep you busy for the long hours in bed!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  3. #3
    Hi,
    It sounds like you are doing alot to ready yourself for the surgery. It is very common to have a low protein level with large sores and I commend you for improving your nutrition. a good protein level is needed for healing after surgery as well. Being in the best shape possible before surgery pays off after surgery.

    I understand your need to sit up daily for your quality of life and to do your care. Make sure you are on a good cushion for you and that you are doing pressure reliefs every 15 minutes, because the less pressure on your sore, the better. Also, start or continue a good exercise routine to get your lungs and muscles in good shape. Quit smoking if you do.

    Regarding your mood, keep up your social relationships and continue hobbies that you can do in bed, as you will unfortunately need to be on bedrest for an extended time after surgery.
    Search this site for further information on flap pre and post surgery information as well as getting the support you need.
    Good luck and keep us posted!

    AAD

  4. #4
    Senior Member lynnifer's Avatar
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    Correction: You won't need the wound vac after a flap surgery.

    ... what was I thinking?? ... still groggy from my sleep pills I guess ... lol
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  5. #5
    Thanks just had to ask. I am taking multi, vitamin, 300mg of C and an iron pill too. I doing so much I forget everything I am doing. I will do my best to keep you posted on my progress.
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  6. #6
    I am sorry to hear about your wound and wish all the best for your recovery. Just out of curiosity though, how did you get such a sore and how long did it take to get that bad? Pressure sores are near the top of the list of the worst things that can happen to an individual, IMO because of the length of time they take to heal and there's no way of knowing what's going on beneath the surface of the skin.

  7. #7
    Have you ever considered hyperbaric treatment? It helped heal a stage IV sore I had enough to allow for surgery. It's not overly pleasant and was time consuming but it worked well for me.

  8. #8
    Quote Originally Posted by doingtimeonmyass View Post
    I am sorry to hear about your wound and wish all the best for your recovery. Just out of curiosity though, how did you get such a sore and how long did it take to get that bad? Pressure sores are near the top of the list of the worst things that can happen to an individual, IMO because of the length of time they take to heal and there's no way of knowing what's going on beneath the surface of the skin.
    From what I can figure it happened during a transfer. I check myself everyday. The wound formed beneath the surface and by the time it made it to the surface this is what I ended up with. So I went 14 years without a pressure sore of this magnitude and all of my health care providers told me I must have been doing things right. Had a Dr. tell me these are not a matter of if they will happen but when.
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  9. #9
    Quote Originally Posted by orangejello View Post
    Have you ever considered hyperbaric treatment? It helped heal a stage IV sore I had enough to allow for surgery. It's not overly pleasant and was time consuming but it worked well for me.
    I do not have this type of treatment in my area or at least no one has told me of any way to receive it.
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  10. #10
    Quote Originally Posted by knowthill View Post
    From what I can figure it happened during a transfer. I check myself everyday. The wound formed beneath the surface and by the time it made it to the surface this is what I ended up with. So I went 14 years without a pressure sore of this magnitude and all of my health care providers told me I must have been doing things right. Had a Dr. tell me these are not a matter of if they will happen but when.
    Holy crap, that is scary. Did you slam your hip into something during the transfer? How long did it take to make its way to the surface after the alleged transfer that caused it?

    I've always thought deep pressure sores happen because of sitting on something too hard or too long or from a bruise. If only these things started from the outside in instead of vice versa.

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