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Thread: pressure/bed sore healing facility recommendation in nj??..

  1. #1
    Member juras's Avatar
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    pressure/bed sore healing facility recommendation in nj??..

    greetings,

    my first post here...c5-c7 quad since april 1990, 44 y/o male ...living in bergen county, nj...
    i'm hoping to get a recommendation here based on experience for a good place in northeastern nj area to treat a nasty pressure sore...below is the history in more detail...

    i've been quite lucky for the first 20 years of my crippledom to avoid pressure/bed sores...i've healed very well and fast but it seems that i've now crested that quad age apex and my healing ability is suddenly in the pits...
    around early spring of 2010 i noticed a very small [about 2mm diameter] round pressure wound on my left hip; directly above the hip bone...
    as i've done so usually in such cases, i've slapped a band aid on it with a dab of antibiotic cream but this time instead of healing it kept slowly getting larger...

    within about a month since i've noticed it, it grew to something like 5-7mm [i'm using metric units since that's what hospitals use in their evaluation/treatment process] and so i've had my mother, who lives near my apartment and is my health aide as well, wash it with hydrogen peroxide [i now know, a crappy idea], and cover it with antibiotic cream and a larger band-aid type of plaster which has a hypoallergenic adhesive [my skin's become intensely vulnerable to adhesives over the past few years] on daily basis for a time...
    the wound kept on growing slowly but steadily through out the summer however...when its diameter got to somewhat close to a quarter coin size, i've decided that it's finally time to get professional help...in late september '10 i've notified my physician about the sore and asked for any recommendation on a facility to treat it and which accepts medicare/medicaid ...he recommended 'wound healing center' at englewood hospital [nj]...
    i was evaluated therein and diagnosed with a deep, stage 4 pressure ulcer which requires immediate, intense treatment...

    i was thus started on a dressing change regimen 3x/week by their visiting nurse service and 2 -3 weeks control visits at the center...
    after 2 such surgeon eval appointments at the hospital, it was obvious that the wound's deteriorating, therefore i was started on a 'vac' 'suction/negative pressure' device [changes of dressing/hook-up every other day] and my regular mattress was replaced with an air mattress...there were a couple of issues with a few particular nurses who weren't exatly properly trained in changing the dressings/vac device but it is now rather clear that the vac device wasn't working for my wound...its rental is quite costly [around 6 grand/month including the supplies/nursing services] and i suppose that about 6 months into the treatment, medicare insisted that due to the vac's inability to heal my wound, an alternative treatment should be seeked...at this point my wound was quite extensive in size but most importantly, the tunneling/undermining underneath the wound edges is rather deep...my bone/muscle is exposed via wound and in the beginning of may, i was taken off the vac device...

    since then, i'm on a daily [daily due to of excessive drainage] regimen oof dressing changes of varying materials every once in a while...currently it's 'hydrofera blue' to directly pack the wound with, on top of that goes something sponge-like called 'optilock' [just previously to that it was 'biatain' sponge], on top of this a gauze-like pad is applied to cover/cushion the dressing and everything is secured with a 'tagaderm' clear adhesive sheet directly over it...

    i'm not having a good rapport with the surgeon at the facility and although he told me that he recommends a 'flap' surgery, i'm in a treatment limbo of some kind and no action's being taken apart from the daily dressing changes despite what he recommended..he has a sizable ego and we don't get along too well [actually that's an understatement hehe] because i don't like to be belittled and treated like an ignoramus if i haven't given one a reason for that...regardless of who i might be dealing with...
    at first i was told that unless i'll quit smoking, the surgery's out of question because the surgeon won't take a chance on operating on me if my nicotine habit endangers the healing process [nicotine constricts the blood vessels]...i replied that i'll do my best to quit - and i'm still trying my best but unsuccessfully thus far - but i've started to have immediate reservations about this demand...i remember, relatively not so long ago, when doctors actually smoked in their offices...now i'm literally being blackmailed with my habit by a physician [who apparently had to take the hypocratic oath no less] when my health status is in serious need of treatment and that sounds like bulls..t to me; after all smoking IS still legal despite its opponents best efforts to the contrary...i could understand such behavior better if i was a heroin/crack addict [have history of both in my past but successfully quit both on my own btw] because those substances are illegal but smoking isn't...
    now, i've been told that i should make a commitment to pay a symbolic fee of $5-10/month to show my good faith to the surgeon and he'll then likely do the surgery...wtf??!!..he makes AT LEAST a quarter mil annually yet i should show my good faith with a $5/month 'fee'?..i'd do this of course because despite living on meager less than $700/month disability, health's most important but frankly,i don''t want a surgeon operating on me who's trying to humiliate my integrity...what's his interest in my health improving, i have to ask when faced with such attitude...

    yesterday, i was supposed to see a new plastic surgeon for my wound evaluation but after showing up, he apparently called in from operating room to cancel all his appointments for the day thus i had a nurse there change my dressing but without seeing a physician...my next appointment is in 2 weeks...
    at this point, due to such an extensive period [over 6 months] spent primarily in bed with the vac device, my hips, legs and torso have becoome significantly deformed and my posture has altered dramatically; affecting just about everything else such as digestion, bowel evacuation ability, etc, etc...it's very difficult for me now to sit in my wheelchair, and i'm very crooked when i do, my spasms are out of control [driving is wstarting to become hazardous and taking showers while sitting on the bench is an exercise in fear of flying off it due to constant violent spasms and wild flailing of my legs] due to the - seemingly permanent - shrinkage of my left leg's tendons and i'm no longer able to straighten my leg out...i'm quite literally sinking into a major depression because i can now see that unless thiis wound shall be healed soon, and then i could undergo significant rehab for stretching back my leg/tendons to their previous status quo, i shall no longer be able to even sit in my wheelchair within year's time or less...this, even notwithstanding my ability to drive, shower, etc...

    yesterday, while at the 'wound healing center', i've privately asked a friendly nurse there who's always very emphatic and genuinely concerned about my wound, whether she thinks that i should start seeking another treatment facility and she replied that she wanted to quietly suggest that very thing to me before i've left...

    here i am then, if anyone here has had a good experience with a persistent pressure sore treatment in northeastern nj, i'd love to hear your recommendation[s]...
    unfortunately i'm unable to drive myself during the summer months because i've no a/c in my old beater and i'm unable to sweat due to my disability [i still get around 6-7 serious heatstrokes each summer despite avoiding sun/heat] , therefore my mother who lives quite close to my place has to take a half day off from work now every 2 weeks in order to drive me [her car has a/c] to my hospital appointments...thus i need to find a place within an hour's drive [or less] from my place...i live in park ridge, nj - about 30 minutes drive from hackensack, nj...and it needs to accept medicare/medicaid....
    help???...

    thanks - jerzy...
    };->
    Last edited by juras; 06-10-2011 at 01:21 AM.
    wherever you go there you are...

  2. #2
    Senior Member lynnifer's Avatar
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    Have you been on IV antibiotics at all during these treatments? You should have been. A wound that won't heal has infection ... which is probably in your bone now. You should have had a referral to an orthopaedic surgeon, no?

    Unfortunately I've heard the 'you smoke/I won't operate' deal before. It is true that smoking will impair your healing ... I'm sorry.

    I'm in Canada and can't help with your closest centre (Kessler?), but you need to get that taken care of right away before you develop sepsis.

    I wish you good luck!
    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
    Member juras's Avatar
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    Quote Originally Posted by lynnifer View Post
    Have you been on IV antibiotics at all during these treatments? You should have been. A wound that won't heal has infection ... which is probably in your bone now.....you need to get that taken care of right away before you develop sepsis.
    hi lynnifer and thanks for a superfast reply...
    i think that the next suggested course for action will be a semi-permanent antibiotic 'ball' which gets sewn under my skin or something to that effect..that's what i've heard from a visiting nurse recently anyway...i've had x-rays taken of my hip a few weeks back to check for bone infection [osteomyelitis or something like that] and it seems that up to now, bone's not infected yet...

    i'm anticipating a case of sepsis as well, hence my decision to change treatment facility...i spent 3 months in kessler following my initial injury but i don't believe they have a plastic surgeon on staff...

    thank you regardless - jerzy...
    };->
    wherever you go there you are...

  4. #4
    Like-wise, we would not consider you for flap surgery unless you have stopped the use of all tobacco products for at least 4-6 weeks, and commit to remaining tobacco free for the entire 12-14 weeks of recovery time for a flap. Osteomyelitis must be treated first as well.

    I would recommend that you contact either your own physiatrist or call the outpatient wound clinic at Kessler and ask them who they refer patients to as far as plastic surgeons who are expert in pressure ulcer management in those with SCI. You can also try calling the same people at Mt. Sinai's SCI center in NYC.

    (KLD)

  5. #5
    Member juras's Avatar
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    errr...i've posted this less than an hour ago and the thread now is listed as 'moved' within the 'care' area...there are no more statistics visible with reference to this thread [i.e. views/replies]...why is this??...
    i've studied all categories on forum here and 'care' seemed to be most appropriate...have i made a major faux pas???...and if so, which category has this thread been moved into???...i'm befuddled...i'm very sincere about asking for a recommendation here and need such advice badly...if my posting shall be made insignificant by tagging it as 'moved' and without any stats visible, most'll likey ignore it...some of those could've known the answer to my inquiry...what gives????...........
    wherever you go there you are...

  6. #6
    The Doctors and Clinics forum is specifically for asking for and making recommendations for doctors and clinics to provide your care. Since that is what you are asking in your post, it was moved to this forum. It is a moderator function here to move posts to the appropriate forum.

    (KLD)

  7. #7
    Senior Member lynnifer's Avatar
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    Please contact that outpatient centre tomorrow first thing. I'm worried with the tunneling and how long you've had this wound.

    An x-ray is not 'conclusive enough' to confirm osteomyelitis or at least this is what I've been taught. An MRI would be better. If that wound has been tunneling, that's a sure sign for osteo (bone infection) and it's damn tough to treat ... but I'm just someone who's very familiar with my own wounds, not medically trained.

    Please stop smoking! You seem very polite and we want you around CareCure in the future!

    Try to get onto IV antibiotics as soon as you can. Keep us updated!
    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

  8. #8
    Member juras's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    Like-wise, we would not consider you for flap surgery unless you have stopped the use of all tobacco products for at least 4-6 weeks... Osteomyelitis must be treated first as well....call the outpatient wound clinic at Kessler and ask... (KLD)
    hi kld, thank you as well...how can one be forced to quit like that if smoking isn't against the law?...isn't that logically going against a wellbeing of a patient?..if one requires a surgery, shouldn't such be performed regardless of one's smoking habit rather than take a chance of this person developing sepsis and dying of it???...how does the idea of the hypocratic oath gets away with that type of attitude on part of the so-called physician?...

    i've been smoking pack+/day since i was 12...literally since before i've become a man...i'm now nearly 45 y/o...i know no other life but as a smoker...i would in fact like to quit but i find it an impossible task thus far...
    the longest i stayed smoke free was for about 3 weeks following my sci injury...however, i was in poor shape and full of drugs and crap for the first 2 of thiose 3...as soon as i was better, nicotine hunger got unbearable and i started smoking as soon as i was transferred to rehab facility...before i could transfer into my wheelchair or light my smokes up....the other time was 10 days after having to spend that time in a hospital following a serious car crash in 2003 and extensive surgery on both legs...after 10 days i signed myself out of hospital because i was going nuts without smoking...

    i'd like to quit, i hardly enjoy it anymore and have problems galore as a result but i'm currently still unable to...tried just about anything and went back to it with vengeance...i still want to try acupuncture within the next 2 weeks but the highly recommended specialist is open for only a short time during the week and so i have to wait until my mother can find the time to drive me there...as i've explained elsewhere, due to heatstrokes, i need an a/c in my transportation during the summer...
    i think it's highly prejudicial and borders on illegal to force people to quit before rendering - needed - treatment...for some, quitting nicotine is incredibly difficult...i was a hard core hard drug user for years, i should know as i was able to quit those on my own no less...

    i'll contact kessler and inquire per your suggestion...i was going to do that anyway but don't expect much from them as far as results to my search...wanted to inquire of those who potentially have first hand experience, hence my post here...thanks...
    };->
    wherever you go there you are...

  9. #9
    Member juras's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    The Doctors and Clinics forum is specifically for asking for and making recommendations for doctors and clinics to provide your care. Since that is what you are asking in your post, it was moved to this forum. It is a moderator function here to move posts to the appropriate forum.

    (KLD)
    gotcha...thanks for 'splanation hehe...somehow i've missed the 'doctors/clinics' part here...
    wherever you go there you are...

  10. #10
    Member juras's Avatar
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    Quote Originally Posted by lynnifer View Post
    Please contact that outpatient centre tomorrow first thing. I'm worried with the tunneling and how long you've had this wound.

    An x-ray is not 'conclusive enough' to confirm osteomyelitis or at least this is what I've been taught. An MRI would be better. If that wound has been tunneling, that's a sure sign for osteo (bone infection) and it's damn tough to treat ... but I'm just someone who's very familiar with my own wounds, not medically trained.

    Please stop smoking! You seem very polite and we want you around CareCure in the future!

    Try to get onto IV antibiotics as soon as you can. Keep us updated!
    that's incredibly nice of you to say this lynnifer [btw, is that a conjugation of lynn and jennifer or your actual name?..never heard it, then again my name is jerzy haha]...
    i can't have an mri..full of stainless steel in my hips, legs, neck, etc...'they' also take cultures of my wound every 2 weeks, and supposed to be knowledgable...'they' say no osteomyelitis so far...gotta believe them i suppose...
    i'm working on quitting but not very optimistic at this point...
    thank you for very kind words...although i'm not exactly a polite type by nature hahaha...but i'm quite logical and have no reason to be impolite here....
    };->
    wherever you go there you are...

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