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Thread: Stage 4 pressure sore

  1. #1
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    Question Stage 4 pressure sore

    I am 44 and I have spina bifida. Has anyone here ever had a stage 4 sore and did it ever heal up? I have had it since April 2010 while in hospital.
    Long story short, I was in the hospital and 2 rehabs. from December 2010 until last month when I came home. The whole time I was on a Clinatron bed. It was healing but very slowly. I asked about having the bed at home and after investigating it, my case worker said I could but then about a week before I came home, she said that I would have to go home on another bed and after I have 5 nursing visits, I could get the Clinatron at home. So after 5 days I called to get the bed then they said I would have to be home for 30 days before I got the bed. That was Medicare rules. Anyways, long story short, my dr. has to write a letter to see if I could get the bed. In the meantime in the low air matress that I am on now my sore has gotten worse.

    Anyways, sorry for the long story. I'm glad to be a new member here. Take care all.

  2. #2
    Senior Member rdf's Avatar
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    Welcome Vegas. Some members have had stage IV sores, I'm sure they'll chime in once they see this thread.
    Please donate a dollar a day at http://justadollarplease.org.
    Copy and paste this message to the bottom of your signature.

    Thanks!

  3. #3
    Quote Originally Posted by Vegas1967 View Post
    I am 44 and I have spina bifida. Has anyone here ever had a stage 4 sore and did it ever heal up? I have had it since April 2010 while in hospital.
    Long story short, I was in the hospital and 2 rehabs. from December 2010 until last month when I came home. The whole time I was on a Clinatron bed. It was healing but very slowly. I asked about having the bed at home and after investigating it, my case worker said I could but then about a week before I came home, she said that I would have to go home on another bed and after I have 5 nursing visits, I could get the Clinatron at home. So after 5 days I called to get the bed then they said I would have to be home for 30 days before I got the bed. That was Medicare rules. Anyways, long story short, my dr. has to write a letter to see if I could get the bed. In the meantime in the low air matress that I am on now my sore has gotten worse.

    Anyways, sorry for the long story. I'm glad to be a new member here. Take care all.
    Sorry to see you're having problems. I'm more or less in the same situation. Stage IV ulcer opened up in July 2010. I was hospitalized twice and both times was on a Clinatron bed in the hospital. Upon discharge both times I was told I could not get a Clinatron at home. I'm now on a LAL matteress.

    Sorry I can't help with Medicare rules. My experience has been that nobody knows the rules, not even Medicare! Talk to doctors, nurses, discharge people,CMS people. They will all give you answers and they will all be wrong, then call Medicare and get another answer and it will be wrong. Best of luck to you.

    Bill

  4. #4
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    Exclamation major experience with this..

    SB F. 31. Had a few stage VI's. Once it hits that point unlless you stay totally off it for a year or more it's not going to heal without intervention. Period. The first sore I had was not infected at all so a skin flap surgery took care of it. (PM me if you want details on the skin flap surgery/recovery)

    the second one progressed to ostemyolitius (bone infection) becuase of misdiagnosis for 2 1/2 years. So I'm now a right leg above the knee amputee. You need to see a plastic surgeon and infectious disease guy pronto. I dont' know who in there right mind would let that kind of thing go, but since i've already lost my leg, hindsight is 20/20 right?

    I have SB at the L4/L5 level and both pressure sore were on the icheal (hip) bone.

    Also, go post on the spina bifida suppor forums for more responses of people with SB.

    Lastly and again, please go see plastic surgery and infectious disease to make sure you dont' have a bone infection (which will ruin any chance of healing) and a plastic surgeon to get you fixed up fast so you can get on with your life. Both surgeries for me, while annoying are the best things I ever did. Pain/suffering was actually gone instead of surgery making me feel worse..and how often does that actually happen ; )
    Liza R. McCollum

  5. #5
    I had a stage 4 wound on my back for a year and a half. Made the mistake of using wet to dry bandage and it couldn't dry out during the day because I was up in my chair and the bandage couldn't breathe. So it ripped the scab off and skin around it. So I used silvadene cream and put a bandage over it. Healed nicely.

    Medicare is a pain but get your doctor to write the letter ASP because Medicare will only pay more if you have to go back to the hospital, right?

    Good luck!

  6. #6
    Stage IV ulcers can heal on their own, but take a LONG time and often re-open. My advice is to stay off of it as much as possible, keep it clean and moist and get seen as soon as possible by a wound care program. That gives you the best chance of healing this.

    Ckf

  7. #7
    Junior Member 1happyquad's Avatar
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    I also had a stage 4/5 p-sore (ischial) and treatment was long and exhaustive. I spent a year in bed full time completely off of the sore and since my sore was too small for a wound vac, not infected, and since it showed a miniscule amount of healing Medicare rules forced me to keep trying treatments month after month. After a full year I finally had a CT that showed possible bone involvement which then changed my treatment towards surgery. With bone involvement A 6 week treatment of antibiotics had to be done, visits to a wound clinic were still made and then finally a flap surgery. The recovery from surgery was slow and was done with daily hyperbaric oxygen treatments. Since my sore was ischial building up sitting time and weight shifts are very important. My advice is to find a great Wound Care Surgeon/Clinic and stay as healthy as possible. I was also put on multiple supplements Vit. C, Vit. A, Zinc, multi vit & mineral, and also up your lean protein. Hope this helps and you heal soon.

  8. #8
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    Quote Originally Posted by wheels09 View Post
    Sorry to see you're having problems. I'm more or less in the same situation. Stage IV ulcer opened up in July 2010. I was hospitalized twice and both times was on a Clinatron bed in the hospital. Upon discharge both times I was told I could not get a Clinatron at home. I'm now on a LAL matteress.

    Sorry I can't help with Medicare rules. My experience has been that nobody knows the rules, not even Medicare! Talk to doctors, nurses, discharge people,CMS people. They will all give you answers and they will all be wrong, then call Medicare and get another answer and it will be wrong. Best of luck to you.

    Bill
    . Thank you for the information wheels09. Do you like the matress you are on now? Do you have to lay on your side a lot on that mattress? On the Clinitron you did not have to lay on your side a lot.
    That's again. Take care.
    Ps. Not sure if this area was were I was suppose to reply.

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