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Thread: Stage 2 Pressure Sore on Sacrum Thanks to Hospital

  1. #21
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by jbridges9 View Post
    Argh. They told me I could get in my chair once I had something covering it??

    I have to get into my shower chair to do my BP and take my showers?
    Hospital's normally have walk in wound clinics if not call your doctor and ask where to go. If there is a wait tell the receptionist your sore is on your butt and you need a gurney to lay on while waiting. You'll need to get on one to be examined anyway. They'll clean it, debride if necessary and then tell you how to care for it. Explain about your bp and showers and if you can get up for them or need to stay down. Most wound care doctors and nurses actually love treating someone besides diabetic foot ulcer patients. IF they think 45 minutes or so up is ok every other day make sure they understand how you transfer. Sliding boards are out if that sore is anywhere near the areas that go on the board. Also describe your shower chair to them. But the fastest and best fix is stay off it and do what is necessary so you heal from the inside out. Healing from the outside in often causes bigger problems like infected abcesses later.

    If you need flap surgery in your first two years you might as well get used to the idea of paying for fulltime help or a nursing home by your 5th year. If you don't want to read all the sore information on this site there are printable booklets for free at www.pva.org under Publications. If you are admitted in the future get informed so you can request to speak to the charge nurse once in your bed on what you need to leave in the same shape you arrived but cured of why you were admitted.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  2. #22
    I am discharged from the hospital. All the wound nurses told me it was ok to be up in my chair as long as I did pressure reliefs while in the chair. It looks to be be healing nicely but no one ever checked the inside, however you do that? They said it was very minimal..

  3. #23
    Senior Member lynnifer's Avatar
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    Take charge of your own health. If you're unsure, go with your gut. Seeing a wound care person now may divert a mess later.

    I just can't trust doctors or nurses until they have proved themselves to me.
    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

  4. #24
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by jbridges9 View Post
    I am discharged from the hospital. All the wound nurses told me it was ok to be up in my chair as long as I did pressure reliefs while in the chair. It looks to be be healing nicely but no one ever checked the inside, however you do that? They said it was very minimal..
    You do not need to be an inpatient to go to a wound care clinic in a hospital. Call and ask what their hours are and if you need to bring any records with you or if they have them on file. And those were not wound care nurses if they said you could sit on it and said it was minimal. Wound care nurses know the difference between an AB who gets a rub sore like my husband did when being transferred from the OR table back to the gurney after his hip replacement and someone who is a paraplegic or quadriplegic and pressure sores. The ointment they used on you is normal for many AB wounds so they both heal and avoid picking up a hospital bug.

    So stay off it. See a real WOUND CARE clinician and report on back on how you're doing. If you plan on sitting up and doing flimsy reliefs then please don't follow it up with how your sore is making your pain worse. A wound care RN or MD can explain and show you pictures of how a good healing sore will look and how a badly healing sore looks.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  5. #25
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    Stay off, stay off, stay off. STAY OFF They take awhile to heal. My husband had one too. It seemed like it took forever . Keep a GOOD eye on the hips that you are lying on instead - he kept getting red on each side , we just had to keep turning and turning and turning....

  6. #26
    It looks almost healed but I've been on it not knowing with Vetericyn and the pads that lynnifer told me to get but I'm having crazy spasms and that general unwell feeling is it possible j
    It healed our leaving an infection inside? Howdo you tell?

  7. #27
    Senior Member lynnifer's Avatar
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    You can't feel osteo and often it doesn't come with symptoms until it's too late (but a general feeling of malaise is one of them). #BetterSafeThanSorry Be proactive .. your paralysis has now made you an expert - moreso than average doctors.
    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. #28
    First of all, call the hospital Risk Management department and report that you have a HAPU (hospital acquired pressure ulcer) that you want to report. You may also tell them that you are considering a malpractice action. If Medicare was paying for your hospitalization, then you should also report it to them, as there are now sanctions against hospitals which allow a HAPU to occur in a patient covered by Medicare.

    Secondly, stay off it entirely. This means laying on your sides or prone in bed, not on your back, and definitely no sitting up in bed (semi-Fowler's position) on your back, as this adds shear to pressure. A low air loss mattress would be best until it heals fully.

    Ask your provider to check some labs. You should have at least a CBC, pre-albumin level, and a CRP done. If your CRP is elevated, then an underlying osteomyelitis may have to be ruled out.

    Increase your protein intake, and be sure you are taking a good stress type multivitamin. Keep your fluid intake up.

    Bowel care can be done in bed on your side with a chux or folded newspaper under your butt. Never use a bedpan. Bedbaths are not fun, but are effective in cleaning. You can shampoo with a "shampoo-in-a-bag" kit or use dry spray hair cleaner that you spray on and brush out.

    A seating evaluation would be required to determine if your sitting posture allows you to sit with this wound. If you are a sacral sitter, it may not.

    Keep the wound clean, covered, and moist (but not wet). We use a lot of Xeroform gauze covered with Telfa for stage II pressure ulcers.

    Once it is completely closed, you need to wait a few more days to a week before laying on that area, or sitting with any pressure there, and should start with very short periods of pressure (15-30 minutes), then inspect your skin for any redness before increasing the times gradually over several weeks.

    You may also be able to have a home health agency wound care nurse come to see you at your home instead of going into a clinic. Medicare will generally cover this with a physician's order.

    (KLD)

  9. #29
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    Not sure if this was mentioned, but ANY kind of clothing and as SCI states stay off it, but if you are on it and have any kind of clothing, the clothing will continually ittiate, the slightest you move. This 1 reason why stay off of all the time.

  10. #30
    Senior Member lynnifer's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    pre-albumin level, and a CRP done. If your CRP is elevated, then an underlying osteomyelitis may have to be ruled out.
    jbridges .. c reactive protein and albumin (iron stores .. my observation only that a lot of paralytics run low .. I'm nearly always borderline anemic which won't help healing as crappy low red blood cells can't carry enough oxygen and nutrients to heal). Electrical stimulation can help too.
    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

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