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Thread: Question for SCI Nurse/anyone w wound care expertise

  1. #1

    Question for SCI Nurse/anyone w wound care expertise

    Went into Dr's on the 19th of October with a small, but pretty painful tear right underneath my tailbone. Doctor looked at it and told me it wasn't caused by pressure and there is no sign of infection. In terms of dimension, it's like a finger nail clipping, but off of my pinkie finger. Small cut, but big pain! He just told me to keep it clean and it will more than likely just heal on its own in a couple of days.

    In retrospect - I think it was caused by a rushed transfer to the commode. I have one of those shower-type, where I have to transfer onto one edge and then do one more transfer to get over the "bomb door".

    Anyhow, I kept all pressure off of it by staying in bed only to get up to prepare food (I live by myself) and for nightly BM. It felt and looked like it was improving (shrunken a little in size and stopped discharging anything) but it is still very painful! Some days the pain will subside and then the following day it will be worse.

    Starting about 3 days ago, I resorted to having my BM in bed, because I figured this thing has taken way too long to heal and I'd prefer to resort to extremes now rather than end up in the hospital later. Initially had a pretty pain-free day the following day, which was a relief, but then the pain would come back, waiver the next day, and now it's back.

    It's a bit nerve-wracking because:
    1. It's been like almost two weeks...!!!
    2. Given the initial size of the small tear, I definitely thought it would be healed up by now.

    What I've been doing so far is to simply keep as much weight off as possible (I live by myself, so I do need to get up and prepare things like food, prepare my bed for BM, clean laundry, etc) by laying on my side in bed, and I have kept the wound clean using cotton swabs and MicrocynAH wound gel; I spray the gel into a cotton ball a couple of times and just place the cotton ball over the small tear. The gel allows it to seal and holds the cotton ball there.

    Because of this pain, I've scheduled an appt with the doc tomorrow AM. Anything I should ask him to look at specifically? Perhaps there's really more going on with this wound than previously thought? I obviously trust my doc, but he's not a dermatologist/wound care physician.

    Do these things sometimes hurt more even though they begin to look better?? Seems counter-intuitive.

    Any help/experience is appreciated.
    No one ever became unsuccessful by helping others out

  2. #2
    Here are a couple of pics (I uploaded them to ImgBB, as uploading pics directly to this site is a bit clumsy):

    Here is a broader image. I've indicated which way my tailbone is. The big scar to the right (towards my tailbone) is from a huge pressure sore I developed when I was initially in the hospital in 2005.
    https://ibb.co/mTiuYA

    Here's a closeup:
    https://ibb.co/gNGbfq
    No one ever became unsuccessful by helping others out

  3. #3
    Senior Member bigtop1's Avatar
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    Wound looks good. Clean, pink, good blood flow. Lots of short hairs in area. Perhaps an ingrowing hair follicle causing the pain. You also said that it was painful at the onset. Start using your slide board for those transfers.
    I refuse to tip toe through life, only to arrive safely at death.

  4. #4
    Quote Originally Posted by bigtop1 View Post
    Wound looks good. Clean, pink, good blood flow. Lots of short hairs in area. Perhaps an ingrowing hair follicle causing the pain. You also said that it was painful at the onset. Start using your slide board for those transfers.
    Yeah I trimmed them per instruction on the MicrocynAH spray.

    But, that's just it, brother, it looks like it's improving but the pain level jumped today out of nowhere...that's what's got me worried. Thanks for your reply.
    No one ever became unsuccessful by helping others out

  5. #5
    Senior Member ChesBay's Avatar
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    You may want to ask your doctor if it could be a pilonidal cyst. I had one that went undiagnosed for several years and the pain was severe and constant. After doctors telling me my skin looked fine for several years I was talking to my older brother and he told me he'd had one.
    My next visit to the doctor I told him I thought I might have a cyst. Doc referred me to a plastic surgeon and I eventually had surgery to have the cyst excised.

    just a thought... good luck

  6. #6
    Well, Dr. said it doesn't look infected. He gave me a pretty good exam including a rectal exam to feel if there was anything lurking in the deeper tissue, but he came up with no explanation for the level of pain I was experiencing. When I say pain, today the pain was through the roof. Anyhow, he ordered a blood test, so I dropped that off and he also ordered a CT scan to see if there may be some deeper tissue damage he couldn't pick up on.

    If there is a pocket of necrotic tissue which developed underneath a "seemingly healed" wound, would a CT scan of the area pick this up?

    I just want to be 100% sure. When I was newly injured, I had a small wound develop into a HUGE one which resulted in that crater scar you see in the pic I attached.

    Not sure what else to do besides wait and deal with this pain.
    No one ever became unsuccessful by helping others out

  7. #7
    I found a great band aid called Hydro seal I got a large blister on my heal used just 1 bandaid as it tells you on until it starts to come off. I had posted pictures on here I think I called the post new bandaid. They are made by band aid brand available at target.

  8. #8
    Quote Originally Posted by Lavender lady View Post
    I found a great band aid called Hydro seal I got a large blister on my heal used just 1 bandaid as it tells you on until it starts to come off. I had posted pictures on here I think I called the post new bandaid. They are made by band aid brand available at target.
    Ironically, Dr. said it's really not big enough to even consider throwing a bandage on. However, I'm interested in this product you mention. Do you think they make them in the shape of a sacral/tailbone region? Getting normal bandages to stick there was a total clown-job.
    No one ever became unsuccessful by helping others out

  9. #9
    This bandaid Comes in several sizes, it stayed on my heal very well, I did try to keep a sock on since my feet keep moving. It is designed to stay on for about a week. I think as long as you are not dragging your self with your area across your bed or chair. Mainly protecting the very edges so it doesn't peel back. I just got mine off Amazon.

  10. #10
    Quote Originally Posted by Lavender lady View Post
    This bandaid Comes in several sizes, it stayed on my heal very well, I did try to keep a sock on since my feet keep moving. It is designed to stay on for about a week. I think as long as you are not dragging your self with your area across your bed or chair. Mainly protecting the very edges so it doesn't peel back. I just got mine off Amazon.
    I'll definitely check it out, LL. Thanks
    No one ever became unsuccessful by helping others out

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