I'm hoping someone can give me new insight into this problem. Starting a little over a year ago, I developed a small (less than 1 inch) skin split between my butt cheeks. The split was superficial. Only the top layers of skin appeared to be affected; there was no bleeding or pus discharge. This happened around the time I was studying hard for the Law School Admission Test, so I was not as on top of my weight shifts as I should have been.
Anyway, to make a long story short that first major episode of splitting and healing lasted from November to December, 2004. I was symptom-free for six months and was starting to return to a normal schedule -- commuting from my home in Berkeley to a law office in San Francisco where I'm interning -- when my skin split again in July. This time, I was in bed from July-November. The split would heal, then (1) I would stay off it for a couple more days, (2) I would get back to my wheelchair for a couple hours a day, (3) a few days after the split had healed, I would take my service dog for a 20 minute roll around the park, and (4) if the skin looked like it was holding up I would try to spend a full day in my chair (10 to 12 hours) and resume my normal activities. Then, roughly 10 or 12 days into this routine, the skin with split again and I would be back to square one.
Last November, I visited Santa Clara Valley Medical Center to have this problem diagnosed by wound care nurses and physical and occupational therapists. Their unanimous opinion was that the split was not a "pressure sore." Moisture was the more likely cause, they agreed. Based on their assessment, I altered my routine to make sure the skin in and around the area was thoroughly dried after my bed bath and bowel program.
There were no problems until March 8 when another split was detected. This one healed quickly after a couple of days in bed. I decided to test the theory that it was not pressure related so I returned to a full day in my wheelchair after it had healed. On March 17, it reopened again. Two days of bed rest and it was closed. I gave it one more day of bed rest just to be on the safe side and I got up again... one week later, it split. Same kind of split -- very shallow, less than 1/4" long, no bleeding or seepage -- in the same area between my butt cheeks in the crease.
Like the ones before it, the March 24 split closed quickly. This time I decided to stay off it for a few more days after it had healed. And, like the March 17 split, I decided not to return to full day in my wheelchair, but, instead, to begin gradually spending longer periods of time beginning with two hours and increasing it by one hour a day.
Today, it split again. This time, the split is longer than the ones before. Like the others, it is shallow. There is no bleeding or seepage. I am at a complete loss as to what to do about this problem. I'm supposed to start law school this fall and I am seriously doubting whether I have any future beyond managing these little cuts on my ass.
Thank you in advance for any advice.