12 replies to this topic

[backwoodsrider2]

Have a question about the benefits of fat. I am an SCI and concerned about my body fat. As I get older I am eating better and being more active so losing weight and am concerned I am going to lose too much off my butt and increase my chance of a bed sore. Is having less fat between the pressure points on my butt going to make me more likely to have skin breakdown or is the 15 to 20 lbs I might lose going to be better for my skin and those pressure points?

[Apparelyzed]

Hi, good question!

When I left hospital in '92, I was very thin. The main problems I had were pressure on the back of my pelvis and sacrum, I never had any skin breakdowns, but they did get red, and dry skin tended to form from sheering effects of clothing and pressure.

Fast forwards to 2007, and my weight had crept up to just under 13 stone. This also had it's problems, as pushing my wheelchair was harder, transfers were harder, and increased pressure on my ischiums, despite the extra padding, meant I became uncomfortable.

Present day, I'm now 10st6lb at 6ft in height, and I can push and transfer a lot easier, and although I've lost some of the padding off my ischiums, I haven't really noticed any significant changes in my skin. I eat an average healthy diet, keep hydrated, and don't smoke, which all helps your skin.

Everyone's skin is different, my skin is quite tough, however, I've known others who have not been so lucky, I guess unless you try to lose weight, you'll never know.

Regards

Simon

[E-DOG]

There's a guy here where I live who is nothing but skin and bones. A quadsy, tall, with a pouched out abdomen. Looks like one of those starving Biafra babies. This guy's had a pressure sore for over a year now. He even spent 6 months at the VA trying to get it dealt with. It gets better, then he gets in his chair for a while so he can smoke, drink, etc. and it gets worse again. Fact is, he's always having p/sore problems. No padding at all.

I on the other hand, weigh in at a light and lively 340 pounds and have never even come close to having problems with my skin. Course I have a REALLY HARD TIME with transfers, getting dressed, wiping my whoosits and whatsits when necessary and just general getting around plus attempts to locate Stanley when he needs attention can be rather frustrating.

I would guess that keeping a little padding here and there could be of help. Just don't go overboard with it.

E

[hooplady]

I would love to believe that it was my tender-loving care that healed my b/f's pressure sore, but I really think his weight gain made the difference. Before his injury he had no butt to begin with, then he lost weight in the hospital. He had just a thin layer of skin over the tailbone where the sore appeared. After a few months of my lousy cooking and inactivity, he developed some lovely fat deposits to cushion his backside. His skin is in terrible condition most of the time but so far no new pressure ulcers.

[maisy1996]

I think it would help to have a little fat here and there.i weigh just over 7 stone and i often have red patches at the bottom of my back.so having some fat would prevent it. (:

[wheeliebear75]

I think everyone has a different "perfect weight". And the BMI (Body Mass Index) doesn't always take every thing into account.

I currently weigh about 120lbs.,
When I was 180 from sitting around, eating, & not getting enough activity in; it was much harder to lift myself, & shower properly.......so I often had skin issues in the crack of my butt cheeks.

I end up throwing up a LOT in winter (I hurt so much during winter I'm often ) .......so much so that I tend to drop 2+lbs. a day. This has gotten me down as low as 107lbs.; but I looked like a skeleton in skin, & I end up having what almost looks like bruises on my but where the thigh bones poke outward.

I personally look & feel much better in the 130's.

Too fat harder to do things, too skinny & there isn't as much padding between the bones & your cushion........just try & find a happy medium weight & stay there if you can.

[Meadowlarkmark]

I used to have really tough skin, I went decades without a pressure sore then two years ago while transferring from my manual chair to the pool, I landed too hard on the concrete deck, tore just a little hide which bloomed into a full grown wound--and the wound never has gone away. I have added weight to my bod over the years but none of the weight went to my butt.

[djkrazyleggz]

I have been about 120lbs for the past 15 years and havent really had alot of problems till the past 5 yrs or so i always try to gain weight but simply cant. most of the itime i just try to stay off my butt and keep ointment on the wound, but because of my lack of fat back there it makes it hard to sit comfortably but i try to keep changing positions to keep them from comin back. Is it possible to do somthing to gain more fat on the backside?? anybody

[hotwheels24]

thanks to all for the great advice!!!

staying active, active, active helps me....

but i agree...gaining weight is a stress

[rmorgan]

I was reading this and it's interesting to hear people's thoughts on this. My b/f is t-5 para...6 foot 8 inches and weighs about 160lbs. He's skinny!! haha but he's never had a problem with pressure sores, and lemme tell you there's about no fat between his pelvic bones and skin! He's actually only had one pressure sore and that was in rehab 17 years ago. He uses a high profile Roho cushion and shifts his weight a lot...something he had to teach himself to do, now he just does it without thinking. For his skin, being skinny the cushion allows his skin to breathe and not get hot.

I asked him about this question and he said that gaining weight would be the worst thing you could do. Extra weight causes blood to be harder to circulate therfore skin's not getting the oxygen it needs to prevent the skin from breaking down, thus causing a pressure sore. Heavier people tend to get pressure sores beneath the skin and when it finally breaks through it's a complete hole and harder to get rid of.

I would just say to stay the weight you are, don't try and gain weight!! Just get a cushion that works for you and shift your weight consciously whenever you think about it. And depending on how you sleep, try and flip during the night if you tend to sleep on your back or one side. Everynight, my b/f goes to sleep on his back and then halfway through the night when he get's up to cath he flips over onto his stomach. I believe that this helps him a lot to keep pressure off certain areas of his body (but again, this is only what HE does, not saying that you HAVE to do this)

Good luck! Embrace your skinniness! haha

(p.s. His weight shifts consists only of moving his butt around in his seat a bit...leaning forward, leaning back. Not actually holding himself up for a certain amount of time. I would say he does this in different ways sometimes every other minute and other times it can be 10-20 min. in between his movements.) AND ALSO HE DOESN'T DRINK ANYTHING BUT WATER...I also think that helps a lot too!

Edited by rmorgan, 24 January 2010 - 06:09 AM.

[Heather1984]

I can tell you from personal experience that yes losing too much weight can contribute to pressure sores. I went from 130 pounds to 76 pounds I developed a pressure sore on my tailbone almost over a year ago and it is finally almost healed. I don't have any padding over my bones. My diet has alot to do with it though, If I would eat more it would have healed more quickly. But you also don't need to gain too much weight because that can lead to too much pressure on bones also. Just try to maintain a good weight that gives you a little bit of padding over the bony areas. I think the main thing is pressure release, I know it gets aggravating having to do it but it's something we all have to live with.

[Boggs52]

LOL! Made me think of two guys I first met while going through rehab at the Seattle VA. Both low level quads in electric chairs. The were always hanging out together. One of them was waaaaay overweight, the other damned near skin and bones. We referred to them as "the land whale and his pilot fish".

In 2007 I was hospitalized for a small but persistant decubiti for 6 months. When I entered I weighed 230 pounds on my 6 foot frame. By the time I left I was more than 70 pounds lighter.

I quit drinking non-diet soda. When they set a dinner tray in front of me, I only ate what was on the big plate. dessert and bread were off to the side and I ignored them. I got into pushing myself around the grounds for hours at a time. The pounds just melted.

I have pretty much kept to the routine and have not gained it back.

[mellowgator]

i also have lost weight in the last 6 years. i used to weigh 138 lbs i now weigh 115 lbs . i am able to transfer much easier and i can get my but onto high beds when i travel now. i also look much better in clothes. i haven't had a skin issue yet. i use a stimulite cushion and am mindful of weight shifts. i have an obese mother and she is diabetic with high bp and i certainly don't want to take on the health issues of obesity. i got down as low as 99 pounds which was stress induced. i looked horrible like a skeleton with skin. i guess being light within reason is the best way to go.

mellowgator