[Maltese Cat]

Just wanted to say hello to you all. I've been reading the posts here for a while now, and am hooked! I hadn't realised before how helpful it is to hear about people going through similar things and experiences. i have been with my boyfriend (L1), for nearly two years now, and am still learning about all SCI has to offer. I am really lucky in that my boyfriend is pretty good at communicating, and understanding me when I am having difficulty getting to grips with certain. I hope I have been similarly understanding for him. I wanted to say thank you to everyone here because it has been a huge relief to find this site, and everyone seems so helpful and friendly.
At the moment my boyfriend is on bed rest with a pressure sore, and I am just going through cancelling the various things we had planned around Christmas. We had to do the same last year - it always seems to be october/november time that he gets these sores - does anyone else find this? I wondered if it had something to do with moving from hot to cold with the weather and indoor heating, and skin drying out in cold weather? Could moisturising help?
Anyway, I seem to have got my head around the bed rest stuff much better this year than last year, although its still a bit depressing, and I feel really lonely going off and walking the dog etc on my own. And I know he feels even more glum and lonely being left behind!
Anyway, just wanted to introduce myself. Any advice on the pressure sore stuff would be great!

[gordonr]

Hi Cat,

Please tell us exactly where the sore(s) is/are, and how big and deep.

Also what have the doctors said to do?

Best Regards,

Gordon

[kiwiquad]

Hi Maltesecat, don't know if your b/f's pressure sore is due to climate change or not, but always moisturize.
Total bedrest & apply a 50/50 honey & cinnamon paste. I can't recommend this simple mix enough!
Good luck.

[Maltese Cat]

the sore is a stage 2, on his bum, just under the bum bone (at his least padded spot!). Its ok, he's pretty good at being switched on, and keeps himself totally off it (it only has pressure on it when he sits, so he is on bed rest), and I know that is the single most important and effective thing at healing it.

I'm more interested in the prevention side of things (aside from the usual of shifting positions and using proper cusions etc), and curious about the seasonal aspect of his sores.

They rarely get worse than stage 2, they just take their time to heal and being on bed rest is understandable tedious for him! I wonder if slapping moisturiser all over his bum come september might help prevent?!

He conveniently keeps his doctor a four hour drive away, and as driving means he is sitting on the sore, he avoids visits wherever necessary as they take things backwards again. While not a doctor, and certianly far from an SCI specialist, I am a vet, and so can at least tell when things become infected, and know how to keep things clean.

(Thanks for the honey tip by the way - I've always been a fan of manuka honey in particular, and when doing veterinary work in Africa, we used to use sugar to pack wounds in horses because that was all that the charity could afford, and it worked really well at sorting out yucky infections!)

[gordonr]

Maltese Cat, on Dec 6 2009, 11:23 PM, said:

I'm more interested in the prevention side of things (aside from the usual of shifting positions and using proper cusions etc), and curious about the seasonal aspect of his sores.

They rarely get worse than stage 2, they just take their time to heal and being on bed rest is understandable tedious for him! I

Cat,

Your goal should be no sores at all. I have no sores at all. Lots of people on this site have no sores at all. The fact that your guy is getting recurrent sores means that his routine is not up to snuff.

You mention shifting positions. When you are seated, it is hard to do anything with position which efectively takes pressure off the main spots. But this guy is a para, and an L para at that. So he should have plenty of upper body. When I was in rehab, I was told to lift myself up off the cushion for fifteen seconds, and to do this every fifteen minutes. At first it was difficlt to raise myself for fifteen. Later I increased to thirty seconds. Apparently less than fifteen is not enough to get blood to a closed off area. I realize that this routine takes discipline and it is neccesary to make it second nature. Every fifteen minutes is really all the time. And he will have people asking him what he is doing and if he needs something and all that crap. I just answer, no, its a circulation thing. which it is.

Next, after a few hours I get out of the chair. My normal length in the chair is about four hours. If I am at home, I lie down and watch tv for a while. When I am out, I lie down on the floor of my truck before I get up in the drivers seat. I have found the magic number is ten minutes. Ten minutes is enough to fully restore circulation in my butt. Once again, I realize this is demanding. Many have so much difficulty transferring that they stay much longer in the chair and rely on a very good cushion. But this guy is a low level para, so transfers are no problem, right? How hard is it to get out of the chair for ten minutes every four hours? Maybe he has restrictions at the work place? If so, maybe he should lobby for a bench of some kind to use on his break. As a health issue. Which it is.

So that's it. The normal goal of a para should be no sores at all.

Maintaining no sores means a discipline of raising yourself and regularly transferring out of the chair.

It is dificult sometimes. But it is a hell of a lot less dificult than curing a sore.

It takes a few minutes of forced lie down time. But that is a hell of a lot less than forced bedrest.

Which is easier to find time for?

Hope this helps.

All the best,

Gordon

P.S. No. There is no miracle cream or moisturizer which will stop pressure sores.

[gordonr]

Cat,

Just one more idea with regards to the car. I have a truck which it is easy to lie down in but many people prefer a car. I have been able to rest well in cars which have a reclining seat. It is possible to get right over on one side and then the other, five minutes each (like cooking steak on the grill) and that rests the seated pressure points. So this is something to think about when getting a car.

This car routine is great. IT fits right into the rhythm of the day. When you have been driving, you need a rest for your butt. And after you get out of wherever it is you drove to, you need a rest again before driving home. Say you drove an hour, spent four hours at destination and then drove an hour back. By the time that is over (six hours including two of driving when pressue relief is impossible), anybody's bum will be getting a little red. However, with my method, you insert two ten minute rest periods, and there is no skin prolem at all.

I use the same opportunity to properly empty my bladder as well, so two birds with one stone: comfortable bladder and good skin.

(It is amazing how many arguments an sci can get into with people just bcause his bladder is full and his neural system is overloaded! Think of that urgent situation where you just HAVE to get to the bathroom, and then imagine that an sci with a full bladder is operating under the same neural stress, perhaps worse, because it is experienced as diffuse stress, almost panic, with no object. Forget what you are arguing about. Just take a pee. Presto, Mr. calm and easy is back in the chair!)

BTW, I have been all business in my posts. Welcome aboard. Its very nice to meet you.

[Maltese Cat]

Hi Gordon,

Thanks for the tip on the car - thats a really good idea, and an easy one to fit in to normal routine.

He is actually very conscientious about not sitting for too long, and lifiting himself off the cushion regularly. I think the sores are liekly to be connected with his exercising - he works really hard on his legs, and while he is careful etc there is obviously more scope for problems here.

What I find interesting is the fact that his routine is pretty much the same all year round and yet he only gets the sores in autumn/early winter. He has a weak spot where he had previously had an abcess (doc thought originally UTI, tracked up, became orchitis, and then tracked into bum and gave him a big fat abcess), and that is always the spot he gets the sore. Why winter though?? He probably spends LESS time on his bum in winter than summer - I don't get it.

Thanks for the welcome! loving your posts,

Best wishes,

Cat

[gordonr]

Cat,

From your description, and understanding that the abscess came from so far away, I can't help wondering if there is still some activity in there, and his skin is being periodically atacked from behind.

I personally have a sort of deep pimple on my shoulder, over twenty years old, which does not run any more, but from which dry pus sometimes express, showing that there are still baceria active in there.

Whe I was learning about chronic UTI, I was told that the body is capable of corodonning off chronicly infected areas, which is good, but it also prevents the infection from being wiped out, either by body defences or by antibiotics.

Maybe he has somehing like that inside his buttock.

Best,

Gordon

[luckygirl78]

ask your wound care physician about a skin graph by the name Apigraph.
worked wonders for us!!





quote name='Maltese Cat' date='Dec 6 2009, 03:39 PM' post='141153']
Just wanted to say hello to you all. I've been reading the posts here for a while now, and am hooked! I hadn't realised before how helpful it is to hear about people going through similar things and experiences. i have been with my boyfriend (L1), for nearly two years now, and am still learning about all SCI has to offer. I am really lucky in that my boyfriend is pretty good at communicating, and understanding me when I am having difficulty getting to grips with certain. I hope I have been similarly understanding for him. I wanted to say thank you to everyone here because it has been a huge relief to find this site, and everyone seems so helpful and friendly.
At the moment my boyfriend is on bed rest with a pressure sore, and I am just going through cancelling the various things we had planned around Christmas. We had to do the same last year - it always seems to be october/november time that he gets these sores - does anyone else find this? I wondered if it had something to do with moving from hot to cold with the weather and indoor heating, and skin drying out in cold weather? Could moisturising help?
Anyway, I seem to have got my head around the bed rest stuff much better this year than last year, although its still a bit depressing, and I feel really lonely going off and walking the dog etc on my own. And I know he feels even more glum and lonely being left behind!
Anyway, just wanted to introduce myself. Any advice on the pressure sore stuff would be great!
[/quote]

[Bob C]

Cat, I never heard or read about a seasonal relationship with pressure sores. My wild guess is that if this the issue, it might be caused by heavier pants that do not flex much under his butt. Also, there used to be a cushion material, T-foam I think, that got harder as it got cold. I had one in my van and I noticed that when the temp dropped below 5o F, it was noticeably hard and a few degrees lower, it was like a brick. Something like that could cause it.

This post has been edited by Bob C: 01 February 2010 - 05:03 PM