[dlury24]

I am 25 years old and have been a T7 paraplegic for 5 years. My first 2 years I dealt with a pressure sore on my ischial. I had 2 flap surgeries and the second surgery was finally a success. I have gone without a sore for 3 years now. I get a lot of pimples in the area and they always worry me when I find them. Right now I am not doing much at all to prevent myself from this. I just don't know what to look for or anything. I had really lousy education and rehab about this. I need any suggestions or help on what I can do to prevent from getting another sore. The stress of it is taking over my life. Any procedures like checking daily or creams to put on. Anything will help.

Thank you!!

[cathie]

check skin daily for redness that, pressure relief many times during the day (lifting your butt of your chair).
what sort of cushion do you use?
Also pants with buttons on the back can cause this problem and decorations, zips and seams that don't sit properly.

That's all I can think of at the moment... Will keep thinking

[dlury24]

cathie, on 25 August 2010 - 03:07 AM, said:

check skin daily for redness that, pressure relief many times during the day (lifting your butt of your chair).
what sort of cushion do you use?
Also pants with buttons on the back can cause this problem and decorations, zips and seams that don't sit properly.

That's all I can think of at the moment... Will keep thinking

Thanks I appreciate it. I use a roho cushion. Im not sure on what type it is though.

[4wheelz]

roho is good.. make sure you have it properly inflated.. i just saw a thread about it here, yesterday, i think. you also need to relieve pressure for 2min every 1/2h.. that's 2 min with your butt completely off the cushion. i do the "hand stand" or i do a lean for 2min on each butt cheek. so far so good.

This post has been edited by 4wheelz: 25 August 2010 - 05:16 AM

[cathie]

I think roho cushions are good, you do have to watch the pressure though. You should be able to fit 2 fingers between your ishichium bones and the base. Any more than that it is over inflated and that in itself can cause pressure areas same goes for under inflation. I also use a solid base in mine as the cushion bottoms out with an adjustable tension seat sling.

I also do the push up pressure relief every 1/2 hour because if I do the side to side one I fall over due to my injury level.

I also didn't get taught about pressure relief or really anything else SCI related in rehab and have just gone back for a 3rd go 12 years on. (long story)

[xxm]

In addition to posted above:

The Roho:
Pressure is checked by blood pressure gouge and must be less than systolic blood pressure with him sitting on it. As low as possible provided that his sitting bones area is at least 1 inch above the hard base of the chair. If these conditions are not met now you must change to Roho high profile.

Your Blood Pressure:
If your BP is too low it is not enough to deliver blood to pressure areas. Drink more water to be at least 100 systolic.

Rudy

[tyvin]

All good comments and advice. May I add that the material of your clothes should be as close to cotton as possible and be a good fit. Let me say nothing with polyester in it. Polyester will shred you skin. No zippers or buttons and check your seam if wearing pants and make sure it's in the middle and not on your cheek.

It's funny because the other day while attempting to go to the bathroom in a public restroom (it was God awful filthy!) and doing the usual double jointed acrobatics required to get on the dang seat I was wishing how much I wanted to be a man with a penis so I didn't have to pull everything down. It's such a hassle to take everything down and then back up.



Let's get back to prevention of sores. Purchase a hand held mirror so you can see your okole (butt in Hawaiian). Always check for redness daily. In the am, every time you pee and before you go to sleep. If I were you and went through the flap surgery etc... I would be quite diligent with my checking.

If you don't wear diapers don't bother with creams if you didn't in the first place. The barrier creams are good for people who wear the Depends type stuff so the soiled stuff doesn't compromise the person's skin.

A good diet with high quality protein, fiber and lots of fluid; exercise and staying off of it for prolonged times, a good cushion that's properly inflated or taken care of and awareness and the knowledge to know what to do if a reddend spot cannot blanch.

Later,

[dlury24]

Thanks for all of your suggestions I will put them to use.

[qbounce]

You should be on a "High Profile Quatro, 4" cells by ROHO. I know you said you weren't sure the name of your ROHO, but you should at least be able to confirm that it's a 100% air cushion, and not both styrofoam and air. And that it's a HIGH Profile-4" cushion and not a LOW Profile-2" one.

Or, look into a "Ride by Design" custom fitted cushion. They actually take a mold of your butt and custom design your cushion from it. I've heard great things about it and am going to get my own when the opportunity arises. I think the cushion is by far the most important thing to consider when dealing with pressure issues. I've also had a flap surgery on my coccyx, so I know where you're coming from.

[McRobb]

xxm, on 25 August 2010 - 07:34 AM, said:

In addition to posted above:

The Roho:
Pressure is checked by blood pressure gouge and must be less than systolic blood pressure with him sitting on it. As low as possible provided that his sitting bones area is at least 1 inch above the hard base of the chair. If these conditions are not met now you must change to Roho high profile.

Your Blood Pressure:
If your BP is too low it is not enough to deliver blood to pressure areas. Drink more water to be at least 100 systolic.

Rudy

Could you elaborate on how you check your ROHO's pressure with a blood pressure cuff? I have been told that you can do it but not how to do it. Would appreciate the information.

[xxm]

McRobb, on 04 September 2010 - 02:27 AM, said:

xxm, on 25 August 2010 - 07:34 AM, said:

In addition to posted above:

The Roho:
Pressure is checked by blood pressure gauge and must be less than systolic blood pressure with him sitting on it. As low as possible provided that his sitting bones area is at least 1 inch above the hard base of the chair. If these conditions are not met now you must change to Roho high profile.

Your Blood Pressure:
If your BP is too low it is not enough to deliver blood to pressure areas. Drink more water to be at least 100 systolic.

Rudy

Could you elaborate on how you check your ROHO's pressure with a blood pressure cuff? I have been told that you can do it but not how to do it. Would appreciate the information.

I cut the cuff of an old BP gauge with a scissor and use the blood pressure pump to inflate cushion. The gouge will show when to stop. In fact this measure is needed only to check whether you have the right product for your blood pressure. Once you know that conditions described above are met, you do only the "sitting on your fingers" test.

Rudy

[Pro 5.0 Mustang/Paralyzer]

Hello everyone. I've been reading the thread and have some questions myself. Unfortunately Im living in a nursing home that to my knowledge deals with no other paralyzed people like me and do not take me into consideration when dealing with my issues. Im rarely turned and they never get me up in a chair. Their reasoning is they cant ttake the time topick me up with the lift when each cna has 32 people to care for. Even worse, they took me off my air matrress and put me on a regular mattress that feels so hard it hurts all the time. Should I be on a regular foam matress when i cant move to relieve pressure on my own? MY injury level is a c5 6 7 so i cant move much but i have my left arm. They always tell me my butt is red but no sores and claim they cant constintute a reason for me to have one. Is this true?

[yazwack]

Pro 5.0 Mustang/Paralyzer, on 07 September 2010 - 03:31 PM, said:

Hello everyone. I've been reading the thread and have some questions myself. Unfortunately Im living in a nursing home that to my knowledge deals with no other paralyzed people like me and do not take me into consideration when dealing with my issues. Im rarely turned and they never get me up in a chair. Their reasoning is they cant ttake the time topick me up with the lift when each cna has 32 people to care for. Even worse, they took me off my air matrress and put me on a regular mattress that feels so hard it hurts all the time. Should I be on a regular foam matress when i cant move to relieve pressure on my own? MY injury level is a c5 6 7 so i cant move much but i have my left arm. They always tell me my butt is red but no sores and claim they cant constintute a reason for me to have one. Is this true?

Sorry to hear that you are in a place that does not seem to address your concerns. I have been a paraplegic for 20 years and have had several issues in the past with pressure sores. Luckily, I have been healthy for the past 3 years. You are absolutely correct that it is essential to be turned regularly and on a mattress that will distribute and relieve pressure on your skin. There is a really good information sheet on maintaining healthy skin and preventing pressure sores but out by the Spinal Cord Information Network. This websites link for this topic is :http://images.main.uab.edu/spinalcord/pdffiles/Info-13%202007%20.pdf Their are several other topics on a variety of issues related to spinal cord injury that you might find useful. This link for the other info sheets is http://www.spinalcor...sp?durki=21479.

Another website that I have found useful is by PVA (Paralyzed Veterans of America). They have a guide to self care that has a lot of good information in it and might help you make a case for an air mattress. This guide book for self care can be accessed through this link http://www.pva.org/s...ticle&id=10811. It is available online.

If you are truly unhappy with the care that you are receiving at this facility you have every right to ask to be transferred somewhere else. Medicare has a nursing home comparison tool on their website that provides a rating system for nursing homes in every state as well as other things to look for in choosing a facility. If you go to www.medicare.gov and enter nursing home comparison into the search box it will take you directly to this tool.

Hope this helps. Yvonne