I was at wound care yesterday. The wound continues to make progress. I have great granulation and the wound is fully filled in. After much discussion the wound vacuum is off or as they dryly put we discontinued therapy. A happy day indeed! I referred to the wound vacuum as my ball and chain. It was necessary and speeded healing but the company that has a monopoly on the wound vacuum market, KCI, was a nightmare to deal with. KCI is the perfect representation of evil, the perfect example of all that is wrong with corporate America. Regardless I am wound vacuum free. This does not mean the wound is healed. The skin needs to grow back and close the last part of the wound, around the size of a fifty cent piece. I hope to be free of wound care in a month. For now I am changing the dressing daily and will have wound care come once week to measure the wound and confirm it is getting smaller. As my brother told me on the way home from seeing the doctor, "don't fuck it up now". Words of wisdom and colorful too! I was warned by him and the surgeon--do not sit up too much. There is more healing to be done. To insure I am careful I remind myself that if I wound that wound today I would be very upset. I want to be healed and never ever worry about such problems again.
I have learned a hard lesson--the hardest. Skin care prevention is of paramount importance. Never in my wildest dreams did I ever think it would take six months to heal a wound. Never did I envision myself stuck in bed and isolated. Never did I dream I would miss the ski season. Denial is a powerful emotion. In fact in part it got me through this extended nightmare. One thing has dominated my thoughts as I near the end of my long journey in wound care. Helping others avoid this problem or helping those cope with an existing skin problem. I will give the surgeon a copy of my posts and hope there is something I can do. No one should be forced to endure what I have. It is a form of cruel and unusual punishment to be stuck in one's home for months on end. Worse yet some, many actually, are forced into nursing homes for the exact same problem--a far worse fate than I experienced. Something needs to be done to help those in similar circumstances. Also education in the form of prevention must be given higher priority. High end cushions need to be given to all paralyzed people and those at risk. This would not only be good for people but save valuable health care dollars. We just need the vision to make this happen.
Good news - I would think though that the most important aspect of prevention is
ReplyDelete1) to limit consecutive chair time
2) have proper cushioning (do you remember Claire's post on the sheepskin?
3) Proper physiotherapy (I know, not so simple, but hold on) specifically massage. See if there is an accredited massage SCHOOL in your area. You have two options: if you are mobile enough there are usually student clinics, they offer cheap treatment. The added benefit of having a novice is that because you are paralyzed (if they accept you) the student will need to be chaperoned which in turn means better treatment.
Second option is to contact such a school and have them post a request for in-home treatment by a student. Still a cheaper option and massage is safe (except for wound area ofcourse) as long as credentials are established, i.e. what techniques the student intends to do, discuss where on your body you will be treated. All this of course will depend on someone who has the courage to take on your case, which can be frightening to a novice and if they inspire confidence in your eyes.
Eric, Your points are all well taken. Prevention is everything. A small red mark can bloom into a giant problem swiftly. Reducing pressure is key as is a good high quality wheelchair cushion. Massage and physical therapy are also helpful. Sadly, this is all beyond the budget of most people. Wheelchair cushions are only covered by insurance if you have a demonstrated medical need meaning you develop a sore. Hence you are only covered after you have a problem. The irony is obvious. As always thanks for your thoughts.
ReplyDeleteRe: Seating: Did you see Xerxes' litter in "300"? That's some stylin ride. Probably as many sheepskins on there as you could possibly want.
ReplyDeleteCongratulations! (Congranulations?)