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Wound that won't heal-SCI Nurse

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    Wound that won't heal-SCI Nurse

    My best SCI friend of 35 years has a wound that won't heal. He is T12-L1 Admittedly, he has not taken the best of care, but he has been bed-ridden for three years now and nearly died on four occasions. He has been treated at Thomas Jefferson Univ. Hosp. and Johns Hopkins, among several other facilities. He has been home for several months now, and the sore is still the size of a quarter. He uses a wound vac, but progress has stopped. He is now in his 70's, and he needs to make plans for fixing up the old place, transitioning to more appropriate housing, and making sure that his wife is cared for in the event of his passing. He is diabetic and he is a 100%+ disabled vet.

    He does not believe he can do these things from bed, and he is frustrated at being bed-ridden, as he is not sick. His plan is to bandage the wound as best as possible, and get up and do what he has to do, once he gets his strength back. He knows how to work out, and I'm positive he will get stronger. I can't argue with his decision, but I told him I would check here to see if there was any wound treatment center, anywhere in the country, that he should try before giving up on healing the sore.

    He is in the position of having to choose the best of two lousy options. Given his history, I can't see a happy ending, but he has to do what he has to do for his family. Is there anything that has been overlooked. If so, I think I can persuade him to give treatment one more try. If not, he is going to get back in his chair, work out to get stronger, and make plans that all older people need to make. Without getting into detail I agree that he cannot do what he has to do from bed. Besides, his wife is too ill to care for him any longer, and he has had enough of being in bed. Any suggestions?

    #2
    Just out of curiosity, where is the wound? Diet? E-stim?

    I'm sorry for the position your friend is in. I sometimes think that is how it will end for me as well. Diabetes (runs in my family but I've so far been clear) causes complications for people without paralysis, let alone with. Age (as far as elasticity, collagen) must affect the skin as well.

    I hope the nurse has some great suggestions and I'll be watching the thread for my own selfish reasons as I'm pretty sure this is where I'll be one day.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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      #3
      magic spray

      I was reading a post earler that talked about "magic spray" and think you should read it as well. It may be something worth trying on the wound

      Comment


        #4
        since you named Jefferson, maybe you are in Philly/NJ area.

        Matthew J. Finnegan, MD - best doctor around for wound care and flap surgery. located in Haddon Heights, NJ. 856-546-3900.

        He came highly recommended and did my flap surgery.

        I would suggest calling him.

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          #5
          When I had a large (2.5" diameter) pressure ulcer, I started using Vetericyn VF in the morning and evening. It started shrinking and had absolutely no signs of any infection. When I finally went to a wound clinic, all the doctor did was give me the name of an otc moisture barrier. It healed in about three weeks after that and I did not stay in bed.

          Note: I am diabetic and also suffer from low testosterone.


          Good luck.
          Millard
          ''Life's tough... it's even tougher if you're stupid!'' -- John Wayne

          Comment


            #6
            Regardless of the treatment, if he is sitting on the wound, it will not heal. In addition, it is critical that his diabetis be under strict control. If this is not being done, then he is unlikely to heal the wound. Without knowing more about where it is, and what it looks like, it is difficult to say more. Nutrition of course is critical. I would want to know if what his albumin and pre-albumin levels are, as well as his CRP. Has he had recent tests for osteomyelitis, and if it is present, has it been treated? Why has he not had surgery?

            If he is a veteran, he can also go to a VA SCI Center. The closest to him would be the one at the Bronx VA. They have excellent wound care there.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

            Comment


              #7
              If the sore is on his ischial, he might try a Ride cushion. It works well for me, it keeps my ischials free of any pressure.
              Please donate a dollar a day at http://justadollarplease.org.
              Copy and paste this message to the bottom of your signature.

              Thanks!

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                #8
                My Dad had two pressure sores on his butt. It's been about 3 wks and it's healing fairly well.

                Perhaps a contributor: He was put on an air mattress (puffs and spouts air) which supposed to be specifically designed to prevent pressure sores. The sales reps claimed that the design has been researched.

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                  #9
                  SCI-Nurse. I have a quarter size (2.5 x 2.8) pressure sore on my right ankle. They just put a wound vac on it about a week ago. Do these things really work ?
                  www.adventuresofcolinandheather.blogspot.com !

                  Comment


                    #10
                    For the right wound, a VAC (KCI brand for a negative pressure wound therapy device or NPWT) can be quite helpful, although without being sure that there is no pressure, and that your nutrition is good, and that you don't have underlying osteomyelitis,it cannot perform miracles.

                    (KLD)
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment


                      #11
                      More info

                      The sore is near the rectum, as he has a temporary colostomy.

                      I'm fairly certain he has already been a patient of Dr. Finnegan's. Dr. Finnegan is very good (by reputation), but there are a lot of other factors affecting my friend.

                      I never heard of "Magic Spray", but I will check it out. Is it worth checking, SN?

                      Obviously, I have no idea if his diabetes is under strict control. He tells me that his numbers are good, but I don't know if that qualifies as "strict control". I'll ask him.

                      He has been a patient at the Bronx VA. That's where he has surgery 30-some years ago. I went to visit him there. He laid on his stomach on a gurney for several months. I'm sure treatment has changed since then. He has had at least one more surgery since then. I don't think he has enough tissue for another surgery.

                      I'll have to check out the Ride cushion. The wound vac has helped, but it appears to have maxed out.

                      Is the Bronx VA really the best facility for him? If so, I'll recommend that he go back. Are there any other VA facilities that might have something more to offer?

                      Comment


                        #12
                        He is free to go to any VA that offers care, but if he does it on his own he will not get travel pay. I recall hearing about one vet who was living in Michigan (I believe) who wanted to do his annual checkup in a warmer location (Puerto Rico). He would have to pay for the trip himself, but the care is free.

                        So the short answer is he is free to go to any VA facility he wants. I have no recommendations on any specific SCI center.
                        Anything worth doing, is worth doing to excess

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                          #13
                          I would recommend that given his situation he go where it is easiest for him to go. The Bronx is probably that setting. He can certainly try the "magic spray" - it has done wonders for many people, but not all. It is probably worth a try.

                          He really needs to keep the pressure off of it, but understand his situation makes it difficult. Make sure that he eats plenty of protein and that he keeps his sugars under control - quite a feat when you have a wound.

                          CKF
                          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                          Comment


                            #14
                            Magic Spray

                            Can anyone give more info on MS? How did it work for you? Is it OTC? How much does it cost? Any other suggestions for a decub that won't heal?

                            Comment


                              #15
                              Where can you get Magic Spray?

                              It's like a big secret. There are stories about it, but no website of locator for the product. Need some help here. Thanks.

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