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my VAC bandage is going bad; help!

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    #16
    John, not a hospital that deals in geriatric cases, they are less likely to give you what you need for your SCI. After all, you're an old man, we'll just stick you in a wheelchair. They specialize in problems associated with aging, not spinal injuries. Go for a facility that has experience treating the problems associated with SCI

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      #17
      Thank you. I'm going to try to research trauma centers. But I would think they deal more with broken heads, not butt sores. The geriatric people must see pressure ulcers 24/7.

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        #18
        By the way when my VAC dressing was changed today the visiting nurse noticed significant areas of yellow slough, which were not there yesterday. This is 72 hours after hospital discharge where I had a complete surgical debridment which went to the bone.

        What does this mean????
        Last edited by johngoodman; 22 Aug 2014, 2:40 PM.

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          #19
          Means there is either i fection or you may need to be debrieded again as they didn't get all of it out the first time. Was the surgeon notified? If so what did he say? If not why wasn't he notified?
          T6 Incomplete due to a Spinal cord infarction July 2009

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            #20
            Originally posted by johngoodman View Post
            Thank you. I'm going to try to research trauma centers. But I would think they deal more with broken heads, not butt sores. The geriatric people must see pressure ulcers 24/7.

            John i say trauma centers because they deal with SCI which is who has more experience dealing with pressure sores as it is a complication of having paralysis. Again where do you live we may be able to assist you in finding someplace that specializes or would have more experience in SCI or spinal cord injury. Not all geriatric people get pressure sores by the way my grandmother is 88 and has never had one! In fact they are rarely unless the person is bedbound and not being taken care of properly seen in geriatric centers.
            T6 Incomplete due to a Spinal cord infarction July 2009

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              #21
              Regarding the slough: I have nurses visiting daily at this point from a visiting nurse agency. The agency has a wound care specialist. I spoke to her on the phone just now about the slough. She said that the solution is to stay in bed except for doctor's appointments. Also the nurses will be keeping an eye on it, although frankly some of the nurses who have come so far seem a little bit shakey in wound care knowledge. Actually very shakey.

              Oregon Health & Science University in Portland is the only Level 1 trauma center in Oregon, so I guess that would be the place to go if need be.

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                #22
                I don't know where you are located but McKenzie Willamette Hospital in Springfield has a wound care center and my son once had occasion to speak with one of the doctors working there and thought he seemed to know what he was talking about.

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                  #23
                  There was an article in New Mobillity ~5? years ago about a wound care doctor from Oregon or Washington who included vitamin therapy and L arginine in his protocol and had good results.
                  Maybe someone knows where to find it or him?
                  69yo male T12 complete since 1995
                  NW NJ

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                    #24
                    Originally posted by johngoodman View Post
                    Regarding the slough: I have nurses visiting daily at this point from a visiting nurse agency. The agency has a wound care specialist. I spoke to her on the phone just now about the slough. She said that the solution is to stay in bed except for doctor's appointments. Also the nurses will be keeping an eye on it, although frankly some of the nurses who have come so far seem a little bit shakey in wound care knowledge. Actually very shakey.

                    Oregon Health & Science University in Portland is the only Level 1 trauma center in Oregon, so I guess that would be the place to go if need be.
                    Yes john as everyone has said the only way to heal this at this stage is bedrest except for doctors appts. I would ask that the wound care specialist with the agency look at the wound and advise the nurses how to care for it. What part of oregon are you in? The further you narrow down where you are located the better as someone will generally have an idea of where to go. What you need to be concerned with now is getting the care you need to heal this sore and that would best be at a place that is knowledgeable about SCI and sees this more than a handful of times a year. I am sure once you narrow your location down someone will be able to point you in the right direction. Also maybe even a google search of wound care centers or WOCN's in the area where you are will also be helpful. Once you find a WOCN they can then refer you to someone who should be able to help you. Maybe even the wound care specialist from the agency you are currently using can help you find a doctor that is knowledgable.
                    T6 Incomplete due to a Spinal cord infarction July 2009

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                      #25
                      I have mentioned how skeptical I have become of the medical community. That position has had many causes. In Feb 2012, when I discovered my wound between my rectum and my testicles, (and thought "can't be a pressure wound THERE! It's between the butt checks) I immediately went to the local wound care center which is part of St Claires hospital system, one of the well accredited hospitals in the NY metro area. The head of the center treated me. I felt much relieved when he debrided it a little, gave us instructions for changing it daily, and an appointment for two weeks later. I was overreacting-this is no big deal!
                      Two weeks and more of the same, but this time, "come back in three weeks". Three days later, there was so much crap coming out of the wound and I knew there was more to it. Long story short: a week later I was admitted to the hospital for a two night stay and debridement to be followed by flap surgery after the wound site was stable.
                      I mention this because it is a good example of the lack of qualified people when it comes to treating people like us and our unique set of conditions.
                      Don't let this discourage you; let this inform your aggressive search for the people who DO know what's needed.
                      Good Luck

                      PS: when I was recovering from flap surgery, they NEVER let me into my chair!! Twice they sent an ambulance that took me on a gurney the ~20 miles to Morristown Memorial.
                      My surgeon was Dr Daniel Pyo and I can say that he is incredibly good. Morristown Memorial-well, let's just say I was more than disappointed.
                      69yo male T12 complete since 1995
                      NW NJ

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                        #26
                        John-
                        make sure the following is done:
                        1. No sitting!! I can not repeat that enough. No cushion, No bed, No mattress can replace NO pressure on the area. For you, that means turning side to side and lying on your stomach, if you can tolerate it. NO back lying! Turns should be done every 2 hours.

                        2. Make sure that you find a rehab center that works with people with spinal cord injuries, not a geriatric center. Try to find a wound care center or plastic surgeon.

                        3. Eat well balanced meals, but increase your protein intake. Peanut butter, other nut butters, cheese, meat, eggs are all high in protein. Try to eat snacks that are high in protein and high in calories. It takes a lot of energy to heal a wound.

                        4. Drink plenty of fluids. 2-3 liters a day. Stay away from caffeinated beverages and also soft drinks. Water is your best option, but certainly there are others.

                        Please let your wife know that these should be the guidelines. And that they are firm. You need to follow the advice of people who have experience in this field. Again, I wam more than willing to communicate with her, if you think that would help.

                        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.

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                          #27
                          Thank you all so much. I am not happy about bed rest. I hate it. But my aide has set up some little shelves next to my bed on both sides.

                          I am trying to have this looked ASAP be a wound care specialist, however it seems to be a little complicated. That's not basically a medical title.

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                            #28
                            Where in oregon are you located? Again if you tell us what part of oregon we can help and maybe give you some guidence as to where to go. Do a google search of wound care centers near your area, or again WOCN's in your area. A plastic surgeon is a good start but look them up and make sure they have flap surgery expierence. And a WOCN is a wound ostomy continence nurse they would be your best bet for a good start but again a doctor or plastic surgeon would be better
                            T6 Incomplete due to a Spinal cord infarction July 2009

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                              #29
                              And do get your wife into the conversation. By all means, communicate with SCI-nurse, and if you'd like, PM me and i'll give you my phone numbers. Julie and I (Phil) should be around all day tomorrow if either of you would like to talk.
                              69yo male T12 complete since 1995
                              NW NJ

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                                #30
                                Hopefully the wound care person turns you onto an infection specialist too. If not, make sure they do.
                                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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