When to seek second opinion

[Podkane]

I am 40 years plus post incomplete T5 SCI female. As result of incision and drainage surgery for perianal abcess, I have a 2cm x2cmx2cm R Ischial wound. Surgery was 11/14, wound vac 4 months, up on butt, wound reopened, on bed rest wound vac again since 11/15 to present. The wound was smaller and shallower but debriding has enlarged it. My wound doc seems competent is plastic surgeon and director of wound clinic in Colorado Springs. My concern is that I am now 2 yrs out with this wound (he has only been treating me this past year) and really no discussion about a flap, more aggressive TX such as hyperbaric, electrical stimulation etc. Just the vac and complete bed rest. I have put myself on high protein, vitamins, juven etc. because I want this to heal, obviously. Do I find a second opinion bc doc seems to be treating this simply by vac? The wound is clean, healthy, but progress is slow, despite my efforts. Craig is in Denver, but I was told by nurse line there that they do not see outpt if open wound present. Should I seek other opinion, medical care? One issue is that I don't know where/who I would go to in CO for this. Any input appreciated.
Wound

[SCI-Nurse]

Have you had a MRI or CT scan to rule out osteomyelitis? Osteomyelitis is a bone infection. If the wound you have overlies a bony area. that is possibly why it is not healing.

Craig no longer keeps people post op wound surgery closure. They will send you to skilled nursing facility or home with home care to stay on bed rest for 4-6 weeks post op. Then you have to work on a sitting program with a physical therapist starting at 15 minutes per day to put pressure on the wound for short periods of time working up to 8 hours per day.

pbr

[Podkane]

Thanks for the reply SCI nurse.

Have you had a MRI or CT scan to rule out osteomyelitis? Osteomyelitis is a bone infection. If the wound you have overlies a bony area. that is possibly why it is not healing.

Craig no longer keeps people post op wound surgery closure. They will send you to skilled nursing facility or home with home care to stay on bed rest for 4-6 weeks post op. Then you have to work on a sitting program with a physical therapist starting at 15 minutes per day to put pressure on the wound for short periods of time working up to 8 hours per day.

pbr

Good info on Craig. Prior (1yr ago) MRI did not show osteo infection.

[JamesMcM]

I am 40 years plus post incomplete T5 SCI female. As result of incision and drainage surgery for perianal abcess, I have a 2cm x2cmx2cm R Ischial wound. Surgery was 11/14, wound vac 4 months, up on butt, wound reopened, on bed rest wound vac again since 11/15 to present. The wound was smaller and shallower but debriding has enlarged it. My wound doc seems competent is plastic surgeon and director of wound clinic in Colorado Springs. My concern is that I am now 2 yrs out with this wound (he has only been treating me this past year) and really no discussion about a flap, more aggressive TX such as hyperbaric, electrical stimulation etc. Just the vac and complete bed rest. I have put myself on high protein, vitamins, juven etc. because I want this to heal, obviously. Do I find a second opinion bc doc seems to be treating this simply by vac? The wound is clean, healthy, but progress is slow, despite my efforts. Craig is in Denver, but I was told by nurse line there that they do not see outpt if open wound present. Should I seek other opinion, medical care? One issue is that I don't know where/who I would go to in CO for this. Any input appreciated.
Wound

Wound healing
I don't know what you're taking for supplements, but zinc has been proven to help wound Healing. Multivitamins are not best choice, some studies have shown they might be more harm than good. If you are taking a supplement quality is key, liquid supplements are substantially more bio available. I take a liquid zinc 10 mg equivalent twice today I noticed quite the difference, my sword just happens to be in a bad spot that my spasms constantly rub but it still helps. Also protein is essential, trying to rebuild that skin so it needs alot protein at least half a gramme per pound of body weight of quality protein. It's night and day, mind you I'm not 40 years post so obviously your skin is more susceptible but some things to keep in mind.

[Podkane]

Thanks James. Good info on the liquid zinc. I just ordered vitamin a, e, zinc and L Arginine to do the Vitamin protocol cited here from an article in New Mobility. I have successfully evaded doctors and hospitals up to this point, as well as multiple meds. That works up to a point, if you are educated in how to take care of secondary conditions, but this wound is down to me to some degree bc I was impatient to return to work and my former carefree gimp life. I didn't want to stay bed bound so got up too soon, etc and made it much worse, and had to medically retire anyway. This go round I'm pretty much following dr orders but aggressively adding protein (100 grams daily) Juven, no pressure, new RIDe seating system, and spending time on this excellent forum researching what else I can do to return to my former 'carefree' gimp life! I will try the liquid zinc

[Podkane]

Thanks James. Good info on the liquid zinc. I just ordered vitamin a, e, zinc and L Arginine to do the Vitamin protocol cited here from an article in New Mobility. I have successfully evaded doctors and hospitals up to this point, as well as multiple meds. That works up to a point, if you are educated in how to take care of secondary conditions, but this wound is down to me to some degree bc I was impatient to return to work and my former carefree gimp life. I didn't want to stay bed bound so got up too soon, etc and made it much worse, and had to medically retire anyway. This go round I'm pretty much following dr orders but aggressively adding protein (100 grams daily) Juven, no pressure, new RIDe seating system, and spending time on this excellent forum researching what else I can do to return to my former 'carefree' gimp life! I will try the liquid zinc