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    Beginning Sore

    On Wednesday, Nick noticed a red spot on right heel while checking on my skin. It was a bit red with pink on the edges. We called the nurse that checks on me once a week so he could come to see it. He came in and told Nick to massage the area with lotion. Also, we still had to leave the padding that the doctor had put with the splint on my broken leg.

    Later that night, he checked it again and it had turned redder. The doctor told me to take off the splint and to call him on friday if it got any worse. We were wondering how we could keep my leg straight with some support. I remembered having some boots they had given me while hospitalized which were for preventing sores on heels. We decided to use them.

    The next day, the nurse came in again and checked on it. It was still a pretty angry looking red and he told us to massage it with lotion and keep it wrapped with the same padding and ace bandages. Later on, Nick and I decided to just leave the sleeve they put on my leg and the boot on. The nurse told him to massage with lotion three times a day. He says that this will make the blood circulation work better for it to go away and not break the skin.

    Nick and I were wondering if the massaging will not irritate the skin. We don't want the skin to break. Anybody have any ideas/suggestions/answers? This is the first time I meet with a sore on my feet. Also, I have diabetes and am concerned that it could cause me more problems because of it.

    Any replies will be appreciated.

    Raven
    Have courage for the great sorrows of life and patience for the small ones; and when you have laboriously accomplished your daily task, go to sleep in peace. ~Victor Hugo~

    A warrior is not one who always wins,
    but one who keeps on fighting to the end ~ Unknown ~

    #2
    I'm using Neem salve Jukey recommended. It REALLY accelerates healing, don't know if it will stop breakdown. Got it at the health food store. Can you try a whirlpool/jacuzzi rather than massage? Might be more gentle yet still stimulate circulation? Seems Ace bandage would inhibit circulation, to me? Watch it, Raven, 2 friends have lost toes so far this year due to the damn diabetes!
    Blog:
    Does This Wheelchair Make My Ass Look Fat?

    Comment


      #3
      I strongly disagree, should not be massaging it! Keep all pressure off and watch it, if it opens, see a real wound care specialist, not home care nurse. If you can take more protein in your diet add that. Being diabetic and SCI you wll really have to watch it, I would see a specialist pronto. Hope it fades, Deb.

      Comment


        #4
        Raven, I was always told NOT to massage. The loton/cream will help keep the skin from getting dry ( and easier to crack open) but should be put on with out a lot of extra massage.

        Good luck, and watch it carefully!
        T7-8 since Feb 2005

        Comment


          #5
          Hi,

          I do not recommend massaging sores. If it is a pressure sore, you should relieve the source of the pressure such as a tight footwear or bandaging. I would cleanse it daily,cover it with a dry dressing since the skin is not broken and put the boot on-but only if the boot does not directly touch the sore or touches it with a sheepskin or some padding. Inspect it twice daily.

          Being a diabetic, i would have it checked out as soon as possible by a skin care specialist.

          AAD
          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


            #6
            hola

            just wanted to thank everyone for their response.
            this nurse ( in my opinion ) is not helping alot. on the contrary, it seems he's really trying to avoid helping in every way. moms orthopedic dr advised that she needed to have her leg checked daily by this clown. he immediately told us that medicaid won't cover that etc etc. now i can understand the issue that moms coverage won't pay that and so on, and that's fine. the thing is that i get this feeling he really doesn't want to deal with her. on his weekly visit, he tries to make it as short as possible. checks her sugar, asks what size of foley she uses (because apparently he can't remember after asking serveral dozens of times), then speeds out the door. it's not that i expect him to cure every ailment she may have.. but just a little more concern would be nice. or atleast pretend.
            as far as moms broken leg, this red spot has definetly gotten worse. this same
            nurse advised me to put lotion on it and to massage it. from what he advised me to do, he said to massage and to pretty much massage hard to "get the blood circulating". i was kinda concerned about putting pressure like that on her heel. her air boot is open in that area. after putting it on, we usually make sure that her heel is not touching anything. she does still wear that tight sock thing ocassionally. i don't know if we should use the air boot without that long sock thing or both?
            we dont use the ace bandage anymore. just the long sock and air boot.
            i know nothing about medicine or anything like that but i just wasn't sure it was a good idea. i got mom some A+D cream and Zinc Oxide, even Vitamin E. i've been applying that atleast three times a day. the red spot is red like a tomato and is outlined in dark color in one part. her skin isnt flakey or anything since i've been applying that combo.
            what should i do from here?\
            thanks in advance...
            <3
            Last edited by 1010011010; 26 Aug 2007, 3:46 AM.

            Comment


              #7
              Aw geez Nick .. I'm sorry Raven is having to deal with this! {{{hug}}} for her !!

              No .. no massaging ..... and from what you describe maybe there is some necrotic tissue in there. Bill has had numerous sores on his heels .... zero pressure and a dry covering to protect it ... then if it opens up I clean it with saline and cover it with something like Alevyn ! Lynnifer has lots of experience with this I know she'll have some thoughts too! Can you get to someone who only deals with wounds .... an enterostomal nurse??? That would be ideal and particularily in your Mom's case because of her diabetes.

              Obieone
              ~ Be the change you wish to see in the world ~ Mahatma Gandi


              " calling all Angels ...... calling all Angels ....walk me through this one .. don't leave me alone .... calling all Angels .... calling all Angels .... we're tryin' and we're hopin' cause we're not sure how ....... this .... goes ..."
              Jane Siberry

              Comment


                #8
                Whoever told you to massage that heel is misinformed about skin/wound care. Redness indicates tissue damage, and massaging damaged tissue simply leads to more damage. I agree with SCI nurse on eliminating pressure to the area and covering it lightly with a dry dressing. Keep a "wait and see" approach for the moment but be alert to ANY acute changes in what you see. I am VERY concerned of the possibility of a blood clot since this is not uncommon occurence with a fracture and increased immobility.

                NICK and RAVEN: If you see increased redness or streaking or further darkening of that spot and just get a bad feeling in your gut, go to the emergency room and get some dopplers done to make sure there is no blood clot in that leg.

                Talk soon, Mary
                1FineSpineRN

                Comment


                  #9
                  I don't think the long sock will do any harm as long as it is not tight and not thick to add further pressure. The reason shdshould have it checked is being a diabetic and ther may be more damage underneath that is not showing yet. Hopefully not.

                  Keep us posted.

                  AAD
                  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


                    #10
                    Thank you all for your replies. Nick and I had this gut feeling about the massage not being that great an idea so we had decided to check with others here who have dealt with the issue of sores before. We have stopped doing the massaging since yesterday. We are only using the A & D ointment on it plus the Vit E oil. Also, we make sure that when my foot is in the boot, it is free of contact with anything else. I also checked the stocking that was originally put on my leg for the splint and it is not tight nor thick. It is more like a soft knit material and pretty stretchy.

                    I am planning on calling the nurses' agency tomorrow and have them send the nurse who is in charge of wound care. He is the one who took care of me with a sore that took me about six months to heal. It has not opened up since. After that I will most likely make an appointment for the wound care clinic I went to before.

                    Neither one of us feel that this present, new nurse is doing a good job. I noticed he does have a hard time to draw blood for some of tests and he had to come do it again with no results on either day. After that time, I prefer to go to the lab and have them done instead.

                    I don't know if I am wrong, but he has asked Nick to do the wound changing even when he comes to check on me, and I think it is his job to do it then instead of Nick. Am I mistaken?

                    Again, thank you all for all the support and suggestions you have given me. They are really appreciated.

                    Raven
                    Have courage for the great sorrows of life and patience for the small ones; and when you have laboriously accomplished your daily task, go to sleep in peace. ~Victor Hugo~

                    A warrior is not one who always wins,
                    but one who keeps on fighting to the end ~ Unknown ~

                    Comment


                      #11
                      The home care nurses must have SPECIFIC orders from the doctor or they can't/ won't do it. I would discuss this with him but I do think it is wise to call and get the wound nurse there. who can discuss it with the doctor and get the needed orders. Until then there should be no pressure of any kind on the wound. I wouldn't even put padding or coth on it.


                      CWO
                      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


                        #12
                        Well, it finally broke the skin. Nick checked it this morning and said it was a tiny little hole for now. We had some dua derm patch so he put a piece of one on it.

                        Also, I called the nurse who used to treat me for my last sore and he will be coming in this week instead of the other nurse. I told him about the other nurse telling us to massage the area and he said not to do it. I do feel more relieved to know that he is going to be coming in instead.

                        Raven
                        Have courage for the great sorrows of life and patience for the small ones; and when you have laboriously accomplished your daily task, go to sleep in peace. ~Victor Hugo~

                        A warrior is not one who always wins,
                        but one who keeps on fighting to the end ~ Unknown ~

                        Comment


                          #13
                          Yesterday, the wound care nurse came and checked the sore. It got a bit bigger. Nick feels that he is at fault for that. I told him that it wasn't his fault because he followed the other nurse's orders. He believes that if he hadn't put the duoderm, it would not have gotten bigger but I told him that I didn't know either that it would and I am supposed to know more about sores too.

                          The nurse will be coming to see me four more times to check on it. He also talked to the other nurse and had to tell hm how to take care of my wound. He also told him that Nick is not supposed to do it because he is only my provider. He also told him that the beginning red area wasn't supposed to be massaged. The other nurse wanted him(Nick) to do things as if he were the nurse. I am glad Hector(wound nurse) corrected him and had a good talk with him about my care. I have also decided to ask that they send someone else who has more experience with SCI. Don't want to have him make anymore more mistakes.

                          Hector also told me to keep my suger level in control so I won't have any problems with healing. He put some patch which he says should be used and that it will help heal faster. So far, my sugar has been controlled so I am hoping it does heal quickly.

                          As for my broken leg, I have to go back to the ortho next week. Will post more on what the condition of it is then.

                          Raven
                          Have courage for the great sorrows of life and patience for the small ones; and when you have laboriously accomplished your daily task, go to sleep in peace. ~Victor Hugo~

                          A warrior is not one who always wins,
                          but one who keeps on fighting to the end ~ Unknown ~

                          Comment


                            #14
                            Raven, I'm so glad you had the wound care nurse there to see and intervene in your care. Please let Nick know that he was a champion in this struggle not a culprit, finding and starting care was the best thing he could have done. Now that it is open it can get treatment and start to heal. Sores usually start under the surface and eventually break to the surface. You were both smart to question massaging the area, if better circulation is desired ROM is more effective with proper hand placement of the helper. I hope you heal quickly and I hope Nick is okay too, because he seems like a loving and smart son.

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