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Partner with first major pressure sore... not doing well.

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    #31
    If he is an eligible SCI Veteran, he should be seen at the VA SCI Clinic in Denver. Unfortunately their SCI Center is not yet open, but they can refer him to the VA SCI Center which covers this area (Albuquerque currently) and they can do a telehealth video consultation from their clinic to the wound care staff at the Albuquerque VA. This would help determine if he should be referred to that facility for surgical management (only VA SCI Centers are supposed to do surgical wound management for SCI Veterans).

    (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.

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      #32
      Thanks baldfatdad... I will pass this onto Don. Thanks KLD... I have been trying to get Don to agree to see the Denver VA for a second opinion... but he is resistant... He only uses them for his medications.

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        #33
        I wanted to give you all an update on Don. The MRI was unremarkable... so that's good. They cultured again and the wound is sterile. He has a consult with a plastic surgeon on Monday to see about closing the wound. I know he will be told that he MUST stay off the site but who knows. Yes... he is a vet and has had a SCI consult at the Denver VA but doesn't like going there. I asked him to consider a consult there for a second opinion before allowing anyone to close the site. The wound looks better, smaller and not as deep but it's a very slippery slope. I really appreciate all the feedback and concern. I will keep you all posted.

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          #34
          bottom line is he needs stay off of it or it will get worse again i am glad things are looking better however he needs to continue whatever he is currently doing and stay off of it.
          T6 Incomplete due to a Spinal cord infarction July 2009

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            #35
            If he agrees to get a re-evaluation and treatment at a VA, the treatment and possibly most of the post-op recovery can be done on an inpatient basis. Huge difference in coverage options for VA vs Non-VA insurance beneficiaries. Home care is going to circle around to having you in the "watchtower" role again.

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              #36
              Originally posted by ergvepeog View Post
              ... The wound looks better, smaller and not as deep but it's a very slippery slope. I really appreciate all the feedback and concern. I will keep you all posted.
              We haven't heard from you for two weeks, ergvepeog. How's it going?
              Female, T9 incomplete

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                #37
                Hi everyone... Don had a consult with a plastic surgery MD a couple of weeks ago. He talked about doing several procedures to close the wound but advised against it for the time being. The wound was debrided by the plastic surgeon and I watched as he did it and he was great. They have changed the dressing protocols several times and the wound is getting better. It was 5 cm deep and now is 3 cm. The diameter has gone from 3 cm to 2 cm. Don has had a nutrition consult and is eating more protein and is on and off courses of Augmenten. He is seeing wound care 2 times a week and changing the dressing QOD. He is seeing the plastics guy once a month. Don is adamant about not having surgery but he may be forced to do this. He is staying out of his chair as much as possible. It's a wait and see situation. I will keep you guys updated. Thanks so much for your help and concern.

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                  #38
                  Hi everyone... here is an update on Don... his wound is smaller in diameter but has gotten deeper. It's tunneled to 6 cm. Home healthcare will be coming in everyday to change the dressing. They want him in the hospital but he is refusing. He will see wound care again next week. It most definitely is depressing for him. I have asked him to register for care cure but he shows no interest. I wish that I could wave a magic wand but I can't. He is 12 years out from injury and now the chickens are coming home to roost. I have tried talking to him but he won't even talk about it... in denial for sure. I will keep you posted. Thanks for all the feedback...
                  Sieg

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                    #39
                    Originally posted by ergvepeog View Post
                    Hi everyone... here is an update on Don... his wound is smaller in diameter but has gotten deeper. It's tunneled to 6 cm. Home healthcare will be coming in everyday to change the dressing. They want him in the hospital but he is refusing. He will see wound care again next week. It most definitely is depressing for him. I have asked him to register for care cure but he shows no interest. I wish that I could wave a magic wand but I can't. He is 12 years out from injury and now the chickens are coming home to roost. I have tried talking to him but he won't even talk about it... in denial for sure. I will keep you posted. Thanks for all the feedback...
                    Sieg
                    Am praying for you both!
                    "Never turn your back on fear. It should always be in front of you, like a thing that might have to be killed." - Hunter Thompson
                    T5/6 complete

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                      #40
                      it sounds to me like yes he is in denial which will only further put him back. it is absolutely CRITICAL that he now stay off of it COMPLETELY and listen to the doctors and be admitted to the hospital.
                      T6 Incomplete due to a Spinal cord infarction July 2009

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                        #41
                        Hi Everyone: Don is actually doing better... Insurance approved home nursing care to come in daily for wound care... The tunneling was 6cm and now 3cm. He is staying out of his chair more and it seems to be helping. The improvement is buying him time but the prognosis is probably not very good... He has had
                        seat mapping done to change his cushion but I agree that he needs to be out of his chair completely. Thanks for all the advise, and prayers... they definitely are needed...

                        Thanks,

                        Sieg

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                          #42
                          I had a grandfather deal with complications to ulcers but never at this level. His was really bad I remember, I think it was stage 2 or 3? I think they are serious enough to consider care of some kind.

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                            #43
                            Pro – stat AWC really helped my stage IV I think. It’s awful tasting liquid protein, but they gave it to me in rehab and I healed really well. Stayed off of it (truly and completely) for months also, but I think the protein also really helped. Company is Nutricia.

                            They have it on Amazon too: https://www.amazon.com/gp/product/B0...A1NHOATTBHRFI5

                            Best of luck to the OP and gasps of wonder at you other sore survivors.

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                              #44
                              Hello. I am a caregiver for my brother who has been complete quadriplegic since 02/2016. Your partner is so lucky to have only developed one sore in 12 years. My brother has 3 stage 4 ulcers... HUGE... and at one point bone was exposed. How large is the ulcer? Is it infected? Have you inquired about a wound VAC for closure?

                              In regards to living with a stage 4 wound, they can live with them, for awhile before the infections start, then sepsis, then antibiotic resistant infections, etc... You need to really have a physician who is on top of things and willing to work with him.

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