I visited my friend this week who is dealing with a Stage 3 pressure wound that has tunneled. This means that the wound appears small on the outside (1 cm) but underneath it is much larger (comparison is a funnel). So while I was there she got up into her wc two times to stand in a standing frame (over a six hour time frame). The wound is covered with a bandage, but I believe she is still doing some shearing of that area plus the pressure of sitting on the wc and then the standing frame. Her attendant and nurse believe that it is okay because the wound is on her Ischium area and they are physically lifting her or are using the hoyer lift.
I read through past posts involving offroaderswife and @europedude and it sounds like the advice my friend is getting is way off base regarding bed rest. She is getting up everyday in her standing frame, sitting on the toilet for bowel movements and using the shower chair as well. She went from a Stage 1 wound to a Stage 3 wound in just 30 days.
Any thoughts?
Inspiration comes and goes but when it arrives, oh how I cherish it.
Yes, califanna. Something sounds terribly wrong. I can only imagine how it distresses you to watch the disaster happen in slow motion.
www.bedsorefaq.com/what-is-a-‘tunneling’-bed-sore/ "Many patients with tunneling bed sores require extensive medical treatment such as surgical debridement. If left untreated, tunneling bed sores may be fatal."
Califanna, this is such a tragic thing to watch. Obvious if the wound has gotten worse in 30 days they are doing things wrong, but no, in denial of reality. Scream in their faces?
Califanna, this is such a tragic thing to watch. Obvious if the wound has gotten worse in 30 days they are doing things wrong, but no, in denial of reality. Scream in their faces?
Thanks. Common sense says don't keep moving her to and from her bed than the wheelchair etc... I will be seeing her again after her next wound appointment and hopefully I can talk some sense into her caregivers. Especially if the wound has gotten worse as it did on her last appointment. Which begs the question, why isn't a nurse just coming to see her instead of her going to the office for the review.
I'm sorry this is happening to your friend - something is clearly awry in her routines or care for this wound to keep worsening.
Her doctor would have to write orders for her to have home health wound care. It sounds like her current PCAs and nurses don't know a whole lot about wound care and prevention, and to be fair, neither do I, but common sense tells you to protect the injured area and not stress it. Does your friend appreciate how difficult it is to heal these things and the risks of developing osteomyelitis and needing prolonged bed rest?
califanna, it seems that your friend should stop doing all that activity until the sore has healed. Get him/her to stay on their side or stomach as much as possible and for bowel routines, see if they can get some kinda padding to put on the toilet seat. These sores are nothing to joke about especially when it's that large and it won't heal quick (few months possibly) so it's better to start off-loading ASAP!
I'm sorry this is happening to your friend - something is clearly awry in her routines or care for this wound to keep worsening.
Her doctor would have to write orders for her to have home health wound care. It sounds like her current PCAs and nurses don't know a whole lot about wound care and prevention, and to be fair, neither do I, but common sense tells you to protect the injured area and not stress it. Does your friend appreciate how difficult it is to heal these things and the risks of developing osteomyelitis and needing prolonged bed rest?
I think annev308, she is not aware. I spoke to her yesterday and she is really overwhelmed by all the infighting between her roommate, caregivers, sympathetic daughter and a social worker that has now been assigned to her situation. My friend does not like staying in bed and believes that getting up throughout the day is still okay as long as her wound is covered. The wound vac has now come back into the picture, which probably means the wound is either getting larger or it is infected.
One thing I have learned from this experience is that as we get older it is important to have a health care directive in place.
Yeah, the health care directive is crucial. It's easy to lose track of just how important that stuff is, and it's often too late to get everything in place once we're aware it's needed.
I had a minor chemical burn go from being a partial thickness blister to a full thickness weeping 4"x 5.5" mess that required three weeks of debridement thanks to a home health nurse not following very specific care orders. Three months later, it's almost closed. And although it's not in an area that gets any pressure, I have had to change the way I transfer, how I pressure relieve, which chair I use, what cushion I use, my bathing schedule, detergent and fabric softener, how I transfer in and out of my standing frame, how often my sheets are changed - the list goes on and on. It *is* overwhelming and it sucks.
I'm so sorry this is happening to your friend and that her care team hasn't made ensuring that she grasps what's going on a priority. I hope the infighters can refocus their energies on getting her through this.