MY PRESSURE ULCER JOURNEY
I never knew what pressure ulcers were until I got one for almost all pressure points. I am currently facing possible amputation. If this happens what am I gonna do?
24 hour support will be needed. I don’t like the idea of amputation. The problem is, I’ve been having pressure ulcers, foot x-rays and MRIs/CTIs. I’ve had a series of meetings about my right foot. I’ve got antibiotics to take. Blood sugars, protein levels, blood circulation, feet pulses and kidneys all contribute to the feet. I also got to see photos from MRI scans. I got permission to take photos of them. The heel bone is infected. I know what it’s like to be cured of pressure ulcers, but they keep returning, especially on my feet. What’s going on?
As a result, I have chosen to join the fight against pressure ulcers.
During my first year of college, the pressure ulcers started. When this happened, I got a social worker, carers, District Nurses from the Chelsea and Westminster Hospital in London while studying. I also have a Tissue Viability Nurse and a Podiatrist. Before the pandemic, I visited the doctor’s office for appointments. Now I get home visits.
One day, the wound on my right foot seemed smelly to the nurse as if it’s infected so I was on antibiotics for 7 days. Sensation and movement is limited from the ankles down as a result of lower spine damage due to Spina Bifida. Pressure ulcers can also be caused by bed mattresses or wheelchairs. Bermuda has a lack of resources and a lack of information. There are no Spina Bifida clinics/specialists in Bermuda. Lived with parents. Swimming in the salt ocean in Bermuda beaches has contributed to the healing process. Before England and College, I had no pressure ulcers.
Pressure wounds usually take 3 months to heal. My wheelchair has a ROHO Cushion with air pockets. Now my footrests have air pockets. It’s ultimately an airbag under my feet. https://www.permobil.com/en-us/products?category=SeatAndPositioning
Podiatry and District Nurses tend to clash from time to time. District Nurses visit three times a week while Podiatry only visited once. District Nurses know how to dress my foot correctly. Which one is more important?
Pressure Sores (also called bedsores or decubitus ulcers)
Pressure sores, also called bedsores or decubitus ulcers, are areas of broken skin and underlying tissues that have been damaged by pressure. Pressure (such as sitting in the same position for too long) restricts blood being supplied to the area, so the tissues become deprived of oxygen and toxins build up, which causes the skin and tissue cells to die. People with Spina Bifida may not feel this damage beginning because of reduced feeling in parts of their body.
PURSUN GROUP IN LEEDS
Prevention is better than cure! You must have tough skin. Pay attention to pressure points. Additionally, make sure you have good quality, well-fitting shoes that do not cause red marks on your feet. You may want to ask your GP to refer you to an orthotics centre to have shoes made especially for you. The styles are much better than they used to be!
Make sure you have a well-fitting wheelchair with a pressure-relieving/ reducing cushion. Pressure mapping in the wheelchair cushion. Always use your footplates to support your feet and stop your legs from ‘hanging down’, which is bad for the circulation. Ergonomic Assessment required.
Feet must be elevated above the head, especially in bed, for good circulation. Check your wheelchair does not leave red marks on your legs or body. When you see a reddened area of skin, tell your GP straightaway. Don’t wait to see if it improves on its own. If left untreated they can take a lot longer to heal. If you do have a skin breakdown, make sure your health professionals look at the reasons why it happened, and don’t just apply dressings. Change your sitting position frequently throughout the day and have a chair at home to sit in other than your wheelchair. Try to spend part of each day off your bottom. Check your skin regularly for pressure sores using a mirror to see areas of your body you cannot see otherwise. Pay particular attention to areas of skin where you have little or no feeling.
Massage is now advised against as recent evidence suggests that it is not beneficial for pressure areas and may be harmful.
Hygiene: Access to Showering facilities instead of bathing facilities in England. District nurses clean and dress wound 3x a week maximum, in addition to personal daily showering. Skin care included Aqueous cream. No scented creams are allowed on broken skin. I shower daily but due to pressure ulcers and a PICO, I also use a LIMBO to cover my damaged foot to keep it clean and dry.
Why does immobility cause pressure ulcers?
Poor mobility/immobility: Patients who are unable to independently change position are at increased risk of developing a pressure ulcer, due to pressure exerted over bony body parts which results in reduced blood flow to the tissues and subsequent hypoxia.
CURE
I also use a Profile bed, I prefer loose clothing vs tight clothing like dresses or sweat suits. Compression socks/stockings/orthopaedic shoes/socks because sensation and movement is limited from my ankles down.
Incontinence can also contribute to pressure ulcers. Pressure ulcers must be kept clean and dry.
Previously during the first four months of my first year in college, I skipped meals for the sake of my studies. I was also given a Dietician who put me on a high protein diet. My meal plan looks something like this:
Breakfast
Mid-morning snack
Lunch
Mid-afternoon snack
Dinner
Dessert
Why does malnutrition cause pressure ulcers?
Unplanned weight loss is a major risk factor for malnutrition and pressure ulcer development. Suboptimal nutrition interferes with the function of the immune system, collagen synthesis, and tensile strength.
Pressure Ulcer Prevention at Home
- Treat your skin gently to help prevent pressure ulcers.
- When washing, use a soft sponge or cloth.
- Use moisturizing cream and skin protectants on your skin every day.
- Clean and dry areas underneath your breasts and in your groin.
- DO NOT use talc powder or strong soaps.
- Try not to take a bath or shower every day
https://tvs.org.uk/stop-pressure/
https://www.shinecharity.org.uk/self-care/skin-and-tissue#Sores
https://nhs.stopthepressure.co.uk/patients.html
https://medicinehealth.leeds.ac.uk/leeds-institute-clinical-trials-research
Every day has to be a STOP THE PRESSURE day when you are a person living with skin vulnerability or reduced mobility.
LET’S WORK TOGETHER TO STOP THE PRESSURE!!!
STOP THE PRESSURE, START THE RELIEF!!!!
STAY TUNED FOR THE REST OF THIS SERIES ON PRESSURE ULCERS!
