X Marks the Spot

There's an old saying that states, "Opinions are like assholes; everyone has one." I'm in the minority of people that have two. Assholes, not opinions. Well, one asshole, one hole in my ass...I guess it's more of a crater than a hole.

The medical term for the sore is ischial pressure ulcer, grade IV. What makes people in wheelchairs particularly susceptible to getting pressure sores is the fact that paralysis prevents most people from sensing when an injury to the skin occurs. The poor blood circulation in the area caused by continuously being seated accelerates the speed of the tissue breaking down, hinders new tissue growth, and adds to why these types of sores are so difficult to get healed up. The location of my sore has also been extremely problematic in contributing to it's breakdown as well as it's protracted recovery time. The red X on the attractive Moroccan girl in this picture, me captured rudely ogling her cake, is an approximation of where my sore is located, if she were me.







(Click for a better view)

It started as an irritated patch of skin then through a combination insufficient cushioning and the neglect of out-of-sight,-out-of-mind the skin broke down and a sore opened up. For about a week it was a superficial skin abrasion. At the end of two weeks it was about the size of a quarter and I scheduled a doctor appointment. The doctor discovered that some of the tissue inside the sore had started to die and after cleaning it out and giving me instructions on how to dress it, encouraged me to stay off of it as much as possible - not the easiest set of medical advice to follow in my situation. My bad, it turns out, and when I saw the doctor again ten days later, the sore had deteriorated significantly, was now a centimeter deep in one spot and there was more necrotic tissue. A third visit, the next week, showed more deterioration of tissue and the depth of the sore had increased as well. The hope in treating it was to keep it from getting to the point where surgery was necessary to help it heal properly.

Well, to make a long story short, the month of days spent mostly lying on my side so as to not put unnecessary pressure on the sore, multiple wound dressing changes, way too much TV, and no social life helped to decreased the circumference of the sore, but a MRI scan revealed osteomyelitis in the ischial bone underlying the sore. In layman's terms, a bad infection in the bone that, while localized for the time being, if it were to spread further would be real bad. So, in a week and a half I'm scheduled for surgery to remove the infection. That will be followed up by more lying around doing nothing as the sore attempts to heal properly. I'm looking at mid-November by the time I'm back to full steam.