For most of us, if we get a cut or scrape or even a deeper laceration, we start to heal immediately and in a few days or weeks, it’s much improved. The skin has miraculous healing powers. Immediately after a cut, the body clots the bleeding sends white cells and special chemicals to the site to fight off infection and within hours new cells start replacing those that were lost. It’s awesome how God created such an amazing process for regeneration within our own bodies that take place day after day.
When everything in the body is working properly, skin breakdown is not big deal, but that’s not always the case with an MS patient. For one thing, MS is an auto-immune condition meaning the body already has it out for itself. Therefore, it’s NOT working properly much of the time. Then, if there are mobility issues, the circulation to areas that do not move as well is often impaired and that slows down wound healing, too. On top of that, if you’re taking interferon like Rebif, then you could suffer from a decrease in the production of replacement cells. And on top of that, if you’re on steroids, your wound healing is REALLY impaired. So getting a skin tear is a big deal with a wheelchair-bound basically immobile individual.
That being the case, when I give Lynn a bath, I really try to check out his skin and keep a watch on any cuts or scrapes that might be present. He gets a lot of skinned elbows because he doesn’t pull in his arms as he should when rounding a corner going into a room(and no, he won’t wear elbow pads, I’ve tried). Usually, those heal pretty well because he moves his arms a bit more than his legs.
My greatest worry though is open wounds on his buttocks. He has two almost pin-head size openings on his buttock near his coccyx. Not a good place to have one. He can’t sleep in a bed right now because his legs are so uncomfortable so he sits in his wheelchair probably 22-23 hours a day–that’s a lot of time sitting on one part of the body; plus he doesn’t move his core very much. He can’t really reposition himself in his chair other than to tilt his chair backward so he can slide backward.
Therefore, getting a wound on his coccyx area is a big deal. It’s a risk all the time for more shearing with movement and the pressure makes circulation to the area less.
He has had buttock wounds before and I’ve tried various types of skin barriers and patches to treat them. Often the patches, even though designed for wounds, tend to tear the skin in other places when they are removed due to the adhesive. I’ve had small areas the size of pin-heads enlarge in a week to wounds the size of a quarter due to the removal of bandages or dressings. It’s very discouraging and something to watch very carefully.
I know from when I was working as a nurse that patients who do not manage skin wounds well can die just from the horrible wounds and infections that develop over time. I also know that at times the layers of tissue under what appears to be a scab are often continuing to deteriorate. Wound care is very complex. If the person you’re caring for gets a wound that keeps getting bigger rather than smaller and isn’t in time, showing the nice pink edges of healing, or if the wound starts to smell or drain a lot, see a doctor or wound specialist pronto. Skin wounds are nothing to ignore. Take them seriously and don’t wait, too, long to have someone who knows how to treat them properly take a look. If you don’t, the results can be tragic.
5 thoughts on “Oh, No. Is That a Skin Tear?”
Hello Donna, I have often read parts of your journey…I am also friends with Linwood Schools…he led me to your site. I also live with a spouse that has MS….We have been married almost 44 years….Sam was diagnosed shortly after we moved to VA from a small town in Western NY state…the year was 1974…Back then there was none of the medical advantages of today…I am impressed with the strength and devotion you have with Lynn…..we live one day at a time and try to make it blessed…I am sure that you feel much the same way….I have silently thought of the both of you since Linwood told me about you….he is a good man….I just wanted to say Hello to you and Lynn…if ever you need a friend Sam and I are here….
Thank you for your kind words. Linwood has mentioned you to me as well. I hope all is well with you and Sam and maybe one day we’ll even run into each other somewhere in the area. Take care. Donna
Donna, I think of you and Lynn often. I do not know how you are getting everything done. Please make sure you take care of you, too. Would love to see you sometime.
By the way, you are doing such a good job on this site! I am sure it helps those who hear about it that are dealing with this illness and other long-term care illnesses. I had a student this year whose mom has MS. I taught their daughter my first year teaching, too. She has a walker to use sometimes, but is doing well overall. Do you know the causes of MS? I guess what I am really asking is if she could pass on to her children. I was told by another staff member she was diagnosised before her marriage and the childrens’ births. They are a wonderful, christian family. The husband made an outdoor planter at the end of this school year.
What do you do for relaxation? Do you have someone to help you with Lynn’s care?
What a nice surprise to hear from you. I think of you often too! I have family that helps with Lynn every once in a while but otherwise I do it on my own. His family and mine are so good about helping as are several members of our church. MS is not inherited exactly but there is a family predisposition to it. Lynn’s Dad had it for example. There is no gene for MS but it does tend to run in families. New drugs are available to help decrease the progression but there is no cure. It also affects everyone very differently.
If you are ever in Richmond, let me know. would love to see you!