I have been fairly quiet on my updates for the past year. This has been the case for a reason as I have been dealing with among the worst types of ailments an active wheelchair user can get. A pressure wound. I will be posting a series of posts on what I went through, how I managed to exercise albeit limited execrise and the types of exercises I was still able to perform.
I had to deal with extremely limited time up in my chair. I had to deal with a wound vac. And I had to deal with a pick line for taking IV antibiotics. I trained through all of this.
The Wound
On January 1 of 2018 I woke up, with a minor hangover from the New Years celebration but nothing too bad. When I was getting up I could feel a lump on my backside, it felt like a golf ball was under my skin. My wife and I tried to deal with it as best we could but over a week or so this turned into a wound. My first advice to anyone in a wheelchair is if they feel something abnormal on their backside would be to go to a wound doctor as soon as possible. Its possible the doctor could have drained or treated whatever was going on before it got any worse. Then again, most pressure wounds have been building for a long time deep within the tissue and there may not have been anything that could be done.
Anyways, since that time I have been dealing with this wound and have done everything possible to avoid flap surgery. I had flap surgery back in 2007 for a somewhat similar issue and wanted to avoid going the flap route if at all possible. I have heard many stories where once a person goes back for that second flap, or beyond, they can very easily break down leaving you with a worse situation that when you started. My thought was to allow it to heal more naturally and prevent another breakdown within a short timeframe.
I am still not fully healed but after just completing IV antibiotics we are starting to see improvements again. This is the other reason I kept avoiding the flap, there was often slight incremental improvement. Often a few millimeters at a time but improvement is improvement and when your goal is to avoid surgery, any improvement will suffice.
Hyperbaric Oxygen Therapy (HBOT)
I am currently receiving Hyperbaric Oxygen Therapy (HBOT), where I drive in 2 hours round trip each morning for a 2 hour session. I have completed 44 of these sessions, with 16 remaining. There are a lot of amazing things reported from HBOT treatment. Among its biggest reasons for success is it gets blood flow to places where blood flow may be restricted, like the backside of a person in a wheelchair. One negative to this treatment is it can take a long time to see any visual evidence it is working, at minimum 30 treatmets in some cases. This was further complicated in my case due to Hurricane Micheal which ripped a part Panama City Florida. Panama City is where I was receiving my treatment, had just completed 11 treatments before the hurricane hit. I had to find a new place to receive treatment as well as get the insurance approved for the new clinic. This all took time and has delayed the effectiveness of the treatment as it is preferred to stack the treatments with 4-5 per week. For me this was broken up once because of the hurricane, then a second time when the new year started as my health insurance changed.
Wound Vac
Another treatment I received was getting a wound vac. I hated this thing. And it is VERY likely I will have to have another one to attempt to aggressively close up the remaining wound. On one hand the wound vac did work initially, but then it didn’t. And probably caused infection to occur. The wound vac is like a ball and chain attached to you, literally. Doctors and nurses will claim you can live your normal life with it but this is not the case. A person can do some things around the house but in no way are you going to want to do more in public than you absolutely have to. I am not looking forward to having another one put on but I am hopeful it will be on for a short time, and close up this wound.
IV Antibiotics
I just completed IV antibiotics, something I probably should have received months ago. Some doctors do not believe in antibiotics, my original doctor was one of these people. When you have a wound where wheelchair users get wounds, and you are having trouble getting it to close down, its very likely you have osteomyelitis. You need to get IV antibiotics to address this problem. This means getting a Pick line, which means more limitation on exercise. And you get this for 6 weeks. I just finished up my 6 weeks yesterday and was able to go back to doing a full workout, or a modified workout for someone with a wound.
Whats Next?
As I stated, I still have the wound. But it is getting much better. I will post weekly updates on where things are at with the wound as well as begin releasing what I did to maintain my fitness. As much as anything, when you have a wound you need to keep your mind right as you are forced into a life of seclusion. For me that means exercise, pretty much daily exercise.