Wound Care - Long Term Chronic Issues

[Guest guest]

It has been awhile since my last post. (That almost sounds

confessional, doesn't it?) Oh well, I need some help from you all.

My daughter, 16, developed a blister on her right foot last August.

Now, being a teenager, she decided that it was not important to let

me know that she had this injury. I did not discover it until mid-

October when we went to her orthopedic surgeon for a follow up. I

was shocked to see this deep hole on the side of her big toe.

Immediately we were referred to a podiatrist who tried

several " usual " treatments to close the wound. The problem is that

the lower level of skin does not form and she aggressively grows new

callous skin – but a tiny hole remains open in the center and drains

small amounts of liquid.

Since October, she has had two podiatrists, two leg casts (to

alleviate pressure on her toe), two rounds of wraps to reduce any

swelling, a surgical intervention where it was sewn together. As

soon as the stitches dissolved, the wound opened right up again.

She has also had multiple rounds of antibiotics and is now using

regranex to try to encourage skin, not callous, growth. She has

also had multiple examinations by several physicians who all tell

me " well, everything looks fine, no infection, no cancer, good blood

flow to the area - it should have healed by now " .

Now, she is normally ambulatory for most of her day and since

January, she has been using her wheelchair to keep weight off the

foot. Big problem with that is she has gained 18 pounds. Without

swimming (her favorite) and regular exercise with walking, she is

unable to get moving enough to keep the weight off.

I was told today that this second podiatrist is out of options, he

cannot recommend skin grafts because of the chronic wound and we are

off to another wound/burn care facility.

Has anyone ever had this kind of care issue? My daughter has

lipomyelomeningeocele with her tethered cord at L4. I know the

nerves in her right leg are severely compromised because of the

lipoma and the tethered cord only worsens her nerve conductivity.

Any advice? Is there something we have not done?

Thanks in advance,

Mom to a, 16, Lipomyelomeningeocele, Tethered Cord at L4, Right

Leg compromised with ortho supports

[Guest guest]

Hi ,

Had one more thought, a while back I went to a " laser treatment center " which

was supposed to help treat back injuries and many things with lasers.

They had some pictures up of severe wounds they had treated this way.

Also, I googled " wound healing centre " and found a large number on the net,

below are a few. Seems that many use a hyperbic oxygen chamber.

http://www.kennedyhealth.org/140.cfm

http://www.etmc.org/wounds

http://www.riversidehealth.org/body.cfm?id=23

http://www.lvhhn.org/services/excellence/wound/

http://www.uth.tmc.edu/anes/wound1.htm

good luck

Lynn

Wound Care - Long Term Chronic Issues

It has been awhile since my last post. (That almost sounds

confessional, doesn't it?) Oh well, I need some help from you all.

My daughter, 16, developed a blister on her right foot last August.

Now, being a teenager, she decided that it was not important to let

me know that she had this injury. I did not discover it until mid-

October when we went to her orthopedic surgeon for a follow up. I

was shocked to see this deep hole on the side of her big toe.

Immediately we were referred to a podiatrist who tried

several " usual " treatments to close the wound. The problem is that

the lower level of skin does not form and she aggressively grows new

callous skin - but a tiny hole remains open in the center and drains

small amounts of liquid.

Since October, she has had two podiatrists, two leg casts (to

alleviate pressure on her toe), two rounds of wraps to reduce any

swelling, a surgical intervention where it was sewn together. As

soon as the stitches dissolved, the wound opened right up again.

She has also had multiple rounds of antibiotics and is now using

regranex to try to encourage skin, not callous, growth. She has

also had multiple examinations by several physicians who all tell

me " well, everything looks fine, no infection, no cancer, good blood

flow to the area - it should have healed by now " .

Now, she is normally ambulatory for most of her day and since

January, she has been using her wheelchair to keep weight off the

foot. Big problem with that is she has gained 18 pounds. Without

swimming (her favorite) and regular exercise with walking, she is

unable to get moving enough to keep the weight off.

I was told today that this second podiatrist is out of options, he

cannot recommend skin grafts because of the chronic wound and we are

off to another wound/burn care facility.

Has anyone ever had this kind of care issue? My daughter has

lipomyelomeningeocele with her tethered cord at L4. I know the

nerves in her right leg are severely compromised because of the

lipoma and the tethered cord only worsens her nerve conductivity.

Any advice? Is there something we have not done?

Thanks in advance,

Mom to a, 16, Lipomyelomeningeocele, Tethered Cord at L4, Right

Leg compromised with ortho supports

[Guest guest]

Has Apligraf been suggested?

~Jen

21, SB lipomyelomeningocele L1-2, wheels/crutches, AFOs, PT 2x/week,

self-cathed, latex allergy, drives with hand controls, detethered five times

(ages 18 months, 5 years, 11 years, 14 years, and 19 years), Botox injections

into left piriformis and hamstring

|

| My daughter, 16, developed a blister on her right foot last August.

| Now, being a teenager, she decided that it was not important to let

| me know that she had this injury. I did not discover it until mid-

| October when we went to her orthopedic surgeon for a follow up. I

| was shocked to see this deep hole on the side of her big toe.

| Immediately we were referred to a podiatrist who tried

| several " usual " treatments to close the wound. The problem is that

| the lower level of skin does not form and she aggressively grows new

| callous skin – but a tiny hole remains open in the center and drains

| small amounts of liquid.

|

| Since October, she has had two podiatrists, two leg casts (to

| alleviate pressure on her toe), two rounds of wraps to reduce any

| swelling, a surgical intervention where it was sewn together. As

| soon as the stitches dissolved, the wound opened right up again.

| She has also had multiple rounds of antibiotics and is now using

| regranex to try to encourage skin, not callous, growth. She has

| also had multiple examinations by several physicians who all tell

| me " well, everything looks fine, no infection, no cancer, good blood

| flow to the area - it should have healed by now " .

|

| Now, she is normally ambulatory for most of her day and since

| January, she has been using her wheelchair to keep weight off the

| foot. Big problem with that is she has gained 18 pounds. Without

| swimming (her favorite) and regular exercise with walking, she is

| unable to get moving enough to keep the weight off.

|

| I was told today that this second podiatrist is out of options, he

| cannot recommend skin grafts because of the chronic wound and we are

| off to another wound/burn care facility.

|

| Has anyone ever had this kind of care issue? My daughter has

| lipomyelomeningeocele with her tethered cord at L4. I know the

| nerves in her right leg are severely compromised because of the

| lipoma and the tethered cord only worsens her nerve conductivity.

|

| Any advice? Is there something we have not done?

|

| Thanks in advance,

|

|

|

| Mom to a, 16, Lipomyelomeningeocele, Tethered Cord at L4, Right

| Leg compromised with ortho supports

|

====================================

Fitz-Roy

Boston College Lynch School of Education

(973)563-0709

May-June 2006:

Boston College

66 Commonwealth Avenue #236

Chestnut Hill, MA 02467

" All big things in this world are done by people who are naive and have an idea

that is obviously impossible. "

[Guest guest]

I totally agree and would really push trying to find a foot care specialist such

as a plastic surgeon or orthopedic that specializes in foot ulcer healing like

diabetics. In our area there is a very good plastic surgeon that does a great

job apparently. Although it might seem like no big deal to some of her doctors

if its limiting her ability to walk and all that, plus long term healing,

effects on the rest of her, etc...

If you can't find anyone, call your local hospital and ask, usually hospitals

have this type of specialists.

Best wishes

Wound Care - Long Term Chronic Issues

It has been awhile since my last post. (That almost sounds

confessional, doesn't it?) Oh well, I need some help from you all.

My daughter, 16, developed a blister on her right foot last August.

Now, being a teenager, she decided that it was not important to let

me know that she had this injury. I did not discover it until mid-

October when we went to her orthopedic surgeon for a follow up. I

was shocked to see this deep hole on the side of her big toe.

Immediately we were referred to a podiatrist who tried

several " usual " treatments to close the wound. The problem is that

the lower level of skin does not form and she aggressively grows new

callous skin - but a tiny hole remains open in the center and drains

small amounts of liquid.

Since October, she has had two podiatrists, two leg casts (to

alleviate pressure on her toe), two rounds of wraps to reduce any

swelling, a surgical intervention where it was sewn together. As

soon as the stitches dissolved, the wound opened right up again.

She has also had multiple rounds of antibiotics and is now using

regranex to try to encourage skin, not callous, growth. She has

also had multiple examinations by several physicians who all tell

me " well, everything looks fine, no infection, no cancer, good blood

flow to the area - it should have healed by now " .

Now, she is normally ambulatory for most of her day and since

January, she has been using her wheelchair to keep weight off the

foot. Big problem with that is she has gained 18 pounds. Without

swimming (her favorite) and regular exercise with walking, she is

unable to get moving enough to keep the weight off.

I was told today that this second podiatrist is out of options, he

cannot recommend skin grafts because of the chronic wound and we are

off to another wound/burn care facility.

Has anyone ever had this kind of care issue? My daughter has

lipomyelomeningeocele with her tethered cord at L4. I know the

nerves in her right leg are severely compromised because of the

lipoma and the tethered cord only worsens her nerve conductivity.

Any advice? Is there something we have not done?

Thanks in advance,

Mom to a, 16, Lipomyelomeningeocele, Tethered Cord at L4, Right

Leg compromised with ortho supports

[Guest guest]

Another thing, I just read about the liquid draining, has the foot been x-rayed,

MRI, bone scan? You will probably need some imaging to make sure there is no

infection deeper in.

Wound Care - Long Term Chronic Issues

It has been awhile since my last post. (That almost sounds

confessional, doesn't it?) Oh well, I need some help from you all.

My daughter, 16, developed a blister on her right foot last August.

Now, being a teenager, she decided that it was not important to let

me know that she had this injury. I did not discover it until mid-

October when we went to her orthopedic surgeon for a follow up. I

was shocked to see this deep hole on the side of her big toe.

Immediately we were referred to a podiatrist who tried

several " usual " treatments to close the wound. The problem is that

the lower level of skin does not form and she aggressively grows new

callous skin - but a tiny hole remains open in the center and drains

small amounts of liquid.

Since October, she has had two podiatrists, two leg casts (to

alleviate pressure on her toe), two rounds of wraps to reduce any

swelling, a surgical intervention where it was sewn together. As

soon as the stitches dissolved, the wound opened right up again.

She has also had multiple rounds of antibiotics and is now using

regranex to try to encourage skin, not callous, growth. She has

also had multiple examinations by several physicians who all tell

me " well, everything looks fine, no infection, no cancer, good blood

flow to the area - it should have healed by now " .

Now, she is normally ambulatory for most of her day and since

January, she has been using her wheelchair to keep weight off the

foot. Big problem with that is she has gained 18 pounds. Without

swimming (her favorite) and regular exercise with walking, she is

unable to get moving enough to keep the weight off.

I was told today that this second podiatrist is out of options, he

cannot recommend skin grafts because of the chronic wound and we are

off to another wound/burn care facility.

Has anyone ever had this kind of care issue? My daughter has

lipomyelomeningeocele with her tethered cord at L4. I know the

nerves in her right leg are severely compromised because of the

lipoma and the tethered cord only worsens her nerve conductivity.

Any advice? Is there something we have not done?

Thanks in advance,

Mom to a, 16, Lipomyelomeningeocele, Tethered Cord at L4, Right

Leg compromised with ortho supports

[Guest guest]

Has she been evaluated for connective tissue disorders like EDS? Some

people who have wound healing difficulties have keratin issues that

need to be treated a bit differently. If she is not swimming due to

the hole in the skin oozing there are also tempoary sealers like

tegaderm that she might be able to use for an hour or two that would

prevent the water from entering and causing infection.

Charnel

>

> Hi,

> I realize that this is not the same issue as diabetics, but for

years have heard of wound healing problems with diabetics, and that

there are special doctors who have " particular treatment strategies "

to deal with poor wound healing. Could you get in contact with one of

these and see if they could help/had suggestions.

>

> the other suggestion is, a few years ago, I saw advertised on t.v.,

a " wound healing centre " for diabetics with particularyl severe

problems in wound healing. I am sorry I don't know the name /

locations, but possibly if someone on the board knows of it , you/your

doctor could contact them for suggestions?

>

> Lynn

>

>

> Wound Care - Long Term Chronic Issues

>

>

> It has been awhile since my last post. (That almost sounds

> confessional, doesn't it?) Oh well, I need some help from you all.

>

> My daughter, 16, developed a blister on her right foot last August.

> Now, being a teenager, she decided that it was not important to let

> me know that she had this injury. I did not discover it until mid-

> October when we went to her orthopedic surgeon for a follow up. I

> was shocked to see this deep hole on the side of her big toe.

> Immediately we were referred to a podiatrist who tried

> several " usual " treatments to close the wound. The problem is that

> the lower level of skin does not form and she aggressively grows new

> callous skin - but a tiny hole remains open in the center and drains

> small amounts of liquid.

>

> Since October, she has had two podiatrists, two leg casts (to

> alleviate pressure on her toe), two rounds of wraps to reduce any

> swelling, a surgical intervention where it was sewn together. As

> soon as the stitches dissolved, the wound opened right up again.

> She has also had multiple rounds of antibiotics and is now using

> regranex to try to encourage skin, not callous, growth. She has

> also had multiple examinations by several physicians who all tell

> me " well, everything looks fine, no infection, no cancer, good blood

> flow to the area - it should have healed by now " .

>

> Now, she is normally ambulatory for most of her day and since

> January, she has been using her wheelchair to keep weight off the

> foot. Big problem with that is she has gained 18 pounds. Without

> swimming (her favorite) and regular exercise with walking, she is

> unable to get moving enough to keep the weight off.

>

> I was told today that this second podiatrist is out of options, he

> cannot recommend skin grafts because of the chronic wound and we are

> off to another wound/burn care facility.

>

> Has anyone ever had this kind of care issue? My daughter has

> lipomyelomeningeocele with her tethered cord at L4. I know the

> nerves in her right leg are severely compromised because of the

> lipoma and the tethered cord only worsens her nerve conductivity.

>

> Any advice? Is there something we have not done?

>

> Thanks in advance,

>

>

>

> Mom to a, 16, Lipomyelomeningeocele, Tethered Cord at L4, Right

> Leg compromised with ortho supports

>

>

>

>

>

>

[Guest guest]

Let me play the devil's advocate a bit here. It comes from

personal experience.

Her not telling you about it may not have had anything to do with the fact

that she is a teenager, it could be, but it may not as well. It sounds like

she was aware of it, and dealing with it in her own way, whether it be right

or wrong. Just because it was still there when you found out about it,

doesn't mean she wasn't trying to take care of it.

Yes, I do believe in properly trying to treat something. I am glad that you

have gotten her to do that. But I have also found, in my experience, that

sometimes just letting things be is the best.......sometimes all the messing

with something, even though it is done to make things better, can aggrevate

what you were trying to make better.

You did say it calloused over......no this is probably not the ideal thing,

but since it did callous over, maybe that is just how things are going to

be.........and all you can do is keep an eye on that callous to make sure

that doesn't break open.

With her Dr.'s telling you everything is fine, even though underneath the

callous it is still open..............if I were you,

I would just do what I mentioned above. Since you have had

a few opinions saying everything is fine, albeit it is still open

underneath, I hope you will be able to find some peace of mind in that.

I don't see why she would not be able to swim........many people swim with

cuts and scraps.........and they don't even cover them. I would think that

if she would use some Tegraderm or Duadurm (SP?), and cover the area with

that, that there should be no reason she should not be able to go swimming.

You've done just fine......everything a good parent would do. Some things

just don't work out the way you want them to.

Again, what I said above was based on my personal experiences.

Me

Nebraska, USA

mymocha@...

My daughter, 16, developed a blister on her right foot last August.

Now, being a teenager, she decided that it was not important to let

me know that she had this injury. I did not discover it until mid-

October when we went to her orthopedic surgeon for a follow up. I

was shocked to see this deep hole on the side of her big toe.

Immediately we were referred to a podiatrist who tried

several " usual " treatments to close the wound. The problem is that

the lower level of skin does not form and she aggressively grows new

callous skin - but a tiny hole remains open in the center and drains

small amounts of liquid.

Since October, she has had two podiatrists, two leg casts (to

alleviate pressure on her toe), two rounds of wraps to reduce any

swelling, a surgical intervention where it was sewn together. As

soon as the stitches dissolved, the wound opened right up again.

She has also had multiple rounds of antibiotics and is now using

regranex to try to encourage skin, not callous, growth. She has

also had multiple examinations by several physicians who all tell

me " well, everything looks fine, no infection, no cancer, good blood

flow to the area - it should have healed by now " .

Now, she is normally ambulatory for most of her day and since

January, she has been using her wheelchair to keep weight off the

foot. Big problem with that is she has gained 18 pounds. Without

swimming (her favorite) and regular exercise with walking, she is

unable to get moving enough to keep the weight off.

I was told today that this second podiatrist is out of options, he

cannot recommend skin grafts because of the chronic wound and we are

off to another wound/burn care facility.

Any advice? Is there something we have not done?