Sickle Cell Foot Ulcers: My Wound Care Process

I’m still struggling with foot ulcers. I don’t know why, but the last 5-10% of a wound always takes the longest to heal. If 90% of my wound heals in two months time, the remaining 10% will take two addional months. Don’t ask me why. Nor can the doctors explain why.

I thought in this post I would explain my process I use for cleaning my wounds.

1.  Lay out your supplies in an organized way.
2.  Have a clean work area
  a.  I have a fairly large plastic tote with a lid that holds all of my cleaning supplies. I place a clean hand-towel on top of the lid and rest my foot on top of the tote; it’s my “work area”.
3.  Have something to collect your waste
  a.  I have a small trash can that I line with plastic grocery bags.
4.  Sterilize your hands and/or use gloves.
  a.  Though I never use gloves, I always sanitize my hands before starting.
5.  Carefully remove the old bandage
  a.  Sometimes it hurts to remove the tape that is on my skin. To make it less painful, I’ll lightly spray the tape with my wound cleanser. This helps a lot.
6.  Clean the wound
  a.  Using gauze sponges, I remove the bulk of the medication. I then spray the wound with wound cleanser; I use MicroKlenz.
  b.  I then pat the wound dry with clean gauze pads. For me, using a swiping motion with gauze is agonizing. I gently place the gauze on the wound and dap it.
7.  Lidocaine
  a.  The pain from cleaning the wound is usually pretty severe. Lidocaine jelly has been a wonderful blessing. A little lidocaine goes a long way.
  b.  Using a q-tip, I apply the lidocaine to the wound. It takes only a few minutes for it to begin reducing the pain. I leave it on for about five minutes.
8.  Second cleaning
  a.  Using q-tips, I remove as much slough from the wound as I can. I also clean the area around the wound and remove as much dead tissue as I can. Keeping the wound and surrounding tissue as clean as possible is vital.
  b.  I then use gauze pads to remove remaining lidocaine.

9.  Apply prescribed and/or preferred medication.
  a.  When I go to the wound clinic, the nurses always put the medication on the Telfa (non-stick gauze bandage) and then put the bandage on the wound. I dislike this method of application for the following reasons. 1) It puts medication on the healthy skin as well as the ulcer; 2) it causes the healthy surrounding tissue to become macerated (wet), weakened, and break down; and 3) it makes a mess.
  b.  When I apply my medication, which is Silver Sulfadiazine cream most of the time, I use a q-tip to put medication on the wound and only the wound. I clean all medication off the surrounding healthy tissue.
10.  Bandage the wound
  a.  Telfa is a non-stick gauze bandage. This means it doesn’t stick to the wound and is not painful when removing it.
  b.  When I cover my wound, I cut the Telfa to fit my wound. I don’t use a massive pad to cover a small wound. By cutting the Telfa to fit the size of the wound, it helps protect the healthy skin and keep it from breaking down. So if my wound is boomerang shaped, I cut the Telfa in the same shape.
  c.   Be careful not to use too much medication, whatever it may be. It can get very messy, gooey, and cause healthy tissue to break down.
  d.  If I am using manuka honey, I have to use a larger size telfa bandage than I do when using silver cream. The honey will leak all over the place if there isn’t a big enough bandage to contain it all.
11.       Tape the bandage
  a.  Everybody’s skin is different. For my skin, the 4M paper tape is best. I use as little tape as possible because it saves on tape and protects my skin. Using a lot of tape that really adheres to the skin is painful to remove and risks damaging the fragile skin around my wounds.
12.       Wrapping the wound
  a.  Depending on the wound’s location and circumstances, I wrap the wound using a conforming gauze roll.

Though it is often painful to do so, we have to take care of our wounds. Some days I just dont feel like messing with my feet. But I suck it up and clean them anyway. Normally I clean my wounds twice a day. Sometimes, due to the pain, I have to do it three or four times a day. I just have to clean the wounds and apply lidocaine to reduce the pain they cause. 

These wounds suck. They are awefully painful. They are frustrating to deal with. It plays with your emotions when you get wound after wound and it seems unending. But, it is what it is and we have to deal with them. Keep your wounds clean. Keep your skin healthy. Avoid dry skin. Be strong and have faith.

Meditation: Coping with Stress & Sickle Cell

When my means of transporting my wheelchair fell apart, I was under a serious amount of stress. For nearly three months I was consumed with thoughts as to how I was going to get out of the dilemma I was in. I was so stressed that it was beginning to impact my health, and I worried it was going to land me in the hospital; something I’ve avoided for almost three years now.

The anxiety I felt caused an odd tingling chill to run up and down my spine. My skin itself felt as though it was shivering. My whole body had a faint dull ache.

When I began feeling this way, I decided to start meditating. As can be read in “More on Meditation” and “Controlling Your Pain,” I use to meditate three times a day; always before taking pain medication. The past year or two, I’ve been hit and miss with that practice. But being as stressed as I was, I knew I needed to resume my meditation sessions to help calm myself down. And it worked.

Sometimes I used audio recordings of singing bowls. Other times I used my own singing bowls. Regardless of which I used, the benefits were immediate. While meditating, I often recited various phrases in my mind. Here are some examples:

   • “My mind is calm. My body is relaxed. I am totally at peace.”
   • “I am mentally calm. I am physically relaxed. I am totally at peace.”
   • “I am filled with light and laughter.”
   • I may imagine Jesus Christ is reaching out to me, touching me with his hand, and saying to me, “Your faith hath made thee whole.”

I also adopted the practice of ending my meditation sessions with a prayer. By combining prayer with meditation, I felt a greater level inner calm. At the close of each meditation session, the physical stress and mental anxiety I previously felt, had vanished. There is zero doubt in my mind that my meditation practices helped keep me out of the hospital during these past few stressful months.

All through my life meditation has been of huge importance to my physical, mental, and spiritual health. In regards to my chronic pain, my doctors marvel that I’ve been on the same pain medication regiment for many, many years. I haven’t had to increase my dosages or change prescriptions for some time now. I explain to them this is because I use a variety of techniques to mentally manage my pain along with my medications. Meditation is my first tool in managing my pain. Pain medication is the second.

Whether you use it for stress or for pain management, I hope you also learn to use the powerful tool that is meditation.

Hello Again

I realize I have been absent from my blog for some time now. I didn’t realize how long until today. Hopefully I will be more faithful at posting. Again.

My attention these past few months have solely been on finding a means of transporting my electric wheelchair. As I wrote in “I’m Back,” I had an online fundraiser that was successful and promptly purchased a Bruno Chariot to transport my wheelchair behind my car. Two months later, I began having problems. Apparently the snake oil salesmen that sold it to me, did so knowing the trailer was not rated for my car. Because it wasn’t rated for my car, the trailer broke two hitches. 

For over two months I struggled to get a refund, and finally received it in full. I then sold that car and hunted for a new means of transporting myself and my wheel chair. After much stress, prayer and investigation, I decided to buy a wheelchair van. After finding a used van in my price range, that is what I purchased. So once again, I am able to get about on my own.

It’s easy to take for granted the simple things in life. Like being able to go to the grocery store by yourself and not have to have somebody go with you so they can push you around in a wheelchair. Independence is such an important thing to have. Until you loose a measure of it, you don’t realize how much you cherish it.

Well...having not posted any articles in some time, I have had time to think about several topics I wish to write about. By not writing for almost three months, I feel as though I have let my followers down. I apologize to you for my negligence, and will do my best to be more faithful in the future.

Sincerely,
    Your friend,
          Jon