Pressure wounds are one of the most common problems encountered by individuals with spinal cord injuries. According to the University of Washington, approximately 60% to 80% of people with spinal cord injuries will develop at least one pressure wound throughout the duration of the injury. Treating a pressure wound is often a difficult process that includes extended periods of bedrest and in many cases surgery. While the doctors and nurses who treat pressure wounds are very skilled at what they do, their attention is focused on healing the wound, not the many other ways that having a wound can impact an individual’s life. Recovering from a wound can affect a person both physically and mentally, often leading to depression and anxiety.
In the fall of 2014, I developed a small wound on my right ischium. This spot had been a problem area for the 13 years I had been injured so I didn’t think much of it. I spent all of my time during those months either staying off of it or working on finishing my first semester of graduate school. I managed to make it to the new year without making the wound worse, or so I thought. After switching doctors in January 2015, I quickly learned that the previous doctor had not been treating the wound properly and I had a serious problem on my hands. What I thought was a superficial wound that was just being stubborn, turned out to be a stage-four wound that had reached the bone and was tunneling. I was devastated. The doctor recommended a woundvac but that produced no results. Further complicating matters was the osteomyelitis that developed in the ischium. After consulting with several surgeons, I knew I needed surgery to remove the infected bone, several weeks of bed rest and intravenous antibiotics, surgery to close the wound, and ten weeks of bed rest to follow. I knew what I was facing, I knew it would be difficult, but I thought I could handle it.
I did not anticipate the depression and anxiety that was about to play a huge part in my recovery. Despite the presence of my family and friends, being on bed rest was isolating, boring, and extremely depressing. I went from being very active to completely inactive with only television, books, and the internet to keep me occupied. Furthermore, anxiety about my recovery became overwhelming at times. Fear of infection, a failed wound flap, and how my life would change because of the wound often dominated my thoughts. It was clear that I would need professional help to manage these problems.
Up to that point, I had never received any mental health services. Even while I was in the hospital after my injury, I met with a psychologist once or twice and that was it. I was also very stubborn and figured I could deal with my problems by myself. This was no longer the case. I was fortunate to have a counselor that was able to visit me at home and that my insurance was willing to pay for. Throughout those challenging weeks my counselor helped me to focus my thoughts on the day to day progress of my recovery rather than worrying about what may or may not happen in the future. I knew that I was doing everything properly according to my doctor’s instructions and everything else was out of my control. If I needed further treatment at the end of ten weeks of bed rest, I would deal with it when the time came. Learning to let go of the fear of what may happen was extremely difficult but became an invaluable tool that I still try to use every day. In addition to helping me learn coping techniques, my counselor became an outlet to vent my frustrations. Being stuck in bed for months is awful and the emotions that accompany such a challenge cannot be suppressed healthily. Having an outlet to voice frustrations to can be a great benefit to a person going through such a life-changing challenge.
Maintaining a healthy state of mind during a medical challenge such as recovering from a pressure wound is a vital component of a positive outcome. Although one may not have access to a counselor who is able to do home visits, it is important to have a family member or a friend to talk to without fear of judgment. Simply talking about your feelings can help to relieve a huge burden. In addition to having someone to talk to, there are many books and apps that can help teach a person to focus their thoughts positively. Using meditation, breathing techniques, and relaxation techniques during times of distress will help ease the mind. There is no shame in seeking treatment for mental health. When physical health is in jeopardy it is of utmost importance to focus energy on the mental well-being that we can control when everything else is out of our control.
Go to PART 2 – Regaining Health
Go to PART 3 – Prevention
Written by Mike Franz
Mike is a C6 quad from Michigan who has been injured 16+ years.