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Old 03-21-2012, 06:54 PM #1
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Default ? for wheelchair users............

Does anyone have a problem with pressure sores/points under your heels? Since having the weeping edema situation, a home health nurse has been coming here once a week and has checked my feet. There are just red marks now, but she said they could develop into pressure sores. It feels like somebody is sticking me with a needle when just sitting. It really, really hurts and sends my foot/feet into spasms.

What the heck is this???? I'm only sitting for goodness sake, so have been trying to keep my heels up......isn't easy being they no longer work normally! If you've had this problem, what did you do to help the situation? I really don't need any more pain. Thanks for any suggestions.
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Old 03-21-2012, 07:09 PM #2
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I have a family member in a WC with lots of problems with ulcers on her feet. Talk to your doc, don't fool around with it!! (Not that you would, just sayin')
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Old 03-22-2012, 10:54 AM #3
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Judy, I'm not in a chair 24/7 but I'm sitting on the couch most of the time. I can transfer pretty easily, so No pressure sores. But, have I told you about my Diaper rash/yeast/whatever infection from hell?

When you are in your chair, are you able to stand up and stretch a bit or if not can you do that squeezy exercise (flexing your butt & leg muscles?

When I'm on the couch/on the PC/reading/watching TV, I try to keep it all moving = put legs up and down, stretch, wiggle toes, squeezy butt and stand up, if able.

Also, if the above is pretty impossible for you, there are special cushions for your wheel chair to help ward off pressure sores.

Let us know what you, with your Doc, decide to do and if it helps you.
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Old 03-23-2012, 12:28 AM #4
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Thank you for your replies......

Sally -- Most of those "exercises" you mentioned are impossible now, but I try to move around as much as possible. Yes, I do have a gel cushion (not the kind that makes you seasick) that helps my sitter, but this is really weird, under the heels of my feet. I usually wear slippers so it's not bare skin hitting the footrest and not standing much, there's not much pressure applied in those spots. Going to do some research here on the computer. Keep moving as much and as long as you can!!!

B2Y -- Do you know any more about your family member's problem with foot ulcers? What was the cause and maybe what was done medically for them? I suppose it's sort of like the weeping edema that makes blister type lumps on my legs, which break open and "weep". Right now that seems improved and I've gotten a reprieve wearing the unna boots and ace bandages. You can bet I'll stay on top of the situation since they hurt so much. As if I don't have enough trouble trying to stand up for a couple minutes transferring, etc., now the pain is through the roof too.

Sometimes I really feel like throwing in the towel, but then reason steps in and reminds me how much I value my independence. Thanks for being there --
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Old 03-23-2012, 01:55 AM #5
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Oh yes.... I know all about sore heels, and I'm not in a wheelchair. Mine get sore intermittently and hubby had nasty heel blisters when he had his knee operation.

Heels are particularly vulnerable to pressure areas because there's very little soft tissue between the bone and the skin to absorb pressure. There are some things you can do to help ease the pressure.

During the day you should:

*Examine your heels every day to ensure no blistering.
*Use moisturizer on your heels twice a day, but don't massage the skin..
*Some hospitals apply a transparent film dressing to the heels to help prevent friction, you could try that.
*Wear socks during the day to help prevent friction (remove at bedtime).
*Wear padded sneakers or shoes that fit properly when in the wheelchair
*Move your feet regularly to maintain a good blood supply

At night : Place pillows vertically under the legs to keep heels off the bed surface.

You could also try gel pads or memory foam pads (like wheelchair cushions) to rest your heels on

I hope that helps.
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Old 03-23-2012, 10:37 AM #6
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Sorry Judy, I didn't get that this was only about the heels of your...duh
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Old 03-23-2012, 10:53 AM #7
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My relative that's in a wheelchair is a paraplegic, and she has limited (if any) feeling in her feet. The only things I know for sure about her situation are that she didn't tend to the pressure sores when they were just babies so they got out of control; and one of her docs told her that being a heavy smoker compromised her circulatory system and made skin wounds harder to heal. (I won't quote what she said about THAT)
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Old 03-23-2012, 03:39 PM #8
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Quote:
Originally Posted by Blessings2You View Post
My relative that's in a wheelchair is a paraplegic, and she has limited (if any) feeling in her feet. The only things I know for sure about her situation are that she didn't tend to the pressure sores when they were just babies so they got out of control; and one of her docs told her that being a heavy smoker compromised her circulatory system and made skin wounds harder to heal. (I won't quote what she said about THAT)
I can only imagine! I don't smoke, watching my Mom die from cancer years ago and my father in the other twin bed having a heart attack, was enough to make me stop!! In reading a couple different places here on the internet, I'm thinking this is being caused by my new powerchair. The footrest seems like it's up too high -- which I told the guy when first getting it -- but he said the increased pressure would be good for the circulation, but not so good for getting pressure sores. Next week I'll call and tell him I need an adjustment!

Thanks Koala for the great suggestions!
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Old 03-23-2012, 11:51 PM #9
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Sorry Judy, but I guess not many of my suggestions were beneficial if you're still wearing Ace bandages.

Painful heels in your case would be caused by pressure, and we must think of ways to relieve that pressure so you do not advance to pressure sores on your heels.

If your nurse is still coming regularly, ask her to check your heels every time she comes. They should not be red, and if are... then measures should be increased to prevent your skin breaking down.

Are the Ace bandages overly tight around your heels? Maybe they could be loosened just a tiny bit over the heel area.

Are your heels pressing on any areas of the wheelchair? If so, hopefully you can get it adjusted.

Do you elevate your legs at all while you're sitting, to help with the Edema, like while watching TV ? If so, make sure your heels hang over whatever you're resting your legs on.

Pillows under your legs at night, with your heels over the ends, will prevent pressure at night.

I was hoping more of our RN members would offer suggestions, but I will ask some of my own RN friends, and a doctor friend and see what advances have occurred in pressure care since I retired. I'll see what I can find out for you.
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Old 03-24-2012, 05:07 AM #10
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Perhaps a second thread with "pressure sores" or something in the title?
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