Daily Archives: June 3, 2006
We start with nutrition because it’s basic to health no matter what is going on in your body systems.
While you are in the hospital, you will probably find that one of the most annoying things is that everyone will keep after you about your weight. It seems they are never satisfied -you are too thin, or you are too heavy, but never “just right”.
There are good reasons for this. If you are very much underweight and eat a poorly balanced diet, you are more likely to develop pressure sores. Also, you may not have enough energy to keep you going through a busy day of therapy. If you are overweight, you will find it more difficult moving and doing transfers. If you have surplus flesh where you shouldn’t, you will have more skin irritation.
The skin is the external covering of the body. It is tough and, at the same time, pliable. Its major function is to protect the underlying cells. Just like the heart or the liver, the skin is an organ. In fact, it is considered the largest organ and is every bit as complex, if not more complex, than any of the other organ systems of the body.
The skin serves several protective functions:
Causes – Because your blood flows more slowly after SCI, your healing ability is reduced. In addition, your skin cannot tolerate as much pressure as before. Your skin can now tolerate a minute amount of pressure for a long time, but it can only tolerate great pressure for a short time before the circulatory system is disrupted and a pressure or skin sore results.
The decrease in circulation and lower tolerance for pressure is further aggravated by the lack of sensation after SCI. This lack of sensation means there is no longer a feedback mechanism to tell you that there is a problem – that you have been sitting too long without moving or that you have injured yourself, for example.
OTHER SKIN PROBLEMS IN SCI
Where skin comes in contact with skin, (e.g., groin, armpits, under breasts)
|Pimples, red blotches due toMoisture and lack of air.||Keep area clean and dry. Allow air to reach rash area.If no improvement in a couple of days, see doctor.||Apply ointment or powder unless ordered by your doctor.|
(Usually fingers and toes)
|Skin turns pale or white then turns red due toCombination of loss of sensation & extreme cold.||Wear warm footwear and gloves in cold weather as preventive measure.If it occurs, put part in lukewarm water and call doctor immediately.||Stay out in cold too long.|
A skin sore begins as a red area on the skin. This reddened area may or may not feel hard and/or hot. If you have black skin, the area may appear shiny instead of red. At this stage, the progression is reversible. You must remove all pressure from this area until the skin returns to its normal color.
If pressure is not removed, a blister, pimple or scab may quickly form over the hard red area of the skin. This hard red area of skin means that the tissue underneath is dying. At this point, remove all pressure over the area and consult your physician.
Check your whole body, but pay special attention to bony areas
By inspecting your skin regularly, you can spot a problem at the very beginning. Checking your skin is your responsibility and the way to spot the warning signals of a problem. Don’t just ask someone else how your skin looks. If you need someone to help you check, you must be able to tell him or her what to look for.
Relieve Skin Pressure
In addition to routinely checking your skin, a second important way to prevent pressure sores is to relieve skin pressure by changing position or being positioned so that pressure is taken off a bony area. The purpose of relieving pressure is to let the blood supply get to the skin. If pressure is not relieved, blood will continue to be pressed out of a blood vessel and will not get to the skin to keep it healthy.
Take Routine Care of Your Skin
The third way to prevent skin sores, the most serious problem in SCI, is to keep your skin healthy. Health skin is skin which is intact, well lubricated with natural oils, and nourished by a good blood supply. Skin stays healthy with good diet, good hygiene, regular skin inspection, and regular pressure relief. We’ve already discussed skin inspection and pressure relief. We’ll focus here on hygiene and nutrition.
Hygiene -You must keep your skin clean and dry. Skin which is frequently moist from urine, sweat, or stool is more likely to break down. Dry skin well after bathing, but don’t rub hard with a towel as rubbing can damage the skin. You may have heard that alcohol massages over bony areas are good for you. They are not. Alcohol dries out your skin and dried, cracked skin is not healthy. If back rubs help you to relax, a gentle one with lotion should be given.
- Make sure your wheelchair foot pedals are adjusted to the right height.
- Use a prescribed cushion on wheelchair seat.
- Sit up straight in wheelchair (slumping or slouching leads quickly to early Skin Breakdown over tailbone).
- Check feet carefully when wearing new shoes – shoes should not be too tight or too large.
- Apply support hose and Ace wrap evenly so that they don’t wrinkle and cause extra pressure.
The Kidneys are two fist-sized organs located in the back of the abdominal cavity. The kidneys perform complex functions that are vital to life. They constantly receive blood from throughout the body and filter it to remove toxic wastes from the blood and regulate the water volume and chemical concentrations of the body. In this blood filtering process, the kidneys use fluid and waste products to form urine.
The Ureters are tubes through which urine leaves the kidneys and travels to the bladder. The ureters enter the bladder through the ureterovesical junction, the valve in the muscle wall between the ureter and the bladder.