Under Pressure (Ulcer)

I swear, this universe has a way of keeping me in my place.

Seriously.

It was just my last post, Accidental Prepper, that I spouted off about the (plentitude of) precautions I take to assure Ryan’s health. You know, how I go to extreme measures in fail-safes, redundancy, and backup plans. In that post I laid-out how I prevent Ryan from getting pressure ulcers, commonly referred to as bed sores.

I should know better than to brag.

Turns out, I didn’t plan for EVERY MOTHER-EFFING thing. I now fear that he might develop one. I simply never even considered what happened that put him at risk. I’m hoping he will not — because of the precautions I put in place — but, only time will tell. It takes days, to weeks, for a pressure ulcer to fully present itself; since it develops deep in the body’s tissue and erupts outward.

I have Ryan’s wheelchair as comfortable as possible for him since he spends roughly twelve hours in it a day; exercising, stretching, and resting. The seat has a pad, then an alternating air flow cushion, and finally a protective cloth pad on top. The cushion has multiple cells in it that (alternately) inflate and deflate automatically every 3 minutes to relieve pressure and allow blood flow. This is adequate to prevent pressure ulcers from occurring, but I also manually tilt him into a fully reclined position for at least two minutes every two hours (or less). This nearly shifts all his body weight off of his buttocks. As with the cushion, just doing this should be adequate, even on its own.

As you see, I’m diligent about keeping his skin in pristine condition. One of my greatest, ongoing fears is him getting a pressure ulcer.

They are devastating.

Minimally, they cause extreme pain for months. It’s common for an infection to set in and not uncommon for people to die from them. I decided to not show a photograph of an active bed sore because, well, it’s shocking. If you want to see what I mean then google “pressure ulcer” images… but brace yourself for what you’ll see before hitting the enter key.

So, here’s what I didn’t plan on happening to Ryan.

Each morning Ryan’s wheelchair is prepared for the day. Among various tasks, a freshly laundered cloth pad is laid over his seat cushion by the overnight nurse (when we have one, that is) or by me. The nurse we had yesterday is meticulous, so I know what happened was simply an oversight. Sadly, that doesn’t make it any better and I hate that an Incident Report must be submitted to the state of Virginia. Anyhow, she placed the cloth over the seatbelt buckle that was lying on top of the cushion, thereby concealing it with only that thin top pad between it and Ryan.

Since his routine for that scheduled weekday involves three hours of intense cycling, tactile stimulation, and range-of-motion — all in his chair — he sat on it all day.

I hope that he got some relief from his cycling and my stretching him… but that might have only made it more prone.

Now I wait.

In the meantime, I must plan for the worst. I’m already working with Ryan’s doctor and a wound care specialist to get ahead of what might develop. Be assured, I am all over this like a cheap suit. I’ll assess him every six hours; by checking the skin for “blanching” and the area for either extreme hardness or extreme softness under the skin. If detected then preemptive antibiotics might become necessary. It’ll be challenging but, to the greatest extent possible, I’ll position him to keep his weight off of his buttocks.

I hate that this never ends for Ryan. It saddens, scares, and angers me to the core. It’s coming up on ten years since he was brutally attacked and it’s just not getting any better for him. Honestly, it’s worse.

Still, right now I can’t let my hatred and inner-rage toward those punk-ass monsters (Jonathan Matthew May and Austin Issac Vantrease), who made him perpetually vulnerable, to divert my focus.

Be clear, I remain patient and will circle my attention back to those two losers when appropriate (i.e., I’ll fill you in when I do.). Like I said before (in the trailer to the documentary Storming: The Ryan Diviney Story), “right now I have other things to do”.

This has never been more true.

Note: I’m feeling confident that you should be able to leave comments again. These were being blocked because the website’s protection and firewall were too strict (by default) during a recent upgrade.