One of the many destructive ways that my disability wreaks havoc upon my body is pressure sores. These are open wounds on your skin caused by constant pressure and rubbing on some part of your body. These types of skin ulcers are common in people with SMA, since we tend to be pretty much skin and bones (muscle and fat can act as padding to alleviate pressure) and spend all day immobile in a wheelchair unable to reposition much (causing constant pressure on the same parts of your body). These sores are difficult to get rid of without weeks of bed rest, and if they are not managed appropriately they can cause major issues like sepsis and bone infections. In order to avoid these potentially life threatening problems, I go to a wound specialist periodically to make sure I am doing everything I can to take care of these spots. It was at my last visit to the wound doctor that I learned something about how wounds best heal, and that this information doesn’t only apply to the wounds on your skin, but also the wounds in your heart.
I had been struggling with a pressure sore on my right hip for months. It was located on the bony part of my hip where all of the pressure rests when I am up in my wheelchair. It was not getting better with what I was doing to treat it, and I wanted to see if we could do something more to help it heal. So, after scheduling an appointment with the wound clinic, my nurse and I made the drive to the hospital, worked our way through the lengthy check-in and registration process, and eventually we were granted access to the patient examination room of the clinic. Once I reached the exam room, a nurse bombarded me with hundreds of questions about my health, medical history, current medications, and a bunch of other things that had absolutely no bearing on why I was there. Finally, after jumping through all of their hoops like a dancing monkey, it was time to transfer from my wheelchair to the examination table, where I waited for the doctor to come look at my hip. After a brief wait, I heard a quick knock on the door, and the doctor came bustling in.
This friendly, white-haired, old man with warm hands and a great bedside manner greeted me and quickly began getting ready to examine my wound. He poked, prodded, and probed my pressure sore in every way imaginable, as I did my best to block out the pain he was causing me by going to my “happy place.” After completing his assessment, he said the good news was that the tissue in the sore looked healthy, had no signs of infection, and that the outside of the wound looked great and was closing up. However, the bad news was that there was quite a bit of tunneling. This is when the wound, instead of getting bigger on your skin, burrows into your body deeper and deeper. To get rid of a pressure sore that has tunnelled, you have to pack the wound with special, medicated hydrofibers and let it heal from the inside out. Not only is this a lengthy healing process that requires you to endure the painful process of unpacking and repacking the wound every day or so, but you also have to make sure that the outside of the wound doesn’t close up eliminating your access to the tunnel. Sometimes you actually have to purposely make the outside of the pressure sore larger to maintain your ability to get to the tissue on the inside. After my nurse, the doctor, and I decided on the best course of action to treat my hip, I got back into my wheelchair, loaded up into the van, and started heading back home. It was while I was riding in the Drotarcade staring out the window on the the return trip, that I realized how all wounds work the same way.
Three years ago, a nurse who had been with me for a little over 6 months started developing the bad habit of being late for her shifts. Now, I realize that everyone is late from time to time, which is why at first it was not a big deal, but gradually it got to the point that almost every shift she would show up 10 to 30 minutes late. Not only that, but she would often walk in carrying a big bag of fast food that she had obviously taken the time to pick up on her way to my apartment, despite the fact that she was running late to begin with. It is kind of hard to believe that you are really sorry about being late, when you took the time to grab a Big Mac. This was not only disrespectful to me and unprofessional, but it was also disrespectful of the nurse that had to stick around until she got there. Trying to avoid confrontation and hoping that the situation would take care of itself, for a while I just let it go, accepted her apologies and excuses when she finally arrived, and didn’t say anything. As she continued to come in late though, I started noticing that everything she would say or do would irritate me. I eventually got to the point where she bothered me so much that I would dread the days she worked. It was at this point that I, and my other nurses, finally had had enough, and I spoke to CareStaf about getting her replaced.
This story is a great example of how physical wounds and emotional wounds both need to be cared for in the same way. With my tunnelling pressure sore, it is important to treat the wound from the inside out. Even if the outside of the sore completely heals and closes up, you will still have a tunnel on the inside that can continue to burrow and damage your body. The situation with my nurse was the same thing. On the surface I seemed fine, I would accept her apologies for being late, not say much with a smile, and appear to put it behind me. On the inside though, my feelings of being disrespected and taken advantage of were festering and tunnelling deeper into my mind. Over time these negative feelings tunnelled so deep that everything about this nurse bothered me, and her mere presence made me unhappy. In order to actually resolve the situation and get rid of these negative emotions, I had to gain access to these thoughts by opening up on the outside and having an honest talk with my nursing agency about her behavior. This uncomfortable conversation, that eventually led to confrontation, allowed me to gain access to my feelings by reopening these wounds in a more honest way. This allowed me to start healing from the inside. With both physical and emotional wounds, you cannot merely heal what you can see on the outside of the sore and call it a day. You have to get down deep within the wound, even if that means creating a bigger wound on the outside, and treat the inside of the sore if you want to completely heal.
Whether you are injured physically or emotionally, the wound that is created should be cared for in the same way. You cannot simply treat the surface of the wound by slapping on some antibiotic cream and a bandaid or putting on a happy face, if you want the wound to actually heal. You have to go beneath the surface, to the core of the wound, as uncomfortable and painful as that may be, and let the wound get better from the inside out. What wounds have you only treated on the surface that are slowly tunnelling deeper into your mind? Grit your teeth, rip off that metaphorical bandaid, and get deep into your wound. Don’t let it tunnel so deep that it causes permanent damage to your life or relationships. By biting the bullet and treating your wounds from the inside, you will greatly improve your emotional health and lead a much happier and more fulfilling life.