Living From the Bedside

Pressure sores are nothing to fool around with for individuals with disabilities. They account for $1 billion in medical costs each year according to Emedicine in 2003. Additionally, it is estimated that between 5% and 8% of all paraplegics and quadriplegics will die from a pressure sore (decubitus ulcer). Bed rest is a common regimen once the pressure sore has developed. It may last a couple days or many months. The reoccurrence rate is 90% once the pressure sore has healed. Careful management of skin integrity is crucial in the prevention of pressure sores or reoccurrence.

So, what can you do to make your bed rest tolerable?

Environmental Control

Controlling household appliances, such as the television and lights, gives the user increased independence along with the capability to control a wide variety of electrical devices. There are many ways of operating them ranging from voice recognition to switch scanning. Some options are:

• Relax III is a switch operated electronic aid of daily living (EADL) which is capable of operating the television, telephone, X10 modules, and VCR. TASH supplies this device. There are actually several models to choose from dependent on price and features desired.

• Sicare is a voice activated EADL providing command to common devices. It has programmable codes making it easy to set up. It is also sold by TASH.

• X10 Mini Control Unit is a less expensive option provided the user is capable of pressing a half-inch square flat button. It provides on and off activation of appliances plugged in to a module. RadioShack sells a starter unit.

Computer Usage

• Laptop computers are easier to position. Most are able to open up flat then be placed on a wooden stand at a high level for easy viewing. It becomes possible to use the laptop either on one’s side or lying flat on one’s back. The access method may need to be accommodated as typing on the keyboard is difficult.

• Voice recognition is one solution. It allows the user to completely operate a computer hands-free. Dragon NaturallySpeaking Preferred has proven to be the most accurate to use. It is important to have enough RAM and speed. 512 MB of RAM running over 2 GHz provides a conducive environment to implement voice recognition. The software is found at many local computer stores such as CompUSA and Best Buy.

• Monitor stands are positioning units for the monitor when a laptop computer is not available. A monitor stand, available at many local computer stores, is an adjustable stand capable of being pulled up and down or right and left. A desktop computer should be placed near the bed along with the monitor, keyboard, and mouse. A hospital stand, available at most medical supply stores, will allow the user to have the computer directly over the bed. Make sure the stand supports the weight of your unit.

Reading

• Page Turner devices are electrical units in which a book is placed. A page is turned when the user presses a switch or operates a joystick. GEWA Page Turner features the ability to turn forward and backward, read multiple thickness of books or magazines, operate through a variety of access methods, and turn more than one page at a time. It is pricey, but the cheaper versions do not work as well. Zygo sells the unit.

• Adjustable copy holders or book stands are a simple solution. They can be placed on a hospital table mounted onto a microphone stand. The PerfectData spring-loaded stand provides easy positioning since it can be placed to the side of the bed and positioned over the person. It adjusts in many angles not available in standard stands.

Playing Games

• WebCam is a camera which attaches to your computer to give a live picture. The problem with playing games from bed is the inability to see the table where the game pieces are. A WebCam positioned over the table allows the bedridden individual to easily participate in games without straining the neck.

• Cardholders are wooden blocks of wood with a series of slots carved in. The cards stand up without support when placed into the slots. Courage Shop Services create specialized models.

• Shufflers will actually mix up your cards with a touch of a button. Place half of the deck on one side and the other half on the other side to have the cards shuffled.

The Bed

• Hospital beds provide flexibility as the head and feet are able to go up and down. Some medical companies will rent a hospital bed when it is needed for a short period of time.

• Furthermore, there are specific beds for wound care. One company specializing in these beds is www.WoundCare Beds.com on the Internet. Circulation is improved by continually alternating the air pressure of the mattress. The Alternating Pressure System with Pump from Medical Harmony is one option.

• Several mattress options are available. Memory foam adjusts to the form of your body each time you lay on the bed. A bubble mattress has small air filled pockets to provide less pressure over the entire body.

• Moisture is detrimental to skin breakdown. Several companies sell a device that alarms when wetness is detected.

Technological Treatment

• Varipulse provides a high-powered wash of the wound. The pulsating sodium chloride water stimulates circulation at the same time it cleans the wound of bacteria. Two places in the Twin Cities offering this wound care are the physical therapy departments at Unity and Mercy Hospital.

• The Versatile 1 Wound Vacuum System promotes wound healing by applying localized negative pressure on the wound bed. This occurs through a high quality piston operated suction unit that is assisted by a very innovative pressure regulator.

• As a solution to all types of chronic wounds, Regenesis® Biomedical has introduced the Provant Wound Closure System. Provant is based on Cell Proliferation® Technology (CPI®) which allows the body to naturally heal the wound by stimulating dormant cells, causing them to release natural growth factors, and divide rapidly, helping heal wounds in half the time and up to half the cost of traditional wound therapies. To learn more about Provant® and how it can help you or a friend, visit www.regenesisbiomedical.com or call Advanced Healing Systems at 612-435-2111.

• After medical professionals have indicated you can start getting up, it still will be a while before resuming all normal activities. It starts by being up in your wheelchair a couple minutes a day then slowly leading to more and more time. 70% of pressure sores occur on the buttocks or ischium. A seating evaluation should be considered to lessen the chance of reoccurrence. There are several organizations such as Courage, Gillette and Advanced Therapy Services which use a weight distributed technology to determine an exact pattern of your pressure areas.

• Beyond wound care technology, the Internet provides essential information regarding treatment and prevention of pressure sores. Check out www.emedicine.com/MED/topic2709.htm

Even with activities and technology for wound care, the process may seem excruciatingly slow and you may become bored regardless of your best efforts. Keep a “cheery” face and remember it’s only temporary.