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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 30054
Experience:  Over 20 yrs of Family Practice
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THIS IS A QUESTION ABOUT A PRESSURE ULCER FOR A WOUND CARE

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THIS IS A QUESTION ABOUT A PRESSURE ULCER FOR A WOUND CARE SPECIALIST ...

HELLO ... I WILL BE APPROACHING MY 6TH AND LAST ROUND OF STAGE 3 BREAST CANCER CHEMOTHERAPY NEXT TUESDAY. IT SEEMS THAT AMONGST OTHER SIDE EFFECTS, AFTER MY LAST ROUND, I HAVE DEVELOPED 3 THINGS ...

1. A SMALL ABSCESS ABOUT 1 INCH ADJACENT TO MY ANUS

2. AN ANAL FISSURE

3. A SMALL PRESSURE ULCER (PROBABLY STAGE 2)

MY QUESTIONS MOSTLY SURROUND MY PRESSURE ULCER AND I HAVE GOTTEN MIXED INFORMATION FROM SPECIALISTS (COLON / RECTAL DR., GI DOCTOR, AND GENERAL PRACTIONER/PRIMARY DR. , AND ONCOLOGY PA). HERE ARE SOME DETAILS FIRST...

1. THE SORE IS ON MY BUTTOCKS -- LOTS OF FATTY TISSUE, NOT ON THE BONE. ITS ABOUT 3 INCHES DOWN FROM TOP OF CRACK AND ONE INCH TO THE RIGHT. SO, CLOSE TO BONE BUT REALLY ON THE FATTY TISSUE.

2. I AM ABOUT 25 POUNDS OVERWEIGHT. LOW MUSCLE TONE AND LOTS OF FAT.

3. I AM NOT BED RIDDEN AT ALL, HOWEVER I SIT IN A RECLINER AND WORK ON A LAPTOP AROUND 16 HOURS A DAY WITHOUT EVER GETTING UP.

4. THE SORE STINGS AND BURNS IN THE SHOWER. WHEN THE COLON RECTAL DR. WAS SWABBING SORE WITH Q TIP, IT FELT EXACTLY LIKE A NEEDLE BEING INJECTED ABOUT 1.5 INCHES INT0 MY TISSUE AND I COULDNT WAIT FOR HIM TO STOP.
COULDN'T WAIT FOR HIM TO STOP. I GENERALLY HAVE A DECENT TOLERANCE FOR PAIN, AND EVEN THE FISSUE (WHICH HE SAID WAS SEVERELY PAINFUL) DIDN'T SEEM AS BAD AS THAT NEEDLE LIKE FEELING ON THE PRESSURE SORE. THE DR. SEEMED TO THINK I WAS JUST ANXIOUS WHEN I NEEDED TO STOP HIM TWICE AND HE SHOWED ME THE Q TIP. I AM NOT SURE HE IS REALLY THE SPECIALIST TO SEE FOR PRESSURE SORES, AND PERHAPS JUST THE FISSURE AND ABCESS.

I HAVE BEEN TOLD SEVERAL THINGS:

1. SITZ BATHS (BECAUSE ALSO TREATING FISSUE AND SMALL ABSCESS)
2. NEOSPORIN AND KEEP IT COVERED
3. NEOSPORIN AND NO COVERING
4. SITZ BATHS - NO NEOSPORIN AND NO COVERING AND KEEP IT CLEAN


MY QUESTIONS ARE THE FOLLOWING:

1. SHOULD I BE SUBMERGING THE SORE IN WATER 3 X A DAY?

2. SHOULD IT BE COVERED OR UNCOVERED 24/7 - OR COVERED DURING THE DAY
AND UNCOVERERED AT NIGHT?

3. WAS THE REASON FOR THAT PAINFUL NEEDLE LIKE FEELING TYPICAL OF A BED SORE - OR COULD THIS ACTUALLY BE SOMETHING ELSE? TODAY IT LOOKS TO MY
HUSBAND LIKE THERE IS A VERY VERY TINY WHITE PIMPLE IN THE MIDDLE OF IT.

4. I HAVE BEEN LIDOCAINE IN PLACE OF THE NEOSPORIN. YOUR THOUGHTS ON THAT?

THANK YOU! :)
Hi--one question first please. How big is the sore and how deep?
Customer: replied 3 years ago.

IT IS RELATIVELY SMALL I THINK. MAYBE THE SIZE OF MY PINKY FINGERNAIL - AROUND THE SIZE OF A PENCIL ERASER - MAYBE A TINY BIT BIGGER.

Customer: replied 3 years ago.


OH SORRY, AND IT'S SHALLOW - LIKE AN OPEN BLISTER THAT IS DRYING UP A LITTLE. NOT AS RED IN THE MIDDLE


 

OK--was it cultured to see if it's infected?
Customer: replied 3 years ago.


I think that's what the colon rectal doc was doing with the q-tip that felt like a needle. he said he was just "swabbing it".

OK. Yes, you should do the Sitz baths three times a day. If you're going to apply any topical preparation on it then it needs to be covered lightly with a piece of gauze and some hypoallergic tape. The fact that the swabbing was painful indicates that it is infected so you do need the Neosporin, although you can mix that with the lidocaine gel. All that said, unless this seems to be closing and healing within the next week or so, you really should have it looked at by a wound specialist since you may need debriding and Duoderm patches
Customer: replied 3 years ago.


THANK YOU ... SO LIDOCAINE FIRST, OR NEOSPORIN, OR BOTH ACTUALLY MIXED? ARE LARGE WATERPROOF BAND AIDS OKAY? SHOULD ALL DRESSINGS BE OFF AT BEDTIME?

You can mix the two--no problem doing it that way. The Bandaids are OK also. I'd suggest you leave the ulcer open and uncovered through the night
Customer: replied 3 years ago.


THANK YOU SO MUCH! ENJOY YOUR WEEKEND! :)

My pleasure but let me know how you do
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