pressure wound

Training With Health Issues: Post Surgery Update - 3 Weeks

It has now been about 3.5 weeks since my surgery. I am still in the weeks 3-4 time up restrictions of 30 minutes up for every 2 hours. I left in a few sections below from my previous posts as I think that info is valid for ANYONE looking for more info on dealing with wounds, the only real update is in the Training section.

Training Update

As I stated in my last post the great part about the current window I am in is I get to work out a little! Due to only having 30 minutes of up time I do a 20 minute timed work out.

  • A1 Bodyweight Pull Ups x10reps

  • A2 Bodyweight Dips x20reps

  • Done on a rotation every 2 minutes for 10 sets each. Equating to 100 pull ups, 200 dips.

I have stuck pretty much to this routing above. I set a timer on my phone for 20 minutes, then do 10 rotations of A1 then A2. A couple enhancements are each workout I change up the type of pull ups from Pronated Grip ( hands facing away from you) to nuetral grip/hammer grip to supinated grip (hands facing towards you). The dips are done exactly the same way each time. Although I am upping the reps per set after every 3 workouts and am now doing 23 dips per set. The more work you can do in the same timeframe equates to Density and is among my Top of the Top methods to building muscle.

I have also upped the number of pullups to 11 per set. So the workout I did last night resulted in 110 pull ups, 230 dips. In 20 minutes. I will not be adding any weight to these exercises until the restrictions are fully lifted. By adding more volume in the same exact timeframe is all the increased intensity required at this stage.

I do this workout 3 times per week. Starting Friday I will be allowed up 1 hour for every 2 hours so I will look at tacking on 10-15 minutes of workout time.

This workout will get your heart moving, will build back up any strength you may have lost due to down time. An added benefit is there is absolutely zero weight bearing on your bottom, which is huge. You can substitute horizontal rows, or pushups or many other types of exercises. The important element is to do something to get your body active again.

Adding Cardio

I also added 1 session last week of cardio with Battle Ropes and Punches with my Quiet Punch. I again set my timer for 20 minutes and rotate between a session of Battle Ropes and punches. I did this for 6 rotations of:

  • 50 Rope Waves per Arm

  • 50 Punches per Arm

I will be doing these cardio sessions on the days I do not do the pull up/dip workout for 6 workouts total between the two types os workouts. My goal is to get my heart moving, break a sweat, but not risk being up too long or anything too overly strenuous. However the competitive athlete in me continues to want to push harder. In good time.

My Advice

As I noted in previous posts I had been battling the pressure wound for well over a year. My advice to anyone in a wheelchair that gets a wound like this on their bottom to not waste more than a month or two seeing a wound clinic or wound doctor. They cannot help us. For wounds like this there is a 99% chance surgery is the only answer. Please seek out a reconstructive surgeon as soon as humanly possible to get your life back on track as soon as you can. You are wasting your time, and money, seeing a wound doctor.

Surgery

From Previous Post: The surgery is called a wound flap. I had one done 10 years ago and the recovery time had scared me off of going through it again. I kept going to wound doctors hoping the tiny bit of improvement would continue but it hit a brick wall several months ago. The surgery for my situation took about 2 hours. When I went in for the consult with the surgeon he looked at my wound for all of about 5 seconds before knowing exactly what he needed to do and surgery was the only option. Again, we are wasting our time seeing a regular wound doctor.

Recovery

From Previous Post: The recovery time 10 years ago scared me off going through this again. I was mistaken as it is not nearly as bad as back then. After the surgery I was in the hospital for one week, not the 3 weeks I was in 10 years ago. After the week I was actually able to get into my chair to get into the car for the ride home, while riding on my side to keep any weight off the side that was operated on.

The restrictions and timeline are as follows:

  • First 2 weeks after surgery, virtually no time up at all. This is the biggest challenge but the first week of this is spent in the hospital so it is 1 week at home, no getting up.

  • Weeks 3-4 I am allowed up 30 minutes, for every 2 hours. This is still very limited but allows me to do the necessities and heavily lifts the burden off of my wife.

  • Weeks 5-6 I am allowed up 1 hour, for every 2 hours. Same as above, but now I at least have time to get up and make my own meals.

I am currently in the middle of week 3, so heavy restrictions but I am able to do stuff up in my chair.

Training With Health Issues: Wound Update - Surgery

I posted a couple months back about my pressure wound. It came to a point where surgery was the only answer. I have had the surgery and am currently in a recovery window.

My Advice

As I noted in previous posts I had been battling the pressure wound for well over a year. My advice to anyone in a wheelchair that gets a wound like this on their bottom to not waste more than a month or two seeing a wound clinic or wound doctor. They cannot help us. For wounds like this there is a 99% chance surgery is the only answer. Please seek out a reconstructive surgeon as soon as humanly possible to get your life back on track as soon as you can. You are wasting your time, and money, seeing a wound doctor.

Surgery

The surgery is called a wound flap. I had one done 10 years ago and the recovery time had scared me off of going through it again. I kept going to wound doctors hoping the tiny bit of improvement would continue but it hit a brick wall several months ago. The surgery for my situation took about 2 hours. When I went in for the consult with the surgeon he looked at my wound for all of about 5 seconds before knowing exactly what he needed to do and surgery was the only option. Again, we are wasting our time seeing a regular wound doctor.

Recovery

The recovery time 10 years ago scared me off going through this again. I was mistaken as it is not nearly as bad as back then. After the surgery I was in the hospital for one week, not the 3 weeks I was in 10 years ago. After the week I was actually able to get into my chair to get into the car for the ride home, while riding on my side to keep any weight off the side that was operated on.

The restrictions and timeline are as follows:

  • First 2 weeks after surgery, virtually no time up at all. This is the biggest challenge but the first week of this is spent in the hospital so it is 1 week at home, no getting up.

  • Weeks 3-4 I am allowed up 30 minutes, for every 2 hours. This is still very limited but allows me to do the necessities and heavily lifts the burden off of my wife.

  • Weeks 5-6 I am allowed up 1 hour, for every 2 hours. Same as above, but now I at least have time to get up and make my own meals.

I am currently in the middle of week 3, so heavy restrictions but I am able to do stuff up in my chair.

Training

The great part about the current window I am in is I get to work out a little! Due to only having 30 minutes of up time I do a 20 minute timed work out.

  • A1 Bodyweight Pull Ups x10reps

  • A2 Bodyweight Dips x20reps

  • Done on a rotation every 2 minutes for 10 sets each. Equating to 100 pull ups, 200 dips.

This workout will get your heart moving, will build back up any strength you may have lost due to down time. An added benefit is there is absolutely zero weight bearing on your bottom, which is huge. You can substitute horizontal rows, or pushups or many other types of exercises. The important element is to do something to get your body active again.

Training With Health Issues: Train Smart Over Hard

Continuing with the theme of dealing with my health issues over the past year, this post covers a very important consideration. Train Smart over Training Hard.

Train to Remain Sane

I need to workout regularly. If I am not doing some form of strenuous exercise at least 5 days a week I go a bit crazy. The endorphin rush is real. The feeling of accomplishment is real. Since so many of us work desk jobs or live fairly seduntary lifes due to work or netflix or any of the million other modern conveniences, we need to FORCE movement. One of the biggest challenges with my wound was how I would be able to train because if I was not able to I would be miserable to be around. Which is code word for my wife would hate me.

The objective at first was to do something, anything, that allowed me to break a sweat and evolve from there. Something is better than nothing.

Train Around Health Issue

When training with health issues you must intelligently assess your situation and train around it. With my specific health issue, offloading or not putting more pressure on my backside is vital. This is where my absolute FAVORITE exercises for people in a wheelchair are a perfect marraing. Pull Ups and Dips.

Over the past year I have done so many different variations of rep ranges of pull ups and dips its a bit crazy. When limited to a tiny few exercises it becomes even more important to vary up rep ranges or any additonal weight you can add (if possible with your health situation).

I recently had to deal with a Pick line for IV antibiotics which limited me even more! What did I do? I did very little with my right arm where the pick line was installed. I did battle ropes with my left arm only. I was not able to do any repitition style exercises so I utilized static holds.

EX: Instead of doing a full pull up, I would just hold the bar and do 1 arm static holds, or 2 arm static holds. Same thing with dips where I would do 1 dip and hold the top postion for up to a minute.

This went on for 6 weeks and these were not the most exciting exercises in the world, but it was better than nothing.

Wound Update

As I stated, I still have the wound. But it is getting much better. I will post weekly updates on where things are at with the wound as well as begin releasing what I did to maintain my fitness. As of this week I now have a wound vac back on and am still doing Hyperbaric Oxygen Therapy (HBOT) treatment. We are hopeful!

Training With Health Issues: My Pressure Wound

I have been fairly quiet on my updates for the past year. This has been the case for a reason as I have been dealing with among the worst types of ailments an active wheelchair user can get. A pressure wound. I will be posting a series of posts on what I went through, how I managed to exercise albeit limited execrise and the types of exercises I was still able to perform.

I had to deal with extremely limited time up in my chair. I had to deal with a wound vac. And I had to deal with a pick line for taking IV antibiotics. I trained through all of this.

The Wound

On January 1 of 2018 I woke up, with a minor hangover from the New Years celebration but nothing too bad. When I was getting up I could feel a lump on my backside, it felt like a golf ball was under my skin. My wife and I tried to deal with it as best we could but over a week or so this turned into a wound. My first advice to anyone in a wheelchair is if they feel something abnormal on their backside would be to go to a wound doctor as soon as possible. Its possible the doctor could have drained or treated whatever was going on before it got any worse. Then again, most pressure wounds have been building for a long time deep within the tissue and there may not have been anything that could be done.

Anyways, since that time I have been dealing with this wound and have done everything possible to avoid flap surgery. I had flap surgery back in 2007 for a somewhat similar issue and wanted to avoid going the flap route if at all possible. I have heard many stories where once a person goes back for that second flap, or beyond, they can very easily break down leaving you with a worse situation that when you started. My thought was to allow it to heal more naturally and prevent another breakdown within a short timeframe.

I am still not fully healed but after just completing IV antibiotics we are starting to see improvements again. This is the other reason I kept avoiding the flap, there was often slight incremental improvement. Often a few millimeters at a time but improvement is improvement and when your goal is to avoid surgery, any improvement will suffice.

Hyperbaric Oxygen Therapy (HBOT)

I am currently receiving Hyperbaric Oxygen Therapy (HBOT), where I drive in 2 hours round trip each morning for a 2 hour session. I have completed 44 of these sessions, with 16 remaining. There are a lot of amazing things reported from HBOT treatment. Among its biggest reasons for success is it gets blood flow to places where blood flow may be restricted, like the backside of a person in a wheelchair. One negative to this treatment is it can take a long time to see any visual evidence it is working, at minimum 30 treatmets in some cases. This was further complicated in my case due to Hurricane Micheal which ripped a part Panama City Florida. Panama City is where I was receiving my treatment, had just completed 11 treatments before the hurricane hit. I had to find a new place to receive treatment as well as get the insurance approved for the new clinic. This all took time and has delayed the effectiveness of the treatment as it is preferred to stack the treatments with 4-5 per week. For me this was broken up once because of the hurricane, then a second time when the new year started as my health insurance changed.

Wound Vac

Another treatment I received was getting a wound vac. I hated this thing. And it is VERY likely I will have to have another one to attempt to aggressively close up the remaining wound. On one hand the wound vac did work initially, but then it didn’t. And probably caused infection to occur. The wound vac is like a ball and chain attached to you, literally. Doctors and nurses will claim you can live your normal life with it but this is not the case. A person can do some things around the house but in no way are you going to want to do more in public than you absolutely have to. I am not looking forward to having another one put on but I am hopeful it will be on for a short time, and close up this wound.

IV Antibiotics

I just completed IV antibiotics, something I probably should have received months ago. Some doctors do not believe in antibiotics, my original doctor was one of these people. When you have a wound where wheelchair users get wounds, and you are having trouble getting it to close down, its very likely you have osteomyelitis. You need to get IV antibiotics to address this problem. This means getting a Pick line, which means more limitation on exercise. And you get this for 6 weeks. I just finished up my 6 weeks yesterday and was able to go back to doing a full workout, or a modified workout for someone with a wound.

Whats Next?

As I stated, I still have the wound. But it is getting much better. I will post weekly updates on where things are at with the wound as well as begin releasing what I did to maintain my fitness. As much as anything, when you have a wound you need to keep your mind right as you are forced into a life of seclusion. For me that means exercise, pretty much daily exercise.