Intermittent Pressure Sores: Seeking Insights on Persistent Skin Issues
I’m a 35-year-old female, around 178 cm tall and weighing approximately 330 pounds. I reside in Canada and have a noticeable lack of buttock tissue. I’ve been experiencing intermittent pressure sores every six months for about seven years. Initially, these occurrences were more frequent. They start as minor bruises, evolve into small holes, and gradually enlarge before ultimately healing. Recently, I've made strides in my weight loss journey and sit less frequently than someone in a typical office job, so I'm curious about alternate explanations for this condition beyond the common notions of weight and prolonged sitting. Years ago, I sat on a very warm chair while weighing closer to 400 lbs, but after switching chairs, the incidents reduced significantly. These days, I consistently use specially designed seat cushions or chairs with openings in the back, which provide airflow and support for my tailbone. Additionally, I make it a point to take regular breaks to avoid sitting for extended periods. Yet, despite these preventive measures, the sores still manifest, often without any clear triggering event. The progression begins with soreness and redness in the coccyx area, located just above the gluteal crease, often accompanied by swelling. To improve the skin’s elasticity, I immediately start applying moisturizing lotion. Previously, I utilized a skin barrier cream, but now I’ve switched to a moisturizing body lotion. During bathing, I feel it’s beneficial to use a moisturizing face wash while ensuring the area remains well dried and not overly moist. In a few days, small bruises develop; they're not petechiae-sized but are still quite noticeable, usually appearing singularly—though this time I have four bruises. The pain intensifies as I continue to apply cream to the area. A couple of days later, a tiny pinhole emerges, at which point I stop using lotion and start covering it with a dry bandage designed to absorb any drainage. As time passes, this pinhole expands, resulting in the need to frequently change the bandage, which becomes quite painful. I strive to limit my sitting during this healing phase, which typically takes around two weeks. Upon my first encounter with a general practitioner regarding this issue, the response was that it was a pressure sore. He bandaged it but offered little else in terms of help. After mentioning a few more incidents, he seemed disinterested, likely due to burnout and our strained rapport. I’m set to see a new GP next week, and I haven't previously disclosed this recurring issue to her in the last five years. I felt it was necessary to reach out for possible assistance, as I find myself perplexed. Despite knowing larger individuals who lead less active lives without similar problems, I can’t help but think my lack of cushioning may contribute to my predicament. For additional context, I have been diagnosed with hypothyroidism, IBS, and psoriasis. Prescriptions I’m currently on include Synthroid, Mirvala (birth control), Clonazepam, Alprazolam, Pantoprazole, Ranitidine, Escitalopram, Trazodone, Bilastine, and Wegovy. Any insights or suggestions would be greatly appreciated as I navigate this ongoing challenge.
Answers (1)
7/4/2025, 9:20:42 PM
OpenHealth AI
Experiencing intermittent pressure sores can certainly be frustrating, particularly when you are taking steps to prevent them. Given your history and the background provided, let’s explore the factors involved and outline prioritized steps for improvement.
Main Points
- Intermittent pressure sores can originate from a variety of factors beyond weight and prolonged sitting.
- Skin condition, circulation, and skin elasticity play significant roles.
- Immediate actions focus on optimizing skin care and tracking your progress.
Explanation
Pressure sores, also known as pressure ulcers, develop when there is prolonged pressure on the skin, especially over bony areas, leading to reduced blood flow. While your weight and sitting habits are relevant, other factors such as skin elasticity, moisture levels, and pressure redistribution can contribute to the condition.
Factors You May Want to Consider:
- Skin Elasticity & Health: Conditions like psoriasis can affect skin integrity, making the skin more prone to injury. Additionally, hypothyroidism can alter skin properties.
- Circulation: Ensuring proper blood flow is crucial. If there are circulatory issues, they may worsen pressure-related concerns.
- Nutrition: Adequate nutrition supports skin health, so a balanced diet rich in vitamins and minerals is essential.
- Hydration: Ensure you are well-hydrated, as this can contribute to overall skin condition.
Specific Next Steps
- Continue Using Seat Cushions: Stay with your specially designed seat cushions or chairs that enhance airflow and support areas prone to pressure.
- Monitor Skin Regularly: Keep an eye on skin integrity in high-pressure areas to catch any issues early. If you notice redness or soreness, address it immediately.
- Optimize Skin Care:
- Consider returning to a skin barrier cream instead of just moisturizer for additional protection against friction and irritation.
- Use a mild cleanser; look for products free from harsh additives to avoid exacerbating psoriasis.
- Hydration & Nutrition: Ensure your diet includes plenty of fruits, vegetables, lean proteins, and healthy fats to support skin health and overall well-being. Drink sufficient water to stay well-hydrated.
- Document Changes: Keep a journal of your skin condition, noting any changes, treatments, and routines. This will provide valuable information to your new GP.
- Communication with Healthcare Providers: During your upcoming appointment, clearly explain the history of your pressure sores, current strategies, and your concerns regarding skin health. Don't hesitate to ask specifically about improving circulation and skin integrity measures, such as potential referrals to a dermatologist or wound care specialist.
Recap
While your preventive measures are solid, fine-tuning your skin care and dietary habits can offer further protection. Continue monitoring your skin closely, and ensure you communicate effectively with your healthcare provider. Remember that addressing skin integrity is a gradual process, and consistent care is key. You're taking meaningful steps on your health journey, and I'm here to support you as you navigate through this challenge.
Related Questions
Experiencing an Eczema Outbreak
A 22-year-old individual, F, has reported an eczema outbreak that began at the end of April. This is the first instance of eczema appearing on their hands. Initially, there was only one patch, but lately, they have noticed fluctuations in the condition. On some occasions, the affected area appears to improve—it becomes less red, the itching subsides, and the skin seems more settled. However, there are days when they wake up to find new clear bumps forming, accompanied by severe itching. This unsettling cycle has persisted for four months, leading to sleepless nights due to discomfort. The situation is particularly concerning as they are set to start a job on a farm soon. Currently, their routine includes using unscented lotion and soap, though for the first couple of months, they continued with usual products without realizing the issue. Although they possess cotton gloves, there is uncertainty about further steps to take—whether additional care is needed or if a visit to urgent care would be the best course of action. Moreover, they have recently noticed the emergence of eczema patches on their arms and legs, which is completely new to them.
ER Visit Reveals New Diagnosis
A 27-year-old female, standing at 5 feet 7 inches tall and weighing 185 pounds, has a current medication regimen that includes Wellbutrin SR at a dosage of 150 mg twice daily and Lexapro at 20 mg once daily. Her medical history includes diagnoses of Bipolar II disorder, Obsessive-Compulsive Disorder (OCD), and Generalized Anxiety Disorder (GAD). On the 2nd of the month, she sought emergency care due to a case of serotonin syndrome. Her psychiatrist had recently prescribed 7.5 mg of Remeron to assist with her sleep issues. After taking the medication for two days, she started noticing symptoms indicative of serotonin syndrome, prompting her ER visit for treatment. Upon reviewing her medical records, she noted the following diagnoses recorded during her hospital visit: - Carcinoid syndrome, unspecified (Final) - Personal history of other mental and behavioral disorders (Final) - Serotonin syndrome (Discharge Diagnosis) Date of diagnosis: 7/2/25 At no point during her emergency room stay was she informed about the carcinoid syndrome diagnosis. She is also uninformed about the presence of any potential tumors in her body. This raises her concerns regarding the relationship, if any, between this new diagnosis and the serotonin syndrome, leading her to question whether she should follow up with her healthcare provider concerning the carcinoid syndrome diagnosis.
Seeking Guidance for My Son's Developmental Delays
I’m reaching out because my son, who is nearing 14 months, seems to be lagging behind in his developmental milestones. He has yet to walk, talk, sit up, roll over, or keep his legs straight for extended periods. His facial expressions are quite limited, with only an occasional smile to communicate. People frequently tell me how fortunate I am that he’s so calm, but after reflecting on his situation, I’m growing increasingly concerned. I was told that his height might be contributing to his difficulty in walking and that I could have encouraged more tummy time. However, I recently discovered that there was a complication at his birth. By sharing this, I hope to find someone who can relate or understand the implications involved in his case. My family now suspects he might have cerebral palsy. I had no idea about this until I researched it, but many of his symptoms appear to align with the condition. I prefer not to get caught in endless searches until Monday, so I thought it best to seek advice here instead. Here’s a brief overview of what happened at his birth: - After he was born, he cried briefly but had a dusky appearance. - His heart rate was approximately 100 beats per minute, but his respiratory effort was weak despite breathing on his own. - We began Positive End Expiration Pressure (PEEP) at 5 cmH2O with 30% oxygen. At one point, he paused breathing and his heart rate fell below 100, requiring five inflation breaths and a two-person jaw thrust. - Fortunately, his heart rate improved and he started breathing regularly around three minutes after birth. His oxygen saturation levels were low (60% at four minutes), so we increased the oxygen to 50%. - By eight minutes, his saturation remained in the 70s, prompting us to provide 100% oxygen. By 11 minutes, his saturation exceeded 90%, allowing us to wean him off oxygen, and by 15 minutes, he was breathing room air. He was monitored for 20 minutes before being handed over to his dad for a cuddle. In terms of his respiratory and cardiovascular health, he experienced cyanotic episodes, particularly at two hours old, necessitating oxygen. By the time he was admitted to the Neonatal Unit, he was breathing without assistance. He was on oxygen for only a day. A cranial ultrasound returned negative results, indicating no bleeding concerns. He was admitted to the Neonatal Unit shortly after birth due to episodes of dusky skin and rolling eyes post-feeding. He was monitored for possible seizures, but the continuous fetal monitoring for around six hours showed no further seizure activity or abnormal movements. My main concern is whether there’s any long-term risk for brain damage given these circumstances. I would appreciate any information or guidance on this matter. Thank you for any help you can offer.
Should I Seek a Referral to Neurology?
Hello everyone! I’m a 32-year-old female and I recently attended an appointment with an audiologist due to experiencing episodes of muffled hearing two to three times daily. During my evaluation, they made an interesting observation: episodes of pure torsional nystagmus were detected. This type of nystagmus, without an upbeat direction, burst component, or accompanying feelings of dizziness, does not align with Benign Paroxysmal Positional Vertigo (BPPV). Consequently, this could point towards potential issues of a central origin. Given this finding, do you think I should pursue a referral to a neurologist? I’m currently located in Canada, where obtaining such referrals can be challenging, so I’m contemplating how assertively I should advocate for this. Additionally, here are a few other medical details that might be pertinent: - I have a history of migraines. - A brain MRI conducted in 2018 revealed a linear signal abnormality along the corpus callosum, which I didn't seek further evaluation for at that time. - I am presently undergoing assessment by a rheumatologist for suspected spondyloarthritis. Any advice or insights would be greatly appreciated!
What to Anticipate After Kidney Surgery: Recovery Insights and Discharge Requirements
I appreciate your patience with this lengthy message; I’m aiming to cover all relevant details. I’m seeking insights regarding my father’s upcoming surgery, particularly around hospital stay expectations, discharge requirements and restrictions, and the anticipated recovery timeline. I realize there are numerous variables involved, but a general overview would be greatly appreciated. **Patient Profile**: Male, aged 78. **Medical History Summary**: My father doesn’t smoke and only drinks occasionally. He has gastroesophageal reflux disease (GERD) for which he takes medication and has a history of depression (currently, the status of his antidepressants is unclear). Additionally, he suffers from degenerative spinal conditions with bulging discs in the lumbar region. He has undergone multiple soft tissue mass removals from his lower back and flank, initiated approximately four decades ago; however, the malignancy status of these masses remains unverified, as only surgical excision was performed with no further treatment. His history includes a postoperative infection (from golden staph) roughly nine months ago following a mass removal in the same region; at that time, a deeper mass was also excised with subsequent healing complications thereafter. Moreover, there is a family history of cardiac disease and cancer, including two children who face connective tissue disorders and associated health challenges (EDS). **Current Situation**: He consulted his general practitioner about a week ago due to intense abdominal discomfort accompanied by nausea and vomiting. Despite having a high tolerance for pain, he was admitted to the hospital, where he was diagnosed with diverticulitis, leading to a last-minute cancellation of the initial surgical intervention. **Incidental Discovery**: Imaging tests uncovered an incidental mass on one of his kidneys. Notably, there were no previous indications of this mass in imaging done nine months prior, which has been confirmed upon review. Although no biopsy has been conducted, a partial nephrectomy for both kidneys has been scheduled—approximately three weeks after this discovery, the delay being attributed to the surgeon's leave. **Further Observations**: He has mentioned experiencing persistent lower back pain for several months, which he had previously attributed to his established back problems.