Concerns About a Delayed Referral for Wound Treatment
My mother-in-law, who is 77 years old, had an unfortunate incident at her home eight days ago. While she was cleaning, she accidentally leaned back too far and fell, impacting her back and sliding down her kitchen cabinet to the floor. Upon visiting her a few days after the fall, she seemed relatively mobile but mentioned experiencing mild back discomfort. However, yesterday she reported awakening to find blood on her sheets, indicating a potential problem with her back. I went to her house to check on her. When I arrived, she was using a heating pad on her back. I requested to see her injury, and I was taken aback by the sight of her back—it was red and swollen, with a wound the size of a half dollar, accompanied by multiple abrasions. Without delay, I took her to urgent care for a thorough examination. Fortunately, she exhibited no fever, although her blood pressure was slightly high, her heart rate was 108, and her oxygen saturation was at 93%. The nurse practitioner who assessed her suggested that the wounds on her back were simply a peculiar mole (the darker area) and a persistent skin condition, unrelated to her fall. He attributed the pain to musculoskeletal issues and prescribed Tizanidine for her discomfort. When I inquired about proper care for the wounds, he advised simply applying moisturizer. I had concerns about infection, yet he did not address that possibility. To me, the lesion appeared more like an ulcer, not a strange mole. He submitted a referral for specialized wound care, and they should contact her next week to arrange an appointment. While we await this follow-up, is there anything additional I can do to help manage her wound? She is experiencing considerable pain across her entire back. Her medical background includes lupus, scleroderma, rheumatoid arthritis, Raynaud's phenomenon, and multiple spinal surgeries involving lumbar, thoracic, and cervical fusions. Additionally, she is on a regimen of chronic pain medication.
Answers (1)
7/6/2025, 1:10:34 AM
OpenHealth AI
I'm glad you reached out about your mother-in-law's situation. Given her age, the nature of her injury, and her medical history, it’s understandable to be concerned about her wound and overall wellbeing. It's good to hear that urgent care assessed her, but I see why you’re seeking additional guidance, especially regarding her pain and the wound.
Main Points:
- Monitor the wound for signs of infection.
- Manage her pain effectively.
- Keep her comfortable and support healing.
Explanation:
After a fall, especially in someone with underlying health conditions, it's crucial to be vigilant about any wounds. The presence of redness, swelling, and an open wound capable of bleeding can indicate a potential for infection. Pain across her back can be connected to both the injury and her existing conditions.
Next Steps:
-
Wound Care at Home:
- Clean the Wound: Use a gentle saline solution (or clean water) to gently rinse the wound once or twice a day. Avoid using alcohol or hydrogen peroxide, as these can irritate the skin further.
- Apply an Appropriate Dressing: If the wound is open and bleeding, consider a sterile dressing. Change it daily or if it becomes wet or dirty. If you notice increased redness, warmth, or discharge that looks pus-like, it's important to seek medical attention.
- Moisturizer for Dry Skin: If the surrounding skin is dry or scaling, applying a gentle moisturizer (without fragrances) can help, but don’t put it directly on the wound.
-
Pain Management:
- Tizanidine Usage: Ensure she's taking the Tizanidine as prescribed for pain relief. Monitor how well it's working.
- Alternative Methods: In addition to the heating pad, consider gentle stretching or relaxation techniques. Encourage her to avoid activities that strain her back.
-
Monitor Symptoms:
- Keep a close eye on her overall condition and any changes in her wounds. If she develops a fever, increased pain, or a change in the color or smell of the wound, prioritize seeking further medical attention.
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Support for Mobility:
- Encourage her to avoid prolonged sitting or lying down, as this can exacerbate pressure on the area. Gentle movement can promote blood flow and healing.
Reassurance:
Remember that you're doing the right thing by looking after your mother-in-law and advocating for her care. While waiting for the wound care appointment, your attentiveness and proactive management can make a significant difference in her recovery. If you have further concerns or need more tips, feel free to ask.
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