Monday, November 13, 2006

Spinous Process

Spinous process: The protrusion down the center of the back (red in the picture). It is the bone you can feel when running your hands down your back. Unless you are Jack, in which case your spinous process runs along the left side of your back about 3 inches off center (and that is "corrected").

As you may remember, Jack had this area on his back that was protruding and it had me worried. We saw the local ortho and he said it was the spinous process. Over time, the area of protrusion has become longer and more protruding. We are now dealing with an open (broken skin) pressure sore. Not good! Pressure sores could lead to infection, which could lead to sepsis, which could lead to .... well, you get the picture.

So the question is, did we just trade one set of problems for another? Here is a kid with this area on his back that is clearly susceptible to skin breakdown. This area will always be up against something, whether it be his wheelchair or the bed. Are we now going to spend the rest of Jack's life fighting off pressure sores? Does it EVER end? (other than the obvious end.) These, of course, are rhetorical questions. I don't even know which doctor I need to discuss this with. I guess I could start with the pediatrician. I've a mind to lay it in the lap of the orthopedic surgeon, but I'm sure he'll just toss it into someone else's lap.

Sorry for the lousy update, but I'm in a lousy mood and it's only Monday. Thanks for checking in on us.

I suppose I'd better re-read my previous post and change my attitude, eh?

Melisande and Sharon -- Jack is never in his body brace. He only needs to wear it when he is out of bed. Why get him out of bed if he still must lay completely flat because the brace goes to his mid-thigh? There's no reason to get him out of bed just to put him in a body brace. The only time he wears his body brace is to go to doctor's appointments. The pressure sores are simply from laying on the boney area that is sticking out. Thanks for your thoughts!


Melisande said...

No, Ann, you have every right to feel what you feel about Jack. Pressure sores are pretty common in people who are unable to get around. Not that it makes it any better, but they are manageable.

Is Jack still wearing the body brace? Do you think that may be some of the cause?

{{Hugs}} Ann. {{Hugs}} to Jack too!

I'm glad you have this blog so we can all keep up with you and Jack.

Anonymous said...

Hugs to you my friend. So sorry that Jack is having to go thru this and that YOU are having to go thru this as well. :(


Sharon said...

Hang in there Ann. Hannah wears the TLSO body brace for scoliosis and wound up with a pressure sore, right on her tail bone. We were right on it, the pediatrician ordered a wound care specialist to come out and deal with it. She came and we 1.used duoderm and tegraderm(sp?) dressings over it, 2.made a cut out on her brace(very important since that was rubbing on the bone and caused the prob in the first place!), and 3.positioned left to right side only for a while.Not sure about that one for Jack who has to be on his back a while more, right? It has totally cleared up. Sorry you have to deal with this now, and poor Jack! Just be aggressive with it and you will have good outcome. Hugs, Sharon

julie worthington said...

Oh Ann, poor Jack, and poor you. I hope you can get this resolved, pressures sores can be so painful. You are right to feel fed up with all this. Hope the ped or ortho doc can resolve this quickly.

((((HUGS)))) to you all

Karen said...

Ann...I would throw it back to your ortho. Did your ortho do any test to be sure that it isnt hardware gone awry? I would "strongly suggest" to the doctor that he needs a diagnostic test that would conclusively show that it really is a spinous process....
If that was already done, Im so sorry, it bums me out. : (

Anonymous said...


I'm so sorry that Jack is developing pressure sores and that you can see this being a continual problem. I wish I had advice or better yet a magic wand.

Lots of hugs and prayers, Sandra

Cindy said...

A bit of practical advice. When I did geriatrics years ago, I battled pressure areas a lot in that population. One thing we used was something called "rest on". This is foam pad that's sticky on one side. It can be cut to any size and also you can cut a hole for the bony area. This helps to relieve the pressure on the skin over the bone. It's easy to apply and also comes off easily. I would also get Jack a memory foam mattress or at least a pad to cover his mattress, if he doesn't have one already.