Chippertue’s World
 
 

My name is Tammie Lou. I am 57 years old. I was born in San Jose, California. I was raised mostly in the Santa Cruz Mountains near Los Gatos, California.


I am a C-6 complete quadriplegic,

paralyzed from the chest down.  


On March 10, 1995, I was in an auto accident on Pacheco Pass, Highway 152, near Gilroy, California. At the time I lived in Los Banos, California and worked in Milpitas, California (about a 90 mile commute, a 1-½ hour drive each way). I was a mail coordinator for Xicor Inc. a semiconductor company. I was in the passenger seat or "suicide seat" as it is sometimes called. I was commuting with neighbors at the time.

It was raining really hard and the pickup I was in hydroplaned and flipped end-over-end I was told.  


I woke up in the middle of the fast lane not being able to move, but not yet knowing why. For the next three-and-a-half months I was in Valley Medical Hospital of Santa Clara County. My life after that would never be the same. I broke my neck in the accident. At the age of 33 I began to learn a whole new way of life.


I lived with my boyfriend in Los Banos until taking care of me got to be too much for him and he asked my parents to come and get me, he told them they would probably have to put me in a care facility because it was too much trouble but they refused so they redid their mobile home to accommodate me.  At this point we had been together for about 18 years but I understood, it was a lot of work.


We had a lifelong friend who was a contractor so he built a ramp, widened the door to their spare bedroom, made a door from their spare bedroom to their bathroom and put in a roll in shower, until then I basically lived in my parents living room.


I started three chat rooms on AOL. I like learning, listening and helping other SCI (Spinal Cord Injuries) victims and their friends and families. We are all trying to understand and deal with our new way of life. It is not easy and if I can help people adjust I am happy to do it.


With the help of my family and friends I am going on with my life. I now live with my parents in San Jose, California. I attend a weekly peer support group at Valley Medical Center and I spend most of the rest of my time chatting on the computer.


When I first started living there I didn't have any caregivers so my mom did all of my care, needless to say I only got up about once a week to go to the support group at Valley Medical Center… Unless I had a doctors appointment. My aunt Kathy came by to help whenever she could and talked me into going into an independent living Center. It was a really great idea but really bad timing, after everything I went through I was glad I went. It was a couple of months and they were just opening the house, it was supposed to teach you everything you need to know about reentering life after a spinal cord injury. How to schedule rides, shop, hire and fire caregivers… It really taught me a lot but at the same time I hope was a learning experience for them. They expected me to be up by 9 AM and stay up until 5 PM, your caregiver could not be there between 9 AM and 5 PM so my first problem was my leg bag would get full and there was nobody there to empty it so by the time my caregiver got there at 5 PM I was in autonomic dyslexia and soak and wet with urine. My second problem was wants my caregiver left I couldn’t get myself something to eat, they trying to teach me how to open up the refrigerator door but that wasn’t the problem… I couldn’t reach in and grabbed anything and then I wasn’t able to open up anything even if I could grab it. When I tried to call and tell them about the problem there wasn't anybody around because they were moving from one facility to another.


While I was living there I was contacted by an attorney wanting to proceed with my case, my injury was the result of the neglect of Caltrans. They were supposed to check out the problem if there is an accident three times in the same place and my accident was the 33rd, the attorney that I got when the accident first happened was killed by a drunk driver so the case got dropped. After six years I finally got a settlement, Caltrans had to buy me a house and care for the rest of my life… I am so fortunate! I finish the program and then came back home and started looking for my own place.


My attorney sent me up with a company to help me out financially and with doctors and other programs to help my rehabilitation. In the long run they ended up taking advantage of me and I ended up losing a lot of money, thank goodness again for my aunt who noticed and quickly fired them. That's when she took over for me, she is so good at managing finances and helping with decisions. After looking at several houses I decided to buy a mobile home right around the corner from my mom in the same mobile home park as my parents, unfortunately by then my dad had passed away. In March of 2003 I got my own place. I never imagined that I would be able to live by myself, it is a great feeling.  I have a computer program called Multimedia Max that basically runs my house by voice command. Opens and closes doors, turns lights on and off, adjusts the thermostat and even raises and lowers the head and feet on my hospital bed.


I went to an Abilities Expo in San Jose and try to sign up with Canine Companion for Independence but there was a five year waiting list so I went back home and apply for a service dog from a website I found online. I talked to the guy a couple of times and he matched me with a rescue labrador/pitbull mix named Brodie. She was a great dog but extremely animal aggressive. She can pick up things that I drop, open and close doors, and bring me the telephone if electricity goes off or I need help. She makes me feel more confident when I go out and do things and she makes me feel safer living here by myself.


My life is so great now. I try to keep myself busy and take advantage of any surgery that will make me more independent. I recently had Tendon Transfer surgery on both arms. The first one was in June of 2001, the second one was in January of 2002. It has made me so much more independent, I am more amazed every day. It was done by Dr. Hentz, from Stanford University and clinic. He is world known and actually cares about his patients, he is the best doctor I have ever met, he actually answers my phone calls.


I had foot drop surgery done on my feet in October 2003. My foot drop was so severe from lack of range of motion that I was not able to wear shoes for two years. It is so nice to be able to wear shoes again...time to go shoes shopping. I love my new place, it was a three-bedroom with a huge kitchen, a huge living room with a gas fireplace and a dining room.


I lived there for four years and then my uncle talked me into moving to Santa Cruz, every time a house came up for sale on the street where he lived he would call me and tell me about it but I didn't really have any way to get to Santa Cruz to look at them. One time when he called my brother happened to the visiting from Georgia and said he would drive me to look at it, it was perfect for me so after discussing it all the way back I decided to go for it. The house is really small, a little over 600 ft. but had a huge backyard so the same friend that read in my parents house to agree to build a house for me with an apartment above for my mom. It took about a year but the most beautiful house I had ever seen was built and was mine, because the guy has known me since I was little he built everything with me in mind… It was absolutely gorgeous and I couldn't really it. I moved into my very own home in June 2008, I was in heaven. The mobile home park was really nice but I couldn't go anywhere unless I payed a caregiver to drive me, it was out in the middle of nowhere. Here in Santa Cruz I could just cruise out my door and go anywhere, my new house was centrally located a mile from downtown and also a mile to the wharf, beach and boardwalk.


My younger brother Dave works for Delta Airlines, he repairs and maintains the flight simulators. He put together a home automation program for my new home so that with my computer I can adjust the thermostat, turn on and off lights and control my television… Change the channel and adjust the volume. I have my dream house and I can control it with my computer.


Brodie got cancer and passed away shortly after I moved to Santa Cruz. In 2009 my application for a service dog was accepted by Canine Companions for Independence and I was on my way to the Santa Rosa campus for team training for my new service dog. I was with my first service dog in Chili's restaurant after getting asked to leave another restaurant because they didn't allow dogs, instead of arguing with them I just left because I was with my family and the kids were hungry. I met a lady, Jan, and talk to her for a while and she gave me her phone number. I later found out she belonged to Los Gatos Lions Club and because they are a big supporter of Canine Companions for Independence she expedited my application, there was about a five year waiting list. My application was accepted within a year. I got Robby ll from Canine Companions for Independence in November 2009. It’s an interesting process that Robby and the other CCI puppy’s went through to be matched with a person who needs their help, makes them more independent and gives them self-confidence. The puppies are born to a CCI breeder and until they are eight weeks old exposed to a CD that has every kind of noise you can imagine, different situations and a lot of love to make them confident. At approximately 8 weeks old they are turned over to a puppy raiser who teach them basic obedience and continued exposure to anything they might encounter in the future. At approximately 18 months old they are turned into CCI and to a trainer who teaches them about 42 commands and tasks.


After the puppies are trained we are invited to CCI for team training, it is time to train us. After only three days of classes and working with each dog the trainer chooses a pre-match, a combination of dog and person the trainer feels will work the best together. From then on we became a team.  Two main things the trainers look at when matching a dog are the students handling style and which dogs respond best to that handler. Also the individuals lifestyle... do they go out a lot... do they work... do they travel a lot and what skills are going to be most useful to them.


Among the commands that make me more independent are turning on and off lights, opening and closing doors and drawers, picking up things that I drop... that is a big one for me because I am pretty clumsy, even push pads and elevators. Elevators are a little tricky because the buttons are so close together so sometimes we end up traveling a little bit but I can now use elevators. He also gives me confidence to go out into the public because he can do a lot of things for me that I would need to ask somebody else to help me with. He loves to cruise along the cliffs, the wharf and the boardwalk. Since I got Robby ll we are hardly ever home.


Not all of the puppies make it to team training to be matched.  A couple of things the trainers look for in training that would get a dog released are energy level (we need calm dogs that have a lot of self control) and dogs that are not overly reactive (don’t freak out to new things and situations). Other things that pop up are fearful responses, alarm barking and toy guarding. I am so thankful for CCI, the trainers, the volunteers, the breeders and puppy raisers and everyone else involved in allowing me to be placed with Robby, the best friend a girl could have.


There was a contest online for a new product called Google Glass so I decided to apply, it can do anything a computer can do… Take a picture, recorded video, answer and reply to a text, answer the phone and you can even read and write an email all through voice commands in a little prism that sits on a pair of glasses above your right eye. With the later version you can take a picture by just winking. Santa Cruz is the most beautiful place and I love to just cruise around all day exploring and taking pictures.


I got to know a guy named Roger at Dominican Rehab and we decided to start a support group, it didn't last long but a year or two later we decided to try again and so far it looks like it's going to make it. I have met so many really cool people and I'm learning so much, not to mention trying to get over my social anxiety. I started seeing a psychologist downtown and that has helped a lot also.


I would like to go back to work or go to college and take some counseling and anatomy courses and possibly be a counselor or something along that line. For now I just enjoy spending time with my family, old friends and all my new friends online.


Tips that I have learned:


Camelback:

My Aunt is a bicycle rider and she gave me a Camelback water dispenser and it is perfect. I have one beside my bed and one on my chair. I clip it on me so I can get to it easily.


H. wave:

I'm sure I'm not the only one who has a problem with bowel programs? It doesn't always happen when we want or when it is most convenient. I found out by accident, no pun intended, that an H. wave machine or TNS unit really helps a lot. I was doing some rehab at transitions when I discovered that I have scoliosis. They decided to try the H. wave machine to see what would happen. After the about 20 minutes I started getting chills really bad like when I need to evacuate my bowels. After this happened about three or four times I started to wonder if we have something here. I tried hooking up the H. wave machine about 20 minutes before it was time to evacuate and it worked great so I mentioned it to my doctor and she's now doing a study.


Yeast infections:

As I had mentioned before I get a lot of yeast infections, I got a lot of them even before my injury but after it only got worse because I cannot get my legs to separate. At my housewarming party we got on the subject, I have no idea how, and somebody told me that garlic is really good for curing yeast infections and it works really fast. I have tried the creams and the pills and it maybe cleared it up for a day or two but it always came back. Since I have used the garlic, which works with one application and works overnight, I have only got in a few it sure is great. The biggest problem is trying to figure out how to insert the garlic and how to retrieve it, I haven't figured that one out for sure yet but I will and I will let you know.


Bed sores:

I thought I had found a miracle breakthrough to keep bed stores under control but I guess there is no miracle cure. I thought that maybe taking a shower or bath every morning and evening and using a knee spreader would help and it does. My legs don't like to separate very well I get a lot of bladder and yeast infections because no air gets circulated when your knees won't stay apart. Using a blow dryer after to keep dry was a good idea but it's not fool proof. Before I get dressed I put Vaseline where I usually get sores and that helps also.

I also went online and found some leg restraints to put on the bottom of my bed to keep my legs apart while sitting up, there is some pretty kinky stuff out there, I tried to look for medical restraints but the only ones that I found were for pleasure not medical reason but worked just as well. During the night I need to lay on my side and the leg restraints help with that also. Sometime during the night and usually have a spasm and it rolls me over on my back and there isn't much I can do but by using the leg restraints I can keep my legs crossed and keep me on my side all through the night.


Nutrition Guidelines for people with active pressure sores

*note-these guidelines are general and may be modified by your physician or dietician as appropriate.

Current weight:______ weight in kg: (lbs/2.2) ______ Presser sore stage:______

Stage 1 sores need 1.1gm of protein/kg/24 hours

Stage 2 sores need 1. 2 gm of protein/kg/24 hours

Stage 3 sores need 1.3 gm of protein/kg/24 hours

Stage 4 sores need 1.4-5 gm of protein/kg/24 hours


Your current needs: (weight in kg x protein needs per stage) ______gms of protein per day.

Good protein sources include meat, fish, poultry, cottage cheese, soybeans, tofu, and milk products. Choose low-fat options when possible to avoid unwanted weight gain. You can purchase some protein powder in bulk at health food stores (and some grocery stores) and add it to your food to increase protein intake. It adds well to foods such as oatmeal, shakes, and baked goods.

Water is necessary to assist with wound healing. 8 8-oz glasses per day is recommended as a minimum. Carry a sports bottle with you at all times to ensure that you have access to plenty of water.


Supplements recommended:

Basic multivitamin-1 tablet per day

Vitamin C 250 mg two times per day for nonsmokers, four times per day for smokers

Zinc sulfate-220 mg two times per day, or elemental zinc 40 mg per day

Vitamin A-2500 every day for 14 days. Stop after 14 days

Arginine-7 to 15 gms her day

Glutathione-10 to 20 g per day


The above supplements are necessary to promote wound healing. For example, a deficiency in zinc can lead to a delay in wound healing.

For more specific recommendations for yourself, consult your doctor, nurse, a registered dietitian. Above guidelines are general guidelines only and do not include special dietary needs such as for diabetes.


There are four stages of a pressure sore.

Stage 1 - Damage is limited to the top two layers of skin, the epidermal and dermal layers. The skin is not broken, but there is redness that does not turn white when touched. A person with dark skin will also see a change in skin color, which may become darker, dry, flaky, or ashy. The area may be warmer than other areas, and there may be a change in the skins texture.


Stage 2 - Damage extends beyond the top two layers of the skin to the adipose tissue. The skin is slightly broken. The sore appears to be an abrasion, blister or small crater.


Stage 3 - Damage extends through all the superficial layers of the skin, adipose tissue, down to and including the muscle. The ulcer appears as a deep crater and damage to surrounding tissue may be present.


Stage 4 - Damage includes destruction of all soft tissue structures and involves bone or joint structures. Undermining of ajoining tissue and sinus tracts may be associated with these sores.

Stage 1 and 2 pressure sores are usually treated without surgery. Stage 1 treatment is almost always bed rest because it is essential to stay off the pressure sore to allow healing. Other treatments might include wound care, improving nutrition, pressure reliefs and exercises. Treatment for muscle spasms may be necessary to allow the wound to heal.

Surgery might be used for stage 3 and 4 pressure sores located on the sacrum (tailbone), ischium (beneath the buttocks), and trochanter (hips). Surgery may also be needed to treat sores that have not responded to non-surgical treatments, correct a previous surgical failure, remove infection from the hip joint, and prevent exposure of bone, plates or screws.

Pro-Stat® AWC

Pressure ulcers, also known as bedsores, can significantly diminish quality of life and require substantial cost to remedy.  It is estimated that 1 to 3 million people in the US develop pressure ulcers each year.1   Across all settings the estimates of  pressure ulcers prevalence  in the US is  10% to 18% in acute care, 2.3% to 28% in long term care, and 0% to 29% in home care.2,3   The European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel; Treatment of pressure ulcers: Quick Reference Guide. Washington DC: National Pressure Ulcer Advisory Panel; 2009 indicates that patients with pressure ulcers need 30 to 35 kilocalories and 1.25 to 1.5 grams of protein per kilogram of  body weight daily. There are also increased requirements for L-Arginine, L-Cystine, Vitamin C, and Zinc.4  In a 2006 study published in Advances in Skin & Wound Care, Pro-Stat showed a 96% greater improvement in PUSH scores in the treatment group.5  

Pro-Stat® Advanced Wound Care is a high calorie, complete protein liquid, with added Arginine, Citrulline, Cystine, Zinc, and Vitamin C.  It is the only wound care supplement to contain Citrulline, a precursor to Arginine increasing nitric oxide production, (thus increasing blood flow to the wound and collagen formation).  This uniquely engineered combination of ingredients provides a synergistic approach to wound healing while reducing the need for multiple supplements and added cost. Nitric oxide is essential for wound healing.  It increases blood and oxygen flow to the wound, increases collagen formation, reduces inflammation and kills bacteria all helping to close wounds.  Arginine is the only producer of nitric oxide, however, 40% of ingested arginine is broken down by the intestine and liver making less available for nitric oxide production.  Citrulline, prevalent in watermelon, converts to arginine but is not broken down like arginine.  This conversion allows for more nitric oxide production thus facilitating healing.  Citrulline has been shown to be more effective than arginine in raising plasma arginine levels.

Each one fluid ounce (30 ml) serving of Pro-Stat AWC with Citrulline contains:

Protein

17 grams of hydrolyzed complete protein to reduce protein energy/calorie malnutrition, build muscle, repair tissue, fight infections and reduce overall morbidity/mortality. Indicated for pressure ulcers, burns, post-surgical wounds, diabetic foot ulcers, and venous stasis ulcers.

Arginine

The physiological demands of repair and recovery from wounds, burns, sepsis and trauma (including surgical trauma) often require greater amounts of L-arginine than can be synthesized by the body. Additional dietary intake of L-arginine is indicated when these conditions are present.

Needed to promote protein regeneration and the healing of wounds.4

Essential when the body is under stress or in an injured state.5

Conditionally essential, particularly during growth, illness or metabolic stress when the body's production may be insufficient to meet demands.6

Improves markers of wound healing with greater protein and hydroxyproline in the wound bed and promotion of positive nitrogen balance.7

Citrulline

Citrulline supplementation is an efficient alternative to oral administration of Arginine in raising its plasma levels and modulating Nitric Oxide production.  A non-standard amino acid found in watermelon.

Cystine

Cystine controls and promotes positive nitrogen balance for minimizing muscle breakdown and rebuilding lean body mass (LBM).

Required to synthesize glutathione ( GSH ), the cell's major antioxidant that plays a vital role during tissue repair and collagen synthesis.

GSH destroys damaging oxygen radicals that are continually being generated with pressure ulcers and GSH keeps Vitamin C stable and active.

Cystine produces the bioavailable form of GSH.

Ascorbic Acid (Vitamin C)

Vitamin C is essential for wound healing and for the repair and maintenance of cartilage, bones, and teeth. Vitamin C deficiency can lead to a decreased wound-healing rate. The body does not manufacture vitamin C on its own, nor does it store it.8,9

Promotes collagen synthesis and enhances activation of leukocytes and macrophages to the wound site.9

Promotes healthy cell development, proper calcium absorption, normal tissue growth and repair - such as healing of wounds and burns.9

Required for the growth and repair of tissues in all parts of the body.9

Necessary to form collagen, an important protein used to make skin, scar tissue, tendons, ligaments, and blood vessels.9

Zinc

Zinc has been shown to be beneficial to wound healing and zinc deficiency has been associated with delayed wound healing.10,11

Assists in immune function and interacts with platelets in blood clotting.12

When zinc supplements are given to individuals with low zinc levels, the numbers of T-cell lymphocytes circulating in the blood increase and the ability of lymphocytes to fight infection improves.12


I always love it when I get really good advice from people who read my homepage. I met Jennifer on Etsy and she gave me these helpful tips…

And if you can stand the taste of it, how about drinking cranberry juice for the yeast infections? Also, Tea Tree oil is amazing. It has quite a pungent smell to it - and anti-fungal properties, but if you can get a tampon in there, I can suggest this: 

You will need:

Natural, pro-biotic PLAIN yogurt - Activia, Yoplait Original and Stonyfield are great ones that come to mind.

Tea Tree Oil

1 tsp organic apple cider vinegar

tampon

In a bowl or coffee mug, mix the yogurt with 15 drops Tea tree oil and 1 tsp apple cider vinegar, 

soak the tampon in the mixture for a couple of hours

Insert and let sit for a couple of hours twice a day - morning and night - do not sleep while the tampon is in. 

(doesn't smell tasty - but it works really well)

With each of my three pregnancies I had many yeast infections, as I was bed ridden after the 6 months mark. This method never failed me. Symptoms would subside after a few hours and by the next day, infection would be gone. I hope this helps - and that it is a viable option for you. 

"You can put anything on a pressure ulcer and it will heal, as long as it is not the patient"


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