Dr. Joshua Joel Visserman, MD

A properly working immune system identifies foreign substances in the body that might cause illness, such as bacteria and viruses. The immune system then creates antibodies which attack the foreign substances, neutralizing them and keeping the body safe. In people with autoimmune disorders, something goes wrong with this process. For reasons that are not fully understand, the immune system creates antibodies to attack the patient's own tissues.

Symptoms of an autoimmune disorder depend on which tissue is being attacked by the immune system, but common symptoms of autoimmune disease include fever, fatigue, and a general feeling of just not being well. Autoimmune disorders are more common in women than in men, and they may run in families. Autoimmune disorders can affect various parts of the body such as blood vessels, connective tissue, endocrine glands, joints, muscles, red blood cells, skin, and many others.

It is common to have more than one autoimmune disorder at a time. Most are chronic, or life-long illnesses, although they may come and go in flares. Treatment for autoimmune disorders depends on which part of the body is being attacked. For example:

• A type 1 diabetic whose pancreas has been damaged will need insulin.
• A person with Hashimoto's whose thyroid has been damaged will need replacement thyroid hormones.
• Someone with Sjogren's syndrome will need eye drops and mouth rinses to replace tears and saliva.

Many autoimmune disorders of all kinds are treated with immune-suppressing medications, such as corticosteroids (e.g. prednisone) to reduce the effect of the immune system.

Mild sores may heal on their own when pressure on the affected area is reduced. This can be accomplished by simply repositioning the body every hour. If the sores are painful or infected, medications such as pain relievers and antibiotics may be prescribed. Cleaning the wound and changing dressings regularly also help the healing process. Severe pressure ulcers, on the other hand, may require surgery, which involves removal of any damaged, infected, or dead tissue and closing the wound. Wound closure can be achieved either by stitching the skin edges together or by using a flap of the patient's own tissue.

If a patient needs to have pressure ulcer surgery, they will likely be on bedrest for a few weeks to allow the wound to heal completely. The patient and their family members will be given instructions on positioning and transfer techniques to help keep pressure off the wound. When the doctor thinks the patient is ready, he or she will give the patient special exercises to help them regain their range of motion. To prevent the recurrence of ulcers, patients or their caregivers should be diligent about changing positions regularly, observing for early signs of new pressure sores, and replacing any worn-out mattresses or cushions.