Stop the Pressure Day 2024 - Ify Nwokoro

“It got to the point where I just stopped having any hope that I would get up again.”

When Ifeanyi (Ify) Nwokoro (34) from Middlesbrough developed seven pressure ulcers that left him on bed rest for most of a year, he started to lose hope that he would ever get up again.

This condition can start as a tiny mark on the skin and develop into serious skin damage that requires bed rest and consistent care from healthcare professionals. On average, pressure ulcers cost the NHS £22.4 million per day, adding up to £8.2 billion per year.

According to Spinal Injuries Association, people with spinal cord injury are more at risk of developing pressure ulcers due to paralysis, leading to loss of both mobility and skin sensation.

Ify sustained a spinal cord injury in a road traffic accident in 2010 when the driver of the car lost control. He was left paralysed from the chest down and has since become a disability spokesperson, working with the local council and hospitals, speaking at universities, and writing his own blog. This Stop the Pressure Day, he wants to highlight his story to help others with dark skin tones receive a quick diagnosis and avoid the months of suffering he endured.

In 2016, after a week-long stay at hospital, Ify’s carers started noticing dark patches on his back. When he returned home, the marks continued to grow. He then started getting scar tissue and scabs in areas with no other visible damage. When he returned to hospital, Ify learnt that he had ended up with seven pressure ulcers: five on his back and one on each hip.

He said, “The worst of the ulcers were on my hips. One of them was like a tiny hole that started tunnelling. Basically, it had burrowed in different directions in my hip, so you couldn’t see damage from outside, basically it started underneath the skin. So it’s the kind of thing you wouldn’t have known was an issue unless you touched it and you realise the skin on top was almost like a membrane with not much underneath. But with regards to how it looked, it wasn’t the kind of discolouration you would expect to see. It wasn’t reddish, it was slightly darker and I’ve got patches of slightly darker skin all over me, whether it’s from being in the sun or whatever.”

Training on spotting the early signs of pressure ulcers is usually based on white skin, where redness is a common sign that appears early in the process. As a black man, Ify’s skin presents differently and in places, required nurses to touch the area to feel for differences. Unable to feel from the neck down, he cannot know whether anyone carried out touch tests on his skin.

Ify had to get an operation on both hips to remove the dead tissue, which revealed the extent of the damage as the muscles in his right hip were made visible. He said, “About a week or so afterwards, it was healing quite well. A lot of the tissue had grown, the dressings were working, that sort of thing, and they sounded very optimistic about it. I misinterpreted it basically thinking it was almost back to normal and I decided to push through and actually have a look at it. They took a picture and showed me and I just went quiet; I was not ready to see that at all.

“It got pretty bad once I had that image in my head because obviously it would play on my mind like, this is what I’ve got on my hip. I got to the point where some of the nurses spoke to a doctor and I got referred to speak to a psychologist.”

As Ify recovered, he was forced onto bed rest from March until December, causing his mental health to seriously deteriorate.

He said, “It got to the point where I just stopped having any hope that I would get up again. I knew I would get up at some point, but I stopped thinking about it as something that was going to happen because I needed to be able to face each day without getting my hopes shattered all over again.”

Ify said, “With regards to things being noticed earlier or being at least addressed on time before they got worse, I feel that was an aspect of my skin not presenting in the traditional way of white skin. So some things might have either been overlooked or just not seen, especially with the one I ended up getting operated on.”

Despite his ordeal, Ify has no anger for the people who were caring for him at the time. He said,

“I see the need for more awareness about different skin colours and how they will present when there’s issues. I don’t really hold it against anyone because that knowledge wasn’t there, but it is something that needs to be there and I would like to see that change going forward.”

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