What can i do to rid myself of this pressure ulcer/sore?

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What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Thu Aug 16, 2012 2:57 pm

Hi,

As explained in my previous posts i developed a pressure sore/ulcer last July, i assumed it was a sports injury, and put the weakened legs and overactive bladder down to the injury,

then in May just gone noticed a yellow pus in my underwear when waking, and later realised it was an infected pressure ulcer - due to its location on the coccyx

I initially attempted the natural way by increasing and changing my 50mg zinc gluconate to 100mg/ and to zinc picolinate, but this didnt resolve my exacerbated MS sympyoms,
so i reluctantly accept i had to take antibiotics, which i did for the prescribed duration =
Flucloxacillan 250mg 4x daily for 7 days

This seemed to slightly alleviate my symptoms, but nowhere near how i was before May,
A few weeks ago i saw a nurse who didnt think it was too bad and felt it was between a grade 1-2 pressure sore, she took a swab of the ulcer which was tested for MRSA which came back negative/clear.


So its been 3 weeks since i finished the antibiotics and my mobility hasnt returned to its previous state before the infection, and its really getting to me

- for the past 4 years i have been taking low dose Naltrexone which has kept my MS stable with No progression/deterioration, so as you can imagine this is not nice,
My Dr who prescribes me LDN , believes the LDN is still protecting me from deterioration and its purely down to the ulcer,

but im so lost what i can do to heal this damn ulcer,
i sit on a pressure relieving cushion and ensure i get up and walk every 30-60 minutes to relieve the pressure, but it seems im stuck in this situation,

So was hoping someone may have any suggestions what i can do to cure this ulcer?!

I've been following the Wahls diet since April so im sure this isnt hurting

Thank you
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby jimmylegs » Thu Aug 16, 2012 3:43 pm

dc, were you able to have your serum zinc tested? i'm very curious to know if your supplementation regimen increased your serum levels. wondering if there's some barrier to absorption in spite of wahls regimen, or if there's another piece of the puzzle to discover. i think it's really important to be able to say with certainty, via testing, that zinc levels were definitely optimized, and yet the condition did not improve.
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Fri Aug 17, 2012 7:11 am

Hi,
I went to my doctor but he refused to give me the tests on the NHS as believed no benefit would be gained by having the tests,

However, i have found this private profile test for £60:

http://www.biolab.co.uk/index.php/cmsid ... al_Profile

Whats your opinion on this profile test? it includes, plasma calcium, magnesium, copper and zinc

Its a shame this profile doesnt include 250HD3, do you feel its worth paying extra for this test?
On Monday i will call the lab and see if i can replace one of the tests on the profile for a 25(OH) D3 test instead, which of their other tests on that profile would be least useful =
Chromium, Iron, Manganese, Selenium

It says i only need to stop the supplements 24 hours before bloods being drawn
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby NHE » Fri Aug 17, 2012 5:21 pm

Hi dc10,
Did you ever talk to your doctor about the sylvadene cream that I mentioned earlier?


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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Sat Aug 18, 2012 1:01 am

Hi NHE,

I did request a cream but he gave me Cavilon Barrier cream

Do you think this Cavilon cream can benefit a pressure ulcer?
as there is a tiny opening on the ulcer i was told by a nurse to wait for it to heal before applying
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby NHE » Sat Aug 18, 2012 1:37 pm

dc10 wrote:I did request a cream but he gave me Cavilon Barrier cream

Do you think this Cavilon cream can benefit a pressure ulcer?


I'm not familiar with it.
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby jimmylegs » Sun Aug 19, 2012 4:55 pm

if you can spare L60 for the test, i'd say go for it. d3 is worthwhile knowing also. i really like the sample printout
http://www.biolab.co.uk/docs/rep-plasma-minerals.pdf
'mr sample patient' is not a happy camper!!
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Wed Aug 22, 2012 3:52 am

at present i dont have the spare money, but ive just booked to see a different GP in 2 weeks so hopefully this one will authorise the blood tests on the NHS,
But what reason can i now say i 'need' the 5 tests so he does them? i need a logical reason
- the D3 test would cost a further £25

my concern with getting all these 5 tests done, is the benefit i will get from the expense..

lets say i get the tests, some are in range, some too low,

so i increase my diet nutrients (im following the wahls diet) or i could increase the supplement doses,
then i have to get tested again to see if the increased diet nutrients/supplements are working at increasing my results so im in range..

lets say the 2nd test is still too low, then what? i get tested for a 3rd time?

will getting closer or in range for calcium, magnesium, zinc, copper & D3 change and improve my MS symptoms - mobility & bladder?
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby jimmylegs » Wed Aug 22, 2012 4:45 am

you can take a collection of scientific abstracts to the appointment as rationale for the tests.

if the second test result is still too low, then yes you re-adjust the regimen, and then you could likely wait some time before a 3rd test. once or twice a year should be about all. i'm behind on my second test of the year, but i did have it done in january, and i do have the requisition for the second test.

i can't guarantee that optimizing nutrition will erase every symptom or sign. i still have some loss of sensation in my hands and feet. however i do feel very very very very much better. and function measurably better. if diet alone isn't working for whatever reason, i think looking at the tests is especially important.
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Thu Aug 23, 2012 1:45 am

ok thanks. i will print off some journals to show the dr to hopefully get the tests done. is pudmed my best source?


as my appointment is not for 2 more weeks im getting back on the vits,
to be fair i havent noticed much difference by not taking the supplements,
Based on my supplements, would any of the doses/timing be too much/little:

With breakfast - Zinc Glyconate 50mg

30 mins before lunch - Klamath Blue green algae - 4Billion Multidophilus
After lunch - Calcium citrate 250mg - Vit D3 5000IU - Vit B50 50mg - Omega 3 fish oil 1000mg

After dinner - Magnesium glycinate 250mg - Vit C 1000mg - Vit E8 complex 500mg - Selenium 200mcg - Copper 2mg - Ocean kelp 300mg

I take the Kelp + algae in accordance with the wahls diet seaweed/iodine requirement


I reduced the calc/mag dosage due to the high levels i now get on the wahls diet
Any ammendments needed?
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby jimmylegs » Thu Aug 23, 2012 5:11 am

i'd have to see exactly how you're interpreting the diet at this stage, to assess the pro and anti inflammatory info, but the supplements look okay except that there's no multi in there. that sucks that you're not seeing much difference. hopefully the bloodwork will go ahead and give us some useful info. timing looks decent too :)

re journals, i'll find a list i put together for mirry and link you up to it. you can print anything else you find that looks useful too. i search via scholar.google.ca. that way you get all the databases. a lot of results end up on pubmed, but i like scholar better anyway :) link up what you find here, if you want me to give your list the once-over before you go. ciao for now!
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Thu Sep 13, 2012 11:33 am

Some of the blood results are in, I have copied exactly what the report says:

Erythrocyte sedimentation rate = 2 / mm/h / 2-12
'Please correlate results with clinical findings and contact Haematologists for any discrepant/discordant results'

Bone profile -
Serum urea level = 6.6 / mmol/L / 2.5-7.8
Serum albumin = 54 / g/L / 35 - 50
Serum calcium = 2.42 / mmol/L /
Corrected Serum calcium = 2.24 / mmol/L / 2.15 - 2.6
Serum inorganic phosphate = 1.08 / mmol/L / 0.8 - 1.5
Serum alkaline phosphatase = 51 / u/L / 30-130

Serum copper level
Serum zinc level
- BOTH ASSAYED BY ANOTHER HOSPITAL
But the nurse filled both of these in the wrong type of tube solution so i have to have my bloods drawn again! typical!

Serum magnesium level = 0.93 / mmol/L / 0.7 - 1.00

Serum Vitamin D = 122 / nmol/L / 50 - 200
Please note this assay measures total 25-OH Vitamin D
UK consensus is that minimal 25-OH Vitamin D concentration for bone health is 50-80 nmol/L.
< 25 nmol/L indicates severe Vitamin D deficiency
> 250 nmol/L indicates possible Vitamin D toxicity if sustained

- I took a 5000iu Vit D3 the day before the test because i live in the UK which rarely see's sunlight and i am housebound most of the time so saw no point in checking my levels, but did think it was worthwhile to see how well the 5000iu vit D3 i take daily would be absorbed - but for the 5 day prior to takung the D3 i did avoid taking it, so nt sure if my reading would have been higher if i took it for say a week everyday then got a reading



What are others thoughts on these results?

its annoying i didnt get the zinc/copper because of the nurse's mistake
But based on the other results, would this suggest i dont have a problem with malabsorbtion / absorbing nutrients from my diet - Wahls diet so just organic vegetables, fruit, free range meat/seafood, organ meat, seaweed

thank you
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby jimmylegs » Thu Sep 13, 2012 1:18 pm

hi there,

great to see the results are in (mostly)!

so, the ESR looks low, which on the one hand is probably better than having a high ESR, but just in case, i had a quick scout on causes of low ESR:

ESR
http://labtestsonline.org/understanding ... r/tab/test
"Although a low ESR is not usually a cause for concern, it can be seen with conditions that inhibit the normal sedimentation of RBCs, such as polycythemia, extreme leukocytosis, and some protein abnormalities. Some changes in red cell shape (such as sickle cells in sickle cell anemia) also lower the ESR."

i'd have to do more research to figure out what the protein abnormalities might be. as for changing red cell shape, one instance in which that can happen is b12 deficiency. when it gets pronounced, the mean corpuscular volume (MCV) of the red blood cells increases measurably. one of the dumb benchmarks for determining actual b12 deficiency, never mind anything else that goes wrong before it's actually causing structural change in your cells...

now as for serum urea, as much as i'd like to, i can't compare that to anything. serum uric acid has been studied in ms patients. i'd have to have a search to see if anyone has compared serum urea levels in ms patients and controls.

elevated albumin - interesting. that looks like a possible tie-in with the protein abnormalities and the low ESR. on elevated albumin:

http://en.wikipedia.org/wiki/Albumin
"High albumin (hyperalbuminemia) is almost always caused by dehydration. In some cases of retinol (Vitamin A) deficiency the albumin level can be elevated to high-normal values (e.g., 4.9 g/dL). This is because retinol causes cells to swell with water (this is also the reason too much Vitamin A is toxic).[9] ... Normal range of human serum albumin in adults (> 3 y.o.) is 3.5 to 5 g/dL."

Hyperalbuminemia
http://en.wikipedia.org/wiki/Hyperalbum ... lbuminemia
"Typically, this condition is a sign of severe or chronic dehydration. Chronic dehydration needs to be treated with zinc as well as with water. Zinc reduces cell swelling caused by decreased intake of water (hypotonicity) and also increases retention of salt. In the dehydrated state, the body has too high an osmolarity and, it appears, discards zinc to prevent this. Zinc also regulates transport of the cellular osmolyte taurine, and albumin is known to increase cellular taurine absorption. Zinc has been shown to increase retinol (vitamin A) production from beta-carotene, and in lab experiments retinol reduced human albumin production.[2] It is possible that a retinol (vitamin A) deficiency alone could cause albumin levels to become raised. Patients recovering from chronic dehydration may develop dry eyes as the body uses up its vitamin A store. It is interesting to note that retinol causes cells to swell with water (this is likely one reason that too much vitamin A is toxic).[3] Hyperalbuminemia is also associated with high protein diets.[4]"

i went looking for low ESR and elevated albumin together, found this post from a couple years ago:

My blood test has been normal, the only unusual value was the low ESR of 2 mm/h, and some elevated albumin. So I've been looking further into what causes low ESR and found the following:

http://forums.phoenixrising.me/index.ph ... sion.3817/
"ESRs approaching zero are characteristic of trichinosis or chronic fatigue syndrome.
Utilizing this point, if a patient is presumed to have CFS and the ESR is in the normal or elevated range, then an alternate diagnosis should be entertained.
The ESR is also low in cachexia, severe anemia, massive hepatic necrosis, DIC, polycythemia vera..." Source: Infectious Diseases, Sherwood L. Gorbach
I am wondering if others also have low ESR, and if they have done some further investigation into this."

there wasn't any useful reply to the above post, unfortunately. one thing i learned recently is that chronic fatigue syndrome is basically chronic mono or EBV. trichinosis is a parasitic infection, anemia is obvious, hepatic necrosis can be from chronic overdose of acetaminophen/paracetamol, DIC is a clotting disorder "Disseminated intravascular coagulation" which "can reduce or block blood flow through the blood vessels, which can damage the body's organs... In DIC, the increased clotting uses up platelets (PLATE-lets) and clotting factors in the blood. Platelets are blood cell fragments that stick together to seal small cuts and breaks on blood vessel walls and stop bleeding. Clotting factors are proteins needed for normal blood clotting." if it was Polycythemia vera, there would be an elevated red blood cell count.. etc.

too bad they screwed up the copper and zinc levels. your magnesium level looks good, and so does your d3. too bad about the possible skew on the d3 due to taking 5000 IU the day before, but it is what it is.

it does look like you are absorbing nutrients, so that is a definite plus. i suspect the high albumin is nothing more than a reflection of organ meat in the diet etc (because of that i am pretty much expecting the zinc to be good also).

as for the low ESR i will keep looking into that. and hopefully those test will come in soon!
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby dc10 » Thu Sep 13, 2012 2:57 pm

Thank you JL for your detailed analysis, as always its much appreciated!

RE: Dehydration - i drink on average 1 litre of bottled mineral water a day,
as im showing as dehydrated, how much should i be drinking very day?

Its a catch-22 for me as i have an overactive bladder = emptying bladder every 60-90 minutes since being on the wahls diet - or maybe the pressure ulcer is to blame,
nonetheless, will increasing my daily water intake inevitably result in more frequent urination?

Over the last 1-2 months i have also been constipated i pass a big bowel movement every three days, usually it is mainly diarrhea with a few solid stools to start with- is this likely due to dehydration?
what would be a suitable amount to drink of my mineral water every day: (Caledonian Still Natural Mineral Water)
- its good my results aren't worrying, but id rather find a problem than not
- maybe, just maybe, the increased water in take will relieve my symptoms to some extent

What other tests can i request on my next doctor visit (10/10/12) that may shed some light on my aforementioned problems?

:)
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Re: What can i do to rid myself of this pressure ulcer/sore?

Postby jimmylegs » Thu Sep 13, 2012 4:06 pm

hi again, and no probs :)
it's hard to say whether your combination of low ESR and high albumin is in fact due to dehydration, or some other cause. in fact if you were dehyrated and food is moving slowly through your system, i sort of think you'd expect to have hard not loose stool. so i suspect there's something else going on. and yes, if you increase your fluid intake, you'll be heading to the loo more often.

i put your stool conditions into a search and found a link to chinese traditional medicine:
What does your abnormal stool mean?
http://www.pingminghealth.com/article/1 ... tool-mean/
"iii) Dry hard stool followed by loose stool; sluggish bowel movement; unable to make a bowel movement every day; light in colour; stomach fullness and bloating; gain in weight; lethargy; puffiness around the body. These symptoms are usually associated with spleen deficiency which cause food not to be transported properly through the digestive system. I suggest that for this type of condition, you should eat more foods with warm characteristics such as; ginger, lamb, prawns, spring onions, garlic, mandarin, onions. If you cook your dishes you can add a little amount of ginger. It is best to avoid eating cold and frozen foods."

does that description sound like a decent match for your case?

i'm not having much success finding studies of nutritional dimensions of spleen deficiency in traditional chinese medicine, but i did see a correlation with crohn's. really looking forward to seeing your zinc result. it has to be good, since you've supplemented so much, and your other results are great... and if that's the case, it continues to be quite the little mystery to unravel...

in the meantime, i'll have a fun little project trying to match up TCM syndromes with trace element status :)
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