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Topic Title: bed sore remedies
Created On Friday July 23, 2010 10:06 AM
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morenews1

Posts: 124
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Friday July 23, 2010 10:06 AM
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Hi, guys
my mom after her 1 week at the hospital had a bed sore on her butt.
it was treated and it seemed not to big a deal.
but yesterday when i came and looked at her butt, i got horrified.
this sore is in the middle, does not look too bad, but the whole butt(sorry) is all red, like horrible rash which all got together in one raised red spot.
i don't know how else to describe that.
i raised hell in rehab. doctor told me after exemining her again, that it has been treated, that it is all the same thing: bed sore ...not like rash is separate thing.
today she will be seen by wound specialist.
they apply some cream, don't remember the name, but we will see what will be prescribed today by this specialist.
it looks worse than she feels, she does not seem to experiense very bad discomfort.
i just want to know what works better among remedies. i have read a lot on internet, but i don't know what is true and what is not...
i know that pressure has to be taken from this spot...she still has to sit on her butt some time during the day(they don't let there to be in bed for too long).
please advice, thank you, m.

-------------------------
God help us, m.
 
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rzxq2y

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Friday July 23, 2010 12:52 PM
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Hi, Marina,

I believe that Charles (oldtimer3) is an expert on bed sores from his experience with his wife. I hope that he will find your thread and offer his advice. One way to get sme opinion independent of the rehab doctor is to go to your pharmacy and ask the pharmacist. Mayo Clinic website does have an article on bed sore at
http://www.mayoclinic.com/health/bedsores/DS00570

When my wife had her hip surgery, she did get a bed sore at the hospital. It was at early stage. The rehab nurse treated her by cleaning the area with saline solution and protecting the sking with a sticky soft dressing. On this trip, she developed a dime sized sore from sitting in the wheelchair too long. I have been cleaning her with saline solution and cover it with dressing. One of our neighbors is a nurse, she will come over sometime to take a look and see if it is sufficient.

You mentioned that your mother still has to sit in the wheelchair. Does that hweelchair has the same foam padded cushion? Probably the cushion should help. Also maybe you can ask the rehab doctor or nurse whether she should sit on a foam donut ring. Overall,
it seems that her sore is lot more sever than my wife's, and indeed a wound specialist should help.

Best Regards,

MIn-Shih
 
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oldtimer3

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Friday July 23, 2010 1:16 PM
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No expert, but getting her to a wound clinic is very critical at this stage. Most rehabs is not equipped to handle severe cases of pressure sores, especially in that area of the body. If she has any other ailments like being diabetic, it could get really bad. Here is some disturbing pictures if you are so inclined to see them. http://www.badbedsores.com/stages.html
Roho makes a excellent cushion for wheelchairs, might want to check them out. http://www.badbedsores.com/stages.html

-------------------------
Constantly choosing the lesser of two evils is still choosing evil.
Master Caregiver for a bedridden spouse due to PPMS.

Edited: Friday July 23, 2010 at 1:23 PM by oldtimer3
 
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morenews1

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Friday July 23, 2010 3:09 PM
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thank you for responses, guys.
i looked at pictures, the thing is that the sore itself looks even better than stage1(thank God)...what really got me scared : the area around it red as with rash.
like irritation, but not anything what i can see on those pictures.

also i want to buy cushion for her. she has one, but i think she needs more specific to eliminate preassure at this point.
i will check size tomorrow when i will visit her.



-------------------------
God help us, m.
 
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rzxq2y

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Saturday July 24, 2010 11:02 PM
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My nurse neighbor reocmmended DuoDerm as the dressing to cover the wound. I got some today. It is very pricy, but the concept makes good sense to me, providing soft protection, a moist environment for healing, and not sticking to the wound (only to the healthy sking around the wound. I used saline solution to clean her wound and put a piece of DuoDerm on her today. I hope that it helps. I will let you know in a day or two.

For stage 1 or 2, a non-agressive treatment is simple clean the area with saline solution and protect the sore with an approriate dressing.

Best Regards,

Min-Shih

Edited: Saturday July 24, 2010 at 11:03 PM by rzxq2y
 
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oldtimer3

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Sunday July 25, 2010 12:15 AM
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The only negative thing I found using DuoDerm is sometimes it peels the skin away if one is not really careful. Then the next time you apply the bandage is working around the new spot of raw skin. They make a disposable wipe called "No-Sting" that prepares the skin for adhesives.
There is so many different types of bandages, creams, packing material. If something don't work, there is something else that might.
Tiff wound got to stage 3. It was touch and go there for a while, with infections, drainage, nutrition issues, dehydration.

-------------------------
Constantly choosing the lesser of two evils is still choosing evil.
Master Caregiver for a bedridden spouse due to PPMS.
 
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morenews1

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Monday July 26, 2010 8:34 PM
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thank you, i am making note of all your advices.
it seems to be a little bit better.


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God help us, m.
 
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Star1

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Tuesday July 27, 2010 8:03 AM
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This is a very timely thread for me. David has developed a rash and sores on his tailbone and butt cheek. It isn't bad yet, but, I called the doctor yesterday and they are sending a nurse to look at him. The hospital was putting some cream on it and they gave me some to take home but, it is getting worse instead of better. Part of the problem is that with him having so much diarreah the area is really hard to keep clean!

Another thing is I don't know if it is from the brain injury or the diabetes but, he doesn't have much feeling in his rear and private parts so, he doesn't say anything about it hurting until it's almost too late! I think the only reason we caught it early is because he's been so sick that we have to use a bedpan and wipe him ourselves. I'll let you know what the nurse has to say. Pam.
 
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morenews1

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Tuesday July 27, 2010 4:27 PM
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thank you, Pam.
Yes, it is not just a sore, it is red all around it, as rash.
but it is getting better. so please tell us what nurse said : how to take care of it.
because my mom is in nursing home at the moment, i don't write down names of 2 creams they are using.
one is for sore itself, and another one: for rash part.
it is applied 2 times a day, after cleaning with saline liquid.
and i got the correct pillow for her sit in wheel chair.



-------------------------
God help us, m.
 
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rzxq2y

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Tuesday July 27, 2010 10:20 PM
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Hi, Pam, hope that the nurse has seen Dave. Bed sores should be treated as soon as possible.

Hi, all, usin saline solution to clean the wound is about the only thing in common from different people that I talked to. Last year when my wife got an bed sore in the hospital after her surgery, the only things the rehab nurse did were cleaning the wound with saline solution and protect it with a sticky dressing. The treatment went well. This time, my nurse neighbor basically suggested the same.

Some pharmacists suggest to treat the wound area with the cream for diaper rash and cover the area with a non-stick pad. Some pharmacists suggest using the stick dressing, like DuoDerm. As Charles said, there are different things to try. If one approach does not work, try a different one.

I did get some bad advice from the pharmacist that sold me rge DuoDerm. They come in 4"x4" pads and my wife needs only about qurater the size. Each pad therefore can be cut in 4 for her use. But the pharmacist told me that the pads cannot be cut, which is not true.

Hi, Charles, hope that your wife's wound is getting better. When I changed the DueDerm pad for my wife, I did not peel off any of her skin. But I had almost the opposite problem. When I peel off the pad, the gum like adhesive came off the pad and stuck to her healthy skin. It is messy and I had a hard time removing it. Her wound seems to be healing. I will have to see if it is really the case next time I change the pad again.

Best Regards,

Min-Shih

Edited: Tuesday July 27, 2010 at 10:21 PM by rzxq2y
 
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oldtimer3

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Wednesday July 28, 2010 1:58 PM
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One of the main things to use is zinc oxide to keep the surrounding tissue dry. Especially if there is drainage. We are using Prisma to pack the wound cavity, which turns into a gel like substance and adheres to the healing tissue. Apply the zinc to the surrounding areas and apply a sterile gauze with paper tape.
As for the beginnings of a bed sore, Medseptic(Medline product) works wonders.
Tiff didn't feel hers at first until it opened, now it hurts constantly.

-------------------------
Constantly choosing the lesser of two evils is still choosing evil.
Master Caregiver for a bedridden spouse due to PPMS.
 
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Star1

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Thursday July 29, 2010 9:02 AM
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The wound care nurse was here yesterday. She said the reddness and rash, and sore is due to fungus, probably because of the constant diarrhea. I had already been putting anti-fungal cream on him because I always used it for diaper rash when my son was small. She complimented me and the aid for the good care we have been giving him, and she said she was surprised at how well his skin looked for as much as he's been sick and laying in bed! I told her that as soon as we see anything we jump right on it. She left us with some more creams, a spray bottle of some sort of lotion, a spray bottle of a cleaning solution and some powder to keep things dry. She said will be back on Friday to re-check.

I feel better now that the nurse came to look at him. I am always worried about something like a bed sore getting out of control. I guess I never want anyone to say I didn't take good care of him.

He still has diarrhea, and now he is bleeding again. I wish someone could tell me what is wrong with him. Back in April when he went to the hospital with pancreatitis and gallbladder attack, he was bleeding. They gave him a colonoscopy and found an ulcer between the large intestine and small intestine, they figured this was causing the bleeding. He also had a bacterial infection called campylobactor, they said this was also causing the bleeding. Last week when he was in the hospital they didn't find anything, not even the gallbladder problems! Meanwhile, he still has diarrhea every couple of hours, and now he is starting to bleed again.

It's frustrating not knowing what is wrong. We see the doctor tomorrow. Pam.
 
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morenews1

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Thursday July 29, 2010 10:22 AM
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Pam, let us know what doctor suggested.
sometimes it is difficult to diagnose where bleeding coming from.
i have a friend, who had so much tests done...it is very high somewhere, they could not see by regular colonoscopy.
he is young and healther guy, it was years ago.
but i just remember that sometimes it is not so easy to find out.
m.

-------------------------
God help us, m.
 
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Tigger

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Thursday July 29, 2010 1:04 PM
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With all the diarrhea, it is not impossible that his colon and bowel are irritated and *may* be the source of the bleeding. Keep in mind that I was only ever a nurse and that was 20 years ago. Still, it isn't impossible and wouldn't necessarily show up in colonoscopy.

As far as pressure sores go, you can do everything exactly right and a patient will still get them. They won't necessarily feel them because the area becomes "dead". As far as prevention, it sounds like you are doing everything you possibly can. Positional change is really the only way to combat them and a person in a wheelchair doesn't know when they need to change position. You probably already have the surface things that help with this- egg crate foam, lambskin, water pads, etc. so I don't know that there is much else you can do.

You and David are in my prayers, Pam.
 
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Star1

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Thursday July 29, 2010 6:30 PM
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Tigger, thanks. We go to the doctor at 2pm Friday, so, I will know more after that.
 
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rzxq2y

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Saturday July 31, 2010 10:05 AM
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Hi, Pam, did you find out more on Friday?

Hi, my friends, indeed my wife seems not able to feel the pressure sore. When we were in California and she is staying in the wheelchait for too long, she could feel the pressure but could not feel the sore when she was not in the chair. The good news for us is that now we are back home to our normal environment and the area with the sore is no longer taking the pressure. Our nurse neighbor came over last night and checked her. The sore is healing. So we decided to stick with DueDerm. No pun intended, DueDerm is too stick and hard to remove. I did accidentally remove a small piece of skin. But that is healing too. Now my nurse neighbor is changing the dressing for her.

Best Regards,

Min-Shih
 
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TiredDave

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Saturday July 31, 2010 10:32 AM
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Hi Min-Shih,

Sadly the skin can get very delicate. We used to treat my wife's pressure sores with bandages until we started causing other sores with the adhesive. Next time you are getting some medical supplies look for a tape like 3M Micropore it is much easier on the skin. It is the only tape I will use on my wife's skin because it does not tear the skin.

Dave
 
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Tigger

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Saturday July 31, 2010 12:31 PM
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Micropore is a great solution when you need an adhesive on very tender skin. If you can't find it or it doesn't meet your needs, there is another way to remove adhesive without risk of pulling on the skin.

Eye makeup remover is probably the best thing I have found to dissolve adhesive and remove adhesive residue. Apply it with a cotton swab around the edges of the adhesive and let it work a sec. This will loosen the edges. Once the edge has loosened, use the swab to get underneath it. It's a slow job but will dramatically reduce irritation where the adhesive has been.

I use this with cardiac monitor patches too- in fact, I learned this trick when my partner was on Telemetry. One of the nurses told me to give it a try to get all the adhesive off of him when he was released. Worked like a charm.

Edited: Saturday July 31, 2010 at 12:32 PM by Tigger
 
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Star1

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Saturday July 31, 2010 5:38 PM
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The doctor was just as puzzled as the rest of us yesterday when he saw David. He is going to re-run the tests for bacterial infections, he is testing for Giardia [a waterborne parasite] and he is looking into some other tests. He thinks David problems all stem from the fact that his diabetes is so hard to control. Diabetes can cause diarrhea because the nerve endings in the bowel become desentsitized. It can also cause Celiac's disease which might explain the diarrhea. I, personally don't think it is Celiac's disease, because people with Celiac's disease have white, greasy diarrhea and David has never had anything that looks white and greasy.

It really makes sense to me that his diabetes has caused the diarrhea. If this is the case and it's not caused by an infection, they can give him some medicine for it.

The doctor is also getting in touch with the gastroenterologist because he wants David to be seen by the same guy who did his colonoscopy. That's where we are for now. Pam.
 
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Tigger

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Saturday July 31, 2010 11:21 PM
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Pam, hon, thanks for the update!

I'm sure that you know about Smart Water- it works like Gatorade for electrolyte replacement but has no sugar and no taste. Seriously, you could make a pot of coffee with it. When my partner has nausea and diarrhea, I give him Smart Water. What Smart Water doesn't have is sodium. Partner is pretty sensitive to sodium so it works for us but every one is different.

I agree with you that it could easily be the diabetes. Especially if he is brittle.

I will be praying that they have an answer for you soon!
 
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oldtimer3

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Sunday August 01, 2010 9:42 PM
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DuoDerm is supposed to be used until it starts peeling(5-7 days usually) or gets soiled by fecal matter. It is defeating it purpose to take it off too soon. When the wound care doctor changes packing/bandages, first thing I do is go to the maker of the product website and read up on it.
We went back to Tegaderm Ag mesh for packing and to keep the tape from tearing her skin, I am using 2 pieces of DuoDerm on each side of the wound to attach the tape to.

-------------------------
Constantly choosing the lesser of two evils is still choosing evil.
Master Caregiver for a bedridden spouse due to PPMS.
 
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Star1

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Monday August 02, 2010 9:02 AM
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Tigger, thanks, I've never heard of smart water, so that's a new one for me. Where do you get it? Pam.
 
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oldtimer3

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Monday August 02, 2010 9:42 AM
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I have seen it next to the Gatorade at my local store.

-------------------------
Constantly choosing the lesser of two evils is still choosing evil.
Master Caregiver for a bedridden spouse due to PPMS.
 
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rzxq2y

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Monday August 02, 2010 11:33 AM
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Hi, Charles,

I know you are the expert. Last time my nurse neighbor came to see my wife, she did change the DuoDerm, but also did tell us to wait for it to fall off in a few days next time.

My wife's sore is healing well so far. It was technically a stage 2 in the beginning, with some loss of the first layer of skin. Now it is skin color again.

Best Regards,

Min-Shih
 
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oldtimer3

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Monday August 02, 2010 11:26 PM
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Thanks for the praise, Min-Shih. One of the RNs have asked me if I have done nursing before, said nope, but I did stay at a Holiday Inn once.

Just got to be watchful and attentive to what is going on, try and stay one step ahead of the disability/illness.

-------------------------
Constantly choosing the lesser of two evils is still choosing evil.
Master Caregiver for a bedridden spouse due to PPMS.
 
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