New Conundrum

[Narrowminded]

Hi All,

Hopefully someone will have some answers to our newest issue. As you all know I'm working on avoiding shearing with moving Brian around in the bed. We are doing better, but now I have a new issue.

Over the last couple of weeks, worst was today, when bathing him, his backside the skin like sluffs off. Not to open sores, just like the top layer. It almost like a snake molting, but not in one piece.

At first I thought it was the A&D w/zinc, and that was what I was washing off. So, the last couple of times, I just used plain A&D, and today was the worst. The skin under is bright pink, but does not appear to be an infection. What's coming off seems to be dead whitish gray in color.

Anyone have any thoughts on this? He prefers to be bathed every other day due to the turning issues, so it's not like it's been sitting for any great length of time.

Thanks so much.

Hugs,

Sue

 

[lgelb]

A&D was not the answer for us; we used things like wound honey, aloe vera, Nutribiotic ointment, depending on the need. Could be local irritation that he is reacting to it -- even after repeated use, it happens-- like you say, doesn't seem related to immobility per se but you can definitely dry out after 2d. Is the skin beneath smooth?

 

[Narrowminded]

Laurie - the skin beneath is very smooth and actually the skin that's coming off is moist, not dry. I guess comparing it to snake skin wasn't the best choice of words. I was just thinking about how a snake sheds their skin and not thinking about texture.

 

[Loverly]

hmmmm It could be a kind of candida (yeast) from moisture being trapped there. I make my own yeast treatment that i think is more gentle than OTC antifungal.

It's coconut oil mixed with a few drops each of lavender and rosemary essential oils. The coconut oil is very melty. You can just mix it right in your palm. You could also use clove or oregano oils. It worked great for my dad. Healing begins right away.

Another cause of peeling skin can be contact dermatitis, which looks very similar to a yeast infection on the skin. I have used Aquaphor for years on my daycare babies in their diaper area to treat it. It's the best IMO.

Jen

 

[lgelb]

Coconut oil is a good thought. If he's sensitive to it, hemp oil is another option.

 

[Narrowminded]

I can definitely try coconut oil. I use it all the time in cooking and in his food. I also have oregano oil here as well. Use that for him as well if he seems like something is brewing. Thank you Jen for the thoughts and Laurie for seconding the Coconut oil.

Hugs,

Sue

 

[affected]

Please do let us know what you mix with the coconut oil and how well it works as I was a bit stumped on this one!

 

[Narrowminded]

ok, so today I tried just plain coconut oil and we will see how that goes. I want to go one step at a time so I know for sure what is doing what or not doing anything or making things worse etc.

However, we now have another issue. Brian told me last night that when I roll him to bathe or fix his bottom with the tagederm that his shoulder is popping out. Knew that could eventually happen, but wasn't expecting it. Of course when do we expect anything with this disease???

So now we've got a new problem added to the mix. I need to take care of his bottom and the sores that are there, but to do that I have to turn him. He can't be turned at all to the other side and has been that way for some time.

To add insult to injury, the Flomax is fixing his bowel, but now he's needing the pan more than once a day. As a single caregiver that means again turning him to get him on the pan. Not sure how else I'd get him on and even if I could, how in the world would I get him cleaned up after if I don't roll him.

Any thoughts or suggestions, I'm definitely open for them.

It's been a rough few days here. I'm thinking 2017 may be his last year. Don't think anything is imminent at this point, but they obviously just taken another down turn.

hugs,

Sue

 

[lgelb]

Sue,
Is there no way to get him into a Hoyer sling? We did that kind of thing in the sling, since Larry could not be rolled at all.

 

[affected]

Exactly my thought can you sling him over a bedpan?

A friend of mine did this for a couple years with her PALS. He would take clonazepam just before they started and it helped keep him relaxed.

Also can you lift him in the sling to do his skin care?

I would think the coconut oil is just the vehicle to get some antifungal onto the skin. If it is fungal oil alone could just keep it nice and moist. I'm not sure it's fungal but PALS seem to have a lot of fungal skin issues.

 

[Narrowminded]

Ok, well i will have to figure out about a hoyer. We have a ceiling type lift, but not one that used a sling. However, the next question would be, if I got a sling, can it be left under him? How hard are them to put under if you can't roll them? Also, I'm wondering if I need to wait to get the interal catheter first because not sure about washing said sling due to cather or urinal issues.

Always something new to figure out and learn.

hugs,

Sue

Thank you for the suggestions

 

[scaredwifetx]

Sue, i just needed to reach out with a virtual hand and hug. I don't have any words of wisdom. I actually deleted words several times now. I can't find the right ones so I will just say that you are in my thoughts.

 

[lgelb]

The slings can be washed and dried on a low setting in a regular machine, but we had a backup.

You should not leave them under the skin. How hard it would be to put a sling under him in a seated position depends on your setup. Lying on his back without rolling him, it cannot be done, but if you have a ceiling lift, can he not hover over a commode (regular or freestanding) in the lift? The concept is the same as what you'd do with a Hoyer. What kind is yours?

 

[Narrowminded]

Deb - thank you for your thoughts. No need to delete things, it's ok, I totally understand.

Laurie - yes, if we had a sling, I could hover him over the commode chair. Good news is I am getting a hoyer to try out from out local loan closet. Once that is here, we will be able to manufacture the adapter piece to use with our current lift. We had been given a SureHands piece. The part that lifts the person, which worked until his trunk muscles went. We then fabed an I-beam for the ceiling and got a hoist that we used with it. However we don't have the proper hanger attachement to just get a sling. The nice thing is the loaner Hoyer will be electric. Once we can use it, the other thing I can determine, is if I want a hoyer or if we just need to fab the piece to make our current ceiling set up work. It's nice because it's out of the way.

Laurie from what i understand then, you got the sling under Larry from a seated position? Whatever we do to get it there, has to be done in hospital bed and I need to be able to do it by myself.

 

[affected]

Definitely you can put the sling under them in a hospital bed in a sitting position.

Chris could not be rolled completely onto either side, and had to remain semi-sitting all the time. His sling had good head support that was adjustable so you could make the sling work for the individual and he was very comfortable in it.