Slow healing.

[Barbaracole]

Have been on Prednisolone for 5years , have currently tried dropping to 7mg. I had a bad leg wound on August 15th .It is taking a long time to heal . My wound clinic girl 's say it is my age and because I am on steriods .I will try to keep dropping steadily Will it be better to have painkillers and drop rather than stay on steroids rest of my life . The rheumatologist thought I would probably be on 5mg rest of my life. I also don't quite understand the importance of Adrenals.

[SnazzyD]

Hello,

Yes, age and steroids can delay wound healing but so can other things and a holistic approach is needed. For one, diet is important and nutrients such as vitamin C, zinc, protein to name a few. The health of the blood supply both to and from the wound site. Lower legs for example can be a devil to heal. Often as we age our blood return from the leg isn’t as good due to the valves in the veins become a bit less able to keep the blood from flowing back towards the feet. In these cases some sort of compression to the leg works wonders. Sometimes dead tissue in the wound will stop healing or too much new tissue grows and stop the skin from growing back over. What sort of wound is it and where is it?

As for adrenal glands, they aren’t a concern until you start getting below 10mg and 7mg is usually when people start to notice. When you are above 10mg your adrenal glands don’t need to work to give you the cortisol your life depends on. The Pred is a version of it that takes its place in bucket loads so your glands to sleep. So at 7mg your glands need to make up the difference because Pred isn’t in enough a dose to cover your daily needs. The level at which this happens is different between people. You have to keep nudging your adrenal glands by reducing the Pred an eventually the red lights start flashing in your brain and hopefully your glands start to work.

Some people have no trouble and they seamlessly go from Pred to their own cortisol. Some struggle and it can take many months. You know if they are struggling because you feel really tired, weak, sluggish, emotional for no reason and sometimes a fluey ache but not PMR pain. Have a read of these links from Mr Nail’s FAQ’s. Get back to us if there’s anything you want to clarify.

healthunlocked.com/pmrgcauk...

As for dropping more quickly and using painkillers, if it is PMR pain killers don’t work very well if at all. The pain is caused by inflammation and Pred stops that. Anti inflammatory meds like Ibuprofen or Naproxen aren’t very effective probably because they target only a narrow part of the inflammatory process.

[Barbaracole in reply to SnazzyD]

Thankyou so much this is so helpful to understand. It is my lower leg just above ankle really . Also thankyou for adrenal info sorry late getting back sometimes trouble with computer. ! THankyou for taking the time out .

[SnazzyD in reply to Barbaracole]

Lower legs wounds can be problematic, especially if they become chronic due to circulation issues. Have you had it more than 6 weeks? If so, have they done a Doppler test on your legs? I can ask more questions but I won’t if you are happy it’s ticking along nicely.

[PMRpro Ambassador]

Very few people get any benefit for PMR itself from painkillers - they just don't work. They may help for what we call the add-ons, like myofascial pain syndrome causing back pain but even then the benefit is limited and NSAIDs themselves have a lot of side effects too.

There is a lot about adrenals and their role and function in the FAQs but basically this is a short summary:

The body needs a certain amount of corticosteroid to function properly and it is produced as cortisol in the adrenal glands. When you are taking above about 7mg pred, that does the same thing and is sufficient so the body knows that producing any more isn't needed. The adrenals aren't required for that so continue doing their other functions but don't make cortisol. Once you get to lower doses of pred, there now isn't enough for the system to work perfectly and the adrenals need to wake up and produce a top-up. They don't do that overnight and at first it is rather hit and miss. You have enough pred to function but there are no reserves for emergencies if one arises, and that includes injuries. You may feel fatigued, weepy, even a bit dizzy, but over time that usually sorts itself out - and it never is a problem for some.

It is said that pred slows wound healing - depends on the person and wound healing slows as we age anyway. It may need extra attention - with different types of wound dressing. Do you know what she is using?

[Barbaracole in reply to PMRpro]

THankyou so much since the injury . I have different wound nurses I think they have tried lots of things some silver , then when that stops having much effect they try others. I have been referred to a more specialist wound clinic in Cowbridge on the 17th of November they think in my surgery they might try different wound dressings. Also good to understand more about Adrenals too . The pain killers paracetmol worked before I dropped to 7mg for my back injury from raising my wounded leg from the fall . Deep wound from sharp edge of Ikea bed .Great info as always on here.

[cycli]

Great responses here Barbaracole. I had robust skin and was almost bruise proof before pred. Now my legs and forearms look like a patchwork quilt from new skin , scars and bruising. Damage does take longer, partly from age but I suspect a large part due to pred. You'll get there.

[Barbaracole in reply to cycli]

THankyou for reasurrance I feel like I will never get in the sea again some days and that so helps me in the Summer with my P M R >

[Greensleeves in reply to Barbaracole]

Ah you will Barbara , it’ll take time but you’ll get there. It’s a blasted nuisance but you’ll heal . They can do marvellous things now, your injury was where mine was. xx

[Barbaracole in reply to Greensleeves]

Ah gosh thankyou for that !!!!!

[piglette]

Pred is for PMR/GCA and painkillers are for other pain.

[Barbaracole in reply to piglette]

OK thanks.

[Body_bonkers]

My skin has accumulated many scars and bruises now too - did not realise how clumsy I was !

[Barbaracole in reply to Body_bonkers]

Yes I have thought that !

[Greensleeves]

Hopefully you can very slowly get to a lower dose , it’s very difficult , but possible.

You need the pred while your adrenals are probably still dozing , it’s vital you take them.

I understand slow healing, it’s taken over a year for a burn on my leg to heal, it’s still soft in the middle.

GP’s were hopeless. gone are the days when the district nurses would do wound dressings . It was so deep you could see my muscle or something unpleasant.

I had to send them a photo to get prescribed antibiotics when it turned septic.

Disgusting really.

I saw a private skin specialist after many months of self dressings and bandages .

He said it was the steroids thinning the skin and where it was , on the lower leg .

I don’t want another burn that’s for sure. Even a scratch takes weeks to heal .

I had my eyebrows waxed this week as I can’t see to pluck them, I’m having a cataract done soon and thought it would brighten my low mood.

The girl only leaned against my forehead with her thumb and I’m bruised with a thumbprint.

You have to laugh .

Like you, i expect I’ll be on steroids for good now .

I’ve recently got back to 8mg from 20mg after Covid , so quite pleased with myself. Thanks to this wonderful group for their advice. I do treasure Pro and DL.

I’ll be happy to get to 5mg and stay there . It’ll be an achievement.

Take care and don’t worry x

[Merryfield in reply to Greensleeves]

Poor Green. So sorry about the burn issues. The police could use your forehead instead of an ink pad to grab criminal prints. Ok, not funny. I am covered in bruises and my skin is wrinkly and thin like tissue paper. Ugh. If you haven’t already discovered, black facial hair thrives from pred😡

[Greensleeves in reply to Merryfield]

Hello Merry , we have to try and see the funny side , ….usually after the event.

I was trying to scrub this dark thumb print off my forehead when I realised it was a bruise.

The police could certainly use it for evidence ….. assault by wax .

I wish I’d let her do my face , but I had a mask on . I considered trying to do it myself , but don’t think it’s a good idea on balance. I barely have any eyebrows either, £10 for 6 seconds and a bruise. 😕

We might have wrinkly, bruised ,thin skin dear Merry but we’re plodding/hobbling on.

Here’s some flowers to brighten your day . 💐xx

[Merryfield in reply to Greensleeves]

Thanks for the flowers, Green. Yes, we plod on. xo

[Greensleeves in reply to Merryfield]

You’re so welcome Merry . xx

[Viv54 in reply to Greensleeves]

I m in a similar situation had a new hip 5 weeks ago all was going really well until out of the blue got a infection in the last inch of the wound.I have been very lucky , the district nurses come in twice a week to do my dressing. Thanks to my Dr giving me the right Antibiotics im almost there . As for my hip its great no problems ! We are very lucky in Dorset. Good luck with tapering. I was at 20mgs now down to 7 , will have another try to drop when im 100% Best wishes Viv.

[Barbaracole in reply to Viv54]

THankyou Viv I had infection too twice but they used the right antibiotics . I think I have been lucky in that respect.

[Viv54 in reply to Barbaracole]

Good to hear😊

[Greensleeves in reply to Viv54]

You were lucky Viv , thankfully you’ve got a much better healthcare system in Dorset .

My favourite County , I’ve had some wonderful holidays with my Nan In Bournemouth , we’d go speeding over Salisbury Plains , past Stonehenge, magical times.

Gary Glitter was staying in our hotel one time with his huge platforms on , she went and got me his autograph 😳. Little did we know ! Brian Rix was in the swimming pool with a crowd of early 1970’s dancers from the show, I watched fascinated as a woman’s false eyelash was floating on the surface. My Nan said not to stare , but I’ve always been a people watcher.

We went in 2019 and stayed near Durdle Door in a caravan , beautiful coastline. I’d live there if I could.

Thank goodness you caught the infection Viv . You’ll have a new lease with your hip once you’re fully recovered . It will be worth it even though you got the infection.

Well done being at 7mg , you taper slowly in your own time when you’re fully healed , you’ve been remarkable.

I’m going to wait until after Christmas now before I start tapering again, I was struggling at 7.5 mg after losing my Mum . 8 mg is covering the extra needed . I’ve done it before several times now, but this has been the most difficult. It has an effect on our emotions too .

Take care, I’m looking forward to reading when you’re fully recovered. No more hip pain 😊💕. xx

[DorsetLady PMRGCAuk volunteer in reply to Greensleeves]

we’d go speeding over Salisbury Plains , past Stonehenge, magical times.

Not nowadays you wouldn't .. absolute nightmare whatever time of day, month or year!

Know Salisbury Plain and Stonehenge pretty well - much of life spend around there as a youngster and also married to a military man [what wife doesn't know the joys of Salisbury Plain].. oh and working for MOD as well... some would say glutton for punishment...🤦‍♀️

.. and agree about Dorset, but then I would, wouldn't I?😊

[Greensleeves in reply to DorsetLady]

It’s awful how times change DL , my Nan would take us after she’d finished work on a Friday. Just her and me .

The sunsets were glorious , I haven’t been since the 70’s . I wouldn’t want to spoil my happy memories.

We went on the motorway last visit .

You were so fortunate growing up around there , marrying a military man and working for the MOD .

It’s better to remember the good times.

My daughter is married to a lovely military man , experiencing the not so great times at present with him being away . But it’s a part of his job , we’re thankful we have these brave hero’s as we approach the 11th.

Dorset itself is beautiful, it’s got everything. Bournemouth had changed , but the coast and villages are picturesque. 😊 xx

[DorsetLady PMRGCAuk volunteer in reply to Greensleeves]

Lots of it haven’t changed much -certainly has a “mañana” feel about it -which takes a bit of getting used to -took DIL a while when she first came down here.

Son always say once he hits the border he can feel his mind/body revert to “Dorset time” -and he usually drives past Stonehenge twice a week -up to ‘that thar London’ for work.

[Viv54 in reply to Greensleeves]

Thank you for your reply, what great times you had !Gary Glitter has been here for a long time but in HMP Hotel😁 So sorry to hear about your mum.I don't blame you for leaving the taper till after Christmas , loss is a terrible thing .I have no hip pain just can't wait for the infection to clear. Best wishes to you Viv .🌹

[DorsetLady PMRGCAuk volunteer in reply to Viv54]

Paul Gadd nowadays -and will be enjoying his hotel a bit longer…

[Viv54 in reply to DorsetLady]

😂😂😂

[Greensleeves in reply to Viv54]

Thank you Viv , wonderful no hip pain, that infection will soon sort . It’ll all have been worth it once you’ve healed.

Gary Glitter is repugnant, hopefully he’s never free again. We had no idea !

Had some great times with my Nan . She wasn’t a conventional nan , I was ordering wine and speaking French to the waiters when I was 13 to impress her, she was like Marilyn Monroe , but classy . Ex Wren and land army , my Mum was my everything, my heart and soul , only 18 years old when she had me , but Nan was my role model. Comparing me at my age now to her at my age , she lived life to the full . I’m like an old hag . I guess that’s what caring for poorly family does to us .

Get healed soon Viv and enjoy that hip. . Sending hugs xx

[Viv54 in reply to Greensleeves]

Thank you, your nan sounded fantastic what wonderful memories to keep of her .🌹

[Greensleeves in reply to Viv54]

She was wonderful Viv , a one off that’s for sure . Amazing happy memories.

Take care and heal soon 🌹 xx

[Barbaracole in reply to Greensleeves]

OK thankyou for all of that. I have a feeling that this will take a year too . Fell on 15th of August . Son getting married on 1st of June hope it will improve. !

[Greensleeves in reply to Barbaracole]

Hopefully you heal more quickly Barbara, I think you’ll be fine for your son’s wedding, something lovely to look forward to.

You’re getting good wound care . It’s a blasted nuisance and worrying at the time but they’re on top of it.

Try not to worry and know you’ll be fine, this is an annoying blip .

Take care xx

[Barbaracole in reply to Greensleeves]

THankyou for very reassuring reply !

[Greensleeves in reply to Barbaracole]

Bless you, you’re going to be great .xx

[Barbaracole in reply to Greensleeves]

THankyou so much for all you have written !

[Barbaracole in reply to Greensleeves]

HOPEFULLY i CAN GET DOWN TO 5MG S.

[Barbaracole in reply to Greensleeves]

thANKYOU.

[Zebedee44]

Honey is a wonderful natural cure for open wounds and it doesn’t have to be the expensive Manuka honey, any pure raw honey will work. It contains a natural antibiotic.

[PMRpro Ambassador in reply to Zebedee44]

Though it is advisable to use medicinal grade if you are using it on open wounds and keep the container sterile.

[Barbaracole in reply to PMRpro]

Thankyou for all of that . l

[Barbaracole in reply to Zebedee44]

THankyou the nurse on Friday mentioned getting some honey form of treatment I have to pick up, at present they treat me either 2 a week or 3 times a week .It is still very wet so they are going to try that before a referral .

[Greensleeves in reply to Barbaracole]

They were using that on my mum’s pressure sores . Worked very well too .

[Barbaracole in reply to Greensleeves]

Great thankyou .

[Greensleeves in reply to Barbaracole]

You’re so welcome Barbara , you’ll heal soon and are in great hands .

It’s a nuisance right now but you’ll be okay. xx

[Zebedee44]

I used pure honey on an open wound on my pony after surgery and all the staples burst. It was oozing liquid constantly and refusing to granulate. I was amazed how quickly the 1” diamond shape wound dried and the skin closed.

Pony with open wound on cheek.

[Barbaracole in reply to Zebedee44]

Gosh look at that , amazing . I always drink honey in my tea, and before Pmr used to heal well . .

[Zebedee44 in reply to Barbaracole]

I expected a huge ugly scar but it healed over beautifully. Horses have thicker and less stretchy skin so granulation was vital. Once I started treating with honey it dried up and was covered in less than a week. I was amazed, and delighted.

Pony with small scar on neck

[Barbaracole in reply to Zebedee44]

WEll well !

[Greensleeves in reply to Zebedee44]

Beautiful pony , awful seeing the injury but amazing to see it’s healed .

[Tiggy70]

Hi Barbaracole, like you I’m having really bad problems with my thin skin. I had a bad tear (above) on the 28/9 which has just healed (5 weeks). I’ve been using two types of dressing. Against the wound I’ve put an Atrauman moist dressing then a on top a dry Opsite Post-Op dressing. Keeping the wound moist has really helped with the healing and protected it. Both dressings are available to buy on Amazon. I hope your wound soon heals. Ps I’ve just got another wound today from a door catch. I feel I need to wear body armour😩

Leg wound

[Barbaracole in reply to Tiggy70]

Gosh Tiggy like mine only mine longer towards ankle and deep . I will keep in mind all advice.