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Permalink Reply by Claude L. Johnson Jr. on February 22, 2016 at 11:38am

I have had leg ulcers on and off since high school. I only recently found an excellent solution (inasmuch as such exists).

I would only develop ulcers when I was really physically rundown and not getting sufficient sleep. They usually start with itching or tingling in the affected area. Once this starts, an ulcer is almost guaranteed. That's why the most critical thing I can recommend is to make sure you're getting sufficient rest. This is necessary for the healing as well. 8 hours per night will make a huge difference in your healing process. It's well documented how to train your body to go to bed so I won't say too much here but you owe it to yourself to do it. StevePavlina.com (https://www.stevepavlina.com/blog/2005/05/how-to-become-an-early-ri... and other posts; search for sleep) and Tim Ferriss (http://fourhourworkweek.com/2015/10/17/5-tools-i-use-for-faster-and...) have both discussed the topic of sleep at length.

I also highly recommend keeping your leg(s) elevated while you sleep or anytime you are not on your feet. Even at work, I will prop my feet up on my desk, making sure my heels are minimally at neck level or higher if possible. I also have an adjustable desk so I can raise my desk to achieve the desired height without too much discomfort. (I work for a technology company.)

Previously, my main solution was to soak my feet in water & apple cider vinegar. While this works, it would take 3 - 4 months to completely heal the ulcers, and is subject to all sorts of vagaries, it's great for cleaning out the wounds though. The main thing is to get the "slough" (what medical professionals I've seen call it) which prevents the ulcers from closing/healing. Some light abrasion using cotton tipped applicators can help with this.

Since 23 December 2015, I have been treating my most recent ulcers with leg wraps. The layer directly against the skin is called an Unna Boot (http://www.amazon.com/Medline-Unna-Flex-Elastic-Bandage-Convatec/dp...). I've used the Gelocast as well but I like the Medline/Convatec better because they are slathered in the REAL active ingredient...zinc oxide.

The next layer is simply gauze bandage to absorb zinc oxide that leaks through the Unna Boot. On top of that, you use an Ace Bandage to wrap the entire affected area and apply pressure. You don't want to cutoff blood circulation, of course, but the pressure is a BIG part of the success. On the outside of the Ace Bandage is a self-adhesive wrap (like this: http://www.amazon.com/3M-Coban-Self-Adherent-Wrap-Yards/dp/B003XCR6...). Again, pressure is good but you shouldn't feel like your toes are tingling or going to fall off. That's too tight. I find myself re-wrapping the self-adhesive bandage and Ace Bandage as required, especially after applying a fresh Unna Boot.

In the months since starting this, the ulcers have healed far more quickly than they ever have. I was estimated to be in this for 4 - 6 weeks but it has been closer to 2 months. I had ulcers on both feet, and 2 of them on my left ankle. Now, the right ulcer is effectively healed; I think I can remove the wrapping this week when I change it. I expect the left to be completely healed by next week.

I first received this treatment in the U.S. at Grady Memorial Hospital in Atlanta. Previously, I'd never found any medical professionals, not even reconstructive surgeons (aka "plastic surgeons") who did this. I don't live in the U.S., hence why I first did this 2 days before Christmas even though I've had these ulcers since April/May 2015. I was literally willing to try anything I hadn't done before given the impact the pain and inconvenience was having on my life.

Personally, I combined the Unna Boot + gauze + Ace Bandage + self-adhesive bandage process with soaking my feet. I would just soak my feet on the night I changed the bandages. This was a way to clean my feet in general as well as remove dead tissue/slough to create room for the new, living tissue to grow in.

Lastly, the woman at Grady who treated me initially prescribed Zinc Sulfate capsules in 1000 mg dosage, twice per day. I just ran out of these a few days ago. Zinc apparently is hugely important to rebuilding tissue. Again, notice that dosage. The standard over-the-counter zinc supplement is probably 50 g. Get a prescription for zinc sulfate from the physician you have treating you.

==== THIS IS NOT MEDICAL ADVICE JUST PERSONAL EXPERIENCE ===

Lastly, I'd also PERSONALLY advise increasing protein intake during your healing process. (I AM NOT A DOCTOR!) Protein is the primary building block of muscle (well, protein and/or it's sub-components, the amino acids). Since I was formerly a regular weightlifter, I had a lot of whey protein/casein to use anyway. Having up to 30 - 40 grams of protein before bed, whether as a protein shake or cottage cheese or BCAAs (branched chain amino acids), will give your body the fundamental building blocks required to rebuild tissue overnight while you sleep. This is primarily when your body repairs tissues anyway. If you're not the protein shake/cottage cheese/BCAA type, even making sure to increase your protein intake in general will likely be useful. But I am not a doctor. I would test doing this to see how your body responds to protein supplementation in this way.

==== THIS IS NOT MEDICAL ADVICE JUST PERSONAL EXPERIENCE ===

HTH!

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Permalink Reply by Bukky Ade on February 22, 2016 at 10:38pm

Hey Lilly I've had ulcers as part of post thrombotic syndrome. The first time was trial and error but the last two my doctors (I was still in peds at the time) were really aggressive. At one point they tried blood transfusions every six weeks but then i started devolving too many antibodies. Though I do think that it helped a little bit transfusions my not be worth the hassle. I think cleaning it on a regular basis (I did mine twice a day) is the best thing and also look into getting compression socks so that the blood in in your legs can flow better. Specifically prescription Ted hose- they are made to help heal ulcers. Those are the main things but drinking lots of water and keeping your leg elevated are also key. Basically you want to make sure your leg is getting as much oxygen as possible and blood is flowing to the area.
Hope that helps and don't get discouraged if the process is slow consistency is key.

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Permalink Reply by Bukky Ade on February 22, 2016 at 10:43pm

Ps I just used good ole saline to clean the ulcer. They gave me some other stuff to put on after cleaning but can't remember them now. But I know one was a gel like adhesive. Main thing is room temp saline tho

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Permalink Reply by Darryl Alladice on February 24, 2016 at 10:16am

Find a good dermatologist who knows SCD. I usually acquire an ulcer every three years.  Here in New York I recommend Dr. Jacob Levitt at mount Sinai Hospital, Dept. of Dermatology. Lots of leg elevation and rinsing.  I tend to like a lite wrap, giving air a chance to get there to the site. I'm on Regranex now in the morning and a simple saline irrigation in the evening. It's slow, aggravating but healing.  Once I took a trip to Cancun with the sole purpose of being on the beach in the sun for hours at a time.  Pure exposure to the sun really works faster.  Patience patience patience.

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