DEAR DR.ROACH: I am writing to you regarding your recent column about psoriasis.
My husband spent most of his life suffering from severe psoriasis, until he was told of an all-natural solution: cilantro. In a matter of a few months he was completely symptom-free, and remains so after more than a year. He simply adds a few sprigs of cilantro to a garden salad once a day. — J.L.
ANSWER: I also have read that eating fresh cilantro helps psoriasis. I couldn’t find any study that looked at this, and people responding to online support groups reported mixed results. However, it is very safe and might be worth a try.
DEAR DR. ROACH: I am 89 years old and just learned that I have the first stages of bed sores on my buttocks. My dermatologist said that I should stay off of it as much as possible and apply hydrocortisone cream.
I have COPD, and I need to sleep sitting up. I wonder if you have any other suggestions to help my pain and discomfort. — A.A.
ANSWER: Bed sores (also called pressure ulcers) are potentially serious problems that require immediate attention. We “stage” bed sores into four categories. Hopefully you have stage one, where there is skin redness, usually over a bony prominence such as the sacrum, the handshaped bone at the base of the spine. A stage two bed sore may be a shallow, open ulcer or a blister. At stage three there is full-thickness loss of the skin, while a stage four has exposed muscle or bone. Sometimes, it is impossible to stage ulcers from their appearance alone.
A stage one bed sore often is treated with a clear film for protection. Hydrocortisone cream is surprising to me, since steroids can thin the skin when used excessively, which you certainly don’t want to do. The pain should be treated, but you should be taking this as your body’s warning that there is a problem.
The key to preventing further injury is to find a way to take pressure off the area. Sleeping sitting up puts all your weight on your lower back, buttocks and thighs, which in turn puts these areas at a high risk for pressure ulcers. There are several ways to combat this, including different kinds of mattresses and pads, and even a device that adjusts automatically to pressure. Changing positions frequently (every two hours or less) is critical if you are not using a special mattress or pad. There are wound-management specialists, both nurses and doctors, with expertise for your particular situation. I would ask your doctor about finding and consulting with one.
People with COPD are at high risk for poor nutrition, and making sure you are getting adequate protein and calories is critical, as poor nutrition is a big risk for serious bed sores. I strongly recommend a visit with a nutritionist. Also, perhaps your COPD treatment could be optimized to make it easier to sleep in a supine (lying-down) position. This means a revisit with your regular doctor or the consultant doctor who is treating your COPD.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. ©2017 North America Synd.