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Rectal issues

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JillThut
JillThut Member Posts: 97

Well if you've opened this thread you either have them too, have nothing better to do, or maybe you're just curious. Amidst all the sadness on here lately and the sisters with serious issues i am hesitant to post this comparatively trivial complaint. But being as I am in bed on my iPad with a painful hemmoroid I have nothing better to do other than lie here listening to the summer rain. With all the constipation, diahrrea, constipation....and did I say constipation???? Hemmoroids are pretty commonplace and even when I don't have them I frequently have a lot of itching down there. Even in my best physical and emotional state I usually have the itching. My onc says its probably internal hemmoroids. The only recommendations I've gotten have been preparation H both cream and suppositories ...neither of which works....and tucks...which are soothing but I can't very well walk around and function with them. I would really like some kind of prescription super duper numbing cream. Why doesn't it exist? You would think with all the medical advances that can keep us stage IV cancer patients alive longer than previously possible, that someone would have come up with a solution to this problem by now!!

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  • TXGigi
    TXGigi Member Posts: 39
    edited August 2012
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    Sorry for your problem but you mentioned a numbing cream.  I recently had another itch (where the sun don't shine).  I think it was because I was drinking too much lemonaide.  Well I got myself some vagisil and lathered myself with it.  A few hours later I was laying on the couch and put my finger in my mouth.  A while later I could not figure out why my tongue was numb.  After a few seconds it dawned on me - the vaginal creme is like having novacaine but on your vagina. 

    I know this makes no sense to you or help but vagisil is a numbing creme.  They need to make one for the rectum.

  • CoolBreeze
    CoolBreeze Member Posts: 250
    edited August 2012
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    Can we use lidocaine down there?  We get it to numb our ports....I don't know if it can be used internally but maybe outside...

    I opened this thread because since c-diff I have had some issues.  Not the kind you describe though.  It comes and goes - mostly goes but each time I experience anything I panic, thinking c-diff is coming back.

    With the constipation and all the meds we take, it is not unusual to have these problems.... 

  • Hoya03mom
    Hoya03mom Member Posts: 7
    edited August 2012
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    Why can't they make an ora-gel type product for the raging roids?? I wake up in the middle of the night with knifelike pain. All the pain from all my surgeries didn't begin to compare to pain from hemmroids. Try alternating sitz bath (sort of mini tub that fits on toilet seat that you fill with hot water and ice packs. There is prescription cortisone type cream but frankly doesn't seem to help much. Each time prior to going wipe area with Vaseline to help protect and do same afterwards. Don't use toilet paper, use prep h wipes to keep areas clean. I find sitting on harder chairs better or using a donut cushion. Also got some aesculus hippocastanum at health food store pills for under tongue that seem to help. Good luck!!



    Isn't this a fun topic!!

    Kathy

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    Funny...a friend I had lunch with today said the same thing...why isn't there an orajel-like product. And I thought about lidocaine and I have some..but a little afraid to use it down there. It seems either that might work or maybe even vagisil ...should be safe I would imagine. In the meanwhile....ouch!

  • stellaratovsky
    stellaratovsky Member Posts: 131
    edited August 2012
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    A very good creme is clotrimazole and betamethasone Dipropionate. You need a Precription for it. It takes the itch and uncomfortable feeling away.

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    Thanks! I will write it down and ask my onc or more likely my GP if she can prescribe it. I figured there has to be something! :)

  • ridergirl
    ridergirl Member Posts: 94
    edited August 2012
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    While we r in the 'area', saw my RO wed and one question he asked was whether i ever experienced numbness around my anus. What the hell??? Sorry still trying to imagine how that would feel, so if you find a numbing cream maybe you'll have a better idea.... sorry my warped sense of humour is at work again but seriously, wtf?!?!?

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    Lol...have never experienced it personally but would certainly welcome it if I did!

  • CoolBreeze
    CoolBreeze Member Posts: 250
    edited August 2012
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    Damn, I wish my oncologist would ask me that question. It would make for an awesome blog post.  :)

  • blainejennifer
    blainejennifer Member Posts: 441
    edited August 2012
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    Emla cream for topical anaesthsia. It's the same stuff I get to slather on the port, and I've used it down there.

    And, a product called "Annuice". It's a rectal cold pac, and - yes - it does look like a sex toy, but it does the job on internal 'roids.

    I have been battling 'roids since pregnancy, and the Taxol constipation isn't helping.

    There, now everyone knows I've got skittles on my heinie.

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    Shhh..Jen...I won't tell anybody! Glad to know I can use the emla

    cream..I have some. Looked up the anuice device...people give it good reviews...a little expensive but worth it if it works!

  • sas-schatzi
    sas-schatzi Member Posts: 15,879
    edited August 2012
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    Hellooo Not stage IV, but this issue knows no bounds, I did a thread on constipation which may help in some ways

    http://community.breastcancer.org/forum/6/topic/781867?page=1

    When you get done reviewing the comments for constipation, you may see what I saw after reading all  one night to see what the trends were. Prunes/apricots won hands down or rather seats down. I found this very interesting based on all the pharmaceuticals on the market. The centuries old remedy won out.

    Jill-- the butt itch--remember the phrase incompetent asshole. It derived from incompetent rectal/anal sphincter. Regretfully, I'm so old that I remember this stuff lol, Retired nurse. Worked in an operating room(department)in the 70's. There was an old proctologist, his stories yeck. But or Butt here goes, if something interferes with the complete closure of the anal opening trauma, hemorrhoids, tumor,tissue damage b/c of constant diarrhea, prolapse of rectum(whats supposed to be inside falls outside), it can lead to leakage of stool. For example, you evacuate, clean, tissue comes up clean,you think your done. With a weakness even slight in the sphincter, a small amount of stool may leak out. The stool in a place, it's not supposed to be can be a source of the itch. Rhoids depending where they are, can cause the sphincter to not be as tight as it should be--allowing stool leakage. A really small amount of leakage can lead to an itch. First line of defence when itch occurs--develop a routine that works for you. Can include any of the following these are suggestions , you again develop plan.--spray with water either from spray bottle or hand held shower, wipe with tp, wipe with Tucks. With wiping look at wipe what you are looking for on the wipe, is even the smallest amount of stool. If you see stool, then it indicates leakage.

    Haven't researched Kegel's for the Butt, but just tried it now and it's possible lol. I'll leave it too you to research Butt Kegel's, or anal Kegel's. Kegels are repeated muscle contraction to strengthen the vagina. As I was writing this --inspiration--Can kegel's work for anus?

    Frequent diarrhea as Coolbreeze mentioned with C-diff causes tissue damage. So, leakage occurs for a different reason. In this case, protecting the rectal tissue is paramount. Mom had nosocomial acquired c-difficile from the ICU. Nosocomial--means hospital acquired. Tough bug. Used Bag Balm. Bag Balm is several decades old. Produced by one family in Maine or Vermont--up there someplace. It was introduced to use on cows udders. AKA Udder ointment. Crossed over to human use in the 70's maybe earlier. I used it on my udders when breast feeding in 1984.  I asked for Bag balm, DH objected, sent to pharmacy to get the pure lanolin recommend by hospital, pharmacist says I have something better--he comes out with Bag Balm. Same year contact with aunt who worked in hospital nursery. Their choice for skin protection on newborn bottoms was Bag Balm. Introduced it to the Florida Hospital, I worked at while Mom was going through her thing 1996. I came to work back inside the hospital in 1998 from an outpatient facility, low and behold, what was their choice to protect the bottoms Bag Balm in stock in the Pharmacy. Since then many companies have found there is big money in protecting bottoms. There are many products now. But don't think price, means a better bottom.  With the frequency of diarrhea with c-diff, we were going through approx. 88 diapers a week.  As an aside, the size we used in 1996, the grocery kept 2 adult size diapers in each size sm. md. lg. Check out how many are in stock today. Diverging.

    Diet and diarrhea is a problem after c-dif , keep food diary i.e mark down what you eat --on one side  record  food eaten and then time stools occur on the other side of record. Over time you may see a connection with certain foods that trigger-start the diarrhea. One of the common triggers is Lactose. Patients are commonly told to avoid dairy products. But without a food diary, it's unknown if that's one of your triggers. Lactose for Mom was a definite trigger. I made rice milk. Commercial rice/almond/soy milk wasn't available then like it is today. My rationale for using rice milk,since there was no research availabe, was it was the first food used with babies.  I took Uncle Ben's 10 minute rice, boiled it for say 20-30 minutes, dumped into a blender, added the water used for boiling once cooled at increments till it was liquified to the consistancy of milk. Stored in frig., remade every third day. Used for baking, egg custard(see below), drinking.  Added vanilla , she preferred plain after taste test, add sugar if it isn't a trigger or diabetic. Rice milk available now at a reduced cost, but the perservatives may be a trigger. Home made no preservatives that's why I remade every third day. No research available as to how long to keep--every third day was an arbitrary choice. Price comparison was huge. I could make almost 2 qts from 1 bag, it was pennies versus commercial rice milk.

    Questran and diarrhea- Questran is a drug developed to reduce cholesterol, a huge side effect was constipation. It crossed over to be used with dirrhea pts. at least mid 90's b/c it was prescribe to control her diarrhea. Problem is it lowered her cholesterol to dangeroue levels (88) TOO much chol. is bad ---TOO little might be worse. One reasons to maintain normal cholesterol is cell wall integrity. Cell wall function body wide can be altered if cholesterol is to low. Leaky cell walls--Not good. Also, can affect nervous system myelin. I made egg custard   every 2-3 days using the rice milk.  Forget amount of eggs. The lower her cholesterol, the more eggs I used,  Thankfully, eggs weren't a trigger. Homemade egg custard has no perservatives which again can be a trigger.

    Fiber--old standard high fiber diet new standard 2012, low residue diet,reduced fiber( didn't set Gms level -Duh no guide) and miralax for normally functioning bowels.  Obviously, omit if diarrhea present. Good if constpation present.

    Probiotics--add to diet if not immunocomprimised. GET DOCTORS PERMISSION.  One to two Tbl. spoon powdered a day until stool is formed and easily evacuated. Buy from reputable health food store. Follow storage instructions religiously, otherwise good bacteria may die.

    Hygiene, Sophie in next post stressed hygiene. Reminded me that before brain surgery recommended to use hibiclens(allergy) or Dial soap preop. Voila or is that Viola, nope that's my Aunt. Dial reduced  vaginal and rectal  discomfort present since use of frequent antibiotics preop/postop for reconstruction. Now it's in the daily plan. I did homehealth in 1991-1992. There was a study published then that showed Dial to be the best commercial antibacterial soap at the time. Apparently still true.  I find Dial to be very drying to the skin everywhere, except vulva(labia area) and rectal area. So, something recommended for brain surgery helped my butt.   

     Summary

         1.checkout constipation thread many ideas offered by many members.

         2.Butt itch--

             a.  evaluate leakage cause--cause determines plan

             b.  use external ointments after bowel movement to protect skin if there is leakage or frequent         

                  diarrhea

             c.  develop plan for leakage that works for you--not universal

         3. Diet

             a. food diary to identify diarrhea triggers

             b. Substitutions for lactose intolerance

             c. Questran and diarreha

             d. Fiber -new standards 2012

             e. probiotics

         4. Hygiene read Sophie's post and consider Dial soap

     Will edit in future as needed, Pm with questions

     common law copyright sas-schatzi 8/18/12

  • SophieJean
    SophieJean Member Posts: 38
    edited August 2012
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    Hey Jill, Lots of empathy here, I didn't get hemorrhoids but I had about a couple of years of the most awful anal fissures. The symptoms of burning and itching were constant. I'm not sure what combination worked but they disappeared once I finally took seriously that dabbing stuff on them once and awhile wasn't good enough. Here's what was I doing when the problem finally went away (two years ago and still under control during my current chemo)

    1. Super hygiene - I used a protocol that I was given for vaginal tearing from my gyno who specializes in hormone depletion changes in the vaginal system.  That meant no more toilet paper (dabbing only) and instead jumping directly into the shower to use a non-irritating sensitive skin super cleaner (Spectro Jel purple was the recommended product). No Tucks allowed as they can set up skin dryness and irritation cycles all on their own. Then very light dabbing with a towel to dry - actually light blow dry recommended rather than wiping. Vit E capsule - cut into a clean jell and light application surrounding external tissue.

    2. Proctosedyl Ointment (prescription) if the itching was really bad and I had a recent tear. Its a combination of an antiseptic and cortisone cream to reduce inflammation. It has an anal applicator.

    3. Compounding pharmacies can do a mixture of lidocaine and nitroglycerin blend to relax the sphincter ring. Can be used to create short term opportunities from healing when the sphincter is spasming - which I guess it can do when its been traumatized a lot. I expect they can make it without the nitro - just make sure they use the clear ointment to mix it with rather than the white cream. Appraently white creams can cause all kinds of sensitivity problems in mucosal tissue. Just have your Doc write a compounding script.

    4. The anal cold pac is dynamite. Price is worth it - lots of research supporting it over cream approaches.

    5. Get control of the irregularity. For me the too loose was lactose intolerance brought on by chemo as explained in more detail by SAS above. I also added lots and lots of water at every meal - was traveling at the time and for some reason I drink tons of water when I travel. Walked a ton too. EAt enough of whatever it takes to keep stool on the soft but well formed side - I actually eat some dairy now when I feel I'm moving to slow AND discovered Magnisum tablets (Milk of Magnesium) (which for me also gets rid of evil muscle spasms that turn up from time to time).

    None of this might apply to hemmeroids but you might have both going on. Hemmeroids and fissures that is. Good news was there was a great deal of comfort in some surprisingly low tech intervention (aka - reconsider the over the counter stuff and focus on healthy and very clean skin everywhere - if the cold works as well as prep H its not more chemicals and persevatives actually making the skin and tissues more compromised over time - same with Vit E). So treat the symptoms but set your sights on regularity and a healthy bottom. 

    Hope this helps. My gno's mantra for failing skin and tissues in sensitive areas was - CLEAN, Restorative & healing Supports (Vit E) and lubrication.....Keep it simple, gentle, and non chemical. These guidelines saved me in both spots....

    Fingers crossed for relief soon,

    Sophie

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    Thanks all.



    Sas...no leaking. The painful hemmoroid I had last night is better..but still have the itch...seems to be internal and external. Pinpointing the cause is hard.



    I've been pretty much staying on top of the constipation but it doesn't seem to matter.



    Dial soap is actually what I have...by coincidence only because it's the cheapest. Have written down many of these ideas. I think I'll order the anuice. It will definitely be worth it if it works.

  • blainejennifer
    blainejennifer Member Posts: 441
    edited August 2012
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    The anuice works. Truuuuuuust me. I had a thrombosed 'roid that resolved in about two days with morning and evening sessions. This is a little bugger my husband had nicknamed the "Death Star" due to it's size and the pain it caused.

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    That's terrible that you had to suffer so much. I guess the main reason I was apprehensive about it working is because I'm not completely sure it's hemorrhoids causing the itch. I usually have more itch than pain.

  • Leah_S
    Leah_S Member Posts: 1,929
    edited August 2012
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    Jill, I have found that prescription suppositories or cream with cortisone works well. The non-prescription was a waste of time for me. Sitz baths were also good.

    I said recently that I find it ironic that I have chronic conditions that have the ability to kill me (bone mets, asthma, severe allergies) but the one chronic condition that will never kill me is the only one that causes extreme pain - hemorrhoids.

    Leah

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    I know I asked someone on my onc team about a prescription strength anything and they looked at me like there just isnt anything. I know it's not her main focus but it is a side effect making me uncomfortable so I wish she was more on it.



    Your comment reminds me of my chief complaint when I first got sick with mets and didnt know what was wrong with me...I had a lot of gas! I finally contacted my GP and that's how the mets were discovered. So after hearing 6-9 moths and terminal etc etc etc....yes I had a good cry but then...will somebody please do something about the gas!?! I guess the liver was swollen and pushing on the colon....chemo solved the problem!:)

  • effcancer
    effcancer Member Posts: 26
    edited August 2012
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    Hi Jill,

    My RO gave me a scrip for "Magic Mouthwash". I tried it ONCE and it scared the SHIT out of me. BUT, it would seem to me, that if it's ok to swallow that stuff, it should be MORE than ok to, uh, shoot some up your butt. Any chance you have some from rads? If not, talk to your MO. It is a mixture of lidocaine (for sure), and I think MOM and some other tummy stuff.

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    I actually do have it! Not quite sure how I would shoot it up but maybe I could put it around the outside! :) I did try the lidocaine Elma cream but that burned!

  • effcancer
    effcancer Member Posts: 26
    edited August 2012
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    Hi Jill,

    Here's what's in it - lidocaine, MOM nad Benadryl. Fill either a syringe without needle and use that, or a baby booger sucker syringe. Either one would seem to help place this where you want it.

    Effcancer

  • sas-schatzi
    sas-schatzi Member Posts: 15,879
    edited August 2012
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    Jill two things on the burn 1. it's just burning the other is that 2.  micro tears- broken skin. Bacteria from stool can get in and setup housekeeping. The dial i'm talking about is not the one that has skin softing agents--the cream one. The regular antibacterial one--- should have said liquid, as bar soap can become contaminated.

    Have stool check for OVA& PARASITES. One other check, take a tongue depressor wrapped with tape sticky side out. In a dark room have DH (sorry) spread the butt cheeks , hold a flashlight and quickly place sticky tape right over anus. Google "checking for pin worms".  Thes are what are called rule outs ==r/o . Likey not , but should be r/o

    Theer's one last suggestion, I'll go get the links then explain

     So many good suggestions here somethings got to work sassy

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    I might have had broken skin because the hemmorhoid was bleeding. Don't have a DH, Sas, but when I first started with the itch and tried to research it online pin worms were what I suspected. My onc did examine me when I first had the issue and i guess she didnt think so. that was a whole year ago! I have had it off and on ever since. I just ordered the anuice from amazon along with a cryo something which looks like disposable cold packs for the exterior. I just had a stool check recently with my GP's office but I believe they were looking for blood. going to re-google the pinworm thing to see what I think. I agree it needs to be ruled out. I thought it had...but not sure.

  • sas-schatzi
    sas-schatzi Member Posts: 15,879
    edited January 2014
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    Post a reply

    Jill this is something that I worked on along time ago as you can see by the dates. edited a few minutes ago b/c one of the links wasn't working. To judge for yourself and get instructions you need to read the journal articles. I have used thie several time for several different issues. It's not an answer to everything, but who knows sheila

    May  9, 2011 03:26 PM, edited a few seconds ago    by sas-schatzi

    May9th 2011----------This post was written Feb 28, 2011 01:05 pm, edited 24 minutes ago by sas-schatzi sas-schatzi wrote:

    I have found the original article re Bleach baths.

    pediatrics.aappublications.org..

    depts.washington.edu/hmcderma/...

    This is the original journal article. The original research was on community acquired staph with patients with chronic eczema. The importance of this article is it has generated  and been sited as reference for dozens of other articles. Many peered reviewed articles. There are also references to this article by sources that have NO scientific background that do not understand science. Some of these non scientific article reviews are dangerous because they don't know what they are talking about, and in some cases I question if they even read the original research or any peer reviewed articles.

    I came across the original research when I contracted a very serious bacteria during a low immune state that was not controlled until I did the bleach baths. The bacteria I had was more serious than MRSA. After 5 weeks of standard treatment with no response, I did the bleach baths--cured in 24 hrs with another 24 hrs as a back up. Re-cultured and NED.

    Everyone is aware that chemotherapy reduces immunity. What is less commonly known is that tamox and all of the Aromatase Inhibitors(Arimedex, Femara, Aromasin) reduce/lower immune status as does any of the steroids. Other drugs may do this also, but can't flip a name out right now.

    What is , also, not commonly known is that sometimes we can be too aggressive in trying to "fix" a skin problem that we can make the situation worse. That is why the research is so important and seeking medical advice before trying to self treat. We can escalate a battle into a war with our good intentions. 

    dermatologycentral.type.com/re.... The importance of this article is that it is supportive of the research done in the Pediatrics journal. Actually, I thought it gave a better summarizing of how to do the bath than the original article.

    www.ncbi.nlm.gov/pubmed/190403473. Commonly known as PUBMED. All articles here go through serious peer review.  Also, to the right of each article ,are citations of other articles that debate the merits of the original article. Debate under these circumstances is good because it is done by qualified scientists.

    Sometime ago I did a multiple response on a thread re:skin and wound care. I will add it here after I post this. Retyping this would be a real pattuty pain. L&H&P sheila

    Mar 22- adding url to Web Md site --importance of this article is the writers comment on the second page re: community acquired staph

    http://www.webmd.com/skin-problems-and -treatments/eczema/news/200090427/bleach bath

    ----------don't know why this last article would not hyperlink, but it's worth a read.

    AGAIN CHECK WITH YOUR DOC REGARDING ANY OF THE ABOVE INFO.

    SAS

  • sas-schatzi
    sas-schatzi Member Posts: 15,879
    edited August 2012
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    Jill OVA&PARASITES ------O&P----- stool sample that checks for all parasites that can set up houskeeping in the colin, pIN WORM TOO, BUT THE METHOD OF STICKY CHECKING HAS BEEN AROUND ALONG TIME. 

    The links to the bleach baths. For me I had vulva/rectal issues after cephlosporins(Keflex) so often. ALL standard yeast treatments did not work ALL. From Probiotics,local, and diflucan for 10 days. Nightmare. I found the original peds journal article in fall of 09. The bath took care of body issues. I used a 10 % solution on my scalp that had the really bad bug worse by far than MRSA. I'll add the name here b/c it may help someone else, but don't really want to remember it. I was in shock that it was in my scalp. Enterococcus faecalis. When I read about it, it scared the bejeebers out of me. So, after reading the links above. I flashed on the 10% clorox solution. It's required for restaurant workers to wipe tables with, OSHA doesn't require that they wear gloves, if ot was a serious issue for the workers they'd be required to wear protective gear.  1 part clorox to 9 parts water to total 1 cup.  I did two cups the first day am/pm/follow by same the next two days in am, reculture NED and no other resident bacteria either and didn't bleach my hair. If anyone were to consider this clear it with your doc , but they would have to read the journal articles first if they are unfamilar with it. Be prepared to rinse eyes for 10-15  minutes Over kill, but it is what you will find in the literaure) if it should get in your eyes. If someone had color processing on their hair it may, I would think affect haircolor. Mine is not processed.

    AGAIN CHECK WITH YOUR DOC REGARDING ANY OF THE ABOVE INFO.

  • sas-schatzi
    sas-schatzi Member Posts: 15,879
    edited August 2012
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    jill What up

  • learnin
    learnin Member Posts: 37
    edited August 2012
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    Rider girl - re the RO asking about numbness in the anal area - he/she was asking to rule out a type of spinal cord compression called "caudal equinal syndrome" which gives a numb patch in the "saddle area". You have a thorough RO, and it was an important question of you had back pain or mets to spine that could cause compression.

  • ridergirl
    ridergirl Member Posts: 94
    edited August 2012
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    Thanks learnin he did explain his reason for asking as yes i do have mets to spine, was just trying to find the humour in it all somewhere...thats my coping mechanism at work lol

  • JillThut
    JillThut Member Posts: 97
    edited August 2012
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    Sas, no itching today! Still waiting for the anuice to be shipped. Got a scrip from the PA but can't pick it up yet due to insurance issues. They don't have on record yet the fact that I've met my deductible.

  • effcancer
    effcancer Member Posts: 26
    edited August 2012
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    Jill,

    Did you end up trying the Magic Mouthwash as discussed?

    Kerry