Hi,
Noted your history about having recurrent MS for 25 years, being treated with Tysabri, have multiple problems like
optic neuritis,
overactive bladder,
foot drop, extreme
fatigue, and
depression, ENT has developed perforation in nose, painful crusting of nose, breathing difficulty and so on which is your main query.
Your nasal symptoms are suggestive of a condition called ''Atrophic
Rhinitis''.
You are already under god treatment of nasal washes, antibiotics and so on.
The perforation is due to the same condition.
Further management can be as follows to be discussed with your Doctor, particularly an ENT Surgeon.
Oral Iron therapy.
Multivitamins with mineral and trace elements act as anti-oxidants.
Closing one nostril surgically for one year helps for recovery in some cases.
Oral antibiotic therapy when needed.
Soda-bicarb nasal washes.
And anything else as your ENT Would suggest.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. T. Chandrakant, ENT and General Surgeon