Cellulitis - Lessons Learned

saleboat

This is such a helpful post.  Thank you for taking the time to share your experience.

I just had a bout of cellulitis and what surprised me is how long it took me to see that something was wrong.  I had had a lot of discomfort in my affected arm for a couple of weeks-- I just thought I was having some weird flare and it isn't atypical for my arm to ache around my period.  I also wasn't feeling very energetic, but I thought, oh, change of seasons, allergies, whatever.  Also, in the few days before I noticed the redness, my arm really ached in the morning when I'd take my wraps off.

Cellulitis never entered my mind until I noticed a red spot-- and the red spot grew appreciably in a few hours.  I was also surprised that the red spot hurt, kinda like a bruise would.  I also had slight nausea, but no fever.

I did get oral antibiotics pronto, and visited the ER for IV antibiotics.  It responded immediately.  

I feel so much better, and it is like I have a new arm.  The discomfort is virtually nonexistent.  (Sadly, I still have the lymphedema, sniff)

All of this a very LONG way of saying that it seems, at least in my case, that the build up to recognized cellulitis can happen over many days, possibly weeks.  I don't really know for sure, but that seems to be what happened in this instance.

My best to all of you.

LindaLou53

Thought I would BUMP my post from 2008 in case any new "swell sisters" find it helpful.  Fortunately, I have not had a second episode of cellulitis to this point.  I do continue to get annual refills on my Keflex prescription and make sure I have it with me anytime I am out of town.  I have certainly had multiple nicks, cuts, scratches etc on both my hands and arms over the last almost 4 years, but they never developed into a cellulitic event.  I continue to be obsessive about immediately washing any breaks in skin, applying a triple antibiotic ointment and some type of bandaid or bandage as I closely monitor the break for the next few days.  But as I mentioned in my original post, there were no signs of obvious skin break or injury to cause my cellulitis in 2008.  So monitoring for warning signs of heat, redness, pain and swelling are very critical to getting speedy and effective treatment.

dessert1st

Thank you, Lindalou for posting this way back when! I was recently hospitalized with cellulitis for 3 days on IV antibiotics. On oral for 14 and of course I am concerned about reoccurrence. It is believed i got this from a scrape on my non MX side (long story) but infection got in and cause my implant side to get red and hot as well as a small area on my non-mx side as well as my non mx arm. Funny that I had swelling in my non-mx underarm for about 3 weeks and now know it was caused by this. Strange too how you can get LE when you don't have nodes removed from that side!! (Had reduction /lift). I was supposed to have re-reconstruction in November and that has been pushed to January due to the infection. The last few days I have been feeling flu-ish and of course keep checking that area for redness. The fun just never ends does it??? <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

Again, Thanks for posting this linda lou and glad to find that these older post are very helpful.

- Judy

ketch

I'm having a bad flare up of LE (which usually happens once a month), so I got online. I will go to my GP tomorrow for a prescription for Keflex. I'd never thought about having it on hand. Thanks so much!

bhd1

thx for the post. Hope you are doing well

SweetCaroline2

Lindalou, your post on cellulitis is very informative- thank you! Your post helps me realize that my experience is not unique. I just got out of the hospital for my first, and hopefully, only bout of cellulitis. I felt generally just ill and very tired for a few days prior and had a very pale pink flush in my right upper arm ( my lymphedema arm) that later became tender and very red. The arm ached all one day and the skin felt tender and irritated, but I assumed the achiness was from LE and didn't look at it until I was changing into my nightgown. Immediately went to the ER, who used a marker to outline the reddened area, gave me one dose of IV Ancef and sent me home with a script for 10 days of oral Keflex and doxycycline. In the morning, the redness had spread to cover my right breast, underarm and much of the area around my right shoulder blade. I headed back to the ER and was admitted for 3 days of IV antibiotics- Vancomycin and Ancef. I never ran a fever, but had a rapid heartrate, slight nausea, and fatigue. My doctor was puzzled by the blotchy pattern of redness. I came home last night and still don't feel like doing anything- very fatigued, but the blotches have faded to a pale pink and my arm no longer hurts. It is reassuring to me to learn that you have not had another episode of cellulitis. I have read that once you have one episode of cellulitis, you are more likely to get it again. I am considering purchasing a pneumatic pump to help manage my lymphedema- perhaps reducing the edema more would help to prevent another infection.

carol57

Sweetcaroline, pat yourself on the back that you were perceptive enough to know you had a critical need for care. Let's hope that this episode does not repeat itself! Your story is a good reminder that we need to look at ourselves, including using a mirror to see the flip side of the LE quadrant. Take care, get lots of rest--baby yourself!

crystalphm

I am so thankful you took the time to post and describe in detail what happened.

I travel with my job, so I am wondering what is the best antibiotic to carry? my medical doctor gave me amoxcillian 500 4x a day...but now I am seeing Keflex is the best. Is this what I should ask for?

I visited here to post about something completely different and I am sure glad I stumbled on this! Thank you again.

carol57

crystal, I think Kira once posted some options. I cannot recall the details, but my conclusion at the time was to ask for keflex. Maybe some others here will explain what they carry around and why.

flowergrl1960

Crystal, I've had cellulitis six times in a year and a half and only keflex has effectively kept it at bay.  I used to carry around Bactrim, but never felt 'cured' after I finished it and the infection always resurfaced.  I finally went to see an infectious disease specialist who swears by keflex, especially for strep and staph infections.  So far, so good and it doesn't mess with the other 'good bugs' in your system.  judy

Blessings2011

My myofascial massage therapist (who is also a Certified Lymphatic Therapist) says she has one BC/LE patient who regularly got cellulitis every few months. Her doctor put her on a gluten-free diet, and she said that now her recurrences have gone down to maybe once or twice a year.

Has anyone ever heard of this?

nurseronda10

LindaLou, thanks so much for the great info. On my way home from work this morning, I felt a tender spot on my reconstructed breast. Initially, I thought my bra was the culprit. I had a 1 inch diameter reddened area on the lower outer portion of my left breast that was tender to touch. Really hadn't thought much else about it until tonight when I looked at it again. Now it's about 3 inches in diameter so I circled the outer edges with a pen and immediately came here and sure enough my suspicions of cellulitis are reality. Dug through medicine cabinet and found 7 days worth of Keflex 500 mg. Took 2 pills tonight. Hoping it looks better by morning. I have no other symptoms. I do have truncal and breast lymphedema on this same side. Can't find even the slightest skin opening to have caused this.

LindaLou53

"7 hours ago nurseronda10 wrote:

LindaLou, thanks so much for the great info. On my way home from work this morning, I felt a tender spot on my reconstructed breast. Initially, I thought my bra was the culprit. I had a 1 inch diameter reddened area on the lower outer portion of my left breast that was tender to touch. Really hadn't thought much else about it until tonight when I looked at it again. Now it's about 3 inches in diameter so I circled the outer edges with a pen and immediately came here and sure enough my suspicions of cellulitis are reality. Dug through medicine cabinet and found 7 days worth of Keflex 500 mg. Took 2 pills tonight. Hoping it looks better by morning. I have no other symptoms. I do have truncal and breast lymphedema on this same side. Can't find even the slightest skin opening to have caused this."

Hi ronda, I'm glad you found helpful information here on the forums. If your breast is not improved or you have additional symptoms of pain, heat in the affected area or spreading of redness, please call your doctor's exchange or proceed to an urgent care or emergency center. It is great you have marked the spot with a pen and have started on Keflex, but in some cases that may not be enough to stop the spread of infection. Even if you feel your symptoms are resolving, it would still be prudent to notify your doctor's office/exchange and make them aware of the incident. It is possible additional treatment might be suggested. Take care of yourself and let us know how it goes!

PRB1956

Hi there. I recently had a lumpectomy and now I have mild lymphedema..mostly in my hand. I am having 2 root canals done on Monday and then the crown preps on Tuesday. Do I need to take an anti-biotic for these? I have read different reports.. some say yes, some say no.

I told my physical therapist what I was having done because we had to move my treatment. She never mentioned anything about the anti-biotic. She did tape my forearm and hand and it has really helped.

crystalphm

PBR1956...please let us all know when you get an answer. I take antibiotics because of a heart valve issue, I never thought about this concerning the breast issues.

Rakovina

I've had cellulitis in my lymph arm 6 times this year.  Everytime there was no sign of a bite or trauma of any kind.  Each time it has taken bigger and longer doses of antibiotics to sort it out. The last time was IV for 3 days, daily injections for a week, and then oral antibiotics for 20 days.  I now worry I am creating a superbug.  If it happens again, then I will be on antibiotics for life.

Be aware of how quickly it can escalate, and for whatever reason, with me, it always happens late at night <sighs>.

Great information LindaLou.

kareenie

bump for Hope

hugz4u

I just remembered that someone here never handles raw meat anymore but use to and always got cellulitis. Cellulitis stopped once the gloves were used. She wears plastic gloves which I have done since reading her post.

tessu

This great post by LindaLou and the comments that follow are so full of important information about the different ways cellulitis can present, I'm bumping this for all new Swell Sisters.

I would only add that maybe because I live in Finland, or maybe because of the rise of antibiotic-resistent bacteria, I've been advised to NOT apply antibiotic ointment to every fresh skin break on my LE arm and chest, but to instead clean it well with warm soapy water, then use a skin disinfectant or peroxide. This should kill any bugs in the wound but not select for the resistent kind.

And yes get to a doctor sooner rather than later, even if it's the wee hours of the morning!

KleeKai

I started to develop cellulitis of my right radiated breast Christmas Eve. I didn't know what it was, just a 1-inch patch on my chest. Eventually it grew larger until I finally went to see the radiation oncologist New Year's Eve. He diagnosed me and put me on Keflex. Six hours later I called back because I had developed hives and severe itching. I was switched to clindamycin but the hives continued such that I called again on Saturday morning and the resident added doxycycline. By Sunday morning, I was hives, itching and redness. I called Monday morning and finally my three doctors got together for a chat. I went in to see the surgeon who promptly took me off all my antibiotics for 24 hrs and got me on Benadryl.

When I went back to see the surgeon the next day, the redness and hives had decreased. Yeah, I avoided an inpatient admission for IV antibiotics. I am currently off the antibiotics until Monday to give my body time to rest from the hives/rash/itching. When I go back for the recheck, the surgeon will decide which antibiotic to put me on and I will be monitored for reactions. (I don't have a good track record with medications - I tend to be allergic. I am allergic to taxotere - developed facial swelling and hives; allergic to INH - neutropenic fever; allergic to all cillins, of which Keflex is in the same class so not surprising I had a reaction).

Thankfully, I never developed a fever. I did have headaches, but since I'm prone to migraines it didn't occur to me as something odd. I just took something for the headache.

nancyWorld

This post has been a God send for me.... I woke last Saturday with a red rash that was itchy, hot, swollen and painful and growing throughout the day. I had no idea what was wrong but began applying ice packs and taking Benadryl and using lots of lotion. Had it been a week day I would have gone to see my MO but just decided to wait it out since it was the weekend. By Sunday evening it looked better but I began reading and came across this post with all the wonderful info. Monday it looked much better but was still there - much smaller --- I would not have called the doctor if I had not read these posts late Sunday night. I did call and told the doctor that I thought I may have Cellulitis, she looked and thought it likely was, then I showed her a picture from Saturday and she said -- "YES YOU HAVE CELLULITIS, and if you had come in looking like this today I would be putting you on IV antibiotics !!!!" I am now taking Keflex but I felt so pleased that I must have done something right since it was already getting better and extra pleased that my body was trying to fight if off and doing a pretty good job. The area was, however, still hot even though the rash and redness looked better. THANK YOU ALL for helping me realize how serious this condition can be - I now realize that I should have gone to the ER, but had I not read these posts I still wouldn't be treated and the infection would have continued brewing inside me.

*As a side note -- I was dx'd 2/2015 - Stage 3c Grade 3, Her2+ Chemo / bilateral mastectomy + 12 lymph nodes removed/ 33 rounds Radiation. Supraclavicular lymph node also had cancer. Hospitalized for one week with staph infection that occurred approx. 2 weeks after mastectomy. Currently NED. :-)

glennie19

Glad you are doing better, Nancy!!!

nancyWorld

Thank you Glennie.

Gardnergirls

I was just in the hospital in November after having cellulitis for two weeks. The plastic surgeon ended up having to have the expander removed the Friday before thanksgiving. I was given oral antibiotics first then had to be hospitalized for IVs. The expander has been out for two months now. It will be reinserted next week and hopefully off to a good start this time.

nancyWorld

Question, my skin looks back to normal from the cellulitis, still a little warm and I have no fever but I don't feel well. I am on antibiotics, is it normal to feel mostly just exhausted but in general not well for a while ???

Binney4

Goodness, yes! Take some time to rest up and give your body a chance to heal--it's been fighting mightily! It's really not a good idea to "bounce back" too quickly--cellulitis is a bad bugger! :-(

Hugs,
Binney

kareenie

Bumping

SweetCaroline2

In 2013 I had an episode of cellulitis that started in my lymphedema arm and was admitted to the hospital, treated with IV antibiotics, and released. Soon after I got a pneumatic pump to treat my LE (i use it for 1 hour daily) and have had no more episodes of cellulitis. I have read a study that said that use of a pneumatic pump reduces incidence of cellulitis in LE patients, and this has certainly been my experience. The pump was expensive- about $5500, but my insurance company paid for it.

Bootscootin

Bump