Celulitis

jdootoo

Celulitis

jdootoo

Hi everyone, I haven't posted in a while. I am 4 years out and still NED (yay!)

On Thurs I started getting intense pain in my right arm. Within 24 hours my arm was splotchy red from my hand to my shoulder. I was admitted to the hospital for IV antibiotics, and just came home today.

The detective in me has been googling all day, so I am comfortable with nursing my arm back, but now I am feeling really sad... That my arm will never go back down in size, that I will never be able to work again, that the Celulitis will be recurring, etc.

I just need some positive feedback...

One love, Jackie

Binney4

Jackie, web research is a mixed blessing, yes? Don't take it too much to heart! With consistent self-care and maybe catch-up help from your lymphedema therapist, you'll soon be taking back control of your life.

Give yourself some time to heal and some attention to remedial measures for reducing swelling, and you'll be happily surprised at how well your arm will heal. Don't rush back to work, though--pay attention to your doctor's advice so you don't risk a relapse. As for recurring cellulitis, if it does happen again you'll be even quicker to get help, and there are good strategies for ending recurrence if it becomes a habit.

Please do keep us posted, and tell us how we can help. Gentle hugs,
Binney

kira66715

Jackie, it is important to resume some compression with cellulitis, as stagnant lymph fluid acts like an abscess. I'll put in a link and the information. 

I had a bout of cellulitis, and it sure does shake your confidence, but now you know what to watch for, you'll have appropriate antibiotics at home, and this does not doom you to a situation you can not control:

http://www.stepup-speakout.org/Emergencies_and_Medical_Care_lymphedema.htm#compression

Special Considerations for
Cellulitis with Lymphedema: When to Use Compression with Infection

1) The illness can become very severe very quickly: it is advised that people
with lymphedema have antibiotics on hand to start at the first sign of redness,
warmth, fever, pain and then seek appropriate medical care

2) The infecting organism can be unusual: recently a
woman grew group B strep, usually associated with immunosuppression

3) Stagnant lymphatic fluid
functions like an abscess: abscesses require drainage and
cellulitis with lymphedema requires gentle
compression to remove the infected fluid

4) Compression in lymphedema
associated cellulitis: the "common belief"
is to avoid all compression and manual lymphatic drainage. A
literature search did not reveal any studies to support that belief,
the only literature addressing compression and MLD in
cellulitis associated with lymphedema comes
from the International Best Practices Guidelines. The literature
search did again confirm that infection harms lymphatics so prompt
and successful treatment is crucial.

5) Knowledge of bandaging is
CRUCIAL: sleeves and night garments are unlikely to fit in the acute
phase of lymphedema associated cellulitis,
and only multilayered bandaging will allow the gentle and accurate
compression to assist in the resolution of the infection without
over-compressing and inhibiting antibiotics to reach the area.

Outfield states: I'm back in a
sleeve today, after wrapping most of the week. My sleeve didn't
fit when I first tried after the redness receded. I only know
how to wrap because I insisted on learning back when I was first
diagnosed, and that was because I had read about it here and on
the SUSO site. My CLT didn't think I'd need to do it. She
thought a sleeve and a night garment would be enough for me
(which they generally are). I think she was a little annoyed to
teach me. But if I didn't know how to do it myself, I'd be
waiting until sometime next month to get in for an appointment
and I'd still be too swollen for my sleeve.

One patient reports
being hospitalized for 12 days with cellulitis in her leg. In
spite of using several antibiotics, nothing was working. A
surgeon who was called in examined her leg and told the nurses
to wrap it, but neither the nurses nor the physical therapist
would wrap it, fearing the infection would spread up the leg.
When the surgeon returned the following day he wrapped it
himself with four bandages. That worked where the other
interventions had failed, and the patient was released to go
home with a PICC line the following day.

From the International Best Practices Guideline:

Commence antibiotics as soon as possible , taking into account
swab results and bacterial sensitivities when appropriate

During bed rest, elevate the limb, administer appropriate
analgesia (eg paracetamol or NSAID), and increase fluid intake

Avoid SLD (self MLD) and MLD (by therapist)

If tolerated, continue compression at a reduced level or
switch from compression garments to reduced pressure MLLB
(multilayered bandaging)

Avoid long periods without compression Recommence usual
compression and levels of activity once pain and inflammation are
sufficiently reduced for the patient to tolerate

Educate patient/carer - symptoms, when to seek
medical attention, risk factors, antibiotics 'in case', prophylaxis
if indicated

So, this is the best scientific
advice/evidence we seem to have: avoid MLD in the acute phase, but
resume light compression ASAP, and MLD can be resumed when the acute
phase of infection is over.