Cellulitus

wintersocks

I got back tonight from the hospital having been in there six days and treated by IV antibiotics for Atypical Cellulitis. Long story short, I went to have an operation last week for vaginal adhesions, these I was told developed from my previous recent surgery and because I am on Letrozole.

By Sat, three days post-op I noticed my mx side arm was feeling bruised. I looked at it and there were 3/4 red angry patches. I got antibiotics and steroids from the GP. By Sunday I was admitted to casualty with temperatures, the highest being 39.5.  I was given IV paracetamol and oxygen and started on IV Flucloxacillin, . I have now been discharged with ten more days of anti-biotic therapy. 

I ensured before my op to be clear that I was to have no cuffs/needles on my right side and indeed I was issued with a bright red wrist band saying same. 

Six days later at home and I am stunned about what has happened and wondering what this means.

Can any one offer advice/opinion? 

vlnrph

Happy to hear you took action quickly and got treated. Be sure to finish all of the prescription. Stay well hydrated.

Some gals have a special sleeve they wear going into surgery because you never know what might happen once you're asleep. It's printed with warnings about "no BP/IV" etc. Did you have lymphedema prior to this episode?

carol57

wintersocks, how that happened is a good mystery, because with the alert wrist band you'd sure hope that arm precautions would be taken seriously. Any sign of scratches?  Sometimes they move us around, I suspect rather brusquely, when we're 'under' and need to be repositioned for procedures.  Take care, and vlnrph's advice on hydration is certainly spot-on.  

glennie19

I plan on wearing my hot pink arm band and writing on my arm "No iv's, no bp's"  when i have my surg next month.  You have no idea what they do when you are under!  Hopefully they didn't needle stick you, but like Carol said, maybe they moved you roughly and that set it off.

i echo the others:  take all the antibiotics!!

wintersocks

Thanks girls,

vlrnph, yes I have mild lymphodema before. I think the think that shocked me was just how quick it spread - like wild fire. Perhaps it was just a coincidence appearing 3 days post op?  if they did pull me a bit roughly, I am very concerned as I had a diep in the next 10 weeks or so....

I feel absolutely worn out too.  

Binney4

Wintersocks, I'm really sorry you've had to deal with this. Do you know why they're calling it "atypical"? Was it an caused by an unusual  bacterium or something?

With lymphedema, cellulitis is unfortunately a high risk, and very often the direct cause is not identifiable. The entry route for the bacteria might be a paper cut, a hangnail, or just dry skin that allows micro-cracks to form. Or it may simply be impossible to track and precipitating cause. The stagnant lymph fluid typical of lymphedema is protein rich and warm, so it's the perfect breeding ground for infection. And the fact that it spreads like wildfire is what makes it ALWAYS an emergency for us.

Here's information about cellulitis with lymphedema:
http://www.stepup-speakout.org/Emergencies_and_Med...

You sure aren't alone in being stunned by your first experience with cellulitis--it's something we didn't have to consider before and it does come as a shock. You might want to ask your doctor for a prescription for an antibiotic, then fill it and keep it with you, so that if you run into trouble again you can initiate treatment immediately. Also many of us keep a supply of antiseptic wipes, topical antibiotic and bandaids with us so we can treat cuts, scrapes, insect bites or burns immediately wherever we are.

Cellulitis takes awhile to recover from, so do rest up and give yourself room to recover fully. Please keep us posted, and tell us how we can help.
Gentle hugs,
Binney

wintersocks

Binney4,

Thank you so much for your response, it really means a lot. I feel so upset and have felt tears welling up all day....  

Yes, it is described as atypical  because it is an unusual presentation. I was told that cellulitis usually presents as just one area.  I had 5 or 6 very distinct patches. The medics were stumped for a while and then decided on this basis it was atypical.  

I will read the link that you sent tomorrow. it looks like really useful info. It is 12 am here in Britain and I need to try to sleep. I woke several times last night and felt feverish again. But I have not had a temperature today.  x

vlnrph

I was also curious about the "atypical" diagnosis - figured it might have been a British/American English thing...

Another day on the road to recovery: sleeping better, hopefully? I use deep breathing techniques when restless, seems to help with relaxation and can also encourage stagnant lymph flow.

Congratulations on getting scheduled for the DIEP. I had mine while under anesthesia for the mastectomy, so a long surgery but got good results. Just a small patch of fat necrosis and a feeling of fullness due to truncal LE but manageable. That may have come about because I required full axillary node dissection two weeks later. 

wintersocks

Vlnrph

Yes, I am feeling a lttle better, although the experience has plunged me back into cancerland big style, just as I was emerging two years post dx. 

I have arranged a referral to a lymphodema nurse to see what I can do to try to not have that horrible experience again.

I am pleased your diep went well and that you are happy with the results.  I must admit that I am worried that cellulitis might happen...again post diep. 

vlnrph

Assuming DIEP protocols are similar to here in the US, you will get antibiotics pre-op and be seen frequently during the 4 or 5 day hospital stay so any flares should be caught early. Ask the surgeon what experience they have had with lymphedema patients. 

Share your history of infection with all staff taking care of you so that scrupulous preventive measures will be followed. Consider bringing a couple of large signs to post on your door and above the bed reading "no BP/IV on RIGHT arm"; or maybe a positive statement would be better (BP/IV on LEFT arm ONLY)?

Meanwhile, rest up and think about a nice event you can plan for yourself a year from now when, once again, cancerland will be in the past...

wintersocks

vlnrph,

I will share all with my surgeon as you suggest. 

Thank you for your support, it has meant a lot.

Thinking......something nice for a year or so hence!

x.