cellulitis

jinky · June 2011

2 hours ago jinky wrote:

Just came back from ER.... 5 hours......red rash this morning on my painful wrist....about 1 and 1/2 inch long.....can't wrap.....right?.....2 doctors THINK it is cellulitis....put me on cephalexin 500mg to be safe.....4 times a day for 7 days....I outlined it with a pen....is that okay?......it is some kind of infection?....have to see family doc Monday.....help me please....I am tired.....le hugs jinky

moogie · June 2011

Binney and Kira are the experts, but I have had a few small bouts.

If it grows, gets hot, you get chills, fever, etc... after starting the meds-----I would go back to ER for possibility of IV antibiotics.

You did the right thing : denial helps nobody with cellulitis. It may be okay: that dose has arrested it for me 3 times, but once it took a second round of meds to fully get it over with.

DO not be shy if it gets worse, and do not wait till Monday either if there is a downslide.

Wishing you a quick response to meds. I know how hard this is!

mrsnjband · June 2011

I've had cellulitus several times this last year. I had a rash for months and ended up in the hospital. I saw at least 3 different doctors & no one said a word about it possibly being cellulitus. It took months for it clear up.

I've had it a could of times since then & just stayed home and went to my pcp to get oral antibiotics. This last time it went down my arm & did that hurt.

Moogie gave you good advice, if it gets worse (larger) or you spike a temp go to the ER. Outlining with a marker is good, that's what they did to me. NJ

Binney4 · June 2011

Jinky, dear friend, good for you for heading to the ER. Hopefully the antibiotic will do the trick quickly.

Yes, outlining the area with a pen is just right.

You can elevate your arm, and be sure to drink LOTS of water, but steer clear of compression and massage until things improve.

Moogie's got it right, for sure: DO NOT be shy about heading back to the ER if it spreads, if you spike a fever, or if the pain and/or swelling increases.

Please keep us posted! Hugs and prayers,
Binney

jinky · June 2011

Where is the best place to see pictures of cellulitis? Thank you le hugs jinky

Kathleen26 · June 2011

Try http://cellulitispictures.com/

Binney4 · June 2011

Jinky, some of those pictures are extreme, and you're not going to let it get to that point. How are you today? How was the night? Were you able to sleep?

Anxious to hear!
Binney

Towny · June 2011

Get your ass back to the ER if it really is celluitius.. this nothing to mess with...

Binney knows a lot.. so listen to her... Please if it is hot and red get your ass back to the ER!!

IV is the only thing that will kill it off. You do not want to go all over the place.

Icannot believe the ER people sent you home!!!!! Do you have a temp!!!! Please go back to the ER and make them listen to you. You have a compromised immune system!!! Didnt they notice that!!!

Do not second guess yourself... believe it does not go away.... for you own health go back to the ER

Sorry.. I have had this three times!!!!! It does not go away!!! without IVs antibiotics.. it can turn into worse stuff ...

jinky · June 2011

Didn't sleep well....pain ...only ty xs for pain as I can't take ty# 3.....calling doctor Monday or er if I get worse......le hugs jinky

kira66715 · June 2011

Jinky, here's another photo of breast/arm cellulitis--please go back to the ER if you're not much, much better.

Kira

cellulitis " mce_src="" alt="" border="" hspace="" vspace="" width="" height="" align="" />

Towny · June 2011

GO TO THE ER!!!!!!

jinky · June 2011

Towny thank you ...I am on keflex. Supper time will be 24 hours

My neighbour just looked at my hand and he said it looks not as swollen or red and those little bubbles are almost gone. What are these) He thought my hand yesterday was going to explode. I think when you look at it yourself it is hard to know. Not as much pain. le hugs jinky

TifJ · June 2011

Jinky- I do not have lymphedema, but had a cellulitis infection of my port catheter. I started out on just plain oral cephalexin, but it got worse. I had 12 days of IV Vancomycin and Rosephyn, then 11 days of oral Cephalexin again (ended up with an allergic rash and had to stop). This happened 5 days after my last chemo. Thank goodness I had a Neulasta shot or I would have been put in the hospital. Anyway, as the other ladies said, it is nothing to mess around with. You might ask about IV antibiotics!

Binney4 · June 2011

Jinky, sometimes those "little bubbles" form when lymph fluid accumulates. Whatever you do, don't try to pop them, as you'll create an even worse infection mess. If they pop themselves clean the area thoroughly (lymph fluid is caustic and can irritate or break the skin it touches) but very gently. Use a topical antibiotic and keep it loosely covered until it heals.

Lymphedema -- bah!! Yell

Hugs, Swell Sister!
Binney

jinky · June 2011

Do you mean like polysporin and a bandage where it is red? I think I got le of the brain to. lol

moogie · June 2011

I wish you a speedy heal. Every time this happened to me it was on a weekend as well. Le likes a Friday.....What is up with that??

The more I think about this, I wonder if we could come up with a card that we could present to the ER when we know we are either on the verge of cellulitis or already have it. Something clear and simple : "I have lymphedema and any infection can become a medical emergency. Please see the following for protocol so I may avoid hospitalization" Included: clear statements about blood draws + blood pressure cuffs so that argument is answered up front. Not one ER I have visited accepts my statements on this count without a fight.

The card could have some specific info, making it clear that cellulitis in an LE patient needs to be arrested before it looks "FULL BLOWN", some links to medical website info, and the patient's LE doctor phone number. I was thinking of making one for myself, having my doctor review it, and keeping it in my wallet.

I was sent away from the ER 3 times with cellulitis, later confirmed by my MD. Here are some of the things said by ER docs who would not check online for protocol:

- " you have no break in the skin so that is not what is going on..." ( my DR said any break anywhere on your body, even from brushing your teeth can be an opportunity for this to start...and I got one bout from a plane flight when fluid hung around too long in my fingers)

- " it is not raised up..with defined edges." ( by the time it would be raised up, when it is already right now hot,red,growing in size, chills,+ sweaty----I am dealing with a much more significant issue. I do not want to stay around and sample your cuisine for a few days: give me the antibiotics now while I can still go about my day. )

- " it is just folliculitis..." ( with LE and on your LE limb, no such thing as a little folliculitis. Mine tripled in size in about 2 hours, it was circled in pen to show this increase in size to 4" diameter, and the nimrod still had this to say to me.)

Would an official card make any difference? Or would the ER folks still ignore it and believe what they want?

sushanna1 · June 2011

Jinky,

What a nightmare. No advice. Just letting you know that I am thinking about you and hope that this resolves quickly. Hang in there.

Sue

PS I developed cellulitis in my breast after a mammogram in 2009 and was on keflex for about six weeks. One more reason to try to dodge the mammogram.

Binney4 · June 2011

Jinky, yep. Maybe gauze instead of a bandaid -- you're trying to go real easy on the affected skin.

Be well!
Binney

kira66715 · June 2011

Moogie, My LE therapist always tells me about a patient who got stuck by a wicker basket, started to get a cellulitis, went to an ER in NYC and got sent home and by the time she went back it was a rip roaring case of it.

Don't you have an LE MD? I'd think they could write general instructions to ER doctors: when my daughter had a serious bout with migraines, there was a form that could be downloaded from the National Headache Foundation, for your neurologist to fill out to give the ER instructions. We should have the same thing.

Would it help if we created something like that on stepupspeakout?

Jinky--glad you're getting better, this is serious stuff.

Kira

Also, you know that photo I post, from NEJM, it's a free download, and here's the text and the link, it's a start to educate ER doctors:

http://www.nejm.org/doi/full/10.1056/NEJMicm065836

A 54-year-old woman presented with a sudden onset of fever (temperature, 39.3°C) and erythema on the right breast and right arm (Panel A) and on the right side of the back (Panel . There was no history of trauma. Eleven months earlier, she had undergone a wide local excision with axillary lymph-node dissection for an invasive ductal carcinoma (T2N0, 2.5 cm in diameter) of the ipsilateral breast. The postoperative course was uneventful, and she did not receive perioperative antibiotics. Surgery was followed by six courses of chemotherapy and 50 Gy of radiotherapy on the right breast. Examination of the breast revealed erythema, tenderness, and warmth, none of which crossed the midline, but no masses or lymphedema was palpable. The white-cell count was 13,300 per cubic millimeter. Ultrasonography showed no evidence of a soft-tissue abscess. The diagnosis of cellulitis was made, and the patient received oral antibiotics, with complete resolution of symptoms. A follow-up mammogram 6 weeks later showed no evidence of recurrent cancer.

jinky · June 2011

Just got home from the doctor and he wants to check it again Wednesday.....Have a feeling he will put me on intravenous. How many times a day do you have to have it. Is their side effects? Going to lay down now. le hugs jinky

Binney4 · June 2011

Jinky, IV is a drip, usually in hospital, so any side effects will be monitored for you.

Elevate! Stay well hydrated!

Gentle hugs,
Binney

Hindsfeet · June 2011

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mrsnjband · June 2011

It would be really nice to have some kind of card to say you have LE and are at risk for cellulitis. Most placing are totally uninformed about LE & blood pressure. I wear a braclet but most don't pay any attention to it.

I had an argument with a nurse about taking bp in the arm I didn't have a compression sleeve on. Their is no way in he!! I was going to let her do that. Funny thing she never came back to take it in my leg. Probably didn't know how. NJ

jinky · June 2011

Is it okay to put a warm face cloth on my hand which still has a lot of pain? I have cellulitis,arthritis and le. le hugs jinky

moogie · June 2011

Kira and Binney are the best sources for info.

That said, my understanding is that you want to avoid ANYTHING THAT COULD INCREASE SWELLING. Heat increases swelling. Heat will not " draw" the infection out---it will draw more lymph fluid to the area which is the opposite of what one wants with LE.

For pain I would request a pain killer from your doctor if it is that bad. When I had cellulitis in my armpit that pain was significant and NSAIDS sometimes can cause swelling. I know when I use them I puff up a bit.

Also with LE, you never want to introduce a break in the skin because it will just invite bacteria that cannot be effectively cleared away, into your world. In a normal limb, maybe the thought would be to let the infection out and all will be fine-----but it will be fine because a normal lymphatic system can handle the germ fight at the wound. WIth LE, we do not have the lymph system able to handle this kind of battle effectively.

Wait for Kira or Binney to reply before you do anything, but I think you need to get to the ER in any case.

Good wishes for quick healing!

kira66715 · June 2011

Jinky, normally for an infection, warm soaks are a good idea to bring blood flow to the area, and more antibiotics. In LE you need to be careful. If you want to try a warm facecloth, make it mildly warm--NOT HOT--and only put it on for 5-10 minutes at a time.

I agree with Moogie--elevate, and don't accept the pain--let your doctor know. Tney need to monitor as infection, pain and swelling could mean a need for a stronger or different antibiotic.

Also, as Moogie wisely points out, unless a doctor feels there is an abscess that needs to be drained, do not introduce breaks into the skin.

Hope you're improving.

Kira

jinky · June 2011

What pain meds have you tried? Tylenol 3 upsets my stomach. I go to the doctor tomorrow. le hug jinky

mrsnjband · June 2011

I tend to use a soft icepack on my skin with the cellulitis. I use a heavy towel around it so it's not to cold and only for about 10-15 minutes at a time. Not sure if this is the right thing to do but it seems to really help me. It helps to get the heat out of the skin & it helps my arthritis pain too.

I use hydrocodone for the pain. NJ

kira66715 · June 2011

Jinky, I get really nauseated with tylenol with codeine, I've taken vicodin--hydrocodone without any problems

Kira

jinky · June 2011

Was at ER last night and they changed my meds. Now I am on sulfatrim....2 in morning.....2 at night

for 10 days..... also ....pen-vk-300 mg....one 4 times a day...... for 10 days..........also for pain....endocet.....if no better by Sat go to ER......Going to rest now and thanks for all the help.....anyone else take this? le hugs jinky

sisterinspirit · June 2011

Jinky,

Just wanted to let you know that my thoughts and prayers are with you and I hope that the new medications get the infection under control, SOON!

Deb

cellulitis

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