Not sure to trust doc's knowledge of LE after bee sting
So I don't have LE, but I did have a BMX and 3 lymph nodes removed.
I was stung by a bee on Saturday in my lymph node challenged arm (in the forearm). Haven't been stung for 20 years so don't know what my "usual" reaction would look like.
So it's now been 48 hours and I have this 3 1/2" by 2 1/2" area of redness, slight swelling and itchiness.
I go to the doc this morning to play it safe after consulting Dr. Google..worried about cellulitis. I tell her that I had lymph nodes removed and that is why I am even concerned, otherwise I wouldn't have thought twice about it. She says it doesn't look like cellulitis (yet) ,she says it looks like a normal reaction to a bee sting 48 hrs out and then she drew around the red area with a pen so I could watch to see if it was getting worse ~ if it does, I just need to call back and they will call into the pharmacy for antibiotics.
Then she gives me a voluntary prescription for a steriod (prednisone) to help with the inflammation. But when I get back to work and consult Dr. Google about "cellulitis+prednison"... I find this: "Taking immune-suppressing drugs, such as prednisone can leave you vulnerable to infections such as cellulitis" (I didn't know prednisone was an immune suppressing drug?)
Now it makes me wonder if she's really taking my risk of developing LE seriously? Now I don't think I should take the prednisone for this bee sting, should I? Is there anything I should do besides watch it carefully for signs of spreading/infection? Should I lie and say it is so I can get the antibiotic as a preventive?? It's really not bothering me physically, I just want to make sure I'm not setting myself up for LE by ignoring it?
Comments
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SG, prednisone is an immunosuppresant as well as an anti-inflammatory, so I can see your dilemma.
Drawing the line around the reddened area to help you judge spread was a really good plan, and I don't think you need to call for an antibiotic unless you actually note spreading of the redness. But you might want to talk to your doctor and ask if there's any sort of anti-inflammatory you can use that won't expose you to further infection risk, because inflammation is also a LE risk.
Bottom line, you're certainly wise to be keeping a close eye on this and getting help early. If the pain worsens, the redness spreads, or you develop flu-like symptoms, hop on over to the ER. <sigh!>
Hoping you'll be all better soon!
Binney -
Thank you so much for the information Binney!!
So last night the redness was spilling out of the line in several places and it was getting redder...so I was thinking I'd be filling the antibiotic prescription this morning. Then I wake up and it's back within the "circle" and dramatically less red/warm. Hmmmm.... I guess I'll just keep watching?
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I have to admit something funny/embarrassing. So someone at work yesterday says..oh your upper arm is starting to swell too!! ..and I say.. "no, that's just my little bat wing of fat"... but they are insistent and want to compare it to my other arm. After I show them both upper arms they say.. "Oh...well.. yeah I guess it isn't swollen". Lovely!
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Hey, hey! Sounds good, and I hope it just continues to get better. Gotta watch out for the little beasties in that garden of yours!
With colleagues like yours it's a good thing you've got such a great sense of humor!
Be well!
Binney -
Thanks, Binney!
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FYI, I have larger than normal swelling reactions to beestings, and I have always been told to take benadryl right away to help slow down the histamine response. My primary care doc has also given me an epipen..."just in case" my reaction worsens with anaphylaxis the next time.
Now that I have had an SNB, I'm really worried about working in my garden...that's where I've been stung before. Will need to be VERY careful!
Hope your swelling has continued to improve!
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Thank you dancetrancer. Yes...the swelling redness finally went down. Now it just itches!
I did take benedryl the day I got stung. I was just so bummed that this darn bee could possibly cause LE. Why did it have to pick THAT arm! But I also don't want to live in constant fear and freak out anytime a bee comes around.
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I totally can relate Susan. Yeah, why the heck that arm? It's not gonna keep me out of my garden!
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Though I am kinda embarrassed to admit I wasn't exactly being "careful". We were visiting a winery and I couldn't pass up the opportunity to climb up and work on the machine that you pour containers of the grapes into and it separates them from the stem. There were bees flying around all over the place because of the juices. I laid my bare arm on the machine for balance, squishing Mr. Bee. I guess I can't blame him for defending himself!
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LOL Susan! I could see myself doing the same exact thing!
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A few months before my DX I was stung by a bee. I had the same response and was given steroids. It helped keep things at bay but when I went off them it came raging back. It affected the whole back of my thigh from knee to butt. It was a hard, red, raised area and it itched. I ended up being put on oral antibiotics. After almost a week, it was not gone. I had to go to the hospital and get IV antibiotics because it was cellulitis. After that it went away in a few days.
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well, I had to comment because I have just returned from the allergist's office after my third round of Mixed Vespid (yellow hornet, white-faced hornet, yellow-jacket), Honeybee (must give up my desire to be a beekeeper) and Wasp immunotherapy shots (9 shots each visit so far) - so I am really up on all things bee sting related. My initial visit to the allergist was recommended by my primary doctor who treated my yellow jacket sting on my thumb - the swelling from which within 48 hours spread to my elbow and made my hand and fingers swell so that I could not bend them. I had taken benedryl the first day (despite it being contraindicated when on tamoxifen) but when the swelling continued, went to the doctor - who said that such a swelling in itself was damaging to tissue (cellulitis?). She gave me a steroid shot, a prescription for a short course of prednisone, orders to take more benedryl and to add Zantac - which is a different kind of anti-histamine. Over the course of two days, the swelling disappear. The allergist recommended the immunotherapy not because of the local reaction - about which he was NOT concerned as an allergist but because in 2003 I had had a systemic reaction to multiple stings - hives and itching. In the meantime I have learned in no particular order of importance:
1. epi pens really do expire, you should make sure yours in current.
2. The risk of a bee sting is not only anaphlaxis but a sudden drop in blood pressure.
3. Blood pressure medication such as Beta Blockers and ACE Inhibitors impact your reaction to bee stings.
4. Claritan does not reduce the efficacy of Tamoxifen the way Benedryl does.
5. It pays to have beefy upper arms if you have to get 9 shots in one arm.
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Thank you Jelson for that very helpful info!!
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Crap. I forget about Benedryl effecting Tamoxifen.
And I'm glad my arm swelling has already subsided before I read your story, Maria!
Jelson ~ I used to get allergy shots (for animal dander, dust mites)...but couldn't imagine getting 9 at one visit!!
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I just wanted to add that I had allergy testing at the allergist - I didn't start the immunotherapy based on one systemic reaction 8 years ago, but on a panel of allergy tests AND the history of a systemic reaction. My reaction to yesterday's latest round of 9 venom shots has moved from my upper arm to below my elbow. I am popping claritan and benedryl (to hell with the tamoxifen - what is a few days when I will be on it for 5 years?). I have at least 4 more rounds of shots at more concentrated doses of venom to look forward to. I do not currently have lymphedema and am at minimal risk, having had a lumpectomy and no lymph nodes removed - however even I was advised not to have bp/shots in the arm on the lumpectomy side. In retrospect, I think I should have thought twice about seeking out this immunotherapy which purposefully causes inflammation in my body. I guess I am wondering, shouldn't we, and esp those of us at risk for lymphedema or with lymphedma all have a game plan worked out with our doctor that we are comfortable with in the event of a local swelling reaction to something like a bee sting? what to self medicate with, when to make appt with doctor, when to go to ER?
maynot be making any sense, too much benedryl?
Julie E
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I went through the immunotherapy for wasp and hornet sting allergies before bc. The protocol I had was once a week for 6 months then once a month for 5 years. Let me tell you, it gets old fast. It worked, though, since when I got stung I would get breathing problems, chest tightening and throat swelling. If I get stung now I feel ill for about 15 minutes and then I'm OK.
You should be careful with stings on an LE arm or at-risk arm. I was in the hospital with a girl who had a beesting on her hand and developed cellulitis from it. My pcp told me that a lot of bees and other stinging insects have nasty bacteria in addition to venom.
Leah
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Jelson, this has nothing to do with a bee sting but remember when you posted about waking up with your red breast? How long did it take to go away? It happened to me 4 days ago and keeps spreading. Looks pretty ugly. Can you PM me with more details?
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Artsee, you might be dealing with cellulitis. IMO, you should get to an ER asap to have it dealt with. It's a serious infection that shouldn't be ignored.
Best of luck.
Leah
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Where does that come from? I don't recall doing anything to cause this.
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Artsee, I just sent you a PM
do get yourself checked out. As Leah says, it might be something serious.
Julie E
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Artsee, I'm worried 'bout ya'!
Hoping you've gotten to the ER and have things all checked out and back under control.
Cellulitis can come from any skin break, even micro-cracks from dry skin. Or it can just appear with no ready explanation, as it has for too many here. It may be an indication of underlying lymphedema in the breast, as excess lymph fluid can be present even before you notice any swelling. Lymph fluid is warm and protein-rich so it acts as a bacteria "nursery" and can trigger infection way too easily.
If it turns out that you have cellulitis you might want to check in with a well-trained lymphedema therapist for evaluation as soon as it's resolved. Here's how to find one near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htmHoping you're doing well!
Binney -
FROM Jelson ~ "I guess I am wondering, shouldn't we, and esp those of us at risk for lymphedema or with lymphedma all have a game plan worked out with our doctor that we are comfortable with in the event of a local swelling reaction to something like a bee sting? what to self medicate with, when to make appt with doctor, when to go to ER?"
I totally agree!!! I do a lot of research, but when I got stung by that bee...I was kicking myself for not knowing what to do! Should I ice it? Should I take benedryl? Do I need to elevate my arm? What is a "normal" reaction? etc
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Hmmm...that sounds like a reasonable plan. But the one thing that comes clear on this board, unfortunately, is that there's no predicting the countless ways we can all find to get ourselves in trouble!
Being prepared for all of them would be virtually impossible. So no kicking of yourself allowed!
It does pay for anyone with lymphedema to have an appropriate antibiotic on hand, and careful instructions about when to make prompt use of them and who to notify if you start them. Also pays to carry some clean-up cloths, topical antibiotic and a few bandages around with you for scrapes and paper cuts (and bug bites!) And elevation, staying well hydrated, and some calm deep breathing is always an appropriate response to anything potentially involving lymphedema.
Just stay well, everybody!
Binney -
Thanks for those tips Binney!
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