Cellulitis epidemic got me too

Anonymous · July 2012

Thanks Ladies on the Epsom Salts. Ha Paranoia whats that????????? Well seriously I dont think any of us are paranoid at all. You dont even need to have had cellulitis to realise the horrors of the implications of it. All you need is a little imagination! Yeah people just dont get it about the whole cancer thing though and they are typically CLUELESS about all the dramas we have to face day by day and for the rest of our lives.

Jo you remind me of what Im like when I go to town or use public loos, or one of the biggest bug carriers of all...supermarket trolleys. My drill is absolutely DONT touch your face from the time you leave your own house to the time you get back unless youve JUST washed your hands PROPERLY, I would use loo paper around loo seat, I wouldnt touch door knobs and would use loo paper for that and then find a rubbish bin outside and dump it therein. When I was doing Chemo I became "allergic" to people in general and those with a cold/flu in particular. Anyone who as much as looked like are going to sneeze/cough/snort or whatever, would get an instant wide birth from me.

Ha, Kira well one thing I have heard of here in NZ is Epsom Salts. So many meds and things you ladies speak of I have to look up on google. I wish we had some sort of reference here of all the names given to compounds /meds and suchlike that all us BC folk could refer to for the benefit of all countries. For example Elavil in the US is Amitriptyline (SP?) in NZ, or was when I last looked. Back in the day I LOOOOVED horses and rode for years. I dreamed and dreamed of seeing a Quarter Horse. My big favourites. It wasnt until I went to Aussie that I saw one and the kind owner let me ride it. Yes, I cried with joy. Youre right with cats, they have some serious bacteria and both cats and dog feces hold some real nasties.

All this said I dont think one can be too careful anywhere. Its back to basics for me because I believe we are being poisoned from every angle there is. Soil tests in many places have shown elevated barium strontium and aluminum levels which come from aircraft dumping chemtrails on us on a world-wide scale. Thousands of people from every walk of life witness these things which is indicative of the truth rather then so-called conspiracy theory. We've got evil monsanto with its diabolical GE crops, to sprays, to butyl this and propyl that in just about every product in our house.Think of how many things that have been invented in the last 100 or so years. Plastic is a shocker. Radiation galore from the electro magnetic fields eminating from household gadgets to Hi voltage power lines. We are about to have smart meters installed here and Im gonna kick up a stink. These diabolical things emit heaps of radiation and you cant turn them off. These are criminal. .....and we wonder why theres an epidemic of cancer!!!!! Sorry for my early moring rant, but really Im not if it gets people to thinking whats going on around us.

Musical

purple32 · July 2012

QUESTION!
I had a long ppst earlier today in the surgery forum, and I soemhow stumbled upon this forum thread.

Does the folloowing sound at all like cellutlitis ? I have never considered it.

Thx for any help/opinions with this !

==========================

MAJoined: Apr 2012Posts: 611

purple32 wrote:

HI all

I have waited to post this because it really seems petty in comparison to what some woman have gone through surgically, but I decided there may be others who might be able to give me some insights so here I go.

I had a small mass at the 11 o'clock position removed on May 1, 2012 ( with SNB) The HIGHLY skilled BS did a fabulous job. No dents, no nada. She cut into the top of the nipple so any scarring will most likely almost ' blend in ' over the next yr. At least, that's my guess. I was Extremely pleased with the outcome and I wore a bra ( don't now !) 24/7 and used an ice pack a LOT for the first week or so.

Everything looked really great- really perfect.

Just a few days before I was to return for a 3 week follow up, I noticed a sightly pink area at the BOTTOM of the breast. The skin also looked a tad ' lumpy' or like stretch marks. To this day, I cant really tell if it is stretch marks that might have already been there before and are now " highlighted ' by this pink area or not actual stretch marks. I was thinking I may have contributed to creating these marks and redness/pink area myself since I often tucked a little ice pk. in the bra at bedtime.

Thinking maybe it kind of " squished' the area and made the marks which I hoped would just go away.

I am almost 3 mos out and they have not.

In any case, at my post op, I mentioned all this to the RO ( I ended up opting out of rads due to lungs btw ) and she said :
"Oh, most likely afingal infection of skin and I can RX cream. Let's see," She looked and acted like : " Oh no, it's nothing much., It might just resolve. It's nothing."

I showed it to the BS who kind of acted the same way.She did say : " That's odd to develop something 3 weeks out." I told her my bra was tight and I was putting an icepk in it and she said well don't do that anymore (DUH :>)

It's true it is subtle , but the pinkness its about the size of a doorknob - not a dime. And it is not imaginary. My husband can see it, and so can I . It does not hurt, isn't itchy , yadyadyad ... it's just there and so odd because NOWHERE near the 11 o clock mass OR the surgical site!

In any case, it has finally occurred to me, 12 weeks later, that the drs didn't really see much of it ! This may sound stupid, but every morning when I look at it in the mirror, it is still most definitely there. Pink skin ( and also kind a ' bumpy) .

Yet, if I SIT DOWN ( as I was on the examining table) I barely even notice it at all, due the fact that breasts kind of ' sit down with us " if you know what I mean. These DRS are several hrs away btw.

Has anyone else ever had this kind of a ' skin issue' and just ignored it ?

kira66715 · July 2012

Purple32, there was a recent study published about breast LE and it's very common, especially early on and especially with rads--when you take the sentinel node, you block the path of lymph out of the breast.

So, the study--done by Andrea Cheville and others--great researchers, concluded that breast lymphedema is common and shows up as swelling in the bottom portion of the breast, primarily and with associated redness that may show up in any portion of the breast.

It tends to get better. And if it is troublesome, lymphedema therapy--showing how to move the fluid out with massage and use of gentle compression can help.

So, I'd vote for breast LE, and doubt it's an acute celluitis, IMO.

And so few surgeons even admit that breast LE exists.

http://www.ncbi.nlm.nih.gov/pubmed/22415476

Breast Cancer Res Treat. 2012 Mar 14. [Epub ahead of print]
A prospective study of breast lymphedema: frequency, symptoms, and quality of life.
Degnim AC, Miller J, Hoskin TL, Boughey JC, Loprinzi M, Thomsen K, Maloney S, Baddour LM, Cheville AL.
Source

Department of Surgery, Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN, 55905, USA, degnim.amy@mayo.edu.
Abstract

Although lymphedema of the arm is a well-known complication of breast and axillary surgery, breast lymphedema has received scant attention. We sought to prospectively characterize breast lymphedema's incidence, associated symptoms, clinical course, and impact on quality of life. Subjects were enrolled prospectively from a consecutive sample of patients undergoing non-mastectomy breast procedures (excisional biopsy or wide local excision ± lymph node removal) and followed for signs and symptoms of lymphedema in the operated breast. Symptoms and distress were serially assessed with 11-point linear analog scales. Breast lymphedema was diagnosed independent of symptoms, based on the distribution and degree of edema and erythema. One hundred twenty-four women were followed for a median of 11 months, and breast lymphedema was diagnosed in 38 (31%) women. Breast lymphedema was more frequent after breast surgery with axillary node removal (49%) compared to breast surgery alone (0%), p < 0.0001. Breast lymphedema involved multiple quadrants in most women and was characterized by edema in 100% and erythema in 79%. Patients with breast lymphedema were significantly more likely than women without breast lymphedema to report symptoms of breast heaviness (65% vs 22%, p < 0.0001), redness (62% vs 29%, p = 0.0006), and swelling (59% vs 22%, p < 0.0001), but symptom-associated distress was low overall. Three of 32 breast lymphedema patients with clinical follow-up developed chronic edema. Breast lymphedema occurs in approximately one-half of women who undergo breast surgery with axillary node removal. The condition is characterized by diffuse skin edema and erythema as well as self-reported symptoms with a low level of distress.

painterly · July 2012

Hi Purple,

I have been reading this thread to determine if anyone has had a similiar experience to me and lo and behold I see your post which could almost be my own post because of the similiarities. Like you, I had surgery and went to my post op appointment which was 2 weeks after the op. and we talked about how fast the incision was healing. Indeed like in your case, everything was wonderful. Then a few days later, I developed a pink patch at the southern part of the breast and it was warm to the touch. I immediately phoned for an appointment in case I needed antibiotics. I was asked to come in immediately. At first, the BS thought it may have been a hospital infection so he gave me the appropriate antibiotics. The pink area just spread and the antibiotics made me dizzy. They asked me to come in again. It was more apparent this time to the BS that it was cellulitis, so he gave me a fresh lot of antibiotics.

Unfortunately, the antibiotics are not stopping the spreading of the cellulitis. I have been googling cellulitis after breast cancer surgery and treatments. The BS was baffled that it was showing up a few weeks after the surgery but it seems that it is a late complication of breast cancer surgery:

"Delayed cellulitis is an infection of the breast tissue which occurs as a late complication of breast cancer surgery. This is in contrast to surgical site infection which usually manifests within four weeks of a surgical procedure."

If you google cellulitis after breast surgery you will see a picture of a breast that is very inflamed from the condition. Yours in comparision sounds like a very mild case. You said yours was the size of a doorknob; mine is the size of 3 doorknobs as it is now covering 3/4 of the breast. It is a bit of a worry as everything has been smooth sailing. I will phone the hospital tomorrow as they want to know how it is progressing. (They gave me strict instructions to go to the emergency if I had a fever, fortunately, I feel fine).

Interesting that yours has not spread further than the doorknob size. I hope someone else comes along who can share their experience and let us know if they just disappear on their own.

purple32 · July 2012

Interesting, kira.

I wouldnt be the likeliest candidate ( for breast LE) . I only had 2 nodes removed and no radiation.

I dunno'. Maybe. I would really hope my BS would know about this and recognize it. She is an ecxcellent surgeon at MGH in Boston.

THX

Painterly,

I am glad to hear your story, but sorry you are going through this ! Thank you for sharing.
I wish my DR was a little closer to home and easy to get in to see.

No, mine has not spread (yet) and is not angry red.

It is " something" though. I was hoping it would resolve on its own.

What kind of antiBs did they give you ?
Please feel free to PM me. ALSO----I just noticed your DX date ! When did yours begin? Have you been living with this for several yrs ? I'm confused.

Many thanks!

I appreciate any other stories or opinions.

hotandcold · July 2012

Summer epidemic is right. This is my second cellulitus bout in less than 6 weeks. It looks just like the first time. It started with me thinking I had the flu , then I could feel my arm getting hot, then it looked like a bad sunburn. It had distinct edges and looked like I had on a cap sleeve shirt and a glove. Back to the Dr. and I'm on Keflex and Bactrim for 10 days again. This is a bunch of garbage. Feeling a bit better after sitting on the couch all day with my arm propped up on pillows beside me. Sure hard to get anything done with this garbage. Good luck to all.

Katarina · July 2012

Sounds like Breast LE and Cellulitis are very similar and thus always get called Cellulitis.

My breakouts have always been the entire breast and not just spots, although I believe it is being caused by lymphatic fluid that is not adequately draining. I'm going on my gut with this one. Lymphatic fluid builds up and stagnates and then sooner or later a little bacteria finds it's way to the pool and wella!!

Hugs,

Kat

purple32 · July 2012

PHOTO

This is a photo from online, of cellulitis.

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

Mine is a very very light pink patch-- perhaps with a welt or stretch mark in there. One has to look to notice it , but it is there.

Doesnt look a THING like this.

kira66715 · July 2012

Purple, that's why breast LE, which is associated with mild erythema (redness) can be mistaken for cellulitis. Look, breast LE is on the rise, even with just 2 nodes out, just throwing it out there as a possible explanation. Also a lingering seroma could cause the swelling and redness. But in my experience, and I worked for the rad oncs for the last three years and saw a ton of post op patients, the breast surgeons were kind of clueless about breast LE. Even good surgeons.

Hotandcold: on all those links to cellulitis, there are embedded links about management, and if it is recurrent, there's a consideration of suppressive antibiotics. I hope you heal quickly, but I'd hope they treat it until it is definitely gone. Stagnant lymph fluid is like a perfect place for bacteria to hide and smolder and then burst into flames. Healing thoughts, and please let us know how you're doing.

Kira

purple32 · July 2012

Thx kira.

Should it be treated with cipro ? I have a call in to the DR., but I swear they basically didnt even see it post op.

Hope I dont have to run to Boston to get it looked at- I would think they could call in a script .

UGH

purple32 · July 2012

Thanks Jo5.

I wouild think that even if they cannot determine what it is , a simple antiB should not hurt .

I'd like one - just in case.

Does it normally make a mild case go COMPLETELY away...if only for awhile or ????

purple32 · July 2012

, the breast surgeons were kind of clueless about breast LE. Even good surgeons..>"

Kira

What they heck did they THINK it was ? I mean , did they have ANY explanation at all?
Seriously, my drs. just looked at the area and acted like nothing at all was there. I admit it is 'something mild' and my positioning was not the best, but something is , well, something/ not nothing!

kira66715 · July 2012

Purple, they probably wrote it off to post op changes. And often that is edema--and lymphedema is when you hold lymph fluid in the breast and it causes both swelling and redness.

If it's not infected--which is cellulitis--it shouldn't need antibiotics. An infection is normally an acute event, people feel sick, it gets sore, swollen, hot and they can run fevers.

Kira

purple32 · July 2012

I see, kira. Makes sense. I recall my BS saying: " I honestly dont see much of anything at all. I think you just have to get used to the idea that your breast may not look EXACTLY like it did before." I remember thinking: " Why not ? It did 4 days ago, and the week before that and the week before that ..."
WTH happened ?

Oh well.

If it were to stay JUST LIKE THIS I'd be fine, but ......

I dunno'.

Many thanks for all your time- I do appreciate it.

purple32 · July 2012

Mammogram Question:

OK, if this is breast LE, HTH do ppl get mammos ? I can only imagine the dent - no thank you !

ALSO- can anyone point me to what they consider to be a good lymphatic massage video on youtube ? I am still clueless about all this.

THX very much.

Kindergarten · July 2012

Dear Jo-5, You are so right, do not take antibiotics unless really needed. I have just stopped taking a maintenance antibiotic for over a year. I think that is why my bloodwork is showing some abnormalities. I will keep a script on hand instead.

Kindergarten · July 2012

Dear Jo-5, I so agree. I am going to keep a script handy, but never again will I take an antibiotic unless I truly need it. Thanks for telling me about your friend taking allergy meds. i am feeling better and better about my tumor markers. How are you feeling, everything good?

Anonymous · August 2012

Jo, since youve been really hammered with the ugly cellulitis may I ask a few Q's? How long does it take before you know when you have it? How long should you wait and see if you should go to doc? Do you get yours in the same place or different places each time? I know these are probably hard questions, but I too dont want to take anti biots unless really necessary. Many times Ive been able to back off a definite inflammation around skin nicks and the like around fingers with simply salt and antibiot cream.

My shin and every now and then it aches exactly where the cellulitis was. I also have what seems a permanent mark there. Its my one and only case of it and was probably about 5 or more years ago now.

Katarina · August 2012

I've had 4 cellulitis attacks but the last one didn't come with a fever, just a really tender, swollen red breast. How can you tell the difference between Breast LE and Cellulitis?

Hugs

kira66715 · August 2012

Katarina, excellent question as breast LE can cause redness on it's own, but it's not tender, hot, more swollen and often a sudden change.

Sometimes, the redness lingers, even after the infection is over, and it's so hard to tell the difference.

Sure sounds like cellulitis to me. Are things better now?

Kira

Anonymous · August 2012

JO -thankyou so much. Your experience has certainly gone into helping not only me but others Im sure get a bead on this horrid thing. I had a script ready to be filled but I found this can be a nuisance because it kept "expiring" and Id have to keep "updating it" next time at GPs. I live rurally and if its the weekend I have to go further away to a City Pharmacy. LOL of course if I was going to get it, it would be 1.a.m on Saturday morning or something. Anyway, I have a bottle ready and waiting, which I cant wait NOT to use.

I'll have a look at Cipro and see what NZ's version is.

I forgot to ask, each time you've had it, does it leave a visible mark under some circumstances like, when its cold or hot or youre having a tub/ shower or something.? Mine on my shin does and its a red mark about 1 to 1&1/2 " across.

purple32 · August 2012

I hope we can ' cross converse' here . Still on the topoic of LE, I called the RO that I saw on May 1 ( nope I didnt have rads) and I had left a message saying the area she looked at with pinkness etc ... was still there.

She called me back this evening and said that since she was/is not treating me, she would like me to call my PCP and ask him to RX some Nystatin cream for ' the rash" which is very common to recur this way, esp in summer, under a breast fold.

I told her this was NOT a rash and that it never went way at all, and she said she was sure it should resolve in about a week after using the cream. I said : " you dont think there any chance this could be LE?"

She said : " Not at all.":

I am very frustrated right now, Dont feel like I was heard, and I have no faith at all in this cream.

OTOH, if I dont give it a try they will not take me seriously.

I am wondering- could it possibly hurt ?

Does anybody know ?

THX

Katarina · August 2012

I saw my Lymphedema specialist today. She was not convinced that I still didn't have some kind of infection lingering. My other doctor said the same thing in the afternoon.

I'm getting a CBC (full blood panel) tomorrow to see if I'm still infected -- even after 7 days in hospital IV and now on Bactrim and Clindamyacin.

What is Cipro that everyone is talking about? Maybe I need to switch.

Hugs,

Kat

Katarina · August 2012

I ALWAYS HAVE BODY ACHES WHEN I HAVE CELLULITIS. You don't have to have a fever and can have low vitals (pulse/temp) as I did for days.

Either way, untreated and it can become sepsis.

hugs

kira66715 · August 2012

Jo, that "hot red spot" is exactly what I had. And I sure avoid the sun on that arm now.

thank you for all the great information

Kira

Marple · August 2012

JO-5, thank you for sharing your experiences. I think your's is valuable info for us all to be aware of.

purple32, I think you should go to your PCP. It sounds like your rad onc may be in denial. Not to say you have or don't have LE but for her to say what she did. Well, you need to see someone who cares. (Can you tell I'm not a RO fan?)

purple32 · August 2012

"purple32, I think you should go to your PCP. It sounds like your rad onc may be in denial. Not to say you have or don't have LE but for her to say what she did. Well, you need to see someone who cares. (Can you tell I'm not a RO fan?)"

Marple

Neither am I ! Unfortunately, my PCP knows nothing whatsoever about BC, let alone LE. He would just be the puppet to RX for her. I didnt even bother to call him. I am sure this RO is used to RXing Nystatin for rads . I did not have rads, and this is not a ' recurring rash ' either.

I'm just discouraged at the moment, and a little doctored out too.

THX

Anonymous · August 2012

Mmmmm thats interesting Jo. Perhaps mine shows up on my shin under those circumstances stated, because of that location. I dont know. Anyway its weird coz its not like I have a fair skin. I have quite a dark olive skin.

Interesting what you're saying about sunscreen Jo.

Since doing some hard looking at the whole VIT D3 thing Im convinced that we've been "sold a pup" about the sun. Sure, don't get burnt, but get out there and get that sun on you. Marvellous too how the body takes in and regulates how much we need and you dont "overdose on it" I can think of two (there'll be others Im sure) exceptions to getting in the sun: 1/ Heed the advice about light senstivity if youre on Meds that say that and 2/ if you have LE. Theres other parts of the body we can expose to the sun and keep the affected limbs out of it. I would'nt trust sunscreen as far as I can kick it with all the chemicals in it and NANOPARTICLES. The latter I want to look further into when I can, but from what Ive seen its bad news because nanoparticles can be absorbed through the skin.

Jo good advice about the meds and shelf life, because I know it's true. Still, Id be a little hesitant though with antibiots when you have to use them in a life and death situation like cellulitis which could become that so easily. I wouldnt be wanting to take too many chances with that monster.

fishinurse · August 2012

Wanted to look up cellulitis,glad to see this post. This past Sunday, i noticed slight redness to the right breast {had lumpectomy to right breast on June 11 this year with SNB). Later that evening it felt tender,when i checked, the redness,inflammation almost covered the whole breast,no fever. Called onc.,he told me to get to the E.R.,which i did.E.R Doc prescribed clindamycin 300 mg 4 x/day and Bactrim 2x/day. The redness seemed to fade,however when i woke up yesterday,couldnt believe how swollen the breast was,very red,hot to touch,painful,no fever. Had a follow up appt. with surgeon,he looked at it and wanted to extend the Bactrim another 7 days,needed to let oncologist know since i am supposed to get 2nd AC next week. The oncologist looked at,stopped the other antibiotics and put me on Keflex 4x/day for 7 days,can't have chemo next week. A

Keep thinking,what are all these antibiotics doing to my gut! Started taking acidopholus.

fishinurse · August 2012

Thanks for the tip! Definitely have yogurt on my grocery list!

Cellulitis epidemic got me too

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