Monday 2 June 2014

Cellulitis - I am taking a battering

For the last week or so I have been battling to stay out of hospital due to a nasty bout of cellulitis. Its unfortunately made me quite poorly, dropping my blood pressure, causing excessive fatigue and making my postural orthostatic tachycardia syndrome symptoms run wild. So I am afraid I haven't been up to much writing so I apologise if this isn't up to my usual standard.

A week ago when we eventually got some glorious sunshine in the UK I decided to take advantage of it, as for the first time in around six months I had some energy. I spent the Saturday cleaning up our small garden. When I say cleaning up the garden, I mean shuffling around on my bottom washing down the pots that hold our ornamental grasses. It took several hours and it was hard work for someone who hasn't been able to do anything for a while. I worked for too long and pushed myself too hard as those of us with a condition like Ehlers Danlos syndrome and dysautonomia are prone to do when we suddenly get a surge of energy! I wish I would learn not to do this but I never seem to.

As I undressed that night with hubbys assistance, I notice a tiny red mark on my right knee. As it was so small I quickly ran my fingers over it to see if it was a splinter, I had been wearing jeans so I couldn't understand where the mark had come from but at times during the day I had knelt on the decking. I couldn't feel anything and it wasn't hurting so I just went to sleep thinking nothing more of it.

On Sunday I woke up and my right leg was sore, my hamstring was particularly painful and my right knee had developed two blisters and was looking a little pink. I brushed it off as possibly blisters from kneeling, I am prone to developing blisters on my skin very easily, anything where my skin rubs against a surface continually and I will develop a blister. Shoes are a nightmare and as a child my feet would develop blisters even when wearing shoes that I had owned for months and had been worn continually. So you can see why I brushed it off.

As the day progressed my leg became quite sore and by the afternoon walking was becoming an issue. I grabbed an elasticated bandage and strapped my leg up from my ankle to my thigh. I elevated my leg for the rest of the day presuming that it would sort itself out. I have a great tendency to ignore injuries because they happen so frequently.

By Monday my knee was boiling hot and everytime my jeans caught my knee it was sheer agony. I presumed I had an abscess on my knee as I am prone to abscesses due to having the skin condition hidradenitis-suppurativa. By Tuesday my knee was looking like this

It was agonisingly painful, swollen and burning hot. I knew at this point that I had cellulitis and rang my doctors surgery. My gp who was working from home that day rang me back within 30 minutes and agreed with my diagnosis! I was given a 7 day course of flucloxacillin 250mg 4 times a day. It took a good 48 hours for the red ring that had formed around the red centre to subside. The whole time I felt pretty rough with a temperature and just generally unwell.

By Tuesday my knee was looking like this
The swelling had greatly reduced, the red ring that had surrounded it had gone and I was feeling a lot better. I rang my gp to inform him of the progress and it was agreed that I would keep an eye on it. As I was no longer in pain I didn't push for more antibiotics, the reason being that I have real difficulty in swallowing capsules due to my EDS. For some reason capsules get caught in my gullet and I end up with them stuck in the back of throat for ages which causes burning and foul tasting burps! Sorry if thats too much information. I know now that I should have pushed for them as by late Friday evening the fact that infection had not cleared quickly became apparent.

On Saturday morning my knee had swollen up again and my whole knee had turned pink. It was itching like crazy and I was scratching myself to the point of drawing blood. Probably down to the EDS making our skin more fragile. I ended up calling 111 (in the UK thats the number you call when the doctors surgery is closed, they offer advice and assistance) and getting them to place a call to Devon Doctors on call. I was told that it was likely that it could be up to six hours before I received a call back and two hours if I was really lucky. The call handler told me should my condition worsen and I hadnt heard from a doctor, I would have to call 111 again and they would decide what to do eg call an ambulance or get the doctor to ring me as priority. As my knee wasn't as painful or as bad as it had originally been I wasn't unduly concerned. After all last time I had waited 3 full days before seeking advice.

Within 30 minutes the doctor rang me, I explained what had been going on with my knee and immediately he prescribed flucloxacillin but at the dose of 500mg. He asked that for the first three doses I double up the tablets to hit the infection hard. The normal dose would be 1 tablet 4 times a day equalling 2g of antibiotics. The prescription was faxed to my local pharmacy and my father collected them for me so I could start them immediately. This is how my knee looked on Saturday morning

As you can see its no where near as bad as when it first started but my knee had swollen and with the threat of a hospital stay and IV antibiotics I was much quicker to act.

It explains why all last week I was starting to feel quite ill again and why my postural orthostatic tachycardia syndrome was misbehaving so badly. I felt so weak and fatigued I really couldn't understand why.

The antibiotics are making me feel quite nauseous but I am happy to report 24 hours after taking them I have really noticed a difference my knee is much less swollen and the itching has reduced. The pink area has reduced in size however it is still extremely hot to the touch.

For more information about cellulitis you can click on this link NHS Choices. Cellulitis is a nasty infection that left untreated can quickly lead to septicaemia. My sister has been hospitalised in the past with it, hers was on her face as a complication from a horrendous sinus infection that lead to an abscess on her brain. I've never suffered with it before however due to the steroids I have been taking to alleviate the awful PoTs symptoms I've been having since february I think my immune system just couldn't cope.

Of course nurse Frankie has been looking after me whilst I recover!

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