cellulitis or sunburn w/lymphedema

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Ann Barnes - 16 Apr 2005 16:05 GMT

Hi folks,

Question for you, I recently spent 3 days in our local hospital (good size,
quite modern and knowledgeable) because they believed the rash on my
lymphedemic arm was cellulitis. I believe it may have been sunburn. What an
expense! Arm was slightly (very slightly) more swollen, red all over, and
warm to the touch. I know I spent very little time in the sun while
mulching a garden a few days before; other arm and body parts didn't get
even slightly pink, tho.

Also confusing the issue: We have a system at our hospital now where family
docs don't visit and care for you - the hospital hired former family docs
from local groups who are now specialists called 'hospitalists' - anyone
else who doesn't like this system in the US? Anyway, mine had no clue what
the arm looks like normal, how are they supposed to know other than by what
I say? Is it normally pink, and how swollen?

Any way to tell cellulitis from sunburn for the lay person appreciated :-))

Ann in PA (doing great otherwise)

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allan grossman - 16 Apr 2005 18:02 GMT

>Any way to tell cellulitis from sunburn for the lay person appreciated :-))

Hi, Ann -

We've had a couple brushes with cellulitis - one requiring a hospital
stay and one that was treated as an outpatient with IV antibiotics.

I guess everyone's mileage may vary, but in our case cellulitis was
accompanied by fever, swelling of the affected arm and required
opiates for pain management.

Signature

we don't see things as they are, we see them as we are.
-- Anais Nin

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Ann Barnes - 16 Apr 2005 19:32 GMT

Thanks, Allan. I did have a low-grade (99 degree ) fever, but very little
pain. I'm on Ancef (was IV in hosp, now Cephalexin pills) for 12 more days.
Since I can't be SURE it isn't cellulitis, guess I better keep up the
regimine!

I'm also using Neosporin on the area to keep the skin moist and protected,
it'll help if its sunburn, too!
Ann in PA

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allan grossman - 17 Apr 2005 20:56 GMT

>Thanks, Allan. I did have a low-grade (99 degree ) fever, but very little
>pain. I'm on Ancef (was IV in hosp, now Cephalexin pills) for 12 more days.
[quoted text clipped - 3 lines]
>I'm also using Neosporin on the area to keep the skin moist and protected,
>it'll help if its sunburn, too!

Good for you, Ann. I wouldn't rule out cellulitis, but the first time
we encountered it we did everything wrong and I think that's what
landed Deborah in the hospital.

She had some swelling, redness and pain and donned her compression
sleeve and glove. This is a definite no-no if cellulitis is
suspected, as it tends to push infected fluid from the affected arm
into your torso. It was a pretty bad choice.

Anyway, several hours later she was in severe pain - we went to see
our oncologist who put her on morphine and IV antibiotics. She was in
the hospital for three days.

The second time we were a little more aware and she caught it a little
earlier - and we got the same IV antibiotics and a prescription for
Keflex, just like you.

It's be a pretty good idea to finish the course of antibiotics.
Keflex is pretty heavyweight stuff and if you don't kill all the
nasties you may end up with something that's resistant to cephalexin -
and I can't think of many oral antibiotics that are stronger.

It's possible you just caught it quicker than we did and didn't make
as many mistakes - but cellulitis is nothing to fool around with.

Take care -

Signature

allan

we don't see things as they are, we see them as we are.
-- Anais Nin

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Ann Barnes - 17 Apr 2005 22:51 GMT

Thanks, Allan, I will finish the anti-biotics for sure!
I don't know about catching it quicker; I didn't compress it (haven't worn
sleeve in 2 years now), but I did start doing manual massage again in the
hospital, then the next day called my family doctor (who knows more than the
'hospitalists' in the facility) and asked wouldn't that push it up into the
rest of the body, and he said as long as antibiotics were being infused that
would take care of that! So, guess I lucked out and did stuff right...
Ann

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allan grossman - 17 Apr 2005 23:27 GMT

>Thanks, Allan, I will finish the anti-biotics for sure!
>I don't know about catching it quicker; I didn't compress it (haven't worn
[quoted text clipped - 3 lines]
>rest of the body, and he said as long as antibiotics were being infused that
>would take care of that! So, guess I lucked out and did stuff right...

We were told 'no compression garments, no manual lymph drainage' if
cellulitis is suspected. I imagine that's probably erring on the side
of caution, though.

Sounds like you did good, Ann. I'm glad things are going okay :)

cheers -

Signature

allan

we don't see things as they are, we see them as we are.
-- Anais Nin

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Mary Fisher - 16 Apr 2005 19:42 GMT

"allan grossman" <wizard@no_spam.pointbeing.com> wrote in message >

>>Any way to tell cellulitis from sunburn for the lay person appreciated
>>:-))
[quoted text clipped - 7 lines]
> accompanied by fever, swelling of the affected arm and required
> opiates for pain management.

Hello Allan!

How are you both?

Lovely to see you :-)

Mary

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allan grossman - 17 Apr 2005 20:59 GMT

>Hello Allan!
>
>How are you both?
>
>Lovely to see you :-)

And it's lovely to be seen ;-)

We're doing pretty well, Mary. I've been frightfully busy the last
couple of months - two weeks ago I was in Washington DC on business
and am getting ready to head back that way again on Monday, then I
have a trip to Norfolk, VA the following Monday. I've been a bit of a
busy boy ;-)

Deborah is doing well - her last bone scan showed something
questionable on her spine so she's having an MRI next week to
determine whether it's arthritis or something a little nastier, but
her tumor markers are still stable, so here's hoping it's a touch of
arthritis ;-)

Anyway, we'll know more in a couple weeks.

Hugs to you and yours -

Signature

allan

we don't see things as they are, we see them as we are.
-- Anais Nin

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Mary Fisher - 17 Apr 2005 21:52 GMT

"allan grossman" <wizard@no_spam.pointbeing.com> wrote in message >>Hello
Allan!

> Deborah is doing well - her last bone scan showed something
> questionable on her spine so she's having an MRI next week to
[quoted text clipped - 3 lines]
>
> Anyway, we'll know more in a couple weeks.

Please keep in touch ...

> Hugs to you and yours -

And from all here to both of you!

Mary

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A. P. Thorsen - 18 Apr 2005 17:14 GMT

> Also confusing the issue: We have a system at our hospital now where family
> docs don't visit and care for you - the hospital hired former family docs
> from local groups who are now specialists called 'hospitalists' - anyone
> else who doesn't like this system in the US?

Responding to your aside, not your main point:

I can definitely see the disadvantage in cases like yours, but we were
*extremely* happy with the hospitalist when my husband had terminal
esophageal cancer. She knew all the ins & outs of the special things
that could be done in hospital to help keep him comfortable, make tests
less painful, how to work with all the specialized subdepartments to
coordinate care, how to navigate the bureaucracy, etc. It was a huge
help in our case.

Ann T.
Remove 'dontsendspam' from address to reply by email

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Ann Barnes - 21 Apr 2005 02:17 GMT

thanks, Ann T. I am sure someday I'll be there and feel as you do. The
hospital is indeed a world unto itself and having a guide will be good.
Perhaps my only problem was with this particular one, and the fact we just
couldn't seem to communicate - I talked she listened, and somehow it didn't
come out to the nurses, the records or wherever the way I said/meant it. I'm
definitely asking for anyone else next time, hoping for the system to work.
Thanks for all y'alls support.
Ann in PA (formerly from the South)

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