Severe Cellulitis – It all began with a chipped toenail

During the period between Xmas 2010 and New Year 2011, I must have stubbed my toe and the nail cracked, split, then became infected.

It was very painful and I went to the nurse who told me that it would be fine if I bathed it in salt water.

Things started to improve but the toe was still painful.

On the 13th Jan 2011 I was bitten 4 times by an insect. It later turned out that there was a flea infestation at work.

On the 14th Jan I had a very sharp pain on the top of my foot. I didnt really give it a thought because I assumed that it was caused by my trainers being too tight.

Saturday 15th soon after midnight I got up and nearly fell over with the pain.

Took some pain killers and went back to bed.

At 5:30 I got up and rang NHS direct who told me to expect a call back within the hour.

It was 9:30  before I got the call back. I was told to wait for a doctor to call and then get myself to the local hospital for the appointment.

12:30 The doctor gave me 2 lots of Antibiotics and told me to call back if it didn’t start to clear up.

15:00 Things were getting worse I was getting delierious we called back but it took another couple of hours to speak to a doctor.

18:00 We went to casualty at the main hospital where I stayed for over 2 1/2 weeks.

That evening my blood pressure dropped to dangerously low levels, A&E staff started IV drips in an attempt to increase my blood pressure as well as several antibiotics, the ones that they ended up giving me were Meropenm (IV) and Metronidazole tablet.

I was moved to AEU by 10pm, by this time I was feeling a little more comfortable. The infection had spread to just below my knee.

The infection started to spread up my leg, the rate of spread was very rapid by the end of the next day 16th Jan it had spread up to the top of my thigh.

The doctors came round and were very concerned that I may loose my foot. I was in so much pain I didn’t really take in what they said.

The pain was excruciating, the swelling immense. When I put my foot down it turned black with pulsating yellow. It was so painful that even morphine was not touching it.

The 17th of Jan a very low day, the lowest day.

The doctor came round again and the microbologist, the doctor was extremely concerned that I may loose my foot and possibly my leg.  The microbologist suggested a very strong antibiotic called linezoid. Whist this was being arranged I was moved to Medical Ward 3.  The AEU doctor personally saw my transfer (much to the amusement of the staff as it was very rare that a doctor escorted a patient).

Things started to get worse when the Linezoid got lost in the system and the doctors were concerned that I may get pneumonia. Great!

By that evening I thought I wouldn’t see the morning.  One of the night staff nurses was so concerned that she started ringing round the wards in order to find the antibiotics. They finally arrived at about 2:00am.   I am pretty sure that was the turning point and the start of my recovery.

Fully loaded with 3 types of very strong Antibiotics things started to improve.

The redness and swelling went down almost as quickly as it came. Apart from the foot which was excruciating and the simple task of sitting up to eat was so painful it is impossible to describe.

23rd Jan

24th Jan

26th Jan

When laying down the redness has almost disappeared

Then on the 1st Feb …

my skin just peeled,  it was amazing just how quickly it started to shed.

The antibiotics were stopped and I was monitored for the next 2 days before being released on the 3rd Feb. During this period I started to use crutches to get around. My body ached from head to toe, I felt like I had flu. Walking was very difficult because just putting my foot down made the lower leg go purple and it was still very painful.

Feb 9th one week on.

Everything is a struggle, my lower leg still turns a deep shade of purple. I am so tired, all I am able to do is to lie on the sofa, even daytime TV was too taxing.

By mid February I am itching to get back to work. I start to work from home for a few hours a day.

By the end of February I am a little bit more mobile but still the leg is purple, swollen and painful. I am almost working a full day.

During March I am working full time from home. Still struggling to get around but things are improving. Then disaster! I started to get chilblains on my RIGHT foot. I had kicked my middle toe (seen in photo above) at the end of February and the chilblains took hold around the middle of march. Unfortunately the redness started spreading up my middle toe so I started taking antibiotics as a precaution for two weeks.

April 2011

My doctor put me on nifedapine to try to increase the blood flow to my feet. The chilblains started to recede and I stopped taking it. Saw my consultant on 13th April and was sent for multiple blood tests, I think there were 16 in all. I am advised to go back on nifedapine.

By the end of April I am more mobile, still cant drive because of the clutch and the swelling/burning pains that still occur when I put my foot down.

May 2011

I am currently back on the nifedapine and due to go back to the consultant tomorrow. 11th May. I have swapped my car for an automatic and for the first time will be taking myself to the consultant.

12th May 2011

The consultant explained that the burning sensation is down to nerve damage, it should heal but will not be a short term thing. She has suggested that I have Reynaulds Phenomina which explains the cold fingers and toes and will continue to take the nifedapine until I have the results from my Doppler test which is due at the beginning of June.

3rd June 2011

We have been away for a few days, whilst the weather was cool I found that I could do quite a lot of walking and also found that my fingers were warmer. As the week progressed the sun came out and as the temperatures rose the swelling increased. Still it was good to get away both mentally and physically.

7th June

Doppler test day. The doppler test was quick and easy, the doctor had an ultrasound device linked up to a computer and some jelly to put on my leg. He scanned both legs from foot to groin and told me that there was a good blood flow on both sides. The problem is more likely to be within the smaller veins but the machine is not sensitive enough to detect them.

8th June 2011

Went to work for the first time this year, its the best part of an hours drive and up till now I haven’t felt comfortable driving so far in one day. I only went in for the morning to attend a meting.  Driving was hard work, and by the time I got back home my ankle was sore. On the way back I noticed that my eyelid was slightly swollen. Ringing in my ears were the words ‘if anything unusual happens and you start to get swelling go straight to the doctor’ so to be on the safe side I called into the Chemist (drug store) to see if he could reassure me.  He suggested it could be a steye and gave me some drops.

9th June 2011

Woke to a swollen eyelid, my eye was sore and to be honest I started to panic, I had read about pre-orbital cellulitis and orbital cellulitis and wasnt taking any chances.  I went to the doctor first thing. She was very good and whist she was pretty sure it was just an allergic reaction, she gave me some antihistamine drops and suggested hayfever tablets. I was to go back in the afternoon.

By 4:30 things had not got any worse, the doctor was very happy to see it had not changed. To be on the safe side she gave me some antibiotic drops. 4 days later it had cleared up. PHEW.

20th June

Its been cold here in the UK and my fingers were really cold, trying to type is hard and seeing as it is the main part of my job, I need to get things sorted so I went to my doctor.

Since the scare with my eye I had been monitoring my blood pressure and noticed it has been higher than usual so my doctor suggested an alternative drug called felodopine, this is a once daily drug that does the same as nifedipine but is supposed to be more tolerated.

29th June

Been on Felodopine for just over a week and apart from the first few days of dizzy spells, I seem to be getting on ok with them. Typically the weather has got warmer so I cannot be sure but washing fruit for the children’s lunch box is a lot less painful than it was. The hot weather at the weekend did not affect my leg as much as I was expecting, mind you I was just sitting in the garden, it was over 30 degrees and when its like that in the UK its not the sort of heat that encourages you to get up and about.

 

For more, please see the next item (cellulitis blog)