# Medical Question



## CrystalAndZoe

I'm so sorry to so rarely post anymore and then come with a problem. I've been really sick this week. Started to feel ill over the weekend, not really sick just not well. Low grade temp, fatigue, etc... Nothing really stood out to me as to what was going on. Then Tuesday evening I discovered an area on my chest where I've had for years a large pore that tends to fill up and become a blackhead. I've dug around at it in my younger years so the area around it is thicker and harder from I'm assuming scar tissue. And I messed with it last week. Tuesday evening was the first I noticed that it was bright red, hard, hot and really swollen. And it was seeping. So I went home and put hot compresses on it and tried to drain it by squeezing. My fever never went over 100 degrees. Yesterday I felt terrible and the fever continued. It hurt to stand up and it hurt to bend down. And it even hurt in my back opposite where this infected cyst is. I called the MD and she saw me this morning. I now have a lovely drawing of where the bright red is on my chest going over almost half my left breast, and I'm to call immediately if the red goes beyond the line or if my fever spikes. She said it was an infection that metastasized in the breast tissue. She said it was either Cellulitis or like Cellulitis. I received an antibiotic injection that I swear was dosed for a horse. She warned me it was going to hurt and they even used lidocaine with it. And I'm also on a high dose of oral antibiotics. I'm to continue hot compresses and try to drain the infection by squeezing it if I can. She was going to give me a rx for pain but I don't feel well on most pain meds and since Ibuprofen is also an anti inflammatory, she told me to take 800 mgs every 8 hours. All this info for this very simple question. I took my antibiotic in the kitchen. Went into the bathroom to take the Advil, took my contacts out and honestly can't remember if I took the Advil. I'm amazed at how comfortable the Advil kept me today and I'm really in a lot of pain right now. If the pain continues and doesn't lessen in an hour, can I assume I didn't take the Advil and take it? How much harm could taking that much Advil so close together do? Or do I just suck it up...the pain that is.

Oh and she told me to stay off my feet the rest of this week. I guess I kind of needed to hear that because I had planned on trying to go back to the store today and be there late for Little Dog Play Group and Puppy Socialization Class. Sometimes it's nice to have someone tell you that you're really pretty sick and it's ok to stay home and lay around. Honestly, as bad as I feel right now I can't imagine trying to function at the store.


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## Snowball Pie's Mommi

Oh, Crystal ... I am so sorry this is happening to you. I don't mean to frighten you ... but you have got to take cellulitis very seriously. I know from personal experience. I ended up in the hospital ... even though I was on a high dose of antibiotics. Mine was serious because I had facial and optical cellulitis ... that I think I picked up as a staph infection from a hospital that I had tests taken at the day before.

I hope Pam, or one of our nurses, or Gigi ( a physician) reads this tonight ... so that one of them can give you professional feedback on what they think you should do at this point. I think if you are feeling worse ... than better ... then you should check in with the doctor again as soon as possible.

My problem was that certain antibiotics, even at a high dose, were not working ... thus, I landed in the hospital. That's why I think you need to make sure you call the doctor if you feel worse. 

Sending you love and hugs, Crystal.


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## zooeysmom

I'm sorry you're so sick, Crystal  I too hope that one of our docs or nurses can be of help. If it were me, I would not take the change of a double dose--I would wait it out until your next dose. Hope you feel better soon.


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## Snowbody

Crystal - as I said earlier, I'm so sorry that you are going through this. Glad you're taking the doctor's orders. Don't know what to say about the Advil. 800 is a big dose so I wouldn't want to chance double dosing. How many pills do you take to meet that dose? Since it's bedtime I'd just try to sleep and take another dose in the morning. If it's really bad pain and seems to you like you really didn't take your dose, then maybe you could take a much smaller amount...like 200mg. This is why I keep pills I'm taking in one of those cases. Makes me feel old but sometimes I'm too distracted to remember if I took my Lipitor. Maybe it's the wine. :innocent: Feel better and keep on top of this. If you don't improve, get back to the doc.


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## allheart

Crystal, did your doctor consider shingles at all? I'm praying for you sweetheart.


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## AshleyAndSophiePup

Be careful with consistently taking ibuprofen, it can cause kidney failure if you take a high dose for a long period of time. I hope it doesn't get worse and you can start feeling better over the weekend.


Sent from my iPhone using PG Free


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## hoaloha

Crystal, I'm so sorry you're feeling ill due to the cellulitis.  . Hopefully, the antibiotics kick in fast. It sounds like celluluitis with a possible abscess from your description and antibiotics with promotion of pus drainage is the treatment. As for your ibuprofen question, I would not chance the overdose. I treat kids but the same caution applies to adults too. Instead, you can consider an appropriate dose of Tylenol once until the next dose of Advil is due. And definitely monitor your symptoms and seek medical care if things are getting worse. Hopefully, you feel better soon! I agree that you should let your body rest and heal up! ::hugs::


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## gopotsgo

Crystal, I'm sending you a PM


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## hoaloha

just wanted to mention that those are very general recs if I had a patient with cellulitis without other medical issues. Obviously, I can't give specific tailored recs without knowing your full medical history and an examination. Just wanted to clarify that since this is the Internet and all 


Sent from my iPhone using PG Free


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## michellerobison

AshleyAndSophiePup said:


> Be careful with consistently taking ibuprofen, it can cause kidney failure if you take a high dose for a long period of time. I hope it doesn't get worse and you can start feeling better over the weekend.
> 
> 
> Sent from my iPhone using PG Free


Ibuprofen is dangerous it's part of what caused my kidney failure, being given it for years and now they know more about the kidney damage it causes, so please be careful everyone...Even over the the counter Tylenol is ibuprofen.

My dad gets cellulitis from chewing his nails and was hospitalized with it..
Please be careful and get better soon.


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## CeeCee's Mom

I read on FB that you didn't feel well but did not know until now what it was. If you don't feel better today, I would seek help at an emergency hospital. I had a friend years ago that had it in her legs and they gave her prednisone(ms) also. She finally got alright but you may need to seek a second opinion if you do not feel better today. Love you, take care of yourself!! :wub:


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## Maglily

One extra dose ? I don't know, mom's kidney failure was linked to ibuprofen use too, although it was from using it several weeks, when she broke her arm.

I'm glad you said what was wrong, who knew this could happen like it did? not me.
I hope you are feeling better soon though and I hope someone else can advise you better.


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## aprilb

Crystal, I'm so sorry you are sick..my son had cellulitis as a child..it came on suddenly after he was hit in the head with a small rock..get well, soon!:grouphug::wub:


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## revakb2

I can't help with any medical knowledge, but I hope you get well soon.


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## CrystalAndZoe

Thank you everyone. I chose not to take anything else last night. I take 800 mg of Advil maybe once or twice a week at bedtime due to my TMD, so I didn't want to chance it. (Some weeks I don't need to take any. And I don't take any during the day, just at bedtime.) I took my next scheduled dose along with my antibiotic this morning at 7:00. And my doctor did tell me if my fever spiked or if the redness spread past the line she marked, I would most likely be hospitalized. So I'm taking this very seriously. I've not been to a doctor in over 5 years and it's probably been more like 8 years since I've needed an antibiotic. Guess I'm making up for it now. 

Thank you Marisa. You did not say anything contradictory to what my MD told me. She didn't say anything about Tylenol but I know my brother, who is a DDS, often recommends an Ibuprofen/Tylenol combo for pain. 

Gigi I didn't get a PM from you.  But thank you for trying to send one late last night.

I tried to squeeze it again this morning. Normally the amount of puss and fluid that comes out is beyond the imagination. Foul smelling stuff. And it hurts like he$$. But then there is some relief about 5 or 10 minutes after the really bad pain from squeezing goes away. This morning the puss is thicker and does not want to come out so easily. I could just see a tiny amount. It hurt too much to continue, so I stopped. My MD said she would not consider lancing it until the surrounding tissue (larger then a golf ball in one direction but about the size of a golf ball in another) becomes softer, kind of like the thick flesh between your thumb and index finger. It's really hard right now. Not sure if not being able to get puss from it is a good sign or something I should call her about.

So the good news is the redness has not spread. The bad news is it has not lessened either. But it's not been 24 hours yet since I had the injection. She told me I probably won't feel any better until this evening. I think I'll go back to bed now.


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## ckanen2n

Wow, Crystal - what an ordeal. I hope the infection is much better by tonight! Take care!


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## Snowbody

Crystal - I'm so sorry. I always say, with the Malts or anyone I love, "When in doubt, call your doctor." I would give a quick call and tell her how it is this morning with trying to drain it. It always puts my mind at ease when I've spoken to the doctor and then you don't worry yourself like crazy about whether it's good or bad.


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## silverhaven

So sorry to hear this Crystal. Sounds terribly painful. :grouphug: My Mum had cellulitis last year. I had never heard of it before. Take care, and 5 years is way too long not to see a doctor. You should be at least having a physical once a year.


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## edelweiss

Crystal, I hope you are feeling better today & that you will take care of yourself---life can wait! You are in our thoughts/prayers---big gentle hugs.


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## pammy4501

Two questions. Did you MD culture the drainage? Please ask about that. You want to be sure you are on appropriate antibiotics. And did she draw any blood from you? You need a CBC for a blood count. These things can become incredibly serious quickly. Sepsis is nothing to mess with.


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## Maisie and Me

Crystal,

On giving instructions to patients' with abcesses or cellulitis it is NEVER recommended to have the patient squeeze or pick at the area in question. You can introduce added bacteria and aggravate the situation, in fact the patient is instructed NOT to pick or squeeze the area. Frequent warm water soaks, yes and your medication. A lot of patients are being prescribed Bactrim DS for abcesses because a large number of cultures are coming back MRSA, a serious staph infection. You can cause a cellulitis by squeezing and irritating the area. If the abcess is not ready to be lanced very warm water soaks should
be done every 3-4 hours with a new clean cloth each time for approx. 20 min. each time to help draw out the pus.
Hope you are feeling better soon and if you see a red line extending from the area and soreness in the axillary (armpit) call the doctor immed or go to the ER.


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## gopotsgo

Crystal&Zoe said:


> Thank you everyone. I chose not to take anything else last night. I take 800 mg of Advil maybe once or twice a week at bedtime due to my TMD, so I didn't want to chance it. (Some weeks I don't need to take any. And I don't take any during the day, just at bedtime.) I took my next scheduled dose along with my antibiotic this morning at 7:00. And my doctor did tell me if my fever spiked or if the redness spread past the line she marked, I would most likely be hospitalized. So I'm taking this very seriously. I've not been to a doctor in over 5 years and it's probably been more like 8 years since I've needed an antibiotic. Guess I'm making up for it now.
> 
> Thank you Marisa. You did not say anything contradictory to what my MD told me. She didn't say anything about Tylenol but I know my brother, who is a DDS, often recommends an Ibuprofen/Tylenol combo for pain.
> 
> Gigi I didn't get a PM from you.  But thank you for trying to send one late last night.
> 
> I tried to squeeze it again this morning. Normally the amount of puss and fluid that comes out is beyond the imagination. Foul smelling stuff. And it hurts like he$$. But then there is some relief about 5 or 10 minutes after the really bad pain from squeezing goes away. This morning the puss is thicker and does not want to come out so easily. I could just see a tiny amount. It hurt too much to continue, so I stopped. My MD said she would not consider lancing it until the surrounding tissue (larger then a golf ball in one direction but about the size of a golf ball in another) becomes softer, kind of like the thick flesh between your thumb and index finger. It's really hard right now. Not sure if not being able to get puss from it is a good sign or something I should call her about.
> 
> So the good news is the redness has not spread. The bad news is it has not lessened either. But it's not been 24 hours yet since I had the injection. She told me I probably won't feel any better until this evening. I think I'll go back to bed now.


What?! And it was so eloquent too, LOL. Seriously, I don't know what happened or what is happening. I just found out someone else never got a PM from me. I know it used to work, going to have to contact ADMIN about it. Hope you are feeling better but if you have any questions feel free to PM me, I know I can at least get PMs, with your phone number and I will be happy to give you a call.

GG


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## Malt Shoppe

Crystal, I'm not a nurse, but my good friend is one. I asked her about your infection; she advised you go get it lanced because if it's thick now, it's not likely to be expelled. 
That was my thought as well; I went thru a similar ordeal a couple years ago with a sebaceous cyst that became infected. It got terribly painful and this nurse friend insisted I go to the doctor (for the 2nd lancing) and she took me herself. It may also need packing after lancing to allow it to keep draining.

The warm moist compress helps drainage but with a thicker consistency, it's not likely to drain and will become unbearably painful....trust me, I know.

Also, you might consult with your doctor about taking a Migraine Relief med (Acetaminophen/Aspirin (NSAID) & Caffeine Tablets). I take that for my back pains now/then and in 15 minutes, all 'migraines' throughout my body are gone! Excedrin makes it but so does Equate brand from Walmart.
Tylonel is not Ibuprophen, it is Acetaminophen.
My advice, get it lanced today before suffering over the weekend.


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## CrystalAndZoe

Well now dang. I'm getting really scared after reading more of these posts. I just woke up. It's time for my Advil and antibiotics. No culture was done and no blood work. I'm not 100% positive but there may be one tiny area that has a finger of red spreading out from the line she drew around the area. Earlier today I thought maybe it was getting lighter. Now I just don't know. It could be that the Advil wore off or that this always hurt and I just didn't test these areas; but it hurts to press on my sternum and it's a little tender when I press an area right in front of my armpit. Nothing hurts in my armpit area. I was told to keep the area clean and use triple antibiotic cream if I was able to squeeze it. So I've been using rubbing alcohol and a fresh cotton ball for that. I was never told to use fresh hot compresses. I've been using a fabric thing that someone made me that has rice in it. You microwave it and it stays hot for a fairly long time and has the added benefit of moisture. So I've been using that over and over again.

I was expecting not to see or feel much improvement until this evening from what I was told. Is this not correct?

I'm allergic to Sulfa so I was not given what they would normally give. I was given a ceftriaxone sodium injection. I was verbally told, and again I could have heard wrong, that it was the generic for Rocephine (sp?) 1 gm. I'm on Keflex 500 mg 3 times a day.

Gigi, I'll pm you my phone #. I don't want to unnecessarily panic and I don't want unrealistic expectations of how long this will take before I start to feel better. From my years working at the dental office, I know people that had really bad infections would be told it could be between 24-48 hours before they really started to feel better. But I don't want to let something go that should be addressed.


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## socalyte

Hi, Crystal-- I just saw this and wanted to add to the others my hope that you will start to feel better soon. 

I had an infected sebaceous cyst on the side of my breast too, and it started off pea sized and got about the size of a ping pong ball, so not nearly as bad as yours. I am also a nurse but you've been given good advice and don't feel I have a ton to add. I think the rice pack sounds good if it is moist heat, as that is what is usually recommended. Alcohol can damage tissue, so perhaps your doctor might recommend another cleansing agent to use. I completely agree with Pam that the wound should be cultured, and a CBC drawn. 

In my case, it took several days before I felt better; I know it was at least 48 hours before I could see a difference in the size. It was recommended that I not manipulate the area as that could spread the infection and damage nearby tissue.


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## Snowball Pie's Mommi

pammy4501 said:


> Two questions. Did you MD culture the drainage? Please ask about that. You want to be sure you are on appropriate antibiotics. And did she draw any blood from you? You need a CBC for a blood count. These things can become incredibly serious quickly. Sepsis is nothing to mess with.





gopotsgo said:


> What?! And it was so eloquent too, LOL. Seriously, I don't know what happened or what is happening. I just found out someone else never got a PM from me. I know it used to work, going to have to contact ADMIN about it. Hope you are feeling better but if you have any questions feel free to PM me, I know I can at least get PMs, with your phone number and I will be happy to give you a call.
> 
> GG


Crystal, I am so happy that Gigi wants you to call her. 

And, Pam is right that it is nothing to mess with ... again, I learned about that one personally. Mine started with a bad eye irritation and my internist put me on a high dose of antibiotics. However, my sixth sense ... or common sense, told me something was very wrong. The next morning I made an emergency appointment with my ENT. When I walked into his office ... I swear by my life ... he just looked at me and said he was admitting me to the hospital immediately ... and, made the call from his office! He allowed me to go home to get a few essentials ... but, when I arrived at the hospital about one hour later ... I had already been pre-admitted with a room ready ... and, the IV antibiotics and everything else began. I was in the hospital for more than a week. And, then I had to have tear duct surgery right ... after I recovered from the hospital stay and continued antibiotic treatments. Thank God I had a doctor who saw me that day. I had puss running down my cheek when I walked into the ENT's office. The whole thing had exacerbated within less than twenty-four hours ... to a critical medical emergency. My infection was close to the brain, and without finding which antibiotic would finally work for me, I could have died. 

After you talk to Gigi you should feel better in knowing that you are getting professional feedback and advice from a physician. I just know she will advise you wisely.

I don't mean to scare or alarm you with my experience. However, there are so many people that think it is silly to consult wth a doctor. I say ... it is better to see a doctor and be safe than sorry. 

You will get better ... but, please call Gigi.

Healing hugs being sent your way, Crystal.


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## Maidto2Maltese

Crystal... so sorry you are dealing with all this! I've had cellulitis a couple of times... once with added infection. Mine was located on my leg and it was horribly painful... can only imagine it must be so much more so located at your breast!

With my 'simple' cellulitis it was treated with steroid and that just about stopped it in it's tracks...then small improvement each day from then on. When the infection was 'added in' I got antibiotic added and was advised to use warm, wet, salt-water compresses to draw it out. I used gauze pads .I have to say that warm salt water sure brought that infectious '****' 'forth' in no time..and what a relief when all that built-up '****' finally got released! Till then it felt like a pressure cooker with the pain increasing by the hour... once it 'released' it felt so much better! 

I pray you will start to improve very soon!!


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## garrettsmom

Sorry, just seeing this now Crystal. I'm an RN on a surgical floor and I would really recommend going to the ED. Another poster had mentioned the need for bloodwork (CBC) and wound cultures; with which I agree. Also sounds like you may need an I&D (incision and draining). I also suspect that IV antibiotics are in order.......you should NOT be squeezing this! Too late for your advil query, but one double dose shouldn't be that harmful, other than possibly stomach irritation. I don't mean to alarm you and hope you're doing better, but your situation really sounds too precarious for at home treatment.


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## Maisie and Me

Crystal,

You are on appropriate meds at present for your situation. If you are allergic to Sulpha you cannot take Bactrim. A culture and a CBC are in order. Keep a check on the red "finger" extending from the boundries your MD drew. If it gets any larger it needs to be checked ASAP.
I hope you were able to reach GIGI for added support.
If you still have an open area on the skin please put a clean or sterile gauze pad between your skin and the heating pad so that you don't introduce new bacteria.
Some people need IV antibiotics to heal the infection. I would also recommend going to the ER.


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## Summergirl73

I hope you feel better very soon. Not to totally freak you out, but we almost lost my brother about 5 years ago. Totally healthy, big guy got MRSA. His system started shutting down FAST. We got the call that he was going in to surgery and most likely would not make it, if he did, he'd surely lose his leg. Blessedly he lived, but it was an unreal journey to recover. SO PLEASE, PLEASE get your labs drawn just to be on the safe side. Learn from my brothers experience. Be well.


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## CrystalAndZoe

I pm'd Gigi with my phone # but have not heard from her yet. I no longer have a fever but is that due to the antibiotics or the Advil? I'm watching the finger area like a hawk. I don't know if perhaps that area was missed since she drew the line with my bra and shirt pulled off to the side? It's hard to see the redness when I'm putting heat packs on it so I'm making sure to check it when I've not recently done a heat pack. It's no longer seeping or oozing. I can see the large hole or pore, but it's not seeping like it was on Tuesday and Wed. I've stopped trying to squeeze it after this morning's attempt. It was way too painful. Before I didn't have to apply much pressure to get stuff to come out. But that's a really good suggestion to put some gauze over the area. Except I shudder at the thought of getting tape off at some point if it's still this sore. I've been using the heated rice pack over a really thin t-shirt lately. I wonder if that's ok? 

There was a time this afternoon, between 5 and 7 I was actually feeling better and the pain wasn't as bad. But it's starting to hurt a lot more again. But as far as feeling achy, feverish and just plain ill, I'm better. I'm due for my next dose of Advil and antibiotic at 11:00. If memory serves, whenever I've been sick it seems in the evenings, I always tend to feel worse. Maybe that's normal?

So do you think they started out with 'typical protocol' to see if I respond to these antibiotics and if I don't, the warnings to call immediately if the red spreads past the line or my fever spikes, that is when they would do the blood work and culture? 

Thanks everyone for being here for me. I truly didn't realize how serious this was. Truth was, I was feeling kind of wimpy and that's why I was so grateful she told me not to go back to work yesterday or today. I would have felt really pathetic if I had just made that decision on my own. It's kind of scary but it helps to know you all are here to tell me when you think it's truly time to get to the ER. I hate having to go and don't want to if it's not necessary. I'd much rather just see the MD in her office.


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## garrettsmom

Crystal, I'm glad you're feeling better. I am wondering if this MD you saw in the office was an internist/primary care doc? I think your condition warrants having a surgical consult and the quickest way to that is going to the ER where you'll be seen by a surgical resident (given its a teaching hospital). Warm soaks, oral antobiotics and sterile dressings may not be enough if this needs to be surgically drained. Better safe than sorry!


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## Snowball Pie's Mommi

I could be wrong ... but, I thought a culture was important to be done, if possible, before starting on an antibiotic. I thought if a culture is taken after antibiotics have already been started ... then the culture results might not be accurate ... or, hard to determine what kind of bacteria, etc. is causing the infection. To the medical professionals here ... is this true?

Crystal, I have had you on my mind all day and this evening. I almost texted you to see if you spoke to Gigi yet. But, I didn't want to disturb you if you were resting. If you need someone just to talk to ... text me and I can call you back. I'm checking in often to see how you are doing.


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## hoaloha

Crystal, I'm just checking in to see how you're doing. Do you have a follow-up appointment with your doc this weekend? I don't know if rushing to the ER is warranted without seeing your wound. I would call your doctor's office tomorrow, if possible, to give your doc a verbal update at the least and see if she advises you to go to the ED for I&D (incision and drainage). ED physicians (or any physician at that) can do uncomplicated I&D's, does not always have to be a surgeon. Surgery consults are requested depending on the level of complexity, location of the wound, etc. 

Regarding your question about standard procedure-- let me preface this by saying there are multiple ways to practice medicine correctly. That's why medicine is both a science and an art. We know what the most common causative organisms responsible for cellulitis are. Based on that, we determine what the most appropriate empiric antibiotics would be. If there is drainage, suggesting not only cellulitis, but a possible abscess, a wound culture is usually done so that specific antibiotic therapy and isolation of the organism is confirmed. A CBC is not always absolutely indicated- we already know from the exam that you have an infection. The CBC will reflect that and it generally does not alter therapy (you are going to treat no matter what, whether the CBC looks good or not). Since I work in the inpatient ward, I do get a CBC and wound culture since my patients are the sicker ones who need to be hospitalized due to failed outpatient therapy, severe illness, etc... I get a CBC as a baseline and trend the values *in conjunction to* the clinical exam, presence of fever, etc... in order to tailor daily therapy.

Keflex is a good choice for uncomplicated cellulitis due to the most likely organisms (sensitive staph, strep). Reasons why antibiotics wouldn't work with sufficient time? 1. the antibiotic isn't getting where it needs to be. ie. if there is a enclosed abscess that is not draining because antibiotics will not penetrate the abscess wall to kill the bacteria 2. the organism is not responsive to the antibiotic choice. 

There is a rise of community acquired MRSA (methicillin resistant staph aureus) which does not respond to keflex. Bactrim (but contains sulfa) and Clindamycin are the most common oral anti-MRSA drugs that we prescribe in our community. BUT, it REALLY depends on your local drug resistance patterns which your physician should know.

I'm glad you're not squeezing the wound anymore; It sounds like an abscess since you see the "hole" or cavity left there. It's hard to know without seeing or feeling it if there is a deeper pocket of pus because the abscess cavities can often run deeper than what you see on the outside. Warm compresses work well to help promote pus drainage. I'd give your doc a call in the AM and see what she advises. But if you have more significant pain, fevers, or spreading of redness, that's when the ER may be in order. I hope you feel better soon!!! :hugs:


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## hoaloha

Snowball Pie's Mommi said:


> I could be wrong ... but, I thought a culture was important to be done, if possible, before starting on an antibiotic. I thought if a culture is taken after antibiotics have already been started ... then the culture results might not be accurate ... or, hard to determine what kind of bacteria, etc. is causing the infection. To the medical professionals here ... is this true?
> 
> Crystal, I have had you on my mind all day and this evening. I almost texted you to see if you spoke to Gigi yet. But, I didn't want to disturb you if you were resting. If you need someone just to talk to ... text me and I can call you back. I'm checking in often to see how you are doing.


A culture is important to try and get prior to antibiotics because Antibiotics can quickly sterilize blood, urine, CSF, etc... Wound cultures with abscesses can be hit or miss though because even if a patient is on antibiotics, the meds aren't penetrating the abscess well. Usually, if there is a ton of pus drained out and sent for culture, it usually will grow something. But, you're right, Marie. The best and most valid culture is one that has been obtained PRIOR to antibiotics.


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## pammy4501

garrettsmom said:


> Sorry, just seeing this now Crystal. I'm an RN on a surgical floor and I would really recommend going to the ED. Another poster had mentioned the need for bloodwork (CBC) and wound cultures; with which I agree. Also sounds like you may need an I&D (incision and draining). I also suspect that IV antibiotics are in order.......you should NOT be squeezing this! Too late for your advil query, but one double dose shouldn't be that harmful, other than possibly stomach irritation. I don't mean to alarm you and hope you're doing better, but your situation really sounds too precarious for at home treatment.


True should have been done prior to abx adminstration. But if the fever continues or spikes back up, cultures are in order as well as CBC.


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## CrystalAndZoe

Thank you so much Marisa. I just don't think I can bring myself to go to the ER unless it's truly necessary. I lost my Dad at the ER in February and I just don't want to go there again unless I really have to. I know...I'm being irrational about it. But I can't help it.

The area around the hole is rock hard and that is where my skin is still the deepest red. I'm estimating it's about 2" away from the hole around 3/4 of the hole. The hole is maybe 1/4 to 1/2" away from my sternum so the swelling and hardness stops there. But my sternum does hurt to press on. The wider area of redness that the Dr circled is huge and extends to almost half my breast. But I do think that area isn't as dark red anymore. The area where my skin is rock hard is still really an angry red. Someone said she could see how swollen the area is through a really loose fitting shirt.

So is it not true that you don't want to lance it when it's rock hard like that? I begged her to lance it on Thursday and she said she wouldn't until that hard stuff got softer, like the fleshy area between my thumb and index finger. She told me that she wanted to see me if the redness spread past the line or my fever spiked. Or if it was starting to heal but came to a large head and lump that wasn't going away. That was when she would lance it and drain it.


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## KAG

Oh sweet girl I'm so sorry you're going through this. My heart and prayers are with you and I'll be lighting candles for you later today. 

I know that rice pack thing you're talking about. I'm glad you're wearing a tshirt while using it. Please God don't burn your skin with it. 
Xoxoxoxoxo


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## gigigirlz

Just now seeing this .....really have no answers for you....but please...feel better soon...


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## mysugarbears

Crystal, it looks like some great answers. I was wondering if you could maybe use an epsom salt solution to help out the pus, it seems that salt water would help with that. I hope that you start to feel better soon and will most definitely be keeping you in my prayers. :hugging:


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## Maglily

Hi Crystal how are you doing today? can you see or feel some improvement? ....I think you are feeling tired at night because after all day of monitoring this and worrying, plus just fighting the infection...you're worn out, not necessarily that it's worse. that's as much medical advice that i can offer : )
I hope you're feeling better today missy.


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## Snowball Pie's Mommi

Good morning, Crystal. I'm thinking about you and looking for an update. Of course, I am praying that you are beginning to feel better.

Love and healing hugs for you, sweet Crystal.


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## CrystalAndZoe

Well I think I'm seeing some improvement. The larger red area that the Dr drew around is definitely getting lighter. It's not receding. I guess I kind of expected to see it recede. But I'm happy with lighter. And the finger that was coming past the line has really faded. I waited to take my Advil to make sure I could tell if my temp was being held at normal due to that or the infection getting better. And my temp was still normal. The hard area is still an angry red. And it's still hard. And it hurts just as much as it did before. I was hoping to get more relief from the pain at this point. It's just now 9:00 so I'm getting ready to call my Dr to make sure I should not be changing anything at this point.

So I would like to try the salt water that's been suggested. But how? A hot washcloth will cool off really quickly. It's too high up on my chest to soak in a tub. And is that safe? To soak in a tub with what I've got on my chest? Any suggestions?


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## Maisie and Me

Good Morning Crystal! I am going to PM you.


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## Snowbody

Crystal - I don't have any answers but glad you're calling the doctor and also that you seem to feel better this morning. Just wanted to let you know I've been thinking about your and praying for your health. :wub:


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## edelweiss

Wishing you rest in the middle of this issue Crystal. . . not a given!


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## mysugarbears

Happy to hear that you may seeing some improvement and hopefully by now you've spoken to your doctor. With the salt water you could put the cloth soaked in salt water where you need it and put your rice pack on top of a thin towel and let it sit there and that should keep it warm enough to help draw up the pus. Keeping you in my prayers that your on the road to recovery. :hugging:


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## Bailey&Me

Crystal - I'm so sorry I've missed this until now. Glad to read that you're seeing some improvement - hope you continue to feel better quickly!!


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## aprilb

I'm glad you are improving, Crystal..((hugs)):grouphug:


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## Snowball Pie's Mommi

Crystal, are you okay? Please update us if you can. I did try to text you but my iphone is mal functioning ... so, my text didn't go through to you.

I've been thinking about you a lot and hope you are feeling better.


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## Snowbody

Checking in on you, Crystal. Hope you're better.:grouphug:


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## edelweiss

:Waiting::Waiting:
:wub:


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## CrystalAndZoe

I think I'm going to live.  The large patch of redness that was circled is almost gone. I still have a very hard, hot and very red lump that is maybe 2" x 4" that is still extremely painful. In fact, it may be hurting a bit more. It comes and goes. I'm thinking it's pressure that's making it hurt worse. But I'm physically feeling better. I'm even getting dressed today and all the babies got their faces washed and hair brushed. They've been loving being messy all week but I couldn't stand it any longer. So I think that's a sign I'm feeling better.

I got a phone call from Michelle and Gigi and both were so great to talk to. They gave me excellent advice and I can't even begin to express how grateful I am that they took time out of their busy schedules to call. I'll be calling my Dr. again Monday and hope they can see me that day. I'm thinking that what Marisa said in one of her posts, and also what Gigi said on the phone, that the antibiotic can't get to the infection in that really hard lump. So I'm hoping they can lance it and drain it for me on Monday. I'm finding it difficult to sleep. I can recline without much pain, but I can't even attempt to lay on my side. And starting yesterday, it hurts to lay on my back. It's like there is too much pressure there or stretching or something. And I truly do think the salt water hot compresses really helped. Continuing that today. Thank you again Michelle for giving me some great tips on how to do that.

Everyone has been so wonderful to help me through this. And to think, I was only asking if it would be harmful to take a double dose of Advil. Who knew a Maltese forum would be such a great place to walk me through this! I have to confess...when I want great advice on ALL types of things whether they are Maltese related or not, I tend to come here first. :thumbsup:


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## zooeysmom

Crystal, I'm so glad you're feeling better! Yes, that is a good sign if you have the strength to groom your babies! 

Continued healing,


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## Snowball Pie's Mommi

Well, as long as Gigi and Michelle think you will be safe until tomorrow, okay. But, you still have today and tonight to keep an eye and feel on things. I'm still hearing you say that you are feeling considerable pain. We all love you, Crystal, and just want you well.:tender:

And, Snowball wants me to tell you that he loves his Auntie Crystal, too ... and, wants you to get better soon, so that you can send him those little football and leave treats.:wub: I explained to him that he has to be patient. 

I'll be checking in for updates, Crystal. We love you.:wub:


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## cyndrae

Just reading this today. Crystal I am happy you will be seeing the doctor tomorrow.
I know my mom has been fighting an infection/abscess in her lungs all year. At the ER you do get different eyes on the problem and it seemed when we went to the ER we ended up with the specialist who really took control. 

You are on my mind and in my prayers today.


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## silverhaven

So pleased you are feeling better Crystal, and that we had such knowledgeable people on here regarding your issue. Take care, take things slowly and give yourself a chance to heal. :grouphug:


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## MalteseJane

Checking in every day to see how you are doing. Sorry I am of no help here. What you have sounds awful. :grouphug::grouphug::grouphug:


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## Maglily

hey Crystal I'm glad you are up to grooming the babies, yes definitely that's a good sign that you are on the mend. I'm glad you asked for advice on the advil too : ) I would hate to think you are suffering this out without it and the peace of mind that you are on the right track.


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## mysugarbears

Glad to hear that your feeling better and it's great that you got a call from Michelle and Gigi and that they were able to help you. Hopefully you can into your dr's tomorrow and get it lanced so that your not feeling so much pressure and that the antibiotic can get to it. :hugging:


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## edelweiss

Oh yippeeeee. . . I think! I hope. I pray! 
It sounds mostly encouraging, and maybe tomorrow will bring even better news.
Please know we care. :wub:


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## CeeCee's Mom

I hope you feel better tomorrow and get yourself to the doctor in the morning! I want you back at work and feeling fine as frog hair, do you hear me!!!!! LOL!!! Take care and sending prayers and love to you!!!!


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## aprilb

Crystal, I'm so glad you are feeling better..I do agree that you should get that thing lanced..I am praying for you..:wub:


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## hoaloha

Crystal, I'm so glad you're feeling better overall! It sounds like the antibiotics have helped the overlying cellulitis. Hopefully, most of the inflammation from the cellulitis has calmed down so that the abscess can be easily incised and drained. Keep us posted


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## Johita

Praying for you, Crystal. Hope you are 100% better soon.


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## Snowbody

Crystal - glad to hear that it sounds like it's getting better rather than worse but I am happy you'll be talking to the doc tomorrow. I still keep thinking that seeing a specialist might be the best route. Just to play it safe. Let us know what you hear.


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## KAG

Good luck tomorrow sweet Crystal.
Xoxoxoxo


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## gigigirlz

thinking about you....hugs....


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## Bailey&Me

Hi Crystal - checking in to see how you are feeling this morning. Hope you're doing even better!


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## Snowbody

Crystal - checking up on you too. :smootch:


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## CrystalAndZoe

Aw thanks. Nothing new to report. Tried for over an hour to get through to my Dr. office. Guess Monday mornings are super busy. Waiting to hear back from the Nurse Practitioner. I guess it would be her I would see today??? I don't know. Maybe she's just the one to call me back.


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## garrettsmom

Crystal, I know you have an adversion to ERs and can't say I blame you-not a fun place to be; but at this time I believe going there to get evaluated by an ER doc will lead you to receive an I&D by a qualified doc or PA with surgical expertise, not a nurse practitioner or GP. As an RN I see people treated all the time for abscesses and an I&D and IV antibiotics are pretty standard treatment. Don't mess around with your health waiting to get into a doctors office who may just send you to the ED anyway.


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## Snowbody

I also would try to get to a specialist. Is your internist the gatekeeper in your medical plan or can you go to anyone?


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## CrystalAndZoe

Well I saw my Dr. again today. It's still not ready to be lanced and drained. She said she could feel some puss but it's mostly still rock hard. She could attempt it if I really wanted her to but she recommended waiting a couple of more days. She also said for as large of an area that I have and as bad of an infection as it was (yes it was abscessed, but that's the first I had actually heard it), I could expect to have a lump for at least a month. She again offered to prescribe me Vicodin but at this point I'm going to have to just suck it up and get back to the store. I have inventory that I need to order. And I don't think I should be on that while at the store. The pain is getting better thankfully so maybe in another day or so I'll feel much better.

Still can't figure out how this happened so quickly and to this extent so fast. I didn't notice anything until Tuesday late afternoon/early evening. Lesson learned. If you have a large pore that routinely fills up to be like a blackhead, let it go!


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## Malt Shoppe

Michelle, I wish I could agree with your doctor....but I don't. I had a similar experience and was in horrible pain until the infection was lanced. It then had to be packed with a strip of gauze to maintain draining. It's the pressure of that lump that is causing you such pain and is totally unnecessary.

This was a sebaceous cyst that was infected and required a outpatient visit to the hospital to have it removed, much to my unhappiness. I wanted it done in a doctor's office, but no can do.

I believe that infectious pus can leach into your system, not a good thing. I'm shocked your doctor would not require it to be lanced. I don't see how a rock hard lump is going to work itself out.

Please consider going to another doctor and see what that opinion might be.


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## Malt Shoppe

OOPS!....sorry, I meant Crystal.....terribly sorry for the mistake! :w00t:


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## pammy4501

I have to agree with the above posters Crystal. Can your GP refer you to a ID doc? Or a general surgeon?


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## CeeCee's Mom

Crystal, please get a second opinion so that the pain will go away. I think it should be lanced also. If you have a good surgeon in town, let him look at it. I care for you so much and I just want you better!! I had a swelling on my collar bone and I went to a surgeon. Now mind you, I did not have any pain but it was about as big as your ring finger to the first joint. He looked at it and he felt like it had to come out. He always make you another appt. and you go back in. He looked at his nurse and said to me, "Take your jacket off and lie down on this table". I was scared, he came back in and injected the site and took his scapel and cut it out. He then proceeded to take the scapel and cut it lengthwise and said look at this, nothing to worry about, it is a sebaceous cyst and it needed to come out or you would have woke up one morning in a lot of pain. I did not feel a thing and he was so good, you cannot tell that I have a scar there now. So, please go to a surgeon's office and see what he will say. If he concurs with your doctor, we will all stop worrying about you being in so much pain.....Mama has spoken and I still love you!!!!!!


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## Maisie and Me

Crystal,

PLEASE PLEASE PLEASE get a second opinion! 
:smootch::grouphug:


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## Snowbody

Think this way, Crystal...what if it was Zoe ,Jett or Callie who had something like this and was in pain. Would you accept the vet waiting or would you take one of them somewhere else for another opinion since they're in pain? I think you need to see someone else too. If they agree, then they agree but better to get rid of this if there's pain.


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## gopotsgo

garrettsmom said:


> Crystal, I know you have an adversion to ERs and can't say I blame you-not a fun place to be; but at this time I believe going there to get evaluated by an ER doc will lead you to receive an I&D by a qualified doc or PA with surgical expertise, not a nurse practitioner or GP. As an RN I see people treated all the time for abscesses and an I&D and IV antibiotics are pretty standard treatment. Don't mess around with your health waiting to get into a doctors office who may just send you to the ED anyway.


Sorry guys but cannot resist the urge to do a little educating. An abscess, does NOT require IV antibiotics, it does not even require oral antibiotics. Standard treatment for an abscess is I&D and nothing else. There is tons of research/articles to back this up. Any ER doc or surgeon worth his/her salt will know this. What my colleagues sometime do is called "overkill" by prescribing antibiotics after an I&D. This practice is what is partially responsible for the drug resistance we see today. That being said, our dear Crystal, by her description, has an abscess with overlying cellulitis, a totally different animal. This condition does require antibiotics but not necessarily IV antibiotics. 
Dear Crystal, I hope you are feeling better and do feel free to contact me if you have any further questions. One last thing, as I mentioned to you, a deep abscess may not demonstrate fluctuance, hence the needle aspiration I mentioned to you to guide further intervention. And it is true that many Internal Medicine docs may not feel comfortable about abscesses just because they don't have the training in it like surgeons or ER docs do. 
One last thing, NPs have a lot more education and training than PAs do. While I have worked with many good PAs, I would choose an NP over a PA to back me up any day of the week.


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## Maisie and Me

:goodpost:GIGI!


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## garrettsmom

Gopotsgo, I'm not debating the worth of NPs vs PAs, there are great ones and bad apples in each group; I simply am saying that there are PAs specifically trained to perform surgery- they're called surgical PAs. You will never find a NP in an OR because that is not their domain. And for what it's worth, at least in my hospital/region, our surgical PAs are far more reliable and skillful than even our surgical residents. I would imagine a good NP worth her salt would send Crystal to a surgeon ASAP.
I'm not a physician and haven't seen the patient so I obviously can't say if IV antiBx are necessary, just in my experience caring for patients with similar sounding abscesses, they typically are..... And obviously don't see it as overkill.


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## Katkoota

I wish you well, dear Crystal :grouphug:


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## CrystalAndZoe

First off let me start by saying how lucky I am, and how lucky we are as a community, to have such wonderful, caring, loving and knowledgeable people here. You have no idea how much all of your thoughts, concerns, care and guidance has meant to me. Especially since I've been MIA for quite awhile. Thank you doesn't even begin to scratch the surface at what I want to express.

I'm truly feeling better. The pain is still there, but significantly less today. I feel like I turned a corner today. When my Dr. explained why she preferred to wait a couple more days, it just made sense. I guess by doing it yesterday I ran the risk of perhaps having to have it repacked a couple of times and even having the chance of having to do the whole procedure a second time. And in a round about way it could actually slow down the healing process. It was my decision, but when I asked her what she would do if it were her, she said she would give it a couple more days.

Gigi I couldn't remember the words, needle aspiration. So I didn't say anything about that to her. But I'll have it written down for when I go back. 

Thank you again everyone for caring so much!!! It's been really a crummy year and knowing I have people care about me really helps. :heart:


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## Snowbody

Glad you are starting to feel some relief, Crystal. I saw that you're back at work too. Hope that it can be taken care of and that you'll be fine again.:grouphug:


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## Maglily

I hope you are feeling even better today. yes, we are lucky to have this place Crystal and even when you are MIA you're never far from people's thoughts. I'm sure I speak for many about that.


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## Matilda's mommy

Crystal, I have thought of you so many times and have prayed for you, it has been a bad year for you, but when there is darkness you know the SON is about to shine on you even more. He's with you even in those dark days and promises to be with you always.
I will continue my prayers for you and for you mom. I hope you feel so much better tomorrow. I love you


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## Matilda's mommy

just checkin in Crystal, how are you feeling?


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