Don't be a drip; treat cuts and scrapes seriously, particularly if you have CLL (Chronic Lymphocytic Leukemia)

[AussieNeil]

I recently spent 4 days in hospital so that I could have twice daily intravenous antibiotics to control a hand infection which developed from a very small finger cut. The cut on my middle finger (gained while changing a bathroom tap washer) barely drew any blood, but after a few days my finger started to swell and develop raised itchy bumps. The swelling increased, moving down my finger into my palm. Oral antibiotics were unable to control the infection and I ended up being told by my doctor to go to Emergency for admission to hospital so I could be given IV antibiotics. I'm neutropenic due to my CLL and as neutrophils are our first defence against infections, I was at a disadvantage, which was further complicated by my inability to have a range of antibiotics due to presumed penicillin allergy.

Needless to say, I'll be wearing gloves more often now and I'll be taking more care to ensure any cuts and scrapes are promptly cleaned and bandaged.

Here's Mayo Clinic's Cuts and Scrapes First Aid information:

mayoclinic.org/first-aid/fi...

Updates: I've keep a bottle of Betadine handy and using that promptly has kept me out of hospital from further skin injuries.

The doctor treating me in Emergency recommended I take an oral course of Ciprofloxacin, a fluoroquinolone, along with the IV antibiotics. I declined the Cipro, being well aware of the risks associated with fluoroquinolones, which have FDA black box labels floxiehope.com/updated-blac....

A few weeks later, the celluitis came back with a vengeance and was extremely painful. My GP prescribed Cipro, which I accepted. That quickly dealt with the infection - permanently. Sometimes when your immune system is struggling, you have no choice.

After several hospital admissions for febrile neutropenia, doctors began to wonder if I really was allergic to penicillin. It's actually quite common to be incorrectly diagnosed with this. It was subsequently determined that I wasn't allergic to penicillin, which greatly expanded the range of antibiotics available to me. That can be a lifesaver.

Neil

The accompanying image is cropped out of a shot of a drip (not in my IV) that was captured in a 120 frame per second burst capture. I created an animated GIF from the cropped images which I hoped would work here, but sadly it didn't, so you'll just have to be satisfied with the one frame.

[Oleboyredw-uk]

I can vouch for Neil's view. I recently grazed my shin, actually quite a bad graze regardless of CLL or not. I washed it, applied antiseptic cream and placed a plaster on it ( well three actually to get the size I needed). Although the skin was shredded my trousers were fine and there appeared to be no material (dirt, grit etc) in the graze.

Seemed OK, checked in with GP three days later. She said it seemed Ok, but drew round the area with a ball point pen and said if the red area goes outside the line to seek medical help.

Nothing happened that I could see or feel for three more days then after a long walk I was getting out of the shower and noticed a patch of red near the graze the size of my hand. By now I was away from home for a few days so went to local GP (with my folder of notes I keep in my bag). He put me on antibiotics immediately. No reaction for one day (he'd prepared me for this) then massive reductions in area daily.

Now, a week later all looks well.

Note to self: be more careful. When doing all but fine work, so mowing lawn, woodwork, chopping firewood and gardening I now wear the gripper gloves builders use. Unfortunately they dint help this time but have saved my hands from cuts several times over the last year I'm sure.

Rob

[buckinhard in reply to Oleboyredw-uk]

I also was confused... trousers, chins and plasters..... what are plasters?

[Cllcanada Top Poster CURE Hero in reply to buckinhard]

Aka Band-Aids

en.wikipedia.org/wiki/Adhes...

[buckinhard in reply to Cllcanada]

I went to the link, interesting to know differ terms for common things. Thanks Chris !

[djgolding]

Oh! You meant SHIN - it took me a moment or two to recalibrate what I was reading. My assessment of your anatomy or trouser wearing habits became somewhat warped until I worked it out - great laugh thanks Oleboyredw - I need chuckles during my chemo phase!

[PaulaS Volunteer]

I got distracted by the thought of trousers round the chin as well....

[teakbank12]

I was picturing Simon Cowell with his trousers up near his chin!!

Joking aside small nicks & cuts do need watching.

[Newdawn Administrator]

Glad you were able to get it under control Neil. Clearly cuts and grazes have the potential to be very nasty. I've noticed any kind of minor skin lesion/spot etc. takes longer to heal than it used to. Reminder to self - top up the tetanus! (Hope that's ok when you have CLL?

I was trying to figure how big Rob's chin was that he couldn't get a plaster to fit! Lol...glad that's sorted too!

Newdawn

[RemingtonSteele]

You mean it isn't common to wear trousers on the chin? Why didn't somebody tell me this before? I was simply following Neil's fashion sense.

Neil, thanks for the post. I don't know why but I never thought about cuts and infections and how bad they can get. I'll be more careful than ever.

[Dave3579]

Neil totally agree, same goes for insect bites although I am not sure how this forum feels about anti-insect sprays like jungle formula? If I get bitten, my body overreacts and I get a red mark that gets bigger and bigger until I end up on a anti biotic like fluxocillin. I spray jungle formula on my arms and legs if I am in shorts and this stops the bites although I don't know what nasty chemicals I am adding to my system from the spray. its either that or sit indoors all summer

[Ernest2]

Big relief and very glad to hear you all ok, and on the mend.

I use gripper type gloves when gardening, etc.

Be careful though to use right gloves (and think about the job and what could go wrong) - my brother very nearly wrapped his hand round a big drill bit wearing a pair of gripper type gloves drilling a series of 1/2inch holes in wood. Had lost his hand brush so used his hand to wipe the sawdust off the work-piece, and caught the side of the still rotating drill bit with the back of his hand. Rarely wears gloves in any case but only close fitting leather now (not rigger type gloves) for that kind of job. Also more importantly got a few more brushes now - hang on wall hook in defined position if you can is a good way not to lose kit like that.

Moral is - don't let anyone rush you. Get the right stuff for the job. We usually know what's required and how we should go about it.

This summer won't help with the heat so just need to slow down, and enjoy the weather while it lasts.

And yes I need to read my own advice here

Stay safe.

Ernest

[buckinhard]

So, this is why we haven't seen you posting? So sorry, you don't need any more owies !

I usually wear leather work gloves around the horses although when I don't wear them one day my hands get pricked, scratched and just aren't as tough as they need to be. On the other hand when I regularly don't wear gloves my hands get tougher( like a pair of old leather gloves....grinning) and I can tolerate the pricks, sticks, scrapes and cracks. I'm happy you're on the mend, I can you send a pair of my ol' ranch work gloves if need be !

[buckinhard]

very nice camera work !

[AussieNeil Partner Administrator in reply to buckinhard]

Thanks for the offer of some softened by use ranch work gloves and for appreciating the camera work. I too was impressed by what I was able to capture.

The worst of the hospital stay was being tethered to the IV for about 5 hours a day (2 x 2hrs + flush time). The cannula was put into the bend of my right elbow and any flexing of that elbow stopped the drip, so I had to keep that arm extended for the two hours+. Cramps your style when you are right handed. Then the nurses had me on 4 hourly observations and insisted on using my right arm. They only reluctantly switched to my left arm when the raised arm pressure from the blood the pressure cuff made my swollen hand very painful. Eventually the cannula failed completely so I got another put into my left forearm - much better. That led to a funny incident too. By that stage my hand was less swollen, so the nurse was keen to switch back to my right arm for my next observations, forgetting that she had just removed the cannula. My hand didn't hurt when the cuff was inflated but the IV puncture started bleeding. Had to laugh.

I've been extremely ill in previous hospital stays, so I felt weird feeling quite healthy while in hospital. Good practice for chemotherapy treatment though. It was also interesting to see what I was allowed to eat as they put me on a 'Low Listeria diet' which we'd better recognise as a Neutropenic Diet.

[buckinhard in reply to AussieNeil]

I think hospital stays are the MOST boring things that need to be done ! Tellin' ya Neil, you just gotta' find fun elsewhere ! You are being brave, I can't imagine all the stuff you've had to go thru. IV's are evil nightmares, but you are keeping up your sense of humor. Some times all we can do is find the humor in our situation, that's a good thing since we are surrounded by stressors and uncomfortable situations. What did you get to eat? got chocolate ?

[PaulaS Volunteer in reply to AussieNeil]

Sorry you had such problems with the drip, Neil. Has your hand completely recovered now?

[Oleboyredw-uk]

Hah! I'd not looked at this since I posted then wondered what all the fuss was about. Someone needs to write a spellchecker that corrects text to what you meant to say instead of what you said.

That will teach me to write long appends on iPad whilst half asleep. I have now corrected the typing so hopefully it makes more sense.

Plasters are still plasters however, sorry, bandaid to me is a famous 1985 concert(loosly put)!!

Rob

[PaulaS Volunteer in reply to Oleboyredw-uk]

Now you've corrected it, your post does make more sense, Rob, but other people's responses to it are now incomprehensible!

[AussieNeil Partner Administrator]

I'm now half way through a course of Ciprofloxin after having to have my wedding ring cut off a dangerously swelling ring finger last Friday. After two weeks during which the swelling initially resolved but then began to spread and cause several fingers to begin swelling, I thought I would end back up in hospital for more IV antibiotics, which the doctor admitted would not be desirable, given my immune compromised state due to my CLL. I actually came very close to going back to hospital on Sunday, after not seeing any retreat of the infection behind the surgical pen marked up section of my hand by then. Thankfully, my hand is now much less painful but is still resolving. Ciprofloxin may have some worrying risks attached to its use, but I'm also rather attached to my hand and unfortunately don't have much in the way of alternatives available to me due to allergies to several classes of antibiotics.

I was very interested to gauge the experience with Cipro locally. I'd heard it mentioned several times when I was in the oncology/haematology ward for my IV antibiotics, so it appears to be in common use. The five doctors I've spoken to about it don't seem to be too concerned about its use. When I received my tablets (to be taken on an empty stomach) , I noticed that there was no information leaflet inserted - which I thought was rather unusual for an antibiotic that has a reputation for some serious side effects. There were however, two stickers applied; one warning me to 'Avoid excessive skin exposure to sunlight and sunlamps while being treated with this medicine' and 'Do not take dairy products, antacids, iron or calcium supplements within two hours of each dose of this medicine'. the latter warning due to these substances reducing the uptake of the antibiotic.

The prescribing doctor had to ring up for authorisation to prescribe the drug to me - which I gather is part of Australia's mechanism for keeping back certain antibiotics from regular use to slow the development of resistant bacterial strains.

When I asked the dispensing pharmacist if he'd had any feedback on side effects, he said that they knew not to prescribe it to growing children ant that I should drink plenty of water when taking it, as the drug had a reputation for causing crystals to form in the bladder and hence causing pain on urination.

So now you know why I've been relatively quiet lately...

Neil