Do I need to see a GP

[Fennella02]

Good morning all

My question may seem trivial but, when on DMARDS and chronically leucopenic (WBC 2.7), how do I know whether to monitor an infection or get treatment? I have an infected big toe, it's very red, oozing pus intermittently and very painful and has been this way for a week. It isn't getting worse but it isn't getting better either. I can't get a routine appt until 27/11 so anything sooner would have to be an emergency appt but it doesn't seem like an emergency as such . . .

Any thoughts/opinions would be gratefully received.

[EOLHPC]

Good question & not trivial. In your shoes, (no pun intended), I'd be off to A&E now if my GP surgery wouldn't give me an appt in the next 24 hrs (of whichever type). Please let us know how this goes🌻🍀 coco

[Fennella02 in reply to EOLHPC]

That's actually very helpful, thank you. My surgery will always see me if I tell them it's necessary, they've always been very good like that and in return, I try sooo hard not to abuse them by being a worrywort. A localised infection that is neither worsening nor improving had left me confused as to what to do.

I will get an appt and almost certainly a course of antibiotics. Many thanks again. Clare x

[EOLHPC in reply to Fennella02]

Good👌. I can't encourage you enough because:

in the '90s I nearly died due to a similar infection in a finger from a thorn (it hadn't left a bit in my finger...it had just introduced bacteria. My finger was no more than sore, red and a bit swollen). And this was before I was on immunosuppression (so I was just living with my natural immunodeficiencies). A distracted GP gave me a standard course of oral antibiotics. The infection seemed to clear. But within a few weeks I was rushed in to A&E, by my works head of personnel, where the doc told me I'd got sepsis + the infection had spread throughout the tendons in my hand. This all happened while I thought I was clear of infection & had virtually no symptoms until the last few days before ended up in A&E. I was on IV detol in isolation on ward for 3 days. Had the infection not cleared, the medics planned to flay my hand and super wash it out with something ultra potent. Lucky me, the infection cleared. But the finger took nearly a year to recover its normal shape, size & function. A spooky experience, no?😨

Please let us know what happens next: am very interested!

XO

[Fennella02 in reply to EOLHPC]

Gulp.

I have booked an appt for later today. Will let you know the outcome xx

[Lupylass]

With a toe infection you may be able to see the practice nurse if you can't see your GP. Many nurses can treat infections and prescribe antibiotics.

[Fennella02 in reply to Lupylass]

Hi Lupylass.

The nurses are very good but ever so jumpy at the mention of immunosuppression. I never mind who I see. Thanks for the suggestion x

[EOLHPC]

How did things go at your GP surgery yesterday? Hope ok....

[Fennella02 in reply to EOLHPC]

That's so thoughtful of you to enquire. I saw the duty Dr (mine is away unfortunately). She agreed that it needed treatment so it was flushed and dressed and I have a course of Klaricid. I have to go back on Monday when it should be less acutely painful as it may need draining.

I'm silly really. I have multiple health issues yet I do everything in my power not to burden my GP. Being under 2 Rheumatologist's in 2 separate Trusts makes her very cautious and quick to send me to the hosp so I tend to ride out whatever I can at home including acute attacks of chest pain . . . Not sensible. Many thanks again for the advice and support. Your horror story was definitely the push I needed. Best wishes. Clare xx

[EOLHPC in reply to Fennella02]

Oh good. I can relate to your reluctance re the extra cautious GP thing!

You're right, though: we all need these sort of pushes now & then, even though we've plenty of experience generally. That finger excitement was a big wake up call for me, but it wasn't until immunology took the hard line it has (re me, infections, taking precautions, home lab sampling & home antibiotic kits) that I was finally given the extra shove I needed to dare urge you or anyone else to see a dr pronto.

Wishing you a healthy toe ASAP. XO Coco

[misty14 in reply to Fennella02]

Hi Clare

Thank goodness you got the right treatment for your toe. With these illnesses and drugs we have to know when to seek help urgently . Not always easy to judge!. I noticed you say you get acute attacks of chest pain. Have you had the tests for it, been given a diagnosis?. I too have suffered for six years now and been trying an anti inflammatory called Colchicine. It really has worked for me. I can have pain much reduced but it goes away whereas it used to escalate . It's a horrible problem to have so just thought I'd mention it. Take Care. X

[Fennella02 in reply to misty14]

Hi Misty

It sounds as though your chest pain is more chronic than mine. I get a couple of 'bouts' each year. Each lasts for 1 - 2 weeks, starts very suddenly and is so severe that I would have to liken its intensity to that of childbirth. Initially, I would go to my GP who was very laid back about everything and I would get codeine and antibiotics for pleurisy. My new GP is very thorough and always runs an ECG and D-dimer test before sending me to the hospital for CT angiogram to rule out pulmonary emboli. This year, I have gritted my teeth through the pain and kept my fingers crossed that it is nothing more serious than pleurisy or Costochondritis. It's a very foolish approach but I've been admitted too many times.. . .

I've not heard of Colchicine. Is it an NSAID? They try to keep me off those due to my chronically unstable HB. I'm glad it's helping you, do you have a diagnosis for your chest pain?

Thanks for writing. Take care. Clare x

[misty14 in reply to Fennella02]

Hi Clare

Hope your toe is improving. Colchicine is an anti inflammatory drug used to treat gout. It works slightly differently to an NSAID by targeting white cells. Might be worth asking your GP about. I'm glad you get less attacks than me but yours can be a more serious reason!. The pain is apalling!. The diagnosis I have is either serositis , inflammation of lung lining or pericarditis, inflammation of heart lining!. keep as well as possible. X