Cellulitis and a leg ulcer. R.A. related?

I have cellulitis and a leg ulcer very badly and am worried about it as it doesn't seem to be healing up. I was taken into hospital at the beginning where I was given antibiotic infusions on a drip. After two days I was allowed home (because of being safer at home than in hospital) and a nurse came out for four days to give me more infusions. Then I was seen at the hospital again and after tests I was discharged but given oral antibiotics to take. I now have a nurse coming twice a week to change my dressings.

The ulcer looks really nasty and is still discharging and the nurse has arranged for me to have someone come out on Monday to give me another Doppler scan as the doctors' surgery appear to have lost the results of the earlier one I had done there. The nurse says that she thinks I will then be put on compression bandages.

It is all making me feel like and old woman and if I have to wear the bandages all the time, it is ok now when trousers cover them, but will be horrible in the summer when it is hot and I like to wear skirts, dresses or cropped trousers and the bandages will show under them.

I suppose my question is does anyone else have this horrible illness and is it related to R.A. at all? The nurses don't seem to know and getting to actually speak to one of the doctors at the surgery is now impossible and the receptionist just relay messages to and from them. As to rheumatology, it is a case of always being fobbed off by them as they don't seem to know anything I ask them.

I realise you are not doctors but anything that anyone knows will be helpful to me.

Thank you for reading all this.

[helixhelix]

Have you talked to your rheumatologist about what is the best RA treatment for you to be on right now to give the ulcers the best chance of healing as quickly as possible?

RA doesn’t cause cellulitis or leg ulcers, but can make you more vulnerable to get them. Especially if you are on biologics - but I think you are on DMARDs?

So I do think you need to push hard with your rheumatology team and ask them very directly about the implications of this for your RA. You need to tell them that you have low blood oxygen too, as well as cellulitis and an ulcer.

[Hidden in reply to helixhelix]

Thank you for your answer Helix. I think I will do as you say and ring the rhuematology nurses and explain to them what has been happening since I last had an appointment (by telephone) in October. I have been off my RA medication since this all started. No, I am not on biologics but on painkillers and Mtx, leflulamine (not spelt right) and hydroxy. My attacks of having low oxygen levels have been explained now as one of the new GPs at the surgery said that because I have an essential tremor, the gadget that you put your finger in to measure sats has difficulty focusing on anything so it keeps going up and down all the time and not showing a true reading.

[helixhelix in reply to Hidden]

Well that’s a relief that simple explanation for the SATs! Ulcers are not fun, so i hope your GP is on the ball. But won’t hurt to tell rheumy too and put more pressure on them to consider what yoi could take for RA as you really don’t want this turning worse and have a flare at same time! .

[Hidden in reply to helixhelix]

Thank you for answering me helix. I think I will have to ring the rheumy nurses to see what they say about it. The thing that annoys me is that my legs, feet and ankles have been swollen for over two years now and have been discoloured to the point of being a very deep purple at times. I have been to see my GP about it several times over the years it has been happening and none of them seem to have had a clue as to what it was. One doctor called in another one who was said to have an interest in dermatological conditions but she looked at my legs and said she had never seen anything that looked like that before and they both just said to go back if it got any worse. It all came to a head at the beginning of November when something that looked like a blood blister appeared on the side of my leg. After a week, it burst one day while I was getting dressed and after keeping it clean and putting a bandage on it and changing it regularly for over a week, it was still discharging I showed it to a nurse who was taking my blood for a blood test. At first she said she hadn't got time to look at it, but when I insisted and she looked, her face changed and she went to fetch a doctor. I was then taken into hospital a few days later when it seemed to be spreading. I am sure that it should have been recognised and treated before it got that bad.

[DiHi]

How horrible, I’ve got a nasty leg ulcer,which is I hope getter better,certainly in compression stockings! Even brought a thingy to help me put them on! Reminds me of Nora Batty! Yes,it’s very much part of RA. My consultant has taken me off metatroxate for a month,which willHelp. Too much steroids .you can get colourful compression stockings!

Obviously keep your legs up as much as possible’ Good luck

[Hidden in reply to DiHi]

I have been using compressions stockings but they are not helping and the nurses who come to change my dressings say that I need compression bandages. I have been off methotrexate for a month now because of being on antibiotics but doing that has not made a difference at all. I put my legs up when I am sitting and also have an adjustable bed so I can have the foot end up overnight, so I feel I am doing all the right things and I am worried that nothing is helping it.

[Neonkittie17]

So sorry to hear this and there is plenty of time for it to heal before summer. A long way off yet. Glad a nurse is coming to dress it/see it and I hope it starts to heal very soon. I hope you can make contact with the rheumy. They need to know what is happening with you. x

[Hidden in reply to Neonkittie17]

Thank you for your reply Neon. I am really not sure about ringing the rheumy nurses as there is nothing to ask them about.

[Neonkittie17 in reply to Hidden]

I agree but they should be made aware of your ulcer. x

[oldtimer]

I have horrible looking legs now and I just don't wear skirts anymore. Lightweight loose trousers in the summer - there are lots of attractive ones - and heavier ones in the winter. They are so much easier to manage than a skirt too. So don't worry about the summer appearance, just getting better and healing up now. It really does seem to help to elevate your legs about heart level if you can too! Listen to music or the radio with your legs propped up comfortably, moving them to keep the circulation going. I call it cycling in the air.

[Hidden in reply to oldtimer]

Thank you for your replay oldtimer. I feel rather like an oldtimer myself just now! Yes, it is not good to worry about next summer yet as that is quite a long time away. My problem with buying new clothes is that being a size 22, I always find it quite difficult to get much of a choice.

This will make you laugh. One day when my son was four years old, I took him into a changing room as I wanted to try on some trousers. When I put them on, I didn't like them at all and said (more of less to myself) "I don't like them, they make me look really fat." To which my son's little voice piped up "Well, in actual fact, you are rather fat Mummy." I was very taken aback and said "Oh, thank you very much." To which he replied "That alright Mummy, it's a pleasure."

[Hidden]

Hi there,I am not a Dr, or even a health professional in the UK, but I do have an (some may say, un-natural) absolute fascination with wounds. The fact that this started with a blood blister concerns me and think it needs to be seen by a wound specialist and dressed by a wound CNC (clinical nurse consultant). I am not sure if the nurse who dresses them is one, but it doesn't hurt to ask them.

Also speak to your GP about a prescription for a wound healing supplement.

[Hidden]

Hi Nadine, thank you so much for your reply. I wonder why you think that a blood blister is of concern? The nurses that are coming out twice a week to dress it are district nurses so I imagine from what they say, that they do a lot of work treating leg ulcers. I have been in touch with my GP at various times but none of them have ever suggested a healing supplement. When the nurse comes out she or he takes off the covering, cleans it and put on a small piece of what looks like paper impregnated with something, which I was told was iodine at first, but last time a nurse said she was putting on a better one that was more expensive because it had silver in it.

It seems to be taking a long time to heal and of course while I was taking antibiotics I had to leave off the Mtx and Leflulamide but I am now about to start on them again. I am concerned about how long it will take to heal because I am waiting for treatment at several hospitals and don't imagine that they will do anything like that with my leg in this condition. Having asked several of the nurses how long it takes for an ulcer to heal, they have all said it could be many months.

I would be pleased to hear from you as to what your thoughts are again Nadine.