PMR & Cellulitis

[GreatGranny4]

Hi, some of you may remember that I posted a while back asking for tips to cope with long haul flights. Well, I arrived in Australia 6 weeks ago and didn’t have any problems after the flights, I just took an extra dose of Pred as suggested.

However, two weeks ago I developed cellulitis in my left leg, I haven’t had any injuries or broken skin, but I am now on my second lot of antibiotics as the first didn’t really do anything. I’ve also had an ultrasound to check for a DVT and thankfully that was clear. I’m now waiting for results from blood tests but wondered if the PMR could affect my response to the antibiotics or if anyone could suggest anything that might help. I have another two weeks here before flying home. Thank you.

[PMRpro Ambassador]

The PMR itself not really but the pred might suppress your immune system and make it harder to fight off the infection. Paradoxically though, a short course of high dose pred has been shown to shorten the duration of episodes of cellulitis.

Cellulitis can be a long-lasting problem so I hope they can get it under control.

You may not have been aware of a break in the skin but it need not have been much at all - is your skin thinned due to pred?

[GreatGranny4 in reply to PMRpro]

Thank you PMRpro for replying. I think my skin has thinned as I bruise easily and often have purple marks, mostly on my arms, if I catch or bang myself and sometimes without realising I‘ve done anything until the marks appear.

Do you think I should increase my pred dosage? I’m on 10mg which I’ve had problems tapering down from so the rheumy told me to stay on that dose until I get home and have a PET scan.

[PMRpro Ambassador in reply to GreatGranny4]

Difficult to say and you should discuss it with the doctors looking after you. I assume you did tell them you are a long term pred user? The doses usually used in cellulitis are much higher, more GCA levels. I'm not sure how Sick Day Rules would apply here but the Addison's Society says a maximum dose would be 10mg so theoretically you should be fine.

[GreatGranny4 in reply to PMRpro]

I did tell them I was on pred and they knew all about PMR. They asked if I’d declared it on my travel insurance, which I had, as they wanted to do blood tests and some were the same as for PMR and they wanted me to be able to claim the cost back.

Thank you for your help it’s very much appreciated.

[Sophiestree]

I was working in Singapore and a colleague got cellulitis in her face. It was very scary. She had a daily iv of antibiotics and then tablets after that. Maybe the tablets aren't a big enough hit for you at the moment.

I have another friend who got it in his leg and now knowknows the signs before it gets too bad and starts antibiotics straight away.

[GreatGranny4 in reply to Sophiestree]

That must have been very painful for your colleague, I hope she recovered without any further problems.

I think my second antibiotics might be starting to work, I don’t think it’s quite so red and the swelling seems less as my calf is softer. I’m keeping my fingers crossed!

[Pixix]

I know you don’t want to hear this, but I was hospitalised & on IV antibiotics each of the 4 times I had cellulitis…3 in leg & 1 in hand. It needs fast treatment in my experience. If there was a delay between you getting the problem & starting the antibiotics that could be why it’s taking longer? I have ‘just in case’ antibiotics I take when I go on holidays. Hope it works for you…soon! Sad you’re on holiday. I didn’t have PMR when I had the cellulitis, btw.

[GreatGranny4 in reply to Pixix]

Hi Pixix, that must have been awful for you having to be hospitalised each time.

We’re staying with our daughter in Australia, we came over for our granddaughters wedding, we have two weeks left of an eight week stay so I’m hoping it will be okay by the time we leave. I think the second prescription may have started to bring the inflammation and swelling down so I’m keeping my fingers crossed!

[Pixix in reply to GreatGranny4]

Yes, it was lousy, but there was no option! The tough one was my hand. My Mum had a stroke & was in hospital 2 hours from our house, & that day my hand had swelled to large grapefruit size!! The fingers had disappeared! I hid it in my pocket from my Dad while visiting, & my hubby drove home!! We didn’t get home until 10pm, & went straight to hospital. They said there was no option. We were on a visiting rota for Mum by then & luckily I was supposed to be back at work for 3 days. The staff in hospital were good, & let me telephone Dad from their office, so he wouldn’t suspect anything, & it worked!! He never knew. I’m glad you are with relatives, in a way, as they know the area & doctors etc, & can look after you. Pleased to hear that the second antibiotics have worked. I suggest you tell your Dr’s when home, I hope they’ve explained that the problem doesn’t completely go, in a way. It lies beneath the skin, dormant. I haven’t had trouble for about 20 years now!! S x

[GreatGranny4 in reply to Pixix]

Gosh Pixix that must have been an awful time for you, it’s very hard trying to protect your parents from knowing when you’re not well isn’t it? It is reassuring being with relatives as I’m a carer for my husband who has Parkinson’s and heart problems so I know if the worst happened and I was hospitalised he would be looked after. I know it lies dormant so I’ll just have to be extra vigilant in future.

[Pixix in reply to GreatGranny4]

Good that you know it lies dormant, so you can react if it starts! Yes, it was a tough time, & my Mum had complications & didn’t make it out of hospital, sadly. You’ve got your hands full, too, & yes, better for you to be with relatives just in case! Take care!

[GreatGranny4 in reply to Pixix]

Thank you for your support Pixix, it’s never easy losing your Mum no matter what the circumstances but particularly hard for you that she didn’t come home. We have just under two weeks before we come home so hoping everything will be under control by then!

[Pixix in reply to GreatGranny4]

I hope you get better in the next two weeks…& in time to enjoy a bit of holiday there! Take care, S x

[GreatGranny4 in reply to Pixix]

Thank you x

[Esradral]

I don't want to be the bearer of bad news but, I had cellulitis for the first time about 3yrs ago and I had 3 different antibiotics with no response. In the end the doc prescribed the first antibiotic again but at a stronger dose and that thankfully worked.

[GreatGranny4 in reply to Esradral]

Hi Esradral, I seem to have some improvement now, I’m on my second prescription and the inflammation and swelling have both gone down slightly so I’m keeping my fingers crossed now that it’s heading in the right direction.

Have you had it again as you put you had it for the first time three years ago?

[Esradral in reply to GreatGranny4]

Hi again, no. touch wood I haven't had it again but what I didn't tell you was that while I was in so much pain I was having great difficulty putting weight through that leg. Being already the sufferer of 2 very arthritic knees I was used to pain but this was very bad. I was rubbing loads of freeze gel into my knees and where the cellulitis was I was getting a deep stabbing/throbbing pain, it felt like it was my shin bone. The doctor thought it was the cellulitis but I mentioned possible DVT but she thought not however she sent me to the DVT clinic. Here a small blood test revealed I did have a DVT somewhere. A scan a few days later showed it at the back of my knee. But I still had this deep deep shin pain so the doc sent me for an xray and found a stress fracture... no wonder I was in so much pain! Cellulitis, DVT and a stress fracture in one leg! Anyway you have been checked out and are ok thank goodness so good luck with the current antibiotics, put your leg up and rest. Take care.

[Esradral in reply to GreatGranny4]

Hi again, no. touch wood I haven't had it again but what I didn't tell you was that while I was in so much pain I was having great difficulty putting weight through that leg. Being already the sufferer of 2 very arthritic knees I was used to pain but this was very bad. I was rubbing loads of freeze gel into my knees and where the cellulitis was I was getting a deep stabbing/throbbing pain, it felt like it was my shin bone. The doctor thought it was the cellulitis but I mentioned possible DVT but she thought not however she sent me to the DVT clinic. Here a small blood test revealed I did have a DVT somewhere. A scan a few days later showed it at the back of my knee. But I still had this deep deep shin pain so the doc sent me for an xray and found a stress fracture... no wonder I was in so much pain! Cellulitis, DVT and a stress fracture in one leg! Anyway you have been checked out and are ok thank goodness so good luck with the current antibiotics, put your leg up and rest. Take care.

[GreatGranny4 in reply to Esradral]

Thank you. I have osteoarthritis and have had my right hip replaced and I now have problems with my right knee, the cellulitis is in my left leg so I suppose I should think myself lucky!

It certainly sounds like you really want through a lot. I hope everything has now settled down, take care of yourself.

[Esradral in reply to GreatGranny4]

Thank you Greatgranny4 you take care too. X