Foot injury - advice? {It’s a blood clot}

Oh dear. I’m going to invoke @Qadgop_the_Mercotan so he’ll get a notification. I don’t know much, but I know cellulitis is not a good thing.

That was my take. The radiologist called it out as a “residual” thrombus, which makes me think this is an expected thing after a ‘primary’ thrombus. I’ve tried googling that – nothing but scholarly abstracts.

Warning, I only reviewed the last 10 posts or so.

I can’t comment much on the rash, though I do think perhaps a small punch biopsy can help resolve issues if they persist too long and don’t respond to prescribed treatment.

And it sounds like your clots are resolving normally as expected. Residual thrombi that low down in the limb are not really at risk to break free to travel or cause problems.

@Squeegee, how are you doing now?

Hi, @nearwildheaven , thanks for asking after me. I’m going to go back to urgent care to ask after my cellulitis this afternoon. It’s certainly better but the leg is still pink and itchy; I’d think after 8 days on Keflex things would be more resolved. It seems like the antibiotics are beating it back, not curing it. I’ll post an update after.

Glad you checked in.

Sometimes your doc needs to switch antibiotics. One time my late husband had a lung infection and one doc put him on an antibiotic. When he went to his primary doc (a nephrologist, because my H was a kidney patient), he immediately changed the antibiotic, saying, “That’s not the right one for a lung infection.” Sometimes a doctor will throw a “broad spectrum” antibiotic at an infection thinking that will take care of it, but there might be one that’s more targeted. I have hereby exhausted my knowledge of antibiotics.

It’s not always needed, but in some cases, it’s useful to culture the infection to determine what antibiotic will work best.

I guess that’s what @Qadgop_the_Mercotan was getting at, several posts above, mentioning a punch biopsy?

Yeah, a quick google makes me think that’s exactly what he was suggesting. Always nice to know my thoughts are in line with an actual doctor :slight_smile:

It’s worth mentioning it to your doctor for discussion, at least.

Sometimes, the infection is beaten back, but the underlying tissues are badly damaged and need time to heal, which they can’t do if there’s an active infection. Glad you’re doing better.

Whelp, this UC doc was pretty dismissive that my infection was lingering, suggested the color of the leg and discomfort was a combination of the damage from the infection plus puffiness from my residual clots. Didn’t really do more than look at how the legs compare visually.

Next up - Hematologist visit! This doc was a blood specialist, the idea is to determine how long I should be on blood thinners and how in heck I got a clot in the first place. I just got back from visiting him, nice guy and quite helpful and clarifying.

Key takeaways:

  • If this is a provoked clot, then I’ll be on blood thinners maybe 6 months. If it’s unprovoked, maybe a couple of years, maybe forever. We spent most of our time on this, but also lots of discussion of what I’ve been through the last 2 months plus general health.

  • He thought because of what I do and how I work, probably I was dehydrating myself during the day. It’s true: I’ll drink 3 cups of coffee in the AM, then nothing until the evening. His point is that dehydration thickens/makes my blood less viscous, which is a risk factor in clotting. He wants me to drink 40 ounces (!) of water during the day going forward.

  • Because of my dehydration and sitting occupation (software engineer working from home) he thought that was enough to call this ‘provoked’ and would be comfortable with a shorter period on the blood thinners, 6 months or so.

  • He also said I should be wearing compression stockings RFN and sent an order to a local pharmacy that specializes in such things. I’ll get over there in the next couple of days. He did say most people have trouble taking the compression stockings for long periods of time and urged me to do my best for a few months, especially if I do long travel (which I plan to - Thailand in December, woot!).

  • He didn’t know what to make of the ongoing leg rash / scaling / itching. Agreed the color was a bit startling, but just recommended more steroid cream (re-upped my prescrip) + benadryl for itching. I finished the antibiotic round for cellulitis this morning.

That was it. I’ll see him again in March.

Forgot to add - The hematology doctor was comfortable enough with my medical history to not do extensive blood panels. He said they’d look for genetic markers for clotting risk, but with my family history (no clotting in close relatives) he didn’t see the point.

I can now throw in my two cents’ worth of non-professional blathering.

The cellulitis could be fungal. You could add a good antifungal to your steroid cream applications.

Re: compression stockings. They are medieval torture devices, inspired by Satan himself. A bitch to put on, a bitch to take off! However, wear the damn things on your trip to Thailand, and also on the return trip home. They could literally save your life.

The daily intake of water could save your life, as well. You don’t have to guzzle the entire 40 ounces in one sitting! 40 ounces equals 2.4 of those common 500 ml bottles of water. Not really very much at all.

~VOW

You’re a good patient. But more importantly, you’re allaying the worries of the Dopers who are following along. It’s all about US. :slightly_smiling_face:

As @VOW said, the compression stockings are hard to put on, BUT you can get them with zippers. They come in different “strengths,” so make sure you get the right level of pressure for you. Lest your head explode.

Following Thelma Lou’s advice, when you get your first pair from the fitter at the drugstore, carefully note the compression strength prescribed and ask for the measurements they take.

Then order further pairs online, where they are much cheaper and can be found in much more fun and fashionable styles and colors. I used to order from these folks for my home care nursing clients and was never disappointed. Try shopping their sale.

Take good care of them. Either hand wash and hang to dry or machine wash on cool but never, never, never put in a dryer, even on low.

It is sometimes easier to put them on in bed first thing before you get out of bed, that’s when your legs will be the least swollen and therefore it’ll be marginally easier to manhandle them on.

Good advice, and thanks to you and @ThelmaLou for the online ordering advice.

I’m thinking I’ll order some pairs at a slightly lesser “strength” that maybe I can tolerate longer, and alternate those with the “stronger” socks if it’s difficult to tolerate these things for long periods.

Yes, airplanes are clot-inducing. Do everything you can to avoid clotting on the plane.

And 40oz of water? I’m sure i drink that much, just because i enjoy drinking. Huh. I have 12 oz water and maybe 10oz of coffee or 20oz of tea with breakfast. (If i make tea, i brew a pot.) Oh, plus a lot of milk in my cereal. And i have another 12oz with lunch. And 12-24oz with supper. And i often just drink some water if I’m bored, or want a break, or…

I guess it’s good that i enjoy water. If i drank that much soda I’d be sick, i bet.

Me and hematology doctor had a conversation about fluids. He counts water as water. Coffee, soda, anything else doesn’t count. Drink 40 oz of water. It seemed a bit silly to me, but I’ll do it. Hell, my lung clots could have killed me, whatever you say doc. I was quite disappointed that beer wouldn’t count :slight_smile:

Coffee, tea, pop, beer, etc., all require water for your body to digest/process/metabolize/excrete, thereby using up some of the water in the beverage.