13||0|2477|0| 0|0|0|||1||Pseudomonas %28warning%2C gross description%29|Terminus Est||05:01:12|06/28/2015|I was diagnosed this week with a pseudomonas infection of the lower legs %28yes%2C both of them%2C and no%2C I%27m not sure which strain%29. I%27ve been put on ciprofloxacin oral and gentamicin sulfate ointment%2C alongside tramadol for pain. During the initial visit I was given a shot and a prescription for sulfamethoxazole-tmp %28bactrim%29%2C which I was told to stop taking two days later via phone because it was ineffective against the culture they took.%0D%0A%0D%0AThe infected area %28primarily the left calf%29 is covered with small bumps that resemble blisters%2C and one large ulcer that has been described as a shallow split in the skin approximately an inch and a half to two inches in length%2C and I wasn%27t told how wide. The right leg is much less visibly affected%2C and much less painful as well - I suspect that it was infected via contact with the original area during sleep.%0D%0A%0D%0ASince I started taking the antibiotic %28two days ago%29%2C the pain has not reduced by any appreciable amount - it still feels like someone%27s driving a red-hot poker through the back of my leg%2C and it%27s still draining pretty heavily. I can%27t very well look at it to see if it%27s improving or not%2C meaning I have to rely on someone else%27s opinion... but to be perfectly honest I%27m not sure they%27re being entirely candid with me. Parents are like that. I%27m also having trouble with leg cramps%2C which you can imagine just makes the whole thing feel %5Bi%5DGREAT%5B%2Fi%5D%2C but that%27s somewhat beside the point.%0D%0A%0D%0AMy questions are%3A Is hospitalization likely%3F What kind of prognosis can I expect%2C given that I am on medication that cultures suggest should be effective%3F And how the hell can I reduce the pain without aggravating the infection%2C because holy fuggin%27 OW. 1|1|0|||1||RE%3A Pseudomonas %28warning%2C gross description%29|Gryphon||13:43:09|06/28/2015|I am in no way qualified to answer any of your questions%2C but%2C yikes%2C best of luck with that. About the only thing I can suggest in good conscience is that increased hydration may help you with the leg cramps part - and maybe potassium%2C but check with a pharmacist or something to make sure that won%27t interact with your meds in some way.%0D%0A%0D%0AYikes.%0D%0A%0D%0A--G.%0D%0A-%3E%3C-%0D%0ABenjamin D. Hutchins%2C Co-Founder%2C Editor-in-Chief%2C %26 Forum Mod%0D%0AEyrie Productions%2C Unlimited http%3A%2F%2Fwww.eyrie-productions.com%2F%0D%0Azgryphon at that email service Google has%0D%0A%5Bi%5DCeterum censeo Carthaginem esse delendam.%5B%2Fi%5D 2|2|1|||1||RE%3A Pseudomonas %28warning%2C gross description%29|Terminus Est||17:05:52|06/28/2015|I%27m already on potassium %28chloride%2C not citrate - not sure what the difference is%2C honestly%2C but I know I%27ve seen both%29%2C and hydration is something I%27m working on. I%27m going back in to talk to the doc on Tuesday %28would go tomorrow but I have no way to get there%29 so should know more then. 3|3|2|||||RE%3A Pseudomonas %28warning%2C gross description%29|Tabasco||12:08:35|06/29/2015|[updated:LAST EDITED ON Jun-29-15 AT 12:14 PM (EDT)]With the caveat that my area of practice is nursing homes and long term care pharmacy%2C so you%27re a bit outside my usual demographic%2C here%27s what I think.%0D%0A%0D%0ANSAIDs like ibuprofen or naproxen do have a chance of interaction with Cipro%2C so Tylenol would be a better pick for the pain assuming it works for you. The only difference between the potassiums is the amount of elemental potassium each one contains%2C you might also try a magnesium supplement as well. Hydration is definitely a good idea%2C Pedialyte or a half strength mix of Gatorade works well for that and might help with the cramps as well.%0D%0A%0D%0AAs for the infection itself I%27m reluctant to guess without knowing more%2C but the duration of therapy for a major skin infection can be up to two weeks. Two days might not be enough time to see huge improvements. 4|4|3|||1||RE%3A Pseudomonas %28warning%2C gross description%29|Terminus Est||14:30:39|06/29/2015|I do have a question you may be able to answer. The gentamicin ointment - they gave me a tiny tube%2C like 15 grams%2C and no refills%2C and told me I%27m supposed to use it every time I change the bandages. The nurse told me I%27m supposed to do that three to four times daily. How the heck am I supposed to make that tiny little tube of ointment stretch through three bandage changes a day for two weeks%3F 5|5|4|||||RE%3A Pseudomonas %28warning%2C gross description%29|Tabasco||16:44:59|06/29/2015|%3EI do have a question you may be able to answer. The gentamicin %0D%0A%3Eointment - they gave me a tiny tube%2C like 15 grams%2C and no refills%2C %0D%0A%3Eand told me I%27m supposed to use it every time I change the bandages. %0D%0A%3EThe nurse told me I%27m supposed to do that three to four times daily. %0D%0A%3EHow the heck am I supposed to make that tiny little tube of ointment %0D%0A%3Estretch through three bandage changes a day for two weeks%3F %0D%0A%0D%0AWell%2C the short answer is that you don%27t%21 %3A%29 Most likely they just meant to give you enough to make it until your primary doc could follow up.%0D%0A%0D%0AYou are only supposed to use a thin smear of it at each change though%2C as I%27m sure they said. Laying it on thick doesn%27t help it work. 6|6|5|||1||RE%3A Pseudomonas %28warning%2C gross description%29|Terminus Est||02:10:12|06/30/2015|Problem is%2C this WAS my primary doc. Same one that won%27t give me pain meds because%2C and I quote%2C %27You fit a demographic that%27s known to abuse them.%27%0D%0A%0D%0AOnly reason I can think of they did it this way was because the ointment and second antibiotic were actually prescribed after I had left and the cultures came back. I was supposed to go back early this week%2C but... well%2C money. I can%27t go in til Wednesday.%0D%0A%0D%0AThe nurse did give me something to think about though - %27What%27s more important - keeping your legs or an overdraft charge%3F%27 7|7|6|||||RE%3A Pseudomonas %28warning%2C gross description%29|Tabasco||21:06:00|06/30/2015|Well when you put it that way... 8|7|6|||||RE%3A Pseudomonas %28warning%2C gross description%29|Proginoskes||11:46:04|07/03/2015|This immediate situation isn%27t the time for it%2C but I%27d say that the refusal to give you pain meds would be a sign to start seeking out a %5Bem%5Dnew%5B%2Fem%5D primary physician. It%27s not like they%27d be giving you opiates%3B and anyway%2C demographic profiling is %28if it%27s a physician doing it%2C I%27d imagine quite literally%21%29 criminal. Or inviting litigation%2C at the very least. %22Refusal to provide appropriate care based on discrimination.%22 9|8|8|||1||RE%3A Pseudomonas %28warning%2C gross description%29|Terminus Est||10:35:06|07/04/2015|I had to go to the ER day before yesterday for an unrelated condition %28ridiculously bad gout flare%2C literally could not walk%29. They did more blood work%2C and put me on YET ANOTHER antibiotic%2C this one in addition to the cipro primary doc gave me. This after taking two blood cultures and a couple vials to test white count and uric acid count %28both 11.4k%29 and utterly failing to hit a vein the first time while I sat there and hyperventilated while watching them dig around with the needle. Newly discovered phobia%3A Needles.%0D%0A%0D%0AAs for the pain meds%2C primary doc has me on tramadol. She said she can%27t put me on anything stronger because of me fitting the demographic - bearing in mind that anything much stronger actually IS starting to edge into opioid territory. Regardless%2C I will be bringing this up with her next time I actually get to speak with her for more than a minute at a time %28she has the habit of poking her head into the room and telling a nurse to take care of whatever the obvious problem is%2C without ever really stopping to speak to me...%29 10|9|9|||||RE%3A Pseudomonas %28warning%2C gross description%29|Proginoskes||11:40:16|07/04/2015|Oh%2C I had gotten the impression that your primary MD was refusing to give you prescription pain meds of any kind%2C not that what she prescribed was proving insufficient. That makes the issue significantly less WTF%2C although her explained reason still seems litigation-generating. 11|9|9|||1||RE%3A Pseudomonas %28warning%2C gross description%29|Gryphon||14:09:25|07/04/2015|%3ENewly discovered phobia%3A Needles.%0D%0A%0D%0ANo%2C no. Phobias are %5Bi%5Dunreasonable%5B%2Fi%5D fears. For instance%2C being afraid to be in the MRI machine even though you%27ve done before and you know that%2C since you%27re not a robot%2C it won%27t hurt you.%0D%0A%0D%0AFear of needles%2C particularly unskillfully%2Funluckily employed ones%2C is perfectly reasonable. %28And I sympathize with it considerably. Boy howdy%2C have I had some fishing expeditions. One weird side benefit of losing a kidney%3A they%27re not allowed to give me MRI contrast any more%2C so I no longer have to %5Bi%5Dcombine%5B%2Fi%5D my two least favorite medical activities%2C getting an MRI and having an IV line put in.%29%0D%0A%0D%0A--G.%0D%0A-%3E%3C-%0D%0ABenjamin D. Hutchins%2C Co-Founder%2C Editor-in-Chief%2C %26 Forum Mod%0D%0AEyrie Productions%2C Unlimited http%3A%2F%2Fwww.eyrie-productions.com%2F%0D%0Azgryphon at that email service Google has%0D%0A%5Bi%5DCeterum censeo Carthaginem esse delendam.%5B%2Fi%5D 12|1|0|||1||Things I%27ve Learned|Terminus Est||03:41:59|07/21/2015|1%3A Aleve retards wound healing in a major way.%0D%0A2%3A Having a uric acid level of 11.4 is considered alarming.%0D%0A3%3A An improperly dressed wound hurts worse than not having it dressed at all.%0D%0A4%3A Compression therapy works%2C but only if you can maintain it.%0D%0A5%3A It%27s damnably hard to wrap your own leg under the best of circumstances.%0D%0A6%3A It%27s impossible if you%27re overweight.%0D%0A7%3A Apparently%2C your doctor has to exhaust conservative measures before they can hospitalize you%2C when you%27re on Medicaid.%0D%0A8%3A A full course of antibiotics may not be enough to kill a persistent infection.%0D%0A9%3A Medicaid will not refill a prescription within one month%2C regardless of whether it%27s an antibiotic necessary for wound treatment and regardless of whether it%27s one that was originally supposed to have been given as a much%2C MUCH larger package.%0D%0A10%3A Medicaid DOES cover bandage materials. At least%2C certain versions of it do.%0D%0A11%3A In-home care nurses are very%2C very candid. 13|2|12|||1||RE%3A Things I%27ve Learned|Sofaspud||14:50:58|07/28/2015|I realize I%27m a bit behind the times here and hope by now it%27s cleared up%2C but speaking from experience %28I%27ve had two flareups%2C one severe enough that I %2Ashould%2A have been hospitalized%2C and one just a couple weeks ago that we caught early enough to stave off Bad Stuff%29%2C the course of antibiotics generally does nothing to stop the pain -- and the pain will continue for a while even after the infection itself has been cleared up%2C because the infection is destroying tissue.%0D%0A%0D%0AThe first time I encountered it I had %2Ano%2A form of medical insurance whatsoever and couldn%27t afford to pay out of pocket. I ended up going to a community clinic and making arrangements to pay off the bill in small chunks%2C and they gave me 10 days of antibiotics and no pain meds. I needed a second round of antibiotics to finish clearing it up%2C and the leg still hurt %28though not as bad%29 probably a full month afterwards%2C slowly easing up on the throbbing and the ow.%0D%0A%0D%0AThe second time around one batch of 10-day antibiotics %28same ones you mention%29 cleared it up. I have insurance now%2C so they discussed pain meds%2C but my doc preferred I stay off them and use OTC ones if I absolutely could not stand the pain because %28his words%29 I needed to know if it flared up%2C and the only way to tell is if it starts hurting more or in new areas.%0D%0A%0D%0AI don%27t know that the demographic argument is a valid one%2C but I had to admit mine had a point with his %3A%29%0D%0A%0D%0A%0D%0A--sofaspud%0D%0A--