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wieyedoc
wieyedoc, Doctor (MD)
Category: Health
Satisfied Customers: 10792
Experience:  Internal medicine internship in New York City. Two decades+ of medical experience
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My 76 yr old mother was admitted to the hospital with lower

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My 76 yr old mother was admitted to the hospital with lower leg cellulitis. After 10 days of IV antibiotics, she was sent home. She stayed on various antibiotics for a full month. The leg is still hot and painful when she tries to walk. Blood clot was ruled out. Now she is on a short diminishing course of prednisone. My questions are these: 1). Why is her pain level still an 8 out of 10? and 2) is there a specialist (infectious disease, vascular surgeon, etc.) she should see? 3). Is it possible that a pocket of MRSA is present and what test would pick that up? She has no red lines, no open sores and the hot area is about the size of my hand but not terribly red.

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Customer: replied 3 years ago.
Fosamax
Mobic for arthritis
Has a bum knee on the same side as the cellulitis
Customer: replied 3 years ago.

Medications are Mobic for arthritis and Fosamax for osteoporosis.


 


The pain in her lower leg is now so bad again that she says it feels broken/crunchy and has ordered a wheelchair. Her pain levels never got below 8 out of 10 even when the original cellulitis was treated with IV antibiotics. But now we're going backwards and she won't even use the walker because of the pain.


 


Also good for you to know that she has a bum knee on the same side as the cellulitis of the lower leg.

Amy,

Let me answer your questions in order:

1. I don't know. But I do know that this level of pain means something is wrong. It should be investigated in depth.

2. I think you mom needs a team approach...see below:

3. No. I don't think so. It doesn't work that way.

So. What do I mean by a team approach?

I think your mom should go to a large university teaching hospital for a complete work up and treatment.

Why a large University Teaching hospital? Because at an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.

Does this make sense to you?


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 3 years ago.

Unfortunately, I guess I was looking for more information on what could be causing pain within a leg that is not swollen, a little red and a little warm. No one seems to be able to explain the mechanism of cellulitis pain to me so my concern is that perhaps the cellulitis does exist but that something else is going on within the tissue or the bone in that lower leg. The generic go to a teaching hospital for a team approach isn't really helpful as I need to start with someone who will manage that approach. Is that an orthopedic, an infectious disease person (but her white blood counts aren't high), a gerontologist, a vascular surgeon (although venous doppler showed no issue with veins in that leg), or who?

Amy,

At this point I would start with the internal medicine department. The doctors there, as I discussed above, can "walk down the hall" and easily obtain any sub-specialty consults they deem necessary.

Make sense?


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