ER visit

nhusa

nhusa

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To start it wasn’t a good thing but it wasn’t too bad. I learned a lot.

A few nights ago while in bed my feet felt cold, this was followed by my legs being cold to the point they were shivering.
A hot pad set to medium on the thighs then calf’s warmed things to a tolerable level
In the morning both legs and feet were swelled to the point it was hard to walk so my wife insisted that we goto urgent Care.
That became a disaster - the portal said that there was 50to 160 waiting time for an appointment and it didn’t work.. they also didn’t answer the phone… idiots!

So we went to the ER at Duke just off 501 in Durham. They did triage in about 30 took blood and sent us back to the lobby.
About 45 minutes later they had us go to a curtain room and had me pee in a cup.
About 30 minutes later the Dr came in examined me and said my white count was slightly high and wanted to check for blood clots using ultrasound and do a chest X-ray. About 45 minutes later he said that they didn’t see any blood clots, my heart and lungs were clear (meaning no congestive heart failure) and the only abnormal thing was the white count. He then did an expanded blood test that confirmed thar everything was OK except for the white count and he sent me home with an antibiotic.

The Dr and ER staff did a great job
 
put emphasis on the "see" part of "wait and see"
it sounds like they don't know what it was, so they took a wild guess and sent you home to see if the ABs fixed it or not

My wife had some issues a while back, and all the imaging came back normal-ish, but with some interesting stuff - schedule an appointment for 4 months, it got canceled so schedule again for another 4 months, etc.
She got hit with a pain and said "this is not right and not normal" and went to the ER. fortunately the guy who saw her actually knew what it was, and scheduled her for immediate emergency surgery the same day. If she had waited much longer, I wouldn't have had an easter lamb cake today. but lots of people had kept punting it down the field because they didn't know what it was and just gave her pills for pain.
 
DrScaryGuy said:
put emphasis on the "see" part of "wait and see"
it sounds like they don't know what it was, so they took a wild guess and sent you home to see if the ABs fixed it or not

My wife had some issues a while back, and all the imaging came back normal-ish, but with some interesting stuff - schedule an appointment for 4 months, it got canceled so schedule again for another 4 months, etc.
She got hit with a pain and said "this is not right and not normal" and went to the ER. fortunately the guy who saw her actually knew what it was, and scheduled her for immediate emergency surgery the same day. If she had waited much longer, I wouldn't have had an easter lamb cake today. but lots of people had kept punting it down the field because they didn't know what it was and just gave her pills for pain.
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I understand. He did say to watch it and if it moved up my leg ar didn’t go way in a few days to go back to the ER.
 
Dude! Keep check on that (I know-obvious stuff). Hope it gets down and/or they decipher the reason it's up.

My wife and I went out of town this weekend and today (in the motel) I woke up to see a late night missed call from my brother. Checked texts and he had texted after calling and said he was enroute to he ER, having fallen partially through his deck last night! Yeah he's been behind on maintenance on the back deck (recently replaced the front but ran out of cash) and went out to get the inside house cat after she bolted out. He broke though and his right leg went up the thigh. He said he thought his kneecap may have dislocated but when pulling it out he found it was not as bad as he thought, but he'd been wearing shorts and cut himself. He did have some pain and swelling and is now out of work all week. I can't wait for him to get better so I can start the memes and jokes...!
 
Bilateral lower extremity swelling would be much more suggestive of cardiac etiology rather than infectious (things like cellulitis tend not to strike both sides at the same time, and when they do it is usually secondary to preexisting long term swelling from another cause). A clean chest X-ray suggests that you don’t have left heart failure, but it certainly doesn’t rule out right heart failure. Honestly with the very limited information at hand it’s impossible to make any attempt a diagnosis, but i would reccomend that if you haven’t had a cardiac echo recently that might be worth following up on or at least suggesting to your PCP.
 
nhusa said:
To start it wasn’t a good thing but it wasn’t too bad. I learned a lot.

A few nights ago while in bed my feet felt cold, this was followed by my legs being cold to the point they were shivering.
A hot pad set to medium on the thighs then calf’s warmed things to a tolerable level
In the morning both legs and feet were swelled to the point it was hard to walk so my wife insisted that we goto urgent Care.
That became a disaster - the portal said that there was 50to 160 waiting time for an appointment and it didn’t work.. they also didn’t answer the phone… idiots!

So we went to the ER at Duke just off 501 in Durham. They did triage in about 30 took blood and sent us back to the lobby.
About 45 minutes later they had us go to a curtain room and had me pee in a cup.
About 30 minutes later the Dr came in examined me and said my white count was slightly high and wanted to check for blood clots using ultrasound and do a chest X-ray. About 45 minutes later he said that they didn’t see any blood clots, my heart and lungs were clear (meaning no congestive heart failure) and the only abnormal thing was the white count. He then did an expanded blood test that confirmed thar everything was OK except for the white count and he sent me home with an antibiotic.

The Dr and ER staff did a great job
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If I am not having a MI, stroke, or trauma, I would much rather go the DRH's ED than main Duke (and I worked in the ED at main Duke). I am glad you had a good experience. I was going to say the same thing @363medic said.
 
DrScaryGuy said:
put emphasis on the "see" part of "wait and see"
it sounds like they don't know what it was, so they took a wild guess and sent you home to see if the ABs fixed it or not

My wife had some issues a while back, and all the imaging came back normal-ish, but with some interesting stuff - schedule an appointment for 4 months, it got canceled so schedule again for another 4 months, etc.
She got hit with a pain and said "this is not right and not normal" and went to the ER. fortunately the guy who saw her actually knew what it was, and scheduled her for immediate emergency surgery the same day. If she had waited much longer, I wouldn't have had an easter lamb cake today. but lots of people had kept punting it down the field because they didn't know what it was and just gave her pills for pain.
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And some people wonder why many have a hard time trusting the medical "profession".

9 years ago I ended up in an ER with 103 fever and massive headache. They did a chest x-ray, gave me Tylenol, took blood and sent me home with a diagnosis of "fever". Yeah, no shit. The next day, I ended up in another ER with IV antibiotics for cellulitis.
 
1075tech said:
And some people wonder why many have a hard time trusting the medical "profession".

9 years ago I ended up in an ER with 103 fever and massive headache. They did a chest x-ray, gave me Tylenol, took blood and sent me home with a diagnosis of "fever". Yeah, no shit. The next day, I ended up in another ER with IV antibiotics for cellulitis.
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There are a lot of issues: what ED you go to, the type of doc you see, etc. 103 with fever, infection until ruled out. Period. The CXR makes perfect since, rule in/out pneumonia very quickly. Blood cultures, though it takes 2-3 days for them to grow nasties. But until they do and you know what specific antibiotic to you, you should get a broad-spectrum shotgun antibiotic.. Did you have a skin lesion (red/warm)? Cellulitis is not a hard diagnosis to make.
 
Chuckman said:
There are a lot of issues: what ED you go to, the type of doc you see, etc. 103 with fever, infection until ruled out. Period. The CXR makes perfect since, rule in/out pneumonia very quickly. Blood cultures, though it takes 2-3 days for them to grow nasties. But until they do and you know what specific antibiotic to you, you should get a broad-spectrum shotgun antibiotic.. Did you have a skin lesion (red/warm)? Cellulitis is not a hard diagnosis to make.
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Makes sense. They only took blood for normal labs, not cultures. No antibiotics. The red warm skin didn't show up until the next day.

@nhusa how you doing now?
 
Went back to the Duke ER yesterday. The one near Rt 501 in N Durham because the swelling didn’t go down and pain increased. I hope it is the DRH ER that Chuckman mentioned.
I am now in a room on the 5th floor being filled with a heavy dose of antibiotics by a bunch of nurses - some of them are cute, and everyone is nice. Got two doses via IV and will get a third soon. White count now normal but the damn leg still hurts.


Don’t laugh but we think it came from a pedicure I had last Wednesday. At my age it is usually easier to have someone cut my toe nails than do it myself —
 
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nhusa said:
Went back to the Duke ER yesterday. The one near Rt 501 in N Durham because the swelling didn’t go down and pain increased. I hope it is the DRH ER that Chuckman mentioned.
I am now in a room on the 5th floor being filled with a heavy dose of antibiotics by a bunch of nurses - some of them are cute, and everyone is nice. Got two doses via IV and will get a third soon. White count now normal but the damn leg still hurts.


Don’t laugh but we think it came from a pedicure I had last Wednesday. At my age it is usually easier to have someone cut my toe nails than do it myself —
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Yes, the hospital on 501 (Roxboro Road) is Duke Regional Hospital, formerly Durham Regional, formerly Durham County. I like that ED.

Glad they got you squared away. Not laughing, either: pedicures can absolutely lead to a cellulitis.
 
nhusa said:
Don’t laugh but we think it came from a pedicure I had last Wednesday. At my age it is usually easier to have someone cut my toe nails than do it myself —
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Do you bring your personal tools or did they use their own? Some places do not sterilize properly.
 
My last bout of cellulitis was in my left arm and got me 5 days in the hospital getting vancomycin and rocephin. First time was with my right arm while we were on vacation in Florida. Spent all day Saturday and Sunday in the ER for the IV antibiotics.
 
Chuckman said:
If I am not having a MI, stroke, or trauma, I would much rather go the DRH's ED than main Duke (and I worked in the ED at main Duke). I am glad you had a good experience. I was going to say the same thing @363medic said.
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Heck DRH has its own cath lab, but trauma Duke or a burn UNC.
 
nhusa said:
Don’t laugh but we think it came from a pedicure I had last Wednesday. At my age it is usually easier to have someone cut my toe nails than do it myself
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I’ve been dealing with a bad toe. Big toe nail broke off, halfway, new one growing in, but old one doesn’t wat to come off. Podiatrist has been working at it, put iodine on it, now an anti fungal which they say will help. Think it all started with 80lb dog stepping on my toe.

Edit to add, see my veinous stairs sucks thread. Been keeping compression on my legs and they were very happy with the results. Didn’t say anything about a woo that was wanting to lesion that mostly came off as dead skin in the shower. Doesn’t hurt, but sometes I can feel it, like eres growing,

Anyway, I’m clear til July 1st.
 
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Radar said:
Heck DRH has its own cath lab, but trauma Duke or a burn UNC.
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My issue is not what they can do in the cath lab, which is really good, but what happens if the cath lab goes wrong and after crack my chest. For that I'd rather be at the Big House.

CZfool68 said:
@Chuckman should get some kind of raise for being the daily Duke Spokesperson and advocate. He’s earned it.
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I love my hospital, it's top 10 for a reason. I will shout out praises where it's due, but I will certainly throw shade when it's due.
 
It is helpful to get opinions from insiders. And hear how others handled the same situation.

Like they say- they need to be taken with a grain of salt (whatever that means) because one person’s good can be another’s bad.
 
Chuckman said:
My issue is not what they can do in the cath lab, which is really good, but what happens if the cath lab goes wrong and after crack my chest. For that I'd rather be at the Big House.



I love my hospital, it's top 10 for a reason. I will shout out praises where it's due, but I will certainly throw shade when it's due.
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Well your team saved my bacon so I am an advocate. I’ve got my issues with the medical community as a whole, but the Duke hospital and staff have been excellent the 2 times I’ve been there.
 
Chuckman said:
My issue is not what they can do in the cath lab, which is really good, but what happens if the cath lab goes wrong and after crack my chest. For that I'd rather be at the Big House.



I love my hospital, it's top 10 for a reason. I will shout out praises where it's due, but I will certainly throw shade when it's due.
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Very good point
 
FWIW, if the pedicure is a likely culprit, I would suggest sending a note to the NC Cosmetic Arts Board. They take that sort of thing very seriously, and there are pretty strict guidelines in place for what they would consider "whirlpools" (i.e. foot baths, head spas, etc.) from a disinfectant/maintenance perspective.
 
This is getting better very slowly.
The red on my calf seems to be residing a little but the ankle shows there is no improvement after 2 days of pills and 2 days of direct IV antibiotics. I still can’t stand (move) without pain so the next step is to do a CT scan.
 
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noway2 said:
I’ve been dealing with a bad toe. Big toe nail broke off, halfway, new one growing in, but old one doesn’t wat to come off
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Brother in law got an ingrown toenail. Infection went septic. Didn't know if he would survive ICU. Destroyed his kidneys and he ended up on dialysis for the rest of his life, which wasn't that much longer
 
1075tech said:
Brother in law got an ingrown toenail. Infection went septic. Didn't know if he would survive ICU. Destroyed his kidneys and he ended up on dialysis for the rest of his life, which wasn't that much longer
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Something like that happened to my dad, but it was a simple hospital procedure that was successful until, during recovery at home, he fell and spent weeks in the ICU. Some destroyed organs and the rest of his life in a wheelchair with a colostomy.

I hear about a lot of elder people that are healthy, have a simple incident, ( fall etc.) and die due to complications within a short time.
 
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nhusa said:
I hear about a lot of elder people that are healthy, have a simple incident, ( fall etc.) and die due to complications within a short time.
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He wasn't that old. Early 50s

You, good sir, take care of yourself
 
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I’m no dr. But it read to me like the antibiotic was a placebo. I wouldn’t think your symptoms are infection related.

Others above have said it better than I could.

Glad it wasn’t worse and I hope you get it figured out.
 
Chuckman said:
My issue is not what they can do in the cath lab, which is really good, but what happens if the cath lab goes wrong and after crack my chest. For that I'd rather be at the Big House.



I love my hospital, it's top 10 for a reason. I will shout out praises where it's due, but I will certainly throw shade when it's due.
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We don't crack chests since they shut down CT surgery at DRH. We just hope Life Flight can show up in a hurry o_O. Actually we've a pretty good record sinc ewe don't let fellows or residents in
 
The antibiotics are doing something.
My white count has dropped to normal and the inflammatory protein has dropped from 26 to 16 with 0.85 being normal.

The throbbing pain when I move my leg lower -even 6 inches- is the current issue.
 
nhusa said:
Went back to the Duke ER yesterday. The one near Rt 501 in N Durham because the swelling didn’t go down and pain increased. I hope it is the DRH ER that Chuckman mentioned.
I am now in a room on the 5th floor being filled with a heavy dose of antibiotics by a bunch of nurses - some of them are cute, and everyone is nice. Got two doses via IV and will get a third soon. White count now normal but the damn leg still hurts.


Don’t laugh but we think it came from a pedicure I had last Wednesday. At my age it is usually easier to have someone cut my toe nails than do it myself —
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Heck man, I get pedicures routinely. Clean feet, toes, and leg massages. Can't beat it.
 
concepthomes2 said:
Heck man, I get pedicures routinely. Clean feet, toes, and leg massages. Can't beat it.
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Me too! Never thought it could cause an issue,

Going to be more careful in the future ——— if I survive.. beginning to think it is like eating blowfish.:-
 
Home didn’t happen and I’m still in the Hospital.
The decreasing infection seemed to stall and reach a plateau.
They increased the med pain options to include ibuprofen and low dose happy pills.
They switched antibiotics and it only made a little difference.
Then called in an infective disease expert that made an additional antibiotic recommendation.
We are waiting to see if that helps.

It looks like they are scrambling to find something that works.
Wife says, “You ain’t coming home until they can lower the swelling.”

If i were a vehicle they would be swapping parts.
 
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Finally on my way home today because they found something or somethings that are working.
They say it is going to take a couple weeks to get near normal.

One thing the downtime did was give me an opportunity to see what was happening in the world and I realized that we are screwed.

IMG_1096.jpeg
 
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