to think DP should see the doc urgently!

[Equallength]

One leg has been swollen for a while. It comes and goes and a few years ago he had cellulitis in the same leg. He’s scratched it today in the garden and it’s bleeding a bit but more worryingly is leaking fluid! I know there’s an association with congestive heart failure, which has worried me a bit as he has a low heart rate to begin with.

Hes 54 and otherwise fit bit recently gets a bit out of breath. WWYD?

He’s so brasses off with last night’s episode that he’s leaving it until Tuesday to sort out the private GP/referral thing. I’d rather he did it sooner but he’s a sensible sort and does what he says he’s going to do so I’ve got off his case about it.

Hello OP,
I am a consultant specialising in problems such as this. You have unfortunately been given a lot of misinformation here and some people are confused about oedema and lymphoedema which are very different .

To answer your question: yes DH needed an urgent medical review because of the redness which looked to me like a flare up of cellulitis. He has the appearance of skin changes related to ‘chronic venous insuffiency” but this can occur in any chronic leg swelling not just venous problems.

I suspect that he may have chronic Lymphangitis - after a few episodes of cellulitis the lymph channels are scarred and you get chronic leg swelling.
If he was in my clinic I would check the arterial pressure with a Doppler machine to see if safe to wear stockings and scan his veins to see if there is any reflux and anything we could treat.
once the cellulitis settles he should do plenty of walking and when at rest get his legs up with a recliner or on cushions on the sofa.

Thankyou, that’s very helpful. I’ll tell him to walk and keep his feet up in the mean time until he’s seen. He’s v active usually anyway.

Try not to worry too much, yes it has to be sorted fairly soon. Probably right to phone 111 as its a Bank Holiday though and some doctors close until Wednesday.
👍👍👍

If the redness settles and his shortness of breath is as ‘usual’ / just on exercise, this would be a routine appointment or referral to Vasc surg in most GP practices.

Op not sure if anyone answered your question on lymphedema.

There are 2 types, primary and secondary. Primary is hereditary and can come on at any time or never. Secondary can be caused by Injury to limb or due to have lymph nodes removed (ie. Cancer treatment).

It's basically where the lymphatic system breaks and stops working, the lymphatic system is what drives or is the immune system, so the fluid stops moving and collects hence the swollen limbs. which is why people with lymphedema who get an injury on their affected limb are at high risk of cellulitis because the immune system isn't working to make them better.

At first look I thought lymphedema, and I think others have said, it's not widely known or dealt with properly or quickly, some NHS trusts don't have lymphedema teams and it's basically ignored and it's not an area that's studied.

Its not overly life threatening apart from the infection, but its uncomfortable and inconvenient.

Mine is much worse if I have been on my feet, sat in a chair, kneeling or in the heat.

I hope he gets whatever treatment he needs and I am surprised he wasn't given antibiotics and treat the infection at the minimum

I can't diagnose your husband's problem but I would like to address all the arguing about going to A&E. If I thought I had cellulitis, I would want to see a doctor urgently, depending on time my GP or A&E.

I (outside the UK) am able to see my GP same-day if I ring in the morning and have walk-in services evenings and weekend days. Walk-in is staffed by doctors can also do X-ray and basic labs, so for example when one of my kids broke an ankle, we didn't need A&E. We're able to reserve it for things that are really serious.

At the moment the UK is not operating sufficiently accessible primary care services. There's no point yelling at people for "wasting" A&E time when it's the only way to get seen urgently in many places.

Cellulites can lead to sepsis. Sepsis is a killer. For those who survive it leaves 98% with life changing health needs.

Do NOT mix Sepsis with Septicemia. Sepsis can only happen with an infection. You cannot catch sepsis. The body turns on itself and it damages all the organs.

I'm not wanting to frighten you,: if you don't know to keep an eye on this thought of thing and how dangerous it can be.

Sepsis killed my husband. He had complex health issues. An infection from celulites and not being treated properly by the Dr led to him collapsing which was sepsis.

He survived it however was never the same again and passed 3 months later. It had damaged his kidneys which were fine up to that point. With his other health needs his body couldn't cope any longer. My husband was 60 when he passed.

Stats: 250 thousand cases a year and approx 60 thousand deaths says it all.

I'm telling you so you know has it can hit anyone at any stage.

Alot of Covid19 deaths were caused by sepsis as the sepsis can only step in with an infection. Covid is an infection hence

Hi, GP here, cant be bothered to trawl through the 9 pages on this thread, but will offer my advice based on the picture.

He could have cellulitis, but the leaking suggests an underlying problem with fluid. The skin's main job is to be a container and a barrier against infection. If the skin is ruptured, perhaps by being over-stretched, it will leak like a plastic bag full of fluid. Really he needs regular dressings with the practice nurse of district nurse to address this problem.

I only have a picture of one ankle, but the redness and the history suggests he could have something called Chronic Venous Insufficiency. The below video outlines this really well, but essentially the problem is poor venous return, leading to blood pooling, and the consequent leaking of fluid from the bloodstream into the soft tissues causing swelling, but importantly also the leaking of protein. It is the leaking of protein into the skin which causes the chronic skin changes which are regularly mistaken for cellulitis.

@olympicsrock has given amazing expert advice! This is when mn is great

get medical help ASAP. The fluid seeping out will make it worse. It can take months to heal. Sudocream was the only thing that worked for me.

Please could you explain this a bit more... I have been told I have bradycardia a few years back. What should I look out for? Tx

That looks like an oedema, or DVT if he's had cellulitis. The breathlessness can also be caused by pain and causes an elevated heart rate. I would get him to A&E, because none of us will really know.

My blood runs cold when I read posts like this

FWIW, I had cellulitis at the end of last year and it turned to sepsis - 16 days in the hospital and 5 in intensive care with kidney failure. I was convinced it would just go away on its own, so really, err on the side of caution IMO.

You might be in a queue for a while but for future reference you can get an emergency same day appointment with your GP at most practices if you call first thing in the morning, or first thing after lunch.

They'll do a phone triage appointment/call first maybe, but as you were so concerned they'd probably have had you in for an appointment within a couple of days to have a look.

The breathlessness just sounds like he got himself panicked up that he might be ill maybe.

Either way I hope he gets the all clear. Maybe this'll give him some encouragement to improve his lifestyle.

One thing that really struck me OP was your post about your DH being woken by an alarm because his heart rate had dipped. Years ago a nurse who had been doing hourly obs on DH due to an acute illness asked if I had ever noticed DH's heart rate dropping when he slept. I hadn't because I don't tend to monitor family members heart rates when they sleep and when I am asleep, I stay asleep, unless a small child makes a noise or the dog sounds like it is going to vomit.
I wish I had put 2 and 2 together at that point because a couple of years later he had a MI at 54. He had been experiencing sleep apnea for years, being overweight and having a large collar size were major contributory factors. Now I know you have described your DH as stocky and having a fabulous arse, but could it be possible that you are looking at his physique with slightly rose tinted spectacles ?

To be fair I should have realised when the anaethetist refused surgery at the private hospital for routine day surgery due to his weight, he had it done at the local NHS hospital privately instead, with all the back up of the good old NHS if things went tits up !

Hi everyone,

Thank you for your contributions so far to this thread. Just a reminder that we cannot vouch for anyone's expertise on the site, so please seek medical advice from an appropriate healthcare professional.

Best wishes

@Equallength just wondering if your partner is experiencing fever, dizziness, low blood pressure or confusion? Any sign of these and further emergency medical intervention is needed asap.

Speaking as someone that had a VERY nasty bout of cellulitis 20 years ago - got to the point I couldn't keep water down and was severely dehydrated when I finally managed to get a GP appointment (even back then if you couldn't get through at 8.30am when they opened you had to wait 3 -6 days for the next appointment), they prescribed antibiotics which I couldn't keep down as anything going in made me vomit, so that night DH called the out of hours GP, went to see them and got admitted via A&E, ended on the renal ward on IV antibiotics and in for 10 days, can I suggest the following as I have had recurring cellulitis - any slight cut or cracked dry skin for many years seemed to lead to it.

1. mark the outside of the red area in pen and note if it spreads, if it goes more than 6 inches he needs urgent medical attention (111/A&E).
2. if vomiting such that he cannot keep water down and is getting dehydrated you need urgent attention
3. if he has had more than 3 or4 bouts of cellulitis in a couple of years ask the GP for a prescription for 1 course he can hold to use in an emergency when he suspects cellulitis - so he can immediately present it to a pharmacy and get antibiotics, rather than visit a GP - this has saved me many GP visits as I simply call for a repeat prescription to replace the one I used. I also think rapid treatment has reduced the likelihood of cellulitis over the years as I'd say I've probably not had it for 5 or 6 years at least, I'm sure each infection damages the lymphatic system for a lengthy period meaning it's easy to get reinfected.

I have heard that this, and swimming can really help. Shame I'm such a wuss when it comes to water!

On that logic, maybe the drunks could take the pressure off the NHS by not being so drunk.

Why don’t you just urge him to see a doctor even if it’s not serious it’s not up to mumsnet to try diagnose. I know it’s hard to see a doctor at the moment but 111 is helpful it’s what it’s for. Hopefully it’s OK but I don’t understand why you don’t just ring doctor?

Did you read the thread?
Gp surgery has nothing for 3 weeks. 111 handle out of hours and called back to say they would be calling in a few hours by which time he was at A&E which is where the doc would have probably sent him anyway given the combination of his symptoms. Seriously!