Husband leg infection being almost ignored (disgusting pics included)

[NOTSUREWHATIMDOINHERE]

Hello

So been at nurse 3 weeks in row. Had leg infection for 2 weeks antibiotics not working and it's now worse. Smells. Pain so severe he cant walk so will be off work now! Nurse just dressing it and sending him away after asking gp to prescribe 2nd set of different antibiotics after 1st set that was supposed to be the right ones for that infection did absolutely nothing to help him.

What would you do ? We are worried, he can't get about its horrible. He had a venous ulcer but this was due to that part of the leg getting bumped and all of sudden this infection gets worse , he was hiding it from me !

I think the grey can be down to tissue damage or lack of circulation

Thank God there a vascular consultant on here eh!

Who needs the bloody NHS

I cannot believe you've got to this point op, your poor DH

OP

Sorry you are not getting the support you and your DH deserve from your GP.

@olympicsrock has given good advice.

I'm in a lot of pain so take a lot of painkillers, IMHO your DH needs more than OTC meds. I use tramadol, it is prescription only. Obviously you can't just demand that from a GP but you can demand pain relief that actually works.

I also use a TENS machine, but I don't know if that would be suitable for a leg @olympicsrock what do you think?

I use heat and cold as well but I don't think putting an ice pack on that would help, it might make it worse.

Finally a last top up I use camomile tea. It doesn't do much but on top of the other things, for me, it works (which I know could be the placebo affect). It also helps with sleep.

I hope you are both asleep at this point.

Ugh - and I thought my pressure sores were bad but that is truly grim.

Rightly or wrongly, due to the general 'you're young and capable of cleaning this and putting stuff on it yourself, unlike the majority of our patients'... I have done a fair bit of self care for icky ulcers/sores/wounds.

My go to is honey (which I have to be careful with as I am diabetic), and getting off it/elevating it - and that latter is frankly the most important part, and the hardest part.

There is precisely fuck all you can do lying on your front with your rear in the air, particularly if as a result you then have to spend the rest of your time on your back with your legs in the air (lymphedema).

This gets very boring and so most patients not in a hospital will ignore pain in order to stand/sit up, do something other than stare at the ceiling/pillow.

With a leg wound like that I cannot overstate the importance of him getting it elevated and keeping it elevated, regardless of how fucking boring it is. I can't heal some of mine at all really, because it is impossible for me to do this long enough for it to be of use (heart failure means legs in the air higher than my heart results in not breathing well, heart struggling further!).

The other things I have found useful - the clingfilmy adhesive dressings sold for tattoo after care, and a sterile gel that keeps things moist and flexible not dried out and cracked, which I buy from a veterinary site (comes in small tubes that way at a much lower price!). You must of course ensure no part of the dressing is on damaged tissue, ever, just use it to hold on a non-stick dressing or hold on gel/honey etc.

I'd like to say that I am surprised at the poor care and lack of interest but I am really not. When my dad was in hospital, the nurses on the ward ignored the fact he was getting an ulcer until it got infected, despite being shown it/worries being expressed several times. For a while, he was under care of district nurses who were amazing, but now he is getting the dressings changed begrudgingly by the GP surgery, on the condition that he brings his own bandages.

I would also suggest cleansing of the wound bed, wound edge and peri wound skin to remove any invisible biofilm which will delay wound healing.

Remember Ibuprofen also comes in 400mg [standard is 200mg] so maybe he needs a higher dose in the short term before his GP considers codeine - although codeine can also be purchased at the chemist at a lower dose.

Just sending commiserations to your poor OH and to all others with this grim problem.

I have poor circulation due to heart condition and I am on anticoagulant and antiplatelet medications. The other day I banged my shin on the corner of the open dishwasher door ... ouch! Realising the potential for problems I straight away put a compression bandage on it and elevated my leg for several hours, then overnight and it was successful thank goodness. Anyone with poor leg circulation needs to think prevention ... a small knock on the shin can escalate to something awful. Nipping it in the bud is best, however tedious it is.

Glad that OlympicsRock is on this post. I’ve been lurking as I had nothing useful to add over the weekend but wanted to say, I’ve see OR advise on a couple of posts over the last year or so and her advice is invaluable and, in a way I like, she doesn’t sugarcoat her posts - they’re straight to the point and informative while being understandable (I remember her from a triple A post last year!)

glad your husband’s ulcer is looking better and I hope you can get him in to an appropriate specialist to fe the compression bandaging done to continue the healing process x

Sorry but I don’t agree with this.
DH will need months of analgesia and would get gastric issues if having ibuprofen 400ng 3 times daily. I never prescribe long term high dose non steroidals ( if needed for joint problems would think about gastric protection as well) .
He needs at least regular high dose codeine and probably oral morphine to cope with the pain that you get from this kind of ulcer and allow him to tolerate compression and elevate his leg . He should take a regular laxative too to prevent constipation.

@LovedFedAndNoonesDead thanks for kind comments. I think a few people on here would confirm that I am a surgeon.
A few years ago a poster had a husband with type A aortic dissection and I was able to help in a positive way when her DH was in dire straits . We met afterwards in real life and will hopefully be lifelong friends.
I do understand that you can’t trust anyone on the internet however!

Nonsense. If OP’s DH had necfac he’d have become critically ill or worse during the time course of this thread.

He’s got a leg ulcer, it’s going to take a long time to heal, he may pick up infections here and there along the way but the wound doesn’t currently look infected (within the confines of remote visual assessment alone), he needs better analgesia for dressing changes - possibly prn oramorph depending on his pmh, he should perhaps ask for advice about any modifiable lifestyle factors that would help to prevent his vascular disease from worsening and he needs tissue viability/vascular input to optimise his wound healing potential. These are the facts.

Thank you, he is away to the wound nurse at the gp surgery now, I've sent him with a list of questions. He can hardly walk. Hopefully they are actually helpful.

I’m a serial name changer and remember that thread, and others, that you’ve been on. That’s lovely that you’re now friends in real life.

I really hope so, I understand that a wound that looks as bad as this is shocking for lay people to see, and the management of them is a specialist area that most people have zero insight into, I think most of the currently practicing HCP’s on the thread have been of the same general opinion, so I hope that reassures you both.

The level of alarm on the thread was understandable but possibly not helpful. I hope his care turns a bit of a corner and you all begin to feel confident and reassured that his wound is being managed to its fullest potential

Thansk for all the help. Dh saw nurse, they said its not infected anymore, no smell, they said he is to take the now prescribed codeine with laxatives, we would have had no idea what to ask for. He is to get back in 2 weeks for a doppler.

I would go to A and E right away! Sepsis is always a big concern and my guess is he might need IV antibiotics!

Read the thread!
There’s already a vascular surgeon on here giving an input. 🙄

@NOTSUREWHATIMDOINHERE pleased to hear that things are beginning to come together a bit more and that he has some proper pain relief

Hope he's doing his very important bit and keeping his leg elevated🙂

Have they actually put him into compression OP? If not it is wholly inadequate . Feeling pulses or checking g Doppler takes 5 / 15 mins. He MUST start compression bandaging asap or risk further deterioration. Any GP or practice nurse can do this.

No not full , they have bandaged him up to the knee. Slight compression. 2 weeks to find out what the correct compression will be longer term. He is in so much pain they didn't want to risk damage to his leg doing the doppler now apparently.

They said he will be off work 2 weeks likely.

ED, yesterday.

Awful!

Apologies I didn't RTFT

They are talking bollocks. There cannot damage his leg doing a Doppler.
And they just need to feel the ruddy foot pulses! Palpable pulses in a young person who is not diabetic = full compression.

I am so cross on your behalf. He needs more than 2 weeks off to make a difference and if not in compression he won’t make much progress in 2 weeks .

Please see your GP , ask them to feel the foot pulses and listen to the Doppler signal. He doesn’t need to have pressures measured to be put in compression especially if they have been recorded as normal in the last few years. GP should use common sense.
They also need to crack on and refer to vasc surgery . It may be that the nurses stall doing the Doppler studies and refuse to do the compression . I see this quite frequently . The only way round is for a vascular surgeon to ask the GP to apply common sense.

After all until recently he was in compression stockings with no adverse effects ie he CAN tolerate compression.