Help with abscess - NHS refusing to drain it

[LostaraYil]

My adult ds has an abscess on the sole of his foot. The pain is extreme and it is clearly infected. He has been to A&E, the first time he was sent away and told he's fine. He saw a GP and got given antibiotics and naproxen. These have not helped. Second time in A&E he was given codeine and told to go back to the GP. The GP prescribed cocodamol. The pain is still awful, and really it needs draining. Has anyone successfully got the NHS to deal with an abscess and if you did, how? He's been in contact with a private surgeon and has a consultation booked for Monday, but really he needs something sooner and on the NHS! In Wales btw.

Ring PALS

I work in acute surgery and we have a "next few days" clinic for stuff like this. I appreciate smaller hospitals probably don't have this but they should have nurse practitioners who can drain it!

Rather then accident and emergency, it would seem like this is more a gp matter? We're there no appointments available?

Just go back to the gp and tell them the antibiotics didn't work and see what he says?

If you can't get an appointment from the receptionist ask what options there are for minor injury clinics as this needs treated as you're concerned about blood poisoning etc.

See what they say.

Sounds more appropriate for minor injuries than A&E if he's not systemically unwell. Or a podiatrist?

He has an appointment with a podiatrist?(surgeon) on Monday, privately. I'll send him to a minor injury clinic tomorrow, thanks for the suggestion. He's seen the gp, he's also going to go back to them tomorrow and insist on a referral. His brother will have to drive him. The pain is so bad he's been rolling around on the floor moaning. I just don't know what to do to help anymore.

Thanks for the PALS suggestion, but it doesn't seem to exist in Wales. 111 said GP.

I have HS which causes chronic abscess and have had to have a few drained under ultrasound guidance and one under GA when antibiotics didn't clear them up the one under GA I was bordering sepsis
I assume they had taken bloods to check his blood count and crp ?

Could he soak his foot in hot, salt water? It might help with the infection and possibly even encourage the abscess to burst by itself. No poking or prodding it though.

I had this, sending sympathy, it's so painful.

After 2 sets of useless antibiotics, I saw a nurse practitioner who advised me to draw a circle with permanent marker around the abscess (the visible white part) and then report to the GP in the morning showing them how much it had grown overnight. In my case, it had grown an inch in diameter in 12 hours and they referred me there and then to acute surgery who, the next morning, drained and packed it under general anaesthetic.

If your son is in that much pain then consider A&E, I know it isn't ideal but sometimes it's the only way to get the help you need in time.

Keep a close eye on your son for sepsis, I don't mean to scare you but it can get dangerous very quickly. If you're at all worried, ring 111. Mine almost went septic and it was scary how quickly it developed.

My DH had a BP of 75/45 after going into septic shock and had to be resuscitated twice during surgery for a perianal abscess. He was saved in the nick of time by our fast acting GP who sent us straight to a surgery ward at the hospital and they were waiting for him there rather than going through A&E. they did a scan and he was in surgery hours later, please please educate yourself on sepsis it can happen so fast. People
Don't always get all the symptoms but the most common one does seem to be a fast heart rate, uncontrollable shaking (not shivering really violent shaking) and most of all a low BP. He was also quite confused and slurring his speech, and kept saying he was feeling better bizarrely (I think he was just too poorly to realise how ill he was and other people have told me similar stories). Him saying he felt better made me delay ringing the GP, and I also didn't know the signs of sepsis. He had every single one listed on the NHS website! So we were lucky, and on that occasion got the best care. That isn't always the case so trust your gut instincts and straight to hospital if you see any signs of sepsis please. Wishing you both well. X

Thank you for the suggestions, he has been taking photos regularly so can show how it is growing and the red lines have spread. I will tell him to ask for blood tests, they have not been concerned about sepsis because his temperature and BP have been OK when we were in A&E. Surely the antibiotics should have done something by now, he's been on them for 3 days. I'll make sure one of us stays up with him for the night, he has barely slept since Sunday.

I would go to the walk in centre or a&e, sometimes its the sqeakiest wheel that gets the oil and you have to say it needs draining now, antibiotics aren't working, painkillers aren't working, he can't walk, he can't sleep so they need to do something.

It depends. A friend of mine had an abscess on her neck recently and had four courses of antibiotics over a month. Eventually it burst on its own and she’s just had a minor op to remove the sac so it doesn’t reoccur.

Betsi Cadwaladr by any chance? @LostaraYil

This is awful! An abscess can turn to sepsis! Your poor lad!

When you say “the red lines have spread” do you mean it’s started tracking and if so how far has it gone? It can’t be left like that. He needs seeing.

I had one in my mouth last week. They did offer to drain it but I have severe dental anxiety and couldn't tolerate it.

I was given anti biotics and told to use warm salt.water on it 3 times a day and the salt will draw it to the surface.

It did work, and the moment it burst all the pain went away. I did a mix of salt water mouthwashes and dipping cotton wool pads into salt water and holding it over the infected area for a while. It burst after about 12 hours of salting it.

It's worth trying while you try and get other appointments sorted as the relief will be immediate.

If the redness is forming lines moving away from the abscess it will need A&E fast. Say you think it’s ‘tracking’. I had tracking and needed IV abs

Isn't red lines spreading an indicator of sepsis?

I was thinking the Maelor. Fecking useless, that place.

Yes, red lines means the infection is spreading. It’s potentially going up his leg, the poor lad needs to be seen.

He needs different antibiotics asap

IV ABX asap

Do not Leave till he gets it

And gets all the basic sepsis tests

Go to a different hospital

BP and temp can be fine with sepsis they should know this