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.

If it's on the sole of his foot it is highly likely there is a foreign body in there , or it has been caused by a puncture wound of some sort .
Stepping on a nail or sharp stone or glass is a common injury .

He'll probably need an XRAY done too .(to check for damage or infection in bone ) some foreign bodies show on XRAY , not all.
Do you know his tetnus status ?

It sounds like he really shouldn't wait till his Monday appointment .
Do a photo of both of the soles of his feet to compare and the tops of hi feet to see the difference in size and colour .

Salted boiled cooled water to bathe/cleanse it , dry it and a sterile dressing .

And , YY he needs to be seen .

I would go to a walk in surgery

Having been in a very bad way with sepsis, the NHS is a bloody disgrace at dealing with it. There are posters all over my local hospital and on the sides of ambulances but nobody takes it seriously.
I had a pulse rate of 140, the triaging nurse wrote it down as 95 because 140 seemed silly.

1. Marker pen around localised reddening with regular photos every 1 or 2 hours depending on change in shade or size.
2. Try to record who you are speaking to and when.
3. Complain. PALS is often useless, CEO and Chairperson BEFORE follow-up investigations are complete. Those without medical experience/contacts often feel that they can't/shouldn't complain until cause of all issues is understood - I've been waiting more than 18 months for follow-ups and tests - I might have died of old age before the cause of repeat infections is understood.

Good luck to the OP

Try and coax it to burst. Not warm water, hot as you can stand. Bath or shower head on it as long as you can face it.

I nearly got sepsis from one of these and had to take a month off work.

Don’t frighten OP - it’s pretty obvious when someone’s sliding into blood poisoning. I arrived at A&E wearing 2 coats in Aug cos shaking.

But, OP, medics do miss signs - I’d been twice for a 10-cm abscess that was growing as you looked at it, but the two doctors who examined me hadn’t been to specsavers.

Luckily for their GMC registration, I grumbled after another day in sweaty agony, got an A&E doc and was operated on immediately, twice.

Can you not just take him now? Why wait until the morning?

Are you a doctor?
Sepsis has been thrown around the responses with little regard to how OP would feel reading this.
Sepsis can technically occur from any infection, it is a life threading systemic response. It is good to take all pain and infection seriously but also crucial to differentiate between a localised or systemic infection. I hope OPs son gets this sorted

Hoping for an update

I had a huge hard golf ball size abscess a few years ago. I didn't think the antibiotics were working. But on day 4 I fell asleep on the sofa and woke up drenched in puss. The smell was horrendous.🤢🤢🤢

You could try putting magnesium sulphate on it and putting a dressing on, it might draw it out.

Germaloid cream or other pile creams with a local in will also help, as will Vicks if you have that in.

Hot and then cold water will encourage the skin to contract and might encourage it to disperse.

I am an HS sufferer so treat these regularly.

I would get him seen tomorrow

As a couple of others have mentioned on here, I have HS which means you end up pretty experienced with dealing with painful abscesses (sadly).

Best at home remedies I tried have mostly been mentioned:

• Hot compresses. As hot as he can stand, applied for a few minutes at a time.
• Epsom salt baths
• Magnesium Sulphate paste (pharmacies stock this)
• For the pain, ibuprofen and Co Codamol (strongest variants you can get across the counter) and pharmacists also have numbing cream that sometimes helps a bit but probably won't with how advanced your son's sounds
• Weird but works for me: slather in vicks vaporub (no idea why but I cannot explain how much this eases the pain) and some sort of dressing. The latter sounds counter intuitive as you'd imagine anything placed on it would hurt and again, I don't know why (I'm sure someone smarter than me could explain), but for some reason it massively alleviates the pressure

But, and I cannot say this strongly enough, all/any of the above should only be interim measures before you can get him in front of someone medical asap and refuse to leave until they do something.

I massively underestimated how unwell you can get and a couple of years ago ended up in a bad way with an abscess that got out of hand. I was so lucky to get the treatment I did at the time I did. I wasn't septic but, hand on heart, I have never felt that level of unwell. Drs initially didn't take the abscess itself seriously as I was too unwell to attend in person and kept downplaying it (because I'm a wimp and didn't want to have to deal with it being packed once drained 🤢). Ended up in hospital with lots of stern warnings from doctors to never be so stupid again. I am now much more careful.

Sympathy to your son - bad abscesses are so incredibly painful and I can't imagine how bad it must be on the sole of a foot. I hope it gets sorted for him soon.

DH has taken him to A&E again, he was slightly shivery and clammy although he managed about 30min of sleep after a salt water soak before the pain got unbearable again. I don't want to take any risks with sepsis, though I think it's low risk still. Thanks for all the advice, I've given DH a list of things to say and told him to insist that a doctor has a proper look at the tracking and checks for signs of sepsis.

Thanks so much for all the sympathy as well, I am really worried but have been trying to look positive and calm so DH and DS don't panic.

Bloody ridiculous!

I once accidental drained an abcess myself. Was quite incredible! I had banana sliced an aloe Vera leaf and sellotaped it to it. In the morning I woke up covering in purple goo. Panicked something majorly wrong had occurred I rushed to A&E.

The nurse was confused at what had gone on but after she cleaned me up she was incredibly impressed. She said ‘what did you do again’? Apparently it was a better job than they could have done in surgery 🤷‍♀️

Even if it isn't sepsis, I can't accept that it's ok to leave a young man in this much pain.

I’m so pleased to read he’s gone to A&E tonight. Hopefully you manage to get some sleep whilst waiting for an update and he gets the care he needs xx

Some very stupid posts. Especially the person suggesting a ‘lactic acid venous test’ from an ‘arterial blood test’ who clearly has zero idea what they’re talking about.

If it is an abscess - and nobody here knows that, not all soft tissue infections are, an abscess is a very specific type of collection - then nobody here can tell you whether it’s amenable to incision and drainage.

Go back to ED, explain the ongoing pain and apparent spread of infection despite oral antibiotics. Ask if it is an abscess. Ask if Iv antibiotics are needed and ask for an explanation why not. Ask if referral to a surgical team for incision and drainage is needed, and if not why not. Ask what is reassuring the clinician that there is no systemic infection.

Get help from knowledgeable people who can examine the patient after first line treatment has apparently failed, and seek explanations so you understand the rationale for treatment.

There are an awful lot of people responding who are basing their answers on memories of Dr Quinn Medicine Woman.

He's been sent home from A&E again, the nurse decided based on his obs that it's not sepsis, they took a blood test, gave him some morphine and told him to contact the GP in the morning. No one even looked at the foot. He has been advised to push for a referral to a surgeon. The system is so ridiculous.

Why did your DH and DS agree to leave without it being reviewed by a doctor? The magic words, in my experience, are "please would you note in my records that I am extremely concerned about this and you have refused a review by a Dr (an Xray/treatment, etc)."

They were told it would be an 8-10 hour wait due to more urgent cases and he'd probably see a GP sooner. Thank you for the magic words though, I will put something similar in the e-consult form when it becomes available in the morning.

@LostaraYil so he wasn't sent home, they refused to wait. He can't be desperate if he wasn't prepared to wait.

Bless him, sounds awful. My ex had one on his foot once, it looked gruesome and he was in so much pain. I do hope GP can do something. Could you see if the private surgeon could see him today?

Better to see an A&E doc surely than the GP, as he could refer him to someone quicker than a GP, plus maybe they could keep him in for pain relief. I do think waiting in the hospital would have been the best option

If you have minor injuries I would really try there rather than the GP. They saw me really quickly after a cat bite that had obvious fast infection up my hand and wrist and the antibiotics were given there and were like horse tablets, super strong.

I'd try the hot glass bottle on it to drain it.

Get a glass bottle and submerge it in hot not boiling water then take the bottle whilst still very hot and place the open neck over the area of the abscess making sore the bottle opening is completely in contact with the surrounding skin and hold in place.

As the bottle cools down it crates a vacuum and will drain the abscess. You must hold the bottle firmly and make sure it is in contact with the skin to ensure a deal is formed to enable the suction.

The relief is immense. It may take awhile and come in spurts or it make trickle out but it will drain.