Sucky sunburn

This week has totally sucked for me. I got a bad sunburn last Sunday which I thought was no big deal.

<----------my legs slathered in aloe

But after one shift at work my legs swelled badly and a couple of days later, even after I had tried very hard to treat them at home appropriately, they got infected with cellulitis. Cellulitis is basically a Staph infection that gets into your deep skin. ARGH, pain, swelling, burning, I couldn't even stand-couldn't even put my legs vertical! I had my husband drive me to the ER on Friday night of Easter weekend after it had gone from bad sunburn to infected in just a few hours. My legs swelled so badly that my toes were cold and turning purple. Not a happy camper.

Needless to say I didn't get much sleep this week but after 24 hours of Bactrium-antibiotic-and silver sulfadiazine cream, I already starting seeing improvement. The swelling reversed almost immediately and my legs got super hot and painful- all the blood rushing back to the tissues hurts!

So it's been 3.5 days on antibiotics and I can walk under my own power again. Not for long distances and it's difficult to stand very long but YES, I can walk!

I've always been sympathetic to my patients with similar leg infections; they always looked so awful and painful. But I have a whole new level of empathy for them now. My husband asked me what it felt like to have cellulitis-

Wrap your lower legs tightly in packing tape, just tight enough so that you almost cut of all circulation. Then every time you stand or take a step have someone quickly rip a piece of tape of with your hair and some skin and that's sort of what it feels like. Yeah, super fun.

First do no harm...

Doctors are trustworthy right? Authority figures...intelligent...smart...ethical...patient care driven...what's not to trust in a doctor? As Dr. Evil says. "R...I....G....H....T." They're human and flawed just like the rest of us.

So I have a patient yesterday call us for severe hip and joint pain which has been lasting all week. So long that he's been unable to eat and he's taking 4 Alieve every 4 hours on an empty stomach and he's now peeing, crapping and throwing up a little blood.

(lots of painkillers + empty stomach = destroyed stomach/intestinal lining) Always eat something when you take pain meds even over the counter meds (OTC).

Anyhow...So at first I'm thinking what's with this guy calling 911 friggin call your doctor, get an appt like the rest of us shmooes and move on with your life. Turns out he did see his doctor, he did go to his appt and was told he had elevated uric acid and was prescribed Voltarin pain gel which is friggin EXPENSIVE because it's new AND it's ----

Important Safety Information

*Voltaren^® Gel is indicated for the relief of the pain of osteoarthritis of joints amenable to topical treatment, such as the knees and those of the hands. Voltaren Gel has not been evaluated for use on the spine, hip, or shoulder.

It's specifically made to treat osteoarthritis not GOUT (or hip pain duh!) which btw is caused by elevated uric acid.

This patient wasn't told by his doctor that he was diagnosed with Gout, no no, he was told he had elevated uric acid. That's friggin gout moron! Gout will cause similar joint pain like OA but it won't be relieved by the same meds because it's a completely different disease process. HELLO!

You should take pain relievers with Gout but you also have to treat the Gout with medications such as allopurinol and corticosteroids and change your diet, lose weight and exercise. This poor guy wasn't on any Gout medication and was 400 lbs and wasn't doing anything else to treat his Gout. (of course he should be taking some responsibility himself as well like EAT LESS!) But by this time he was in so much that pain lifestyle change was out the window.

So my main grip was with the friggin doctor! This guys insurance wouldn't cover the Voltaren cause it's like $100 a tube!!!!!! AHHHH!!! And the other meds are generic. So I have to ask myself-is this doctor insanely incompetent (which he very well may be) or----------

is he something much worse? Is he deliberately mis-prescribing meds to this guy to get some sort of kick back (like it doesn't happen!) , withholding information that a first year med student would know (gout goes with increased uric acid like peanut butter goes with jelly) and thereby indirectly setting this guy up for more injury by him accidentally injuring himself by taking OTC meds incorrectly out of desperation.

Now this guy should be taking more personal responsibility, absolutely! You are your own best advocate in this mess up system. However, hearing about how totally incompetent and/or unethical this dr is really burned me. Makes me what to march to his office and head butt him, then kick him a few times while he's down just for good measure.

Remember asshole...First do no harm!