Published Jun 3, 2005
Curious1alwys, BSN, RN
1,310 Posts
Ok, technical question.
My brother has no insurance and recently got an ingrown toenail. I think he picked at it, making it worse, but anyway it did not heal. I saw him today and his big toe is all reddish purple near the wound site and his ankles, feet, and lower legs are swollen. Not just on the leg with the ingrown toenail..more so on that leg, but the swelling seems to be in both feet and legs. You can't even make out his ankle bones. He also said that his lower leg was starting to hurt.
I know when I got bit by my cat and my hand turned red and warm and big, (cellulitis?) they treated it somewhat as a medical emergency.
I told him if it wasn't better by tomorrow I was going to pay for him to get into the doctor.
I am pretty sure the toe is infected. It is draining with nasty stuff (you know what I mean). Question is....are antibiotics required and how much of a medical emergency is this? Can the infection in his toe spread?
Just curious as to the degree in which I should freak out. He is one of those types that never goes to the doctor.
Thanks!
Janice
nicolel1182
88 Posts
that sounds pretty bad. I have an ingrown toenail too, its all swollen and reddish purple with stuff oozing out of it, but not so bad it spread to my ankles. They will most likely put him on ABX before anything else to get the infection under control and the swelling to go down
stidget99
342 Posts
Definitely sounds like an infection. Is it a medical emergency? Depends if he has diabetes or any other kind of peripheral vascular disease. If so...get in to the doc ASAP. If not, get in at earliest convenience...surely within the next week or so. In the meantime, he can try warm moist compresses to help w/ the drainage of the "nasty stuff".
gwenith, BSN, RN
3,755 Posts
GO TO THE DOCTOR - DO NOT PASS AN ED JUST GET TO A DOCTOR.
It sounds like he has a bad cellutitis - he need antibiotics NOW before he is in real trouble.
Thank you to all who helped me with this. I took him today.
I should have let his legs rot off though. Honestly.
He did have an infected toenail, but according to the MD that did not account for the lower leg/foot/ankle edema. As of this morning he had some weird rash around his ankles where the swelling was.....almost looks like patches of broken capillaries. It was a lot worse. The MD did not seem to understand why both lower legs were swollen, didn't make much sense to her. She took urine and chest X-ray. While my bro was in the bathroom giving his sample, I confided in the MD about his drug use (which I knew he would never disclose, CNS depressants..pretty much everything though). Urine and X ray came back OK..he's not diabetic. She gave antibiotics and basically hinted on about cirrhosis, liver failure, or kidney failure. Or, she said, for some reason he just had edema and the rash was just coincidental. Very hard to swallow. We kept telling her that he has NEVER EVER had anything of this sort...not even slight edema, never any rashes. She even told him not to drink water (!) because if he was in kidney failure that would make it worse. She told him to make an appt with an internist this week who could do a complete physical and bloodwork. In the meantime, if it gets worse, ER.
He couldn't even stay alert in the dr office waiting room. We thought he had stopped with the CNS depressants, but apparantly he has started up again. He practically falls over out of his seat asleep! They call it "nodding off". Totally embarrassing. Seeing him anymore makes me so sad because all I can do is feel so terrible for him and what a pathetic life he has chosen to lead. I get angry because I don't see why he can't get to a point where he can see what this is doing to him! Last week he told me he had given up fast food, was going to start working out, he looked GREAT. This week I see him and his eyes are rolling in the back of his head, he can't stay upright, his legs are swollen, he looks like HELL, and he really tries to pass it off as normal. Like there is nothing at all wrong with him!!! Does he think we are blind???
So..........I guess I was stupid. I paid for the urgent care visit and his antibiotics..total of $170. Like I said, in hindsight, I should have let his toes get gangrene or something. Sadly, in many ways I wish he was in kidney failure. Maybe it would wake him up. He was scared for a minute in that office when she started on with the chest x ray and urine sample. But, when she came back and said they were OK, you can see him just switch back into that denial mode, "See, I knew I was OK". Yeah right. Maybe he needs the pants scared right off of him. He has a job and I still paid for it cuz I was worried for him and I felt bad. He has no "emergency" money, even though he probably makes enough to save..........that is, if he didn't have to support his "habit". So, to MAKE SURE, that means more Dr appts with no insurance. Great. And do you think this will teach him a lesson, that insurance is important? No, because he is an addict and all addicts care about is their drugs, even if they pretend otherwise, right??
I am just so sad because I cannot do anything about any of it. I just get to sit and watch it happen. You try to talk to him, he gets angry. Deny, Deny, Deny!! What will it take to wake him up?? 30 years old and such a waste.
Now, let's hope the antibiotics work. I was trying to get him to go this week and get bloodwork from inside the grocery store (healthwaves) so atleast we would know his values. But, he is so in denial, he left the brochure in my car. Doesn't even care. Was getting home to get high again. Couldn't even hold his head up while I drove him home. So sad. :-( :-( :-( :-(
I will spend my whole life watching people crash and burn. I swear.
grimmy, RN
349 Posts
janice, i hope you will consider attending a meeting of na (narcotics anonymous) http://www.na.org/
i realize 12-step is not for everyone, but your words sound angry and frustrated. i can only imagine how heartbreaking your brother's behavior must be for you and your family. if the 12-step way isn't for you, you may want to get some counseling so that you can figure out the best way to reckon with what's happening to your brother, so that you find ways to vent your feelings, and strategize for the future. you probably already know it probably won't get better real soon. i just hope that you can protect yourself. hugs. :icon_hug:
JessicaInOr
I am just so sad because I cannot do anything about any of it. I just get to sit and watch it happen. You try to talk to him, he gets angry. Deny, Deny, Deny!! What will it take to wake him up?? 30 years old and such a waste. Now, let's hope the antibiotics work. I was trying to get him to go this week and get bloodwork from inside the grocery store (healthwaves) so atleast we would know his values. But, he is so in denial, he left the brochure in my car. Doesn't even care. Was getting home to get high again. Couldn't even hold his head up while I drove him home. So sad. :-( :-( :-( :-( I will spend my whole life watching people crash and burn. I swear.
Awwwww. ((((BIG HUGS)))) Poor sweetie!
You know what? There just isn't anything you can do for him. It's such a horrible thing to sit back and watch but the reality is that you just can't do anything about this. This one belongs to him and only he can stop and he won't stop until he is good and ready. There may even be a small part of him that is frustrated with himself.
Nobody wants an addiction and I think that is what frustrates people when their family member is an addict of any sort. Outsiders believe they addicted person just doesn't want to get better, they want to be addicted. Nobody sets out with the intention they are going to go get addicted to "X", instead it is something that one day the person wakes up and suddenly they realize what happened. They realize ... oh crap, I have a problem! Even then they aren't usually ready to get help. They think they can do it on their own. Most times they end up going back to their choice of chemical but all we can do it offer hope and not a lot more.
My parents were both alcoholics. My Mom was an addict/alcoholic. She was taking the rich lady's drugs, only pharmaceuticals but she could afford it. She used and abused until the day she died from complications due to alcoholicm. She was 55. My Dad kicked it 20 years ago, but he just died. I'm so glad he had his 20 years.
My point is that I *do* understand! Sometimes don't you feel like nobody gets it? Your brother is a cool guy and I'll bet he has a heart of gold, doesn't he? But people only see the addiction. Am I right?
Maybe taking him to urgent care and paying his way in life might not be such a great idea. Maybe he'll have to go to the local county hospital and wait to be seen. They'll make payment arrangements with him. But bailing him out... pretty soon you'll see that you aren't helping him by doing that. Maybe it's time he starts taking care of himself. What do you think? You know you need to set payment arrangements with him, he NEEDS to pay you back. You must insist on this. I don't care if it is $5.00 per payday, he NEEDS to pay you back!!! That's just a 'have to' for him!!
Hang in there, the ball is in your brother's court now. Let him find his own way, it's just one of those necessary things.
Thank you guys! Your words mean alot!
AzMichelle, .........he won't pay me back. Even if he says he will, he never really would. Normally, I don't help him out money-wise, but this time I really wasn't sure if he had something that could possibly kill him. I had heard horror stories. Or else I would not have done it. My father is an alcoholic. I, too, have dealt with this crap all my life and I am the healthiest of my whole family, psychologically and physically! As I get older, I realize how important it is to take care of yourself because you are the only one you can control and the only one you can change!
I have been wanting to go to ACOA, Al Anon, or NA meetings lately...to find a way to deal........and to be around others I can relate to. Growing up in the house I did I never could relate to others and this indifference has carried over into my adult life. I have no close friends other than my wonderful husband. I also plan to get one on one psychotherapy and/or counseling in July when my husband's insurance plan kicks in for me. One thing I know is.......my life WILL be different and I CAN blossom into the person I want to be one day. I have the power to do that, and I fully intend to.
Days like this just make me sad for how it has to be , but we don't live in a perfect world and there are a lot of people out there who have it much worse than me. I have many things to be thankful for!
Thank you all!:)
afhroends
12 Posts
Your brother might have one of the vasculitides, probably henoch schonlein purpura. You may want to read on these disease conditions
Thank you guys! Your words mean alot!AzMichelle, .........he won't pay me back. Even if he says he will, he never really would. Normally, I don't help him out money-wise, but this time I really wasn't sure if he had something that could possibly kill him.
AzMichelle, .........he won't pay me back. Even if he says he will, he never really would. Normally, I don't help him out money-wise, but this time I really wasn't sure if he had something that could possibly kill him.
As horrible as this sounds you still shouldn't have LOANED him the money or taken care of him. As long as he has you to take care of him especially in a pinch, he has no reason to do anything about his problem.
You can't change his perspective of life, responsibility, or appropriate actions but you can change her own. It is not appropriate to coddle him. I realize you say that you don't generally give him money... well you do. If things get too deep you bail him out such as Urgent Care today. When things get too deep that is EXACTLY the time you should not help him.
Collect payments on that money every bloody payday. I don't care if he wants to pay you back or not, if he won't pay you back then take him to small claims court and garnish his wages.
If you really think you are helping him by allowing things to continue as they are, you are wrong. Remember, when things get too deep, that is your cue to walk away and it might or might not be his cue to clean up his act. By taking him to Urgent Care you are taking care of yourself, not him. If you have grown up with alcoholism your whole life then you already know that.
Hang in there, I wish you luck. ((((MEGA HUGS))))
I think I just need to move away. Far, far, away.:rotfl:
Not kidding here. Hubby wants to "get away from all this" and move back to his hometown. Something to think about.
Thank you for your words. Point taken and you are correct.
Mysister
31 Posts
Boy do I know how you feel. Did you happen to see the Dr. Phil special "Escaping Addiction" with the addicted nurse? That's my sister. (that's where my screen name came from - I was browsing the internet looking for what people were saying about the show and found this forum.) Anyway, I'm sure people watched that show and wondered where her family is. Well, her family (me) has to live their own lives, free from toxic behaviour of others even if they are close relatives. At some point you realize that first of all you can never help enough, and that helping is not really helping. You don't do them any favors by doing for them what they need to learn to do for themselves. A good book is "facing Codependency" by Pia Melody.
Believe me, I know it's not easy. It's taken me years and years to finally distance myself and my family from her.
Best of luck, and prayers for a miracle.