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Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 1:47 pm
by Henrietta
Sorry for the rather general heading but a bit of a none specific question.
First enquiry is whether Odeima as in swollen legs , in Dad's case caused by decreased kidney function is one and the same thing as Lymphodeima, i.e. just shorthand for the same condition?
Dad's legs have been leaking excessive fluid for about a month now. He is on Diuretics and has been having daily district nurses now down to one every 2 days. He has had leg infection, a course of Floxicillan and now has green fluid leaking from his legs so presumeably another infection. What could this be , the only one I know of Pseudamonas. Are there others that can cause the green colour? Swab taken today by nurses although swab last week was clear.

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 2:59 pm
by bowlingbun
Henrietta, I'd be very concerned. I don't know what the cause is, but I do think the medical people should be taking urgent action, but they seem remarkably complacent. I'd be tempted to ring NHS Direct and get their view on the situation. I've had phlebitis, misdiagnose originally by the chemist. I ended up nearly being admitted to hospital, had two lots of oral antibiotics at the same time plus daily injections at the hospital walk in centre.

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 3:04 pm
by susieq
Oh gosh Henrietta wish I had the knowledge to be able to answer your questions properly ! Frankly if the fluid is now green and, especially, if it smells I would suspect another infection.

Mum had badly swollen legs which 'leaked' and, because she would keep scratching at them (!), got badly infected and caused some serious ulcers. Apart from the DN dressing them regularly with creams and special dressings - which almost immediately came off as they got so 'wet' - the only other thing that I found helped was using babies nappies (the kind that have a 'one way' barrier) to try and keep the area reasonably dry. The tip was given to me by a retired DN who said that she found the nappies to be better at coping with the leakage than the usual dressings. The other tip I was given was to keep Mum's legs propped up as much as possible - not easy 'cos she always complained it was uncomfortable !

When she came out of hospital after her first long stay (broke 4 ribs in a fall at home) the skin on legs came away in parchment like sheets and it was a nightmare keeping them (a) dry and (b) creamed - the skin did eventually recover but the leaking never went away completely - and as time went by so did the frequency with which I had to launder her bed linen :(

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 4:29 pm
by Henrietta
Hi BB and susie , I don't think 111 would be able to help at all, they would just refer me back to D/N /GP. I don't think the professionals are being negligent either. They have been every day for over a year re dressing legs when needed and monitoring. I'm afraid regular infections are part of the course it seems in wonky legs and renal failure. Dad has very substantial dressings on his legs upto an inch thick I should think, firstly dressed with special things, then padding then sock dressings- sorry not very technical. I think the nurses have done all they can and DR did offer to come out, which still may be on the cards but I think they are just waiting for swab at the moment.
Yes Dad needs his sheets changed more regularly sometimes and yes it is smelly . I am just hoping it is not pseudomonas again setting in, as I know that is a real nasty that he has had before. You only need to google it together with legs and check out the google images to see just how awful it can get.
I had to google phlebitis and seems to be DVT? If you google that with legs you get a vast range of appearances - it must be extremely hard to diagnose on occasions but sounds awful. Glad you got the right treatment in the end BB.

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 4:51 pm
by Greta
Henrietta, I think there may be some overlap. I have lymphoedema myself and I've spent three weeks in a German lymph clinic and have to have lymphatic drainage every week - this is following breast cancer surgery and above all radiotherapy - the lymph system is damaged. Some unfortunate women have swollen arms for life after lymph node removal and have to wear a sleeve. I also know someone who had it after a knee operation. This is all secondary lymphoedema. Or you can be born with it - primary lymphoedema - and have massive legs, like an Italian boy I saw in a wheelchair who was only able to walk after six weeks' lymphatic drainage.

If your father can't move much, it will be hard to get the lymph flowing.

The lymphoedema support network site (I am a member) does suggest your father's condition may be secondary lymphoedema.
http://www.lymphoedema.org/Menu3/Index.asp

The lymph is not green, anyway. It is a bit like egg white in that if it stops flowing it can harden and become painful.

Doctors tend not to learn about the lymph system. I also suspect there is little they can do in your father's case.

I'm sorry I can't say anything helpful.

If your father had lymphoedema, the kind of tight dressings you mention would be part of the treatment, though. Drainage (a form of light massage to get the lymph flowing) followed by compression to encourage it to move would be standard. So maybe there is some overlap.

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 5:43 pm
by Henrietta
Hi Greta
Many thanks for that info- very interesting . I think that you are right that there is little else they can do besides the current care plan. Just been reading through and yes I think you are right, dad has had compression banadages from time to time and nurses do Doppler tests to check he has sufficient blood flow for compression. I don't think they are using compression just at the moment. The outside stocking has the yellow stripes on it.
Dad has veinous leg ulcers and moves very little, although he does try and do what he can. He's had major surgery, traumas and CKD, and previously had Cellulitis on several occassions so plenty in the mix from that list.

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 5:59 pm
by bowlingbun
Your GP practice sound wonderful.

Re: Swollen legs, Odeima, Ulcers , Infections

Posted: Tue Sep 06, 2016 6:02 pm
by Henrietta
Yes they are BB :D