One thing that can really ruin a vacation or weekend plans includes getting an infection. Learning about what causes an infection lands a little too lightly until it happens.
The first time I got an infection, I was attending a party- high heels, tea length dress, the sha-bang. Waiting outside for the door to open, a little fire ant climbed onto my toes and gave me a curt bite. If you’re not from Texas, there are ants that bite you and feel literally like fire. Your skin turns red, pain occurs, itching, maybe even a white bump afterwards. However, because I have lymphedema and my immune system in not 100%, this red/painful bite became something much more.
The hallmark signs of an infection for lymphedema are: redness, increased local swelling, pain, “malaise” which is a medical turn for feeling tired and just bad, and a fever.
My toes became red and swollen followed by the top of my foot moving into my inside ankle area the next day. So painful, so hot! I went to my college campus medical system that diagnosed me with cellulitis and gave me an antibiotic. It took a few days for the redness to go down; however got better over time.
After my ant bite experience, a few more times throughout my life, I have had a bug bite on my affected foot. I have washed with soap and water and applied antibiotic cream (i.e. Neosporin), watched and waited. I sometimes will use a sharpie to trace around the redness; if it moves out of the boundary I will seek medical attention. Retrospectively I have 90% mananged to prevent infections this way.
Anatomy moment: The lymphatic system returns to the blood circulation via a large vein into the heart called the vena cava.
Clinical implications: If you have an untreated infection, it will reach your heart and infect your heart/blood. Not good. Therefore it is IMPERATIVE should you have an infection to seek immediate medical care.
It seriously is always an ant for me… It’s always before a vacation too. I got the opportunity to attend the World Congress of Lymphedema in San Franciso in 2015. During packing, I glanced down at a searing pain between my second and third toes. Yes. An ant! What timing… I did what I always do and monitored the bite. I hiked up those big San Franciso hills during adventures with myself between sessions. I always knew how much my toes ached whether I was enjoying some green tea in China town or trying to find out where I was on maps.
The other 10% of the time, I had an infection in my leg which was due to impaired lymphatic function. I am so grateful I have been able to get antibiotics due to my access to health care in my country. However, the week that followed would always be rough. I had the rumbly tumblies from the antibiotics and whatever physical activity I would have planned would need to be modified. I.e. 5 mile run planned for the weekend is changed to a walk. I’d need to wrap my leg at night even if I was going on a weekend trip. I.e. short stretch compression bandaging in a tent during a Texas summer. According to the ICF-10 model for disability, my functional limitations and abilities would be just as affected as my red, swollen foot.
Central sensitization is when your nervous system makes changes at your brain, spinal cord, and receptor level to increased protection to a perceived threat. The perceived threat of loss of independence has protected me during walking barefoot outside, a pedicurist trying to cut my cuticles after I’ve declined, and stepping on sharp objects.
Who tries to step on sharp objects?!? The point here is that everything you would normally avoid for bites, scrapes, cuts is paramount.
I’ve attached a great handout that covers the do’s and don’ts of infection prevention. For me, habits I’ve cultivated have been the most helpful in preventing infections. I.e. painting my own toenails, wearing closed toe shoes on my outdoor escapades, learning to love the swimming pool versus that hot tub.
At the end of the day, you can’t control when the ant bites. However, you can control the habits you cultivate to protect yourself. And should you get bit, scratched, or cut, you know what to do next!
Insert round house kick here!
The Lymph Lassie 