Hi, everybody:

I am back after a long time of absence. My two-year-old baby boy was in the ICU for a few weeks because of a bad lungs infection. I was so, so afraid that his lungs infection would cause a failure of his heart, lungs, and kidneys transplants. I was also very afraid because his taking immuno-suppressants would prevent his taking antibiotics and because he has no immune system to fight the infection. To this day, I and his doctors still wonder how he got his lungs infection. His doctors and I can only guess that one of the children he was playing with had an infection of some kind or another and infected him involuntarily. From now on, no more playing with other children for my treasure until his doctors and I find a solution for his life not to be in danger every time he plays with another child.

Now, I have a question for myself. On Friday, February 10, 2012, at my workplace (a garage), I walked away to go back to my office after washing my dirty hands at a water faucet, which is right in the garage, where the mechanics work. I must have slipped on some water or on some oil. I fell on my four members (my knees, my feet, and my hands). "Only" my left knee (the one where my RSD started before spreading to my whole body) got badly scraped. My scraped left knee was burning like hell, as if it was on fire. I can assure you that this scraped knee was burning so much more than an "ordinary scrape". I went to the Emergency Room, where a doctor disinfected my scraped knee. Oww! She had to rub hard with a gauze pad and some Dakin (a disinfectant) so that all the dirt in the wound would come out. Then she put some cream (Flammazine), some gauze pads (six), and a bandage. The doctor told me the burning was normal because scraped knees always burn. I understand this, but what I do NOT understand is why my scraped knee burns much, much more than the other scrapes I had on other areas of my body after previous falls.

Do you think RSD could play a role in my scraped knee's burning being so much worse and thus, so much more painful? My RSD pain had not made me cry in a long time (it was under control) but since this "black" Friday, not a day has gone by without my crying my eyes out because the burning and the pain are so horrible. To make matters worse, the scraped wound has been leaking pus (a very large amount of it) since Friday. The pus, which smells worse than bad, crosses almost all the layers of the six gauze pads of my dressing. I change my dressing every day since Friday. When I get up (even slowly) from a sitting or lying position, I feel my scraped wound beating painfully, as if it had a heart of its own, but a painful one.

What is going on? Now, four days after my fall, my scraped knee shows no signs of healing. Besides that, the wound is still leaking a lot of pus, it is still smelling very bad, it is still very painful (whether I walk on it or not), it is still burning, it is still beating painfully... I have been taking strong oral antibiotics since Friday, but no change for the better has occurred.

What do you think? Any opinions, ideas, or suggestions are welcome. I am starting to get angry at my wound, telling myself that scraped knees usually take a day or two, or three at the most, to heal. I am still waiting for my scraped knee to heal. I am getting sick and tired of waiting. Please help! Thanks a lot for everything.

I'm so sorry to hear about your son but am glad that he is doing better. What a scare!

As for the knee...I think it has flared up the RSD. The other day I was putting something in my purse and my hand (where I have RSD) brushed the velcro and oh my god did it BURN! My whole hand got red and swelled up and felt like it was on fire. This wasn't even a bad scrape...no blood (though there were a couple of small scabs I noticed the next day once the swellind went down so it obviously broke the skin)...but holy crap I felt like my hand was sitting in a ball of flames for days afterwards. So I think the extra burning pain is most likely stemming from the RSD as opposed to just the scrape itself.

If it is not healing up yet then I think you should make an appointment with the doctor. It could be infected despite everything they did to clean it out...which could just be making things worse. You may need stronger antibiotics or different ones. If it was deep then it may take a little longer than normal to heal but it should at least show SOME signs of getting better by now.

I have heard that RSD can weaken the immune system and make it more likely for us to get infections...so maybe that is also part of the problem? But I would definitely make an appointment with a doctor to get it checked out. If it happened at work (did you file an accident report?) make sure you know the laws and if there are any special doctors you need to see or if you can see your own, etc. They should pay for all your medical care but you have to follow their procedures in terms of what docs you can see. These laws vary by state so I'm not sure what they are in your area.

Welcome back Kitty,

Sorry to hear about your baby and the recent fall. I have to agree with Catra if it is not improving and the odor is strong definitley go see your dr. You may have something else going on. (infection) RSD can keep our inflammation levels high as most of us stay swollen unless we have long periods of elevation.

Hi, catra121 and alt1268:

I just got a call from my son's baby-sitter, who told me my son has been crying on and off since I left for work this morning. Just before I left for work, my son was in my arms, hugging me tight, wiping off my tears, patting my head, putting his head on my shoulder, and telling me he loved me. I feel so guilty for not feeling better and for being in that much pain... It is my fault if my baby is crying like that... I just hate this knee so much I wish I could have it amputated! No knee, no pain there! The rest of my body which has RSD does not hurt as much as this knee. I guess it is because my RSD started there.

I agree with you when you say the knee has flared up my RSD. I was expecting it to happen because I know my body, but I was hoping nevertheless that it would not happen. Stupid me! People, at home and at work, do not understand me or, more precisely, they do not believe "just a scraped knee" (these are the words they used) can cause me that much pain. Lucky them! They do not know what it is like to live with RSD!

Quote: "I think the extra burning pain is most likely stemming from the RSD as opposed to just the scrape itself."

This is what I told the Emergency Room doctor, but she refused to believe me. All she had to say is: "Scrapes always burn!" I was thinking that if the Emergency Room doctor did not believe me, there is no reason for my primary care physician to believe me. No medical professional on the island where I live now knows RSD well enough. They just heard "a little bit about it", in their own words, in medical school. How much time do you think medical students spend spend studying RSD in medical school? I do not think they even spend an hour doing this.

I do not want my primary care physician to touch my RSD scraped knee, for fear he will cause me more pain than I already have. I am afraid the pain will climb from the 7 it is at now to a 10+ just because the doctor touched the scraped knee wound and hurt me, even involuntarily.

The Emergency Room doctor told me she only covered my scraped RSD knee because I asked for it. She claimed a scraped knee wound should not be covered with a dressing. What about the dirt, dust, and other dirty things that will penetrate into the uncovered scraped knee wound? What about the rubbing the uncovered scraped knee wound might get from my clothes, or bed (while I sleep)? She forgot about this, obviously! Or, maybe, she just does not have enough knowledge about RSD! I found this Emergency Room doctor to be kind, but kindness does not do all the job. Knowledge is important also.

I will see my primary care physician on Wednesday. I might mention to him the problem with the scraped knee wound causing an RSD flare-up and infection, but there is just no way I can allow him to touch my knee, even if he truly wants to help me. Even I do not dare touching my knee, so it is out of the question to let someone else do it! If I involuntarily hurt his feelings by doing this, too bad for me! I will just get lost once more!

The antibiotic I was prescribed is amoxicilline / acide clavulanique (name in French; name in English unknown). The dosage is two 500 mg tablets three times daily for eight days. I started Friday night.

Quote: "If it was deep then it may take a little longer than normal to heal but it should at least show SOME signs of getting better by now."

I see the surface of the scraped knee wound, but I cannot tell how deep it is under. As for the healing, some people who lack understanding tell me to be patient but, obviously, they do not know what RSD and severe pain are like! Besides that, what you said is totally true, so my instinct tells me: "It should at least show SOME signs of getting better by now."

Quote: "I have heard that RSD can weaken the immune system and make it more likely for us to get infections..."

Do you know the links to Internet documents that mention this fact? These documents would be very useful for me; I could show them to my doctors so they do not say I am making things up.

Quote: "If it happened at work (did you file an accident report?)"

I did file an accident report: one part went to the public health insurance company, one part went to the pharmacist (for the medications), one part went to the Emergency Room doctor, and one part went to the employer. Since I already saw an Emergency Room doctor for this work-related injury, I do not know if I can see another doctor (my primary care physician) and get all the expenses covered 100% for the work-related injury.

Alt1268, the odor from my scraped knee wound is so strong I have the feeling the room I am in is filled with baby diapers full of baby poop. Never before have I heard of pus smelling this bad. I even thought my mother had forgotten the used diapers of my brother's baby in my bedroom because it was smelling like poop in the bedroom (the room in which I spent my weekend).

I do not understand why the antibiotic is not yet doing at least a little something to help with the infection of my scraped knee wound.

Thank you both for sharing your answers and giving some comfort and kindness.

Here are a couple links to RSD puzzles about the immune system:

Puzzle 77

Puzzle 108

I'm sure I've seen more on different sites too but if all else fails I always check the RSD puzzles. I know that I looked into this because since I got RSD I have had several issues with MRSA infections which are resistant to antibiotics.

As far as seeing your primary care doctor...he shouldn't have to TOUCH it to determine if it is infected. As Alt said...if it smells that strongly then it likely IS infected. It might help if you let it get some air for a little bit each day when you are able to sit still for a little while. Sometimes that can help. It might just be a matter of switching to a different antibiotic if the one you are on isn't cutting it...and that doesn't necessarily mean a bigger dose. Some infections are just resistent to different ones.

Hope it starts to get better soon. But if it is infected then that could be why it's so bad. And you don't want to mess around with infections because if they get into the blood stream they can be VERY dangerous...even life threatening. I don't mean to scare you...but infections should always be watched closely and not ignored.

Kitty,

There is a good chance you are not on the right antibiotic. So when you see the pcp ask about being switched to clindamycin or Penicillian based drug. It is far from normal to have a wound smell like a dirty baby diaper. I am assuming the pus is not clear but has some sort of color to it?

Hi, catra121 and alt1268:

Today, on Wednesday, February 15, 2012, I went to consult my primary care physician. I told him everything about how the work injury on my left knee occurred, what treatment I received in the Emergency Room, what treatment I applied at home according to the Emergency Room doctor's instructions, the reactions of my scraped knee wound (burning pain, throbbing pain, pus discharge, foul odor, redness around the wound...) The doctor removed my last dressing, touched my knee, wound included, with his gloved hands, and made another light dressing.

My primary care physician's response about the pus on my dressing was: "It is not pus, it is the cream you are using." The cream I am using, Flammazine, is a white hydrophilic cream, containing silver sulphadiazine. It is as white as snow and not yellowish, like pus. So it is not the cream I am using. It does not take a rocket scientist to understand this. Flammazine is the cream the Emergency Room doctor used for my first dressing, the cream she asked me to use for the dressings I have to make at home, and the cream my primary care physician used for the light dressing he made today.

Of course, I have no way of proving to my primary care physician I have burning pain and throbbing pain in my scraped knee wound, so he does not believe me. Just because there are no tests for pain does not mean it is not there. There is an American proverb that says: "Absence of evidence is not evidence of absence."

Besides that, what kind of nose does my primary care physician have, not to be able to smell the foul odor coming from my scraped knee wound? Everyone else is able to smell it but, of course, not him and he does not believe the people who are able to smell it.

Same thing, what kind of eyes does my primary care physician have, not to be able to see the redness around my scraped knee wound? Everyone else is able to see it but, of course, not him.

So what do I do? The public health insurance company would not appreciate my going doctor shopping. I am so angry at my doctor and at my pain in the scraped knee wound that I want to take the phone book (Yellow Pages) and slam it hard, really hard, on my scraped knee wound, again and again and again.

Catra121, my primary care physician does not even want to hear about the information i might get from the Internet. I realized this today. I did not know he was like this, but now I do. My primary care physician refuses to prescribe any better or stronger antibiotics for me, in creal or oral form.

Thanks for listening to me. Now I am going to send this message and cry my eyes out. Thanks again.

Get a new doctor...NOW. Last year I went in to see the doctor for my yearly physical and I had what I thought was a MRSA infection in my arm pit. It was quite painful. He looked at it and said it was just an ingrown hair. I told him it was far too painful and since I had had a MRSA infection once before that I thought this was another one because it felt the same. He was all, "I GUESS I could take a culture and send it out." He almost forgot and I had to insist again at the end of my appointment. He used a razor blade to knick it just a little bit and then SQUEEZED...thank god that was before I had RSD in that are...and took the culture. I asked about being put on antibiotics and he said he really just thought it was an ingrown hair and that I shouldn't worry but they would call something in for me if it turned out it was infected. I had a lumbar sympathetic block scheduled the following Monday (this was on a Thursday) and I told the nurses and doctors there that I thought I had an infection and they both said it was fine since if I really had one then my doctor would have put me on antibiotics. When I was finished with the block and on my way out of the office I had a voicemail on my phone...guess what? It WAS a MRSA infection...and now I had this invasive procedure with an active infection. And then my RSD spread after the block...can't be sure the two things are related but I have my suspicions.

Anyway...my point being that a poor primary care physician can actually do you a lot of harm if you let them. It appears yours is not willing to listen to the patient at all and take their concerns seriously. You need to find a new doctor...one who is compassionate and caring. After I changed I was amazed at how incredible I felt after every appointment with my new doctor...I always left hopeful no matter how dire the situation or how much pain I was in.

If the knee is not better in the next few days then I would again consider going to the ER if you haven't found a new primary care physician. I know no one wants to spend all this time finding doctors and all that...but the longer you put it off the more damage this guy will do to you in the long term. When you call up a different practice, explain that you believe you have an infection. I know that going through everything with a new doctor, explaining your medical history and problems, is a daunting task but it is worth it when you find the right doctor. It changed my life...seriously. Stand up for yourself and take control...letting the doctors treat you like this is unacceptable. The first time it happens, it's completely on them, but every time after that it the responsibility lies partly on you for continuing to see someone like this who is not providing good medical care. I know...I've been there...and I feel like everything I went through last year is partially my fault because I stayed with this jerk doctor for too long and have him too many "chances" to do what should be his job in the first place. He and the other bad doctors I have seen are all in the wrong of course...but I have learned a hard lesson about standing up for my rights and demanding proper treatment...and how important it is to move on if you will not get it with THIS doctor...there are always others.

Hi, catra121:

I called around for hours yesterday, but I could not find a doctor willing to take me as a patient, even if it is only for the scraped knee wound. What did I expect!? That doctors would just scramble to help me with this wound!? In my dreams!!! I think right now that I have lost trust in doctors, any doctors, forever. It is not that big a deal for them to help me, I am not asking them to go get the moon for me, but none of them would help me with my wound. Ha! Ha! How kind and compassionate they are! (I am being sarcastic here.) If I could read their mind, I am sure they must be thinking I can go to hell with my wound. After all, to them, it is "just" a scraped knee wound which will heal. If this wound was going to heal, it would have started doing so a long time ago. Tomorrow, I will have had this wound for a week exactly. It should have healed by then, but is not showing a single sign of healing. All the scrapes I had in the past, including knee scrapes, healed in a few days. This scraped knee wound should never have gotten infected in the first place. The Emergency Room doctor who first saw me after the work injury occurred and I took the best care we could of this wound, but nothing, absolutely nothing, positive is happening with this wound. Worse, the throbbing, which stopped a few days ago, came back yesterday with a vengeance. It was so painful I literally saw stars. Then the tears came. Afterwards, you could hear my baby and I crying together. I guess my seeing the stars is caused by the intense pain in my knee, which made me contract my body very hard, including my eyes. I also have to tell you (I forgot to do so yesterday) that when my primary care physician changed my dressing, it was stuck really hard to the scraped knee wound. What genius thing did he find to do!? Pull my dressing off really hard and really quick! I am sure you can imagine what happened to my wound after such a thing is done. I am desperate. I just do not know what to do anymore, since no primary care physician will help me.

Catra, I was wondering if you knew of the kind of specialists who take care of infected wounds, since absolutely no primary care physicians want to help me.

Quote: "He was all, "I GUESS I could take a culture and send it out.""

I kept the last dressing with the pus on it (the one my primary care physician made). I wish I could send this dressing out to a lab without a doctor's prescription (because none will give me any) so I could find out what is in this pus (MRSA or something else). Then I could go to my primary care physician with the results and tell him something like: "See! I was right! My scraped knee wound IS infected!" But, unfortunately, I cannot get a prescription. No prescriotion = no pus test, which means the infection will never go away. Gangrene will come and my knee will be amputated! Then, besides RSD, I will have phantom limb pain.

Quote: "He almost forgot and I had to insist again at the end of my appointment."

I wonder if he forgot on purpose, because he did not want to have these culture and test done. Maybe he was afraid you would find out you were right and he would find out he was wrong, because that would be a shame for him! A doctor is supposed to find out what is going on with his/her patient. Finding a diagnosis is "usually" not the patient's job. Doctors are not paid for doing nothing.

Quote: "I asked about being put on antibiotics and he said he really just thought it was an ingrown hair and that I shouldn't worry but they would call something in for me if it turned out it was infected."

He refused to prescribe antibiotics for your infected wound, the same way my primary care physician refuses to prescribe antibiotics for my infected wound. It is obvious pus is not caused by viruses, against which antibiotics are known to be ineffective. Pus is caused by some kind of microbes or another, against which antibiotics are very effective. So why refuse to prescribe them for wounds full of pus? I noticed many, many doctors do not like their patients to ask them for a particular prescription (antibiotics, for example); they like to take the initiative. Of course, if they do not take any initiative, the patient pays the price in terms of aggravation of the wound, pain, and suffering. It smells suing here (I mean me suing a doctor if I EVER find out there was a medical malpractice from his part.

I did not know a person could not have an invasive procedure with an active infection going on somewhere inside his/her body.

Quote: "And then my RSD spread after the block...can't be sure the two things are related but I have my suspicions."

All these doctors who destroy the lives of their patients this way should be punished by the AMA, which should take away their license to practice, so they do not destroy the life of another patient. Unfortunately, it is the fight of the iron pot (doctors and their good lawyers, whom they can afford) against the wooden pot (patients, often without lawyers, whom they cannot afford).

Quote: "Anyway...my point being that a poor primary care physician can actually do you a lot of harm if you let them."

I agree with you one zillion %.

Quote: "It appears yours is not willing to listen to the patient at all and take their concerns seriously."

True again.

Quote: "I always left hopeful no matter how dire the situation or how much pain I was in."

This kind of doctors are angels and since there are so few angels on this earth, I wonder if I will ever find one.

Quote: "If the knee is not better in the next few days then I would again consider going to the ER if you haven't found a new primary care physician."

I will do that. However, I hope I will not hear a comment from an Emergency Room doctor, such as: "Emergency Rooms are for life threatening emergencies, not for just infected knee scrapes. Go back to your primary care physician!" If an Emergency Room doctor tells me something like this, I am stuck because I cannot go back to my primary care physician, who will refuse to help me, just like he refused to do on February 15, yesterday. Like I mentioned at the beginning of this message, I have had no success finding a new primary care physician.

If the microbes from my infected knee wound can kill me, I should rapidly write a testament, so my two-year-old baby boy does not go in an orphanage, in which he will be just a number. I want my treasure to live with my police officer boyfriend, if I should die. My boyfriend loves my baby as if he were his own. I know my baby will have a happy life with him and this is all that matters to me, his mother.

Thank you so much for your compassion, understanding, and information. I will try again to find another doctor, but on a small island, there is not much chance of success. I failed already, like I mentioned in the beginning of this message. I hope this time will be different.

I just wanted to tell you that their are doctors who specialize in infections and related stuff...they are infectious disease specialsts (or ID doctors). They should be able to spot an infection easily and get you on the meds you need. If the first ones they put you on don't work then they can get you on another. This is their specialty so perhaps you would have better luck.

As far as the ER...infections can be life threatening so although I would not expect you to be seen immediately over trauma patients or something like that...it IS serious enough to be treated at the ER. Anyone who tells you differently is speaking out of their rear end. If that infection goes untreated and ends up entering your blood stream it could KILL you. Seriously...look up "sepsis"...this is not something that should be ignored.

I am so frigging amazed at how incredibly ridiculous the medical profession is getting. Seriously...I cannot imagine why a primary care physician would refuse to schedule an appointment with ANY patient that calls unless they do not accept your insurance (which still is not a good excuse because you should still have the OPTION to pay OOP if you choose). It is just insane...and I am so sorry to hear what you are going through. Is there anyone you know who could refer you to their own primary care doctor? I found mine because my boyfriend referred me to the practice (he's been going there his whole life) and when I called to make the appointment they asked me a little bit about what was going on and then they told me who they thought would be the best fit for my sitation...and that's where I met my current doctor. When you called up the different doctors did you try just saying that you were looking for a new primary care physician? Maybe that would at least get you in the door. I don't know...it's all so ridiculous to me.

Anyway...hope that you get the relief you need soon. After a week of the wound not getting any better it should be obvious to anyone that this is more than just a simple scrape. If you luck into a kind doctor at the ER then perhaps you could ask him/her for a referral to a different primary care doctor or infectious disease specialist. The good ones will do that...especially if they are caring and compassionate like you would expect. I'll keep you in my thought.