Medical situation: What would you do?

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
Mind you that I have a severely damaged immune system [relevant tests below (immune in green, cbc in purple, 6'4" male, hiv+ ~34yrs.)].

A few months ago I noticed a hard bump near my elbow as if a part of the bone was growing out to the side. It was painless, examined by two doctors, then x-rayed. It was of no known origin (both doctors said they didn't know, and the x-ray came back 'negative for everything' but no film with which to actually see/interpret it), so off I went a bit perplexed but not worried.

Since then it had changed size a bit in both directions, stayed hard like bone, and didn't hurt until earlier this week.

A day of sudden, searing pain and a lot of difficulty moving my right arm sent me to emergency. I came out with a script for clindamyacin (300 every 6 (ugh) x 7d). But the lady's (I don't remember her long title) first instruction was to come back to emergency if it started to hurt when I moved my elbow. I reminded her that the pain was already a solid 7 when I moved my elbow (also I push a manual wheelchair). She then said to only come back if it hurt too badly to move my arm at all.

She had squeezed it a lot, plus it took hours in the emergency room, and the pain overrode my self-considerations for food and water or my normal large doses of antiretrovirals.

The pain increased a lot and is less now (I've had 8 doses of the antibiotic, but I wouldn't try to drive yet), and the swelling seems to have reached a plateau.

Does it sound right that I should be ok as long as I can move my elbow with lessening (back to a 7) pain and limited extension? Wait and see?

[for those who care, this medical intervention was paid for by my private Medigap plan and Medicare]

e6yIIoS.jpg
 

sandorski

No Lifer
Oct 10, 1999
70,100
5,640
126
My Internet Doctorate doesn't comprehend your chart, but I'd just finish the scrip and heed the advice. It's what, 7-10 days? You will probably see improvements in a few days if anti-biotics solve the issue, finish them either way though.

Kinda sounds like a cyst to me. Had one on an elbow a few years back, like your situation it eventually rapidly grew after just being a hard lump for a few months. Eventually it became like a giant blister that burst open one night when I bump it accidentally. If that happens to you, be sure to wash it thoroughly, bandage it up, then see a Doctor asap to prevent infection.
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
My Internet Doctorate doesn't comprehend your chart, but I'd just finish the scrip and heed the advice. It's what, 7-10 days? You will probably see improvements in a few days if anti-biotics solve the issue, finish them either way though.

Kinda sounds like a cyst to me. Had one on an elbow a few years back, like your situation it eventually rapidly grew after just being a hard lump for a few months. Eventually it became like a giant blister that burst open one night when I bump it accidentally. If that happens to you, be sure to wash it thoroughly, bandage it up, then see a Doctor asap to prevent infection.
The chart is just my most recent blood results showing the current state of my challenges to infections.

And yes I don't want another infection. And you're right, it will have to do its thing, and when the pain was at its worst, as a drama queen, I feared losing my arm at the obviously infected elbow joint (which would be a not impossible road for an already gimp like me).
 

lxskllr

No Lifer
Nov 30, 2004
57,413
7,593
126
Cysts can be drained, and it isn't expensive. Is there any reason they don't want to do that?
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
Cysts can be drained, and it isn't expensive. Is there any reason they don't want to do that?
It wasn't mentioned. I've had that procedure done once, it was painful, and it was at the base of my back. My partner at the time did the daily packing until the cavity went away, but I can reach and see this. Hmmm. It was a hospital off my network (emergency is covered though), and no one asked me for insurance info, but when I got there I think they found me on a computer (I had been there for a paid hernia repair in the 1980's), but until the very end when I mentioned my insurance they didn't ask for cards or numbers. I'm going to go ahead and assume that their apparent assumption that I had no insurance had nothing to do with procedures.

As for why, I don't know. If a lot of it is between bones (like how it feels - especially since the squeezing), is it truly drain-able?
 

lxskllr

No Lifer
Nov 30, 2004
57,413
7,593
126
I'm pretty sure anything is drainable. Your hiv status probably complicates things a bit. It could be they want to minimize invasions to your body. I dunno. I guess it comes down to two options, wait and see, or get a second opinion. I'm of the wait and see school, but then I'm also of the I don't go to doctors school, so perhaps that isn't the best advice :^D
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
I'm pretty sure anything is drainable. Your hiv status probably complicates things a bit. It could be they want to minimize invasions to your body. I dunno. I guess it comes down to two options, wait and see, or get a second opinion. I'm of the wait and see school, but then I'm also of the I don't go to doctors school, so perhaps that isn't the best advice :^D
Trust me, I'm right there with you, and aside from tweedle-dee and tweedle-dumb, no doctors were involved at the hospital (bump 2.0) that I know of.

I was researching while waiting and everything was pointing to Keflex (antibiotic) but I wasn't stupid enough to say I wanted it, but when she said that that was what she was sending me home with a script for I told her I had read about it. My marching orders came with one for clindimyacin. Damn! I hate an alarm in the middle of the night, .5+.25=<1 sleep.
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
Cancer patient here & all I can say is your blood counts are messed up. :(.
Geekbabe! So nice to see your words.

Yes, beyond the immune stuff my numbers look like I'm in stage 3 - 4. There is something called 'HIV-related cytopenia,' but multiple doctors told me that it couldn't explain my WBC, platelets, etc.

A bone-marrow biopsy was done (a horribly long term painful procedure) and no results came back, which I was told meant that the tests were 'negative for everything.' I've since learned that when that happens, the f-ing, damn, stupid spelling of my first name gets 'corrected' along the way, then the lab is lost, and if not claimed is purged. There's no way in a million years that I'd do another biopsy, but there's another possible explanation; HIV looks for places in the body to hang out when being assaulted with the anti-retroviral meds, if it gets in the bone marrow, numbers like these are seen then a pretty quick death.

I've had these really bad numbers for decades.

I'm noticing the huge, cavernous differences between hospitals and medical territories. I used to be treated like sh*t at my ins. cos. approved hospital in Long Beach (south LA), but the new hospital (in a very nice area) treats me like gold, and is NOT religiously affiliated :):):):) where it's unsurprising that gay, HIV+, wheelchair-bound people are discarded with as fast as possible, or made to wait in emergency over 4 hours (the point at which my wheelchair starts hurting my back and I have to leave untreated).

It's so sad to me that the level of patient care can change so much a few miles and 'railroad tracks' away. :(
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
The crooked teeth with the heavy accent are so sexy.
I don't care about superficial stuff like teeth (although I've seen much worse teeth in the U.S. than the UK), but that accent and the general huge differences about everything EU (food regs., education, healthcare, support for when it's needed...) make me weak in the knees. The American need to insult other countries says a lot about why we are where we are now and our Dear Leader.

I know it was tongue-in-cheek, and so is this; insult a Brit. again, and ...
 

AnMig

Golden Member
Nov 7, 2000
1,760
3
81
given your hiv status and duration the mass has been present i would seriously consider a Scrofula (tuberculosis), infected cyst also likely,

I would consult your id doctor
 

Mayne

Diamond Member
Apr 13, 2014
8,820
1,358
126
I have a hard lump on my urethra. I get pain when i wake up with a woodie.
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
given your hiv status and duration the mass has been present i would seriously consider a Scrofula (tuberculosis), infected cyst also likely,

I would consult your id doctor
Thanks, no TB unless I just picked it up in the ER.

I'm back there, and a with-it, real doctor saw me and he instantly understood my hiv and medical experience and said he wanted full blood work and x-rays. Why that wasn't ordered 2 days ago is beyond me, unless the assumption that I had no insurance was part of that. Today I started with my insurance cards and it was a night and day difference. No baby talk from a weird, non-doctor lady.

I'm waiting for results from my tests. +++++++
 
  • Like
Reactions: Thebobo

JEDIYoda

Lifer
Jul 13, 2005
33,981
3,318
126
II would go see a doctor! When was the last time you saw anybody on these forums with the letters MD after their name...lolol.....you get what you pay for!!
 

Thebobo

Lifer
Jun 19, 2006
18,592
7,673
136
Thanks, no TB unless I just picked it up in the ER.

I'm back there, and a with-it, real doctor saw me and he instantly understood my hiv and medical experience and said he wanted full blood work and x-rays. Why that wasn't ordered 2 days ago is beyond me, unless the assumption that I had no insurance was part of that. Today I started with my insurance cards and it was a night and day difference. No baby talk from a weird, non-doctor lady.

I'm waiting for results from my tests. +++++++

Well here's hoping for some good news.
 
  • Like
Reactions: DietDrThunder

TheVrolok

Lifer
Dec 11, 2000
24,254
4,076
136
Sounds like the initial thought was septic olecranon bursitis with warnings of what a septic joint could be like? Certainly being back in the hospital is a good idea with your immunosuppression and failure of outpatient therapy.

Hopefully it's just misdiagnosed gout!
 
  • Like
Reactions: bradly1101

Thebobo

Lifer
Jun 19, 2006
18,592
7,673
136
Sounds like the initial thought was septic olecranon bursitis with warnings of what a septic joint could be like? Certainly being back in the hospital is a good idea with your immunosuppression and failure of outpatient therapy.

Hopefully it's just misdiagnosed gout!

Only had the gout in the big toe and maybe one time in the ankle. And lord it's the most painful thing I've ever had. Indomethacin (sp?) always gives me relief. All though I rarely get since I stopped drinking.

Also every time I hear Gout I think of the Errol Flynn movie Captain Blood, I watch it every time its on TCM.
 
  • Like
Reactions: bradly1101