Question on Back Boil/abscess

[ignis]

 

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Need help, suggestions Please?

 

Maybe start at the beginning, as a kid maybe 8 had what was called a back boil, my Mother would mix bread and warm water put in a cloth on my back, every day, months later went to the Hospital, forget what they did but ended up with a deep black hole..

 

All my life had that hole deep and black about the size of a 2 baht coin but no problems

 

About 3 years ago started to get puss + blood coming out 2 or 3 times a week, for the last year or so every single day.. have seen 5 different Dr’s  both at Government Hospital and at a Private Hospital…

 

All appear the same answer, it is a abscess go to A&E and get it dressed every day…  the Private Hospital gave me Antibiotics {cannot take Penicillin]   Government Hospital no not sell only have Penicillin, so must go to Pharmacy…  again get it dressed every day, problem with this the tape is no good at the Hospital and falls off within 1 hour. = blood/Puss on shirt and bedding..

 

6 months ago the Dr gave me a few 1lt bottles of ‘Sodium Chlorine irrigation’ fluid to clean the wound every day + get from a Pharmacy and use ‘Dermatix’ wound care cream + cover with DuoDERM patch..  

Appears nothing works + 5 lots of Antibiotics + 1,000s of baht of creams and dressings = Blood every day

 

Tried searching abscess on the Web but all appears for a few days or a week or so, not for daily problems for years !

 

Got to see a Dr again next week [my 90 day appointment] anyone any idea what to ask ???  Sick of different Drs looking then saying the same thing.

[Photoguy21]

You could try just asking the question that you want an answer to. Also ask how long will it be before it is completely cured. Contrary to many peoples belief most doctors actually appreciate the patient questioning them. 

[FritsSikkink]

Have you told the doctor you have the problem for years?

[ignis]

1 hour ago, FritsSikkink said:

Have you told the doctor you have the problem for years?

Yes

 

[ignis]

2 hours ago, Photoguy21 said:

You could try just asking the question that you want an answer to. Also ask how long will it be before it is completely cured. Contrary to many peoples belief most doctors actually appreciate the patient questioning them. 

tried that. take 5 days Antibiotic + change the dressing every day should be gone within 7 - 10 days..

 

oddly every 90 day Diabetic Appointment the Dr always want to look to see if it has healed , but after so long [18 months next week] cannot work out why there is not another option..

[Sheryl]

Is this on your lower back, near the buttocks in the middle? If so sounds like pilonidal cyst which often infects and is indeed difficcult to get rid of -- and once gone, can later recur.

 

Treatment is antibiotics, surgical drainage and in some cases surgery.

 

Whrlen you see your doctor ask:

 

(1) Is It a pilonidal cyst?

 

(2) Given how long it has persisted now, is surgery indicated? 

 

[freeworld]

Deleted

Edited April 9 by freeworld

[ignis]

19 minutes ago, Sheryl said:

Is this on your lower back, near the buttocks in the middle? If so sounds like pilonidal cyst which often infects and is indeed difficcult to get rid of -- and once gone, can later recur.

 

Treatment is antibiotics, surgical drainage and in some cases surgery.

 

Whrlen you see your doctor ask:

 

(1) Is It a pilonidal cyst?

 

(2) Given how long it has persisted now, is surgery indicated? 

 

No it is on my higher back Shoulder blade high

 

Did have one at the base of my spine in my 20's, had to have it drained in Hospital then a week or so only sit on a donut cushion

Edited April 9 by ignis
more info

[Sheryl]

22 minutes ago, ignis said:

No it is on my higher back Shoulder blade high

Ok then not pilonidal cyst. 

 

But do ask doctor if surgical drainage is indicated. 

[ignis]

2 minutes ago, Sheryl said:

Ok then not pilonidal cyst. 

 

But do ask doctor if surgical drainage is indicated. 

Yes will do thank you

 

Something no idea about

 

Since 2020 + changing to local Village Hospital my meds have been changed a lot

+ get given more and more Vitamins is this needed + could this be a problem ?

 

Present Dr Prescription  + issued by Hospital Pharmacy

 

Insulin 70/30 Mix   30 units Breakfast. + 20 units Evening Meal

Adjust dosage according to blood test reading…..

Metformine  850 mg  1 x Breakfast. + 1 x Evening Meal

Diabetic Lada since 1991   --------- CKD since 2015

 

Vitamin D 2  20000U  1x week  morning

Vitamin B CO ED    2 x day

Vitamin  B 1- 6       1 x  day     morning

Vitamin  B 6 - 12      3 x a day

Vitamin A 25,000U  1 x a day    Evening

Omega-3 Fish Oil 1000 mg  1x day      morning

Vitamin  B 12  500mg     Evening  3 x week

calcium carbonate 1500 mg 1x day  morning

Calatab  1500 MG 1 x Breakfast

Oemeprazole  20 MG with Breakfast

 

 

hydrochlorothiazide  25 mg Evening [often miss as BP low]

Dozozin  2 MG 1 x  Evening

LO sar tan  40 MG  1x Cut in halve Morning [miss if BP to low]

 

Bestatin  20 MG  1 x cut in halve   Evening

 

Gabapentin  300 mg  1 x before bed

 

81 MG Aspirin  1 x mornings

 

 

 

[Sheryl]

Quite possible many of the vitamins are unnecessary but this has norhing to do with your abscess.

 

Community  hospitals here usually have very limited capacities  Probably not the best place to manage a persistant abscess.  Among other things should get a culture & sensitivity of the pus which they would probably  not be able to do. 

 

I forget where in Thailand you are located? 

[ignis]

11 minutes ago, Sheryl said:

Quite possible many of the vitamins are unnecessary but this has norhing to do with your abscess.

 

Community  hospitals here usually have very limited capacities  Probably not the best place to manage a persistant abscess.  Among other things should get a culture & sensitivity of the pus which they would probably  not be able to do. 

 

I forget where in Thailand you are located? 

Near Sai Noi, use since Covid Sai Noi Hospital.

 

The Dr I normal see said she is moving on, she did ask if I want the April Appointment or go back to BKK Red Cross..so this next Visit will be another Dr..

 

Biggest problem is the very limited stock they hold....  they do have Computers now and my Prescription, many pill I have I have to cut in halve  as they only stock one type and MGs...  The other problem is if I need something they do not have the Dr writes it on a bit of paper to take to a outside Pharmacy..  That is good, but of course it is NOT in the Computer or on Hospital Files. = will take all meds to New Dr..  

 

The Red Cross Hospital = 5 outside patients per day the rest if IN + ward patients   San Noi Hospital see 30 - 50 per day, how can a Dr remember what she asked me to get form a outside Pharmacy 90 days before.

 

So will see this New Dr next week, then think about the very long trip back again to Red Cross.

 

 

[Sheryl]

3 hours ago, ignis said:

Near Sai Noi, use since Covid Sai Noi Hospital.

 

The Dr I normal see said she is moving on, she did ask if I want the April Appointment or go back to BKK Red Cross..so this next Visit will be another Dr..

 

Biggest problem is the very limited stock they hold....  they do have Computers now and my Prescription, many pill I have I have to cut in halve  as they only stock one type and MGs...  The other problem is if I need something they do not have the Dr writes it on a bit of paper to take to a outside Pharmacy..  That is good, but of course it is NOT in the Computer or on Hospital Files. = will take all meds to New Dr..  

 

The Red Cross Hospital = 5 outside patients per day the rest if IN + ward patients   San Noi Hospital see 30 - 50 per day, how can a Dr remember what she asked me to get form a outside Pharmacy 90 days before.

 

So will see this New Dr next week, then think about the very long trip back again to Red Cross.

 

 

If the abscess persists I would suggest going to the Red Cross Hospital and specifically ask about getting it cultured to see what antibiotic it is sensitive to.

 

 

[Stevemercer]

Did the original poster say they were diabetic? I assume this would be relevant?

[TTSIssues]

As you are diabetic, is your blood sugar under control with those meds? My mother is diabetic and I look after her, once we got her blood sugar under control, a lot of other issues cleared up.

 

i am no expert but just a thought? 

[Photoguy21]

19 hours ago, ignis said:

tried that. take 5 days Antibiotic + change the dressing every day should be gone within 7 - 10 days..

 

oddly every 90 day Diabetic Appointment the Dr always want to look to see if it has healed , but after so long [18 months next week] cannot work out why there is not another option..

I would totally agree with you in that it does seem strange.

[Doc Undies]

20 hours ago, ignis said:

tried that. take 5 days Antibiotic + change the dressing every day should be gone within 7 - 10 days..

 

oddly every 90 day Diabetic Appointment the Dr always want to look to see if it has healed , but after so long [18 months next week] cannot work out why there is not another option..

You didn't mention that you have diabetes which can severely affect healing.

[ignis]

38 minutes ago, Doc Undies said:

You didn't mention that you have diabetes which can severely affect healing.

Has been well under control for years

a few posts ago clearly states

 

insulin 70/30 Mix   30 units Breakfast. + 20 units Evening Meal

Adjust dosage according to blood test reading…..

Metformine  850 mg  1 x Breakfast. + 1 x Evening Meal

Diabetic Lada since 1991   --------- CKD since 2015

[ignis]

So many things a small Village Hospital do not stock, wonder if the Dr remembers what they wrote to get from a Pharmacy outside + NO record on Hospital file

 

Dr said get from a Pharmacy outside as Hospital no have  

‘Dermatix’ wound care cream + cover with DuoDERM patch..  {appear to have Allage to glue on Patches ?}      Have also tried 3M waterproof patches as much cheaper still have problem with the glue

Also from Pharmacy out as Hospital no have  Antibiotics  [non Penicillin]

[Sheryl]

A post with misinformation has been removed along with reply to same

[saintdomingo]

On 4/9/2024 at 4:52 PM, Sheryl said:

Is this on your lower back, near the buttocks in the middle? If so sounds like pilonidal cyst which often infects and is indeed difficcult to get rid of -- and once gone, can later recur.

 

Treatment is antibiotics, surgical drainage and in some cases surgery.

 

Whrlen you see your doctor ask:

 

(1) Is It a pilonidal cyst?

 

(2) Given how long it has persisted now, is surgery indicated? 

 

Sorry to wander a bit off topic but I had a pilonidal sinus many decades ago, before lasers etc. Right where the spine meets the bum. In hospital (UK) for 3 weeks after the op and off work for 3 months. I was told it may come back but fortunately never has. Nowadays I'm told it's a quick out-patient job.