What appeared to be a simple rash soon turned into a nasty skin infection that put CLÁIR NÍ AONGHUSAin hospital for 11 days
ONE DAY in late July 2008, I woke up in the early hours feeling pretty unwell and spent a feverish day in bed. That afternoon, a rosy red rash broke out on my right leg underneath the shin.
By evening, the rash reached halfway up to my knee. The following morning, it had expanded and turned a dark purple.
Because my mother had once contracted cellulitis – an infection of the skin tissues – from a septic cut, I suspected that this was what I had, and knew enough to realise that I probably needed antibiotics.
My GP was shocked when she saw the purple. She confirmed that it was cellulitis and explained that the deep colour indicated bleeding underneath the skin.
It was too late to send off blood samples, so she prescribed a double dose of antibiotics and said to return first thing on Monday.
She said if the rash were to deteriorate or spread, I should go straight to A&E.
My husband David and I didn’t call off our dinner out that night.
Despite shivering fits, it never occurred to me to check my temperature. As I was on two sets of antibiotics, the fact that my leg was badly swollen didn’t bother me. We were staying with our hosts, and I had to bail out early to go to bed.
The following evening, a blister, initially the size of a pea, formed on part of the affected skin. Within half an hour, it was the size of a grape. David checked out cellulitis on the internet and said we’d better get to AE.
By the time we reached St Vincent’s, the blister was the size and colour of a small plum.
When the triage nurse examined the leg, I noticed a fresh rash up to the knee. For the first time, I felt afraid. Shortly after midnight, I was admitted and hooked up to the first dose of triple intravenous antibiotics, which would be repeated every six hours.
There are many ways to contract cellulitis – and it can affect different parts of the body – but doctors believed that a walk David and I took through long grass and dense vegetation to the grave of the 17th-century writer Seathrún Céitinn in Tubrid exposed me to something that either bit, cut or stung my bare leg, and the infection burrowed under the skin.
I was spiking high temperatures. The leg was hot to the touch, tender and swollen. It had to be elevated on three pillows to help drain the infection. A blister can indicate the presence of the flesh-eating bacteria but, luckily, I didn’t have a necrotising fascitis.
Doctors debated whether or not to rupture the blister. On the second night, I slept on it, hoping to burst it, but it survived.
The next day, I was warned on no account to puncture it, as doctors were afraid it would become a source of secondary infection.
Many people can’t put a foot infected with cellulitis on the ground because of the pain. But although the skin on my leg was fragile, and unpleasantly tight and sore, I wasn’t in severe pain and was allowed out of bed for trips to the bathroom.
Nurses warned that the least thing – any contact – could compromise my leg. Despite my protests, attending Tom Waits’ concert was out of the question.
Every morning a troop of doctors marched up to my bed to review my condition and discuss it with me.
Their spokeswoman was always cheerful and open to questions. Nevertheless, as a fellow patient noted, it probably wasn’t such a great thing to be on the receiving end of so much attention.
I heard how lucky I was not to have diabetes, as sufferers are more prone to cellulitis, and it’s more difficult to treat.
“Before antibiotics, people died from this. We’re going to take good care of you. We don’t want the infection to come back, and we don’t want you to be left with a condition in your leg. It’s your health and it’s the rest of your life,” I was told.
The nurses went out of their way to minimise the disruption caused by receiving three doses of intravenous injections every six hours.
My veins aren’t particularly suited to needles, and one night it proved difficult to locate a good lead. I panicked but they found a skilled nurse who succeeded where an intern had failed.
If the worst had come to the worst, they could have put in a main line. The swelling on my leg took a long time to subside and, for a while, the skin turned blue whenever I walked on it.
The blister deflated but then sneakily reconstituted itself and delayed my release home.
In total, I spent 11 days in hospital, 35 days on antibiotics, even longer on bed rest, and I attended hospital as an outpatient for two months.
The skin healed, and the scab from the blister fell off eventually, although I still have noticeable marks on my leg.
“You’re not going to be great after this,” a consultant warned me, but I didn’t register what he meant until I tried to become active again.
For a good eight months afterwards, I had low energy. Because the infection can damage nerve endings, every so often I have to double-check that certain sensations don’t indicate a return of the infection.
Now I won’t go on holiday without some insect repellent and anti-histamine tablets. And my GP’s advice is etched in my brain: “If you see that red again, you’ll know to run to a doctor because you’ve seen how cellulitis can surge.”
Cláir Ní Aonghusa is a writer. Her next novel, Civil and Strange, will be published by Penguin on August 6th. It is being launched by Frank McGuinness in Waterstones on July 30th