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Mom is 92 yrs old and has congestive heart failure (CHF), afib and now recurrent cellulitis in her left lower leg. She has edema in the leg and her skin splits and gets infected. This is her third bout in 6 months. She is on a blood thinner, Lasix, metoprolol, levoxyl, and she has a pace maker. The doctor treats her each time with an antibiotic and a topical cream. Anything else we can do to prevent this? She is a clean person, and it seems this pops up out of the blue every 3 months or so now.

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Ty everyone! I don't have the infections yet, but have leg edema, trouble with compression hose binding, dry itchy skin, and diabetes. All suggestions helpful. I use a heavy-duty cream from a jar (Eucerin). The squirt kind adds water. Are there any ideas about compression hose that ends up binding at the ankle?
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Llamalover - She is on Lasix 40 mgs. She has been on Lasix for about 5 yrs. She started at a lower dose and went up to 40 mgs about a yr ago. Her doctor wanted her to take 60 mgs, but she refused because she has to use the bathroom too much. And I think she’s afraid of overworking her kidneys.
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My dad came home form the hospital with a severe case of cellulitis in his leg. LOOONG story short and ONE YEAR later with repeated infections month after month, I did this to resolve it.
-I demanded 14 full days of IV antbiotic. (they kept doing only 7 days)
-I put on 30lb compression hose EVERY SINGLE DAY. He's still wearing them.
-I bought QUALITY Turmeric/curcumin and gave him 2,000-2500mg per day (with meals)
-I loaded him up with quality probiotics twice a day. (at least 2 hrs away from antibiotics if taking them orally)

This was almost 2 yrs ago. It's never come back. It was the only treatment that cured him AND prevented him from getting C-Diff because of the heavy antibiotics. The Dr told me he'd get C-Diff for sure, but she wouldn't listen to me when I told her I could prevent that.
Good luck.
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My mom is 73 and also has congestive heart failure, Afib, COPD, stage 3 kidney disease, and is in remission from lung cancer. (She was a smoker for 50 years). She suffers from edema in her lower legs too because she sits and sleeps in her recliner. She has difficulty breathing in a flat bed even though she's on oxygen. I can totally relate.
My suggestion would be to discuss with her physician whether the lasix is working still. Sometimes if a person takes it for a while it can become less effective. They have other medication like metalozone that can work. Just make sure that the dr starts at the lowest dose possible because my mom became dehydrated very quickly. It worked fast. You may also ask the doctor if your mom should be on fluid restrictions. My mom is. It's a balancing act to make sure she drinks enough to keep her kidneys functioning and at the same time not taking in too much fluid. And finally, if the doctor agrees to compression stockings, and you find they are too tight, you can get about 4 wide ace bandages and wrap her legs from the foot up to the knee. 2 per leg is what we use. Keep them on during waking hours and take the wraps off at bedtime. Use guaze pads and some antibiotic ointment cream to cover any open sores first. And try and keep her legs elevated as much as possible. I can't emphasize enough to speak to her primary care physician about these methods. They will help. Good luck.
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Is she on Furosemide, aka, Lasix for the edema?
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My Mother had the same problem when she was about 89 years old. A podiatrist finally diagnosed the problem, heart related, and he referred her immediately to a heart specialist. She received a stent in the thigh to increase blood flow, and it cleared up beautifully. She has no problems now with her feet or legs. Her primary care general physician could not figure out what the problem was after much "experimentation" and searching for the problem and solution. But, that podiatrist was a god-send!
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Wow! Some great advice. TY everyone! We see the dermatologist on Wed and her geriatric care physician on Fri, so hoping to come up with some answers. I read a bit myself too and realized that she has squamous Cell skin tumors on her body that she has burned off every few months or so. Most of the time, these scabs heal well and on we go. But the ones on her lower legs are starting to cause these problems she’s having now. I feel this is what is leading to the cellulitis because they don’t heal like the rest of her body heals. She has a reoccurring problem with squamous cell tumors these past few years because of too much sun her whole life. It is catching up to her. (Sun worshipper). Any nick or scratch now is causing a problem on her lower legs.  I think we will have to discuss how to treat these tumors on her legs from now on.  Thank you for all your advice!
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I forgot - watch what chemicals you use re laundry for clothing & bed linens.
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You had a lot of great answers above to consider! Antibiotics - careful because overuse causes problems of their own including adversely affecting immune system. Gut is huge factor in immunity so don't overlook the note re prebiotics/probiotics! I would also stay away from alcohol/drying substances in lotions, etc. while at same time moisurizing the skin - dry skin cracks causing pain and leaving open for more infection (watch overuse of hand-sanitizers w alcohol). Avoid hot/cold temps of water - but ask Dr if ok to lightly cover with moist bandages from time to time -- ask him re circumstances on whether should be cool (edema) or warm. Watch too much sun exposure. Elevating legs good - a problem my husband & I have to keep reminding ourselves while elevating - is NOT to cross legs/ankles. I believe the importance of hydrating (inside of body & outside), nutrition & exercise were covered above. While compression stockings are awesome - Confirm with Dr because in some cases, at certain times - loose-fitting clothing, area being lightly covered is more appropriate. Ask if ok to add coconut oil & especially doTERRA Lavender Essential Oil to her lotions, rash creams, to her warm compresses, bath water. I often use just the FCO & Lavender for light massage/ to moisturize. Good luck!
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You might want to ask if another diuretic might be more effective for her than Lasix. And I do only mean ask - there may be very good clinical reasons not to attempt them.

My mother's visiting nurse wanted her to lie down in (or at least on) bed for a couple of hours in the afternoon. Mother wouldn't; but if yours is more co-operative you might find this helpful.

And I agree about mobility exercise, as far as you can persuade her to try. Encourage, remind, assist; but don't force.

Don't forget that although the oedema is most obvious and most visible in her leg, the fluid overload applies to all of her body and it affects oxygen supply, which affects energy levels. So there is a bit of a vicious circle going on. Poor mother feels too exhausted to move around much, but then the oedema gets worse, so she feels even more exhausted...
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Maybe a wound care specialist would have some up to date suggestions? I'd be cautious with the stockings unless okay with the MD or medical professional. Those stockings getting on and off can be quite a work out especially for a swollen leg and even for an able bodied adult. I'd be very cautious about nylon foot coverings as I learned from the podiatrist that warm dark places are where the nail fungus likes to grow. Maybe the stockings come open toe now?
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see a Physical therapist and have them prescribe/order support hose of medical grade quality [at least 30-40 mm]. Hose should be worn most of the time. You can take them off when your family member goes to bed for the night. Put a regular knee high stocking on first. It makes it easier to get the support hose on
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Well this sounds familiar. Dad is on his second bout of cellulitis in 6 months. The first one healed pretty well because it hadn't broken the skin. Diuretics and antibiotics. The second one has an open wound that is not healing. It has been draining for weeks and requires a dressing change every other day. He is at the doctor Monday-Wednesday-Friday and then I usually end up there on the weekend to change it again. I'm not sure how long this is going to last. His legs are swollen and possibly this one is worse because of the summer heat. He is diabetic and not very mobile so I'm sure this is adding to the problem.
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Find a good quality, non-scented moisturizing lotion or cream. Apply to clean, dry legs a couple of times a day. Older skin loses its moisture and therefore its elasticity, hence when it stretches due to the swelling it is prone to splitting and cracking - open splits/cracks and scratches are more prone to infections.

My mom had a cat who would scratch her legs - which caused most of her cellulitis, we believe. It helped a bit to ensure mom wore long pants to prevent these types of open wounds.

Other than a good moisturizer the steps others have mentioned to keep the swelling down are your best bets. Keeping legs elevated did wonders for my moms swollen calves and ankles.

BTW - it might be a good idea to run the moisturizer brand by her PCP if you can. If not - a good pharmacist at a store like Walgreens should be able to recommend a good brand.
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nymima, I had some limited success by propping the foot of my dad's mattress up a 3-4 inches higher than the head. Also, having your mom keep her feet elevated in a recliner or on a foot stool while sitting could help the swelling -- I had no success with this technique for my dad as he wouldn't cooperate for more than a few minutes. Compression socks might also help your mom.
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Is she active? That is one of the biggest factors, no exercise.

I put my dad on a daily pre/pro biotic and it has made a huge difference, he has all of the same issues you listed.

I take him to big box stores and walk him until he's pooped. This has been a huge help as well. He can't take any water pill daily because he has kidney disease as well.

I give him colloidal silver daily, 2 hours after the pre/pro biotic, so far no further infections. You can also spray it on the areas of concern. It really is a fabulous anti-bacterial, anti-viral product, no known side effects, unless you drink loads of it and no drug interactions that I could find.

I hope you find something that helps put an end to this brutal cycle.
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