My little girl needs your best medical opinion, can you help?

Yikes! Why haven’t you already gotten a second opinion? And why would you ask a group of layman on the internet about something as important as your daughters health?

I’m sorry, that sounds harsh, but come on!

Um… because there are people here who’ve dealt with dog bites, and I know there are some doctors hiding around here somewhere…

And I tried getting a second opinion yesterday but never got a phone call back. I’m waiting now for my doctor to call me, because I adore that man. I would have taken her straight in to the ER yesterday, but I’m trying to avoid the trauma of that trip if I can. If my doc tells me to take her in, I will.

@WillWorkForChocolate And how do you determine who is competent, and who is full of crap? Because I see answers of both sorts here. And if someone says they’re a doctor, will you take them at their word?

The internet can be a great resource, but some things (like your child’s face) are probably better served elsewhere.

You should have already taken her to the ER. Your daughters face is going to be with her the rest of her life and scarring that pretty face now, could do psychological damage to her in her future.

No doctor here, but I have never trusted doctors at Urgent Care Centers. They have always seemed to be 2nd best to me.

Your daughter needs the best…now.

An infected dog bite can be a dangerous situation, especially since it occured around her head.

@john65pennington I was trying to avoid traumatizing her with IV needles and the like. I know the Rocephin and the oral antibiotic she was given are very aggressive, so I was really hoping that would take care of the matter. Unlike everyone else and their freakin’ dog in the US, I don’t go straight to the ER for everything.

She doesn’t have fever, there is no streaking around the wound, so it’s not actually a straight up “emergency”. I just don’t know if the hard part is an abscess or just really inflamed tissue. I’m worried that it’s an abscess, but then again I see the worst in a lot of medical instances because of an accident that she had when she was 4.

That’s why I’m waiting for an opinion from my doctor, to see if he thinks the hardness will soften and go away with warm compresses, like it’s just inflamed tissue, or if he thinks it sounds like an abscess and she needs intervention.

I can only wish you good luck with what you are dealing with and support in how you are handling it.

That comment seriously got modded when I’ve seen far worse lately? That was not a fucking personal attack, but whatever…

Fuck this, all I’m gonna get is criticism for not running straight to the ER to sit amongst stupid mothers who take their kids to the ER for a damned runny nose. You guys go ahead and have a field day with it.

You think I’m stupid for attempting to save my poor little girl a lot of trauma and nightmares unless it’s completely necessary? So be it.

What do the ER, needles and nightmares have to do with getting a second opinion? I understand that it may not be an option for you for some reason, but my personal choice would be to camp on the phone of my regular pediatrician, or even a specialist (plastic surgeon?).

My only point, really, is that bite wounds can be serious. And that a facial wound has potential life-long effects. And that I would urge you to seek out further medical advice from the medical community, rather than the internet (especially since you said the first doctor “did something he shouldn’t have” – that’s concerning). That’s all. It’s your decision to make. But you were obviously concerned enough to post this question.

I learned long ago from a few facially injured family members and friends how important it is to consult with a plastic surgeon for any facial wound be it large or small.

I told my husband prior to the birth of our son…”If anything ever happens to his face & I am injured or incapacitated, contact a plastic surgeon ASAP.”

I kid you not, we just had this conversation the other night, again, after seeing a boy with a large split lip that clearly was not properly cared for by a well qualified medical professional.

@syz I made that remark in regards to, “You should have already taken her to the ER”. Despite John’s good intentions, I think too many people go to the ER when it’s unnecessary, and I didn’t want to be stuck behind those people, just sitting there waiting and waiting and waiting.

And I tried to get a second opinion already, if you’ll read my first response to you. What happens when you leave messages for doctors/nurses to call you back, but you get no response?

That’s why I’m still waiting for my personal doctor to call with his opinion. He can actually give intravenous antibiotics in office, instead of referring us to the hospital.

I think it is natural for you to be concerned because you are a mother. I would be too. Can you not phone the doctor you saw, and tell him you are concerned about the lump in her cheek? Perhaps there is a logical explanation? Or do you know a friend who is a doctor you could ask, just to assist your anxiety right now? I am no doctor of course, but a friend of mine was bitten twice in one month and she was ok, even after delaying treatment. So I am sure it will be ok. But, seek that second opinon or, phone the doctor to put your own mind at rest. Hugs.

I would not use warm compress.

If the inflammation has not spread and is actually getting smaller, I think the antibitiotics are working.

As far as plastic surgeon, I think it is probably too late. She would have needed something done within a few hours of the accident. If not done within hours I think she will have to wait until after completely healed, if she is left with a scar you don’t like, they can address it. But, I am not an expert, that is a question you can ask your doctor.

The times I have had cellulitis it was treated with IV or PO, I have no experience with the shot that was given your daughter.

@JLeslie Well, the doc suggested using warm compresses and said it should soften the hard spot, if it’s inflamed tissue. I did warm compresses all day yesterday, and have kept going with them today and it’s not changing at all. The swelling around the hard area has gone down a tad, but the hard area itself has not. That’s what has me concerned.

@WillWorkForChocolate With cellulitis my first concern is, is it spreading? Is the area growing larger and larger. I would not use warm, because warm can cause inflammation, it does not reduce it. If it is an abscess she needs more than just a warm compress.

I am not sure what to tell you, because it is her face, which of course is worrisome for several reasons. It’s more difficult to wait and see another day when it is your daughter, then say if it was you with the bite on your leg. My inclination is if it is working give it another day, I don’t think it is an absess. But, I am not there, and I am not a medical professional.

Had you seen two different doctors at Urgent Care?

If you are very worried just bring her over to her regular doctor, don’t wait for a call back. Seriously. It is early enough in the day, and the doctor can reassure you. It will take him 2 minutes to look at her.

I will not link any websites as the photos are a bit much for even me, but I would not trust a facial injury to anyone at an ER or a family doctor. I’d call a plastic surgeon, or simply drive to one now.

IMO, she should have IV antibiotics now, and the laseration needs to be looked at by a surgeon. Facial scarring should be prevented as much as possible.

I don’t recall where precisely you reside @WillWorkForChocolate, but a phone call to your local Children’s Hospital should point you in the right direction.

If your mommy gut is telling you her injury isn’t being taken care of quite right, trust that instinct.

Take her to a different doctor. You need a second opinion.

@SpatzieLover Wounds need to be sutured within 6 hours I think? Some can wait as long as 24, depending on the injury. I just went through this with a cut on my arm that should have been sewn when I was admitted to emergency and they failed to do it. It bled and oozed and would not close for days, the hospital just kept putting gauze and tape on it, whoch would be soaked pretty fast. Finally, after being discahrged and my husband very upset that something was just not right, I went to urgent care and they gave me a proper remedy, which helped it heal.

I agree with you face should be seen by an expert if it might leave a scar in an obvious place. When I cut myself in my eyebrow, the ER doc gave me stitches because he thought if he did not I would have too much of a scar. If the wound had been on my arm they probably would not have bothered with stitches. If the cut had been smack on my cheek, probably better an expert sew it.

Surgeons have tiny needles to first numb the area ;) then they assess. Again, I would not trust my face or my child’s to anyone else…A surgeon would be directing the healing process

EDIT: @JLeslie I wasn’t talking about sewing, but a fresh scalpel cut or assessment to see if healing will be close to scar free

@SpatzieLover Who are you talking to now? It is too late to sew.

@SpatzieLover It happend over 24 hours ago.

I’m assuming Urgent Care is a walk-in type clinic… can you take her to be seen by another doctor there? Or do they make you stick with the first one? Or if there is another clinic in your area, you could go there… I agree with you about the ER thing but it does sound like she should be seen.

Are you a doctor @JLeslie?

@SpatzieLover no, I say all over the place I am not a doctor. I thought you were talking about stitches to close the wound neatly.

@WillWorkForChocolate Are you concerned about a scar? I don’t think we even know how large the bite is? I do agree with @SpatzieLover if you are concerned with scarring a plastic surgeon is the way to go, your doctor should be able to direct you to one. If it needs to be drained due to an abscess then a fresh cut would need to be sewn, so again I agree with Spatzie that the specialist do the work.

I sent the question to rarebear.

@JLeslie I was somewhat chided by rarebear for asking a medical question concerning my daughter once. We’ll see how that turns out. ;)

As to all the “sewing” stuff, her wound was originally sealed with Dermabond glue, which was wrong, since he should have left it partially open to drain… <sigh>

I finally got her “squeezed in” with a different doctor that I respect, after calling a bunch of different places. WTF is up with places who can’t spare ten minutes to evaluate a child? Bullshit.

Anyhow… leaving now to get our second opinion. Yay.

In on this late. I don’t mind rendering my expertise here since Willwork is already going to go to the doctor. Where I don’t like doing it is when people are using Fluther instead of seeking medical advice.

1) Dermabond is okay for clean wounds on the face, in fact it’s preferred. Dogbites tend to be relatively clean, and as long as the wound is washed out well. So dermabond was not an unreasonable choice. It’s preferred to close these wounds at least partially because leaving them open on the face leaves a poor cosmetic result.

2) Hot compresses is the correct home remedy if you think you have an abscess, before you can get to a doctor.

3) Abscesses require drainage, and generally will not get better no matter what antibiotics you throw at them. The cellulitis will respond to antibiotics.

4) This is not an emergency, so an emergency room may be overkill for this—sometimes it’s more convenient, but usually you wait for hours and hours because you get triaged low. If you can see an urgent care or regular physician, that’s preferred.

I’m sure I speak for all of us when I say that we hope your daughter’s ok and that she’s getting the best help she can get right now! If you will, please post an update as to how she’s doing. Best of luck to you with this matter.

JCA
The Update Lady

Okay so here’s the verdict from the doctor we just saw:

1. Since it was a dog bite and dog bites typically leave behind a lot of bacteria, the wound should never have been sealed up. It should have been left partially open to heal from the inside out, so it could drain if need be.

2. Urgent care put her through hell yesterday for the wrong shot, because Rocephin is never recommended for dog bites. She had to get another shot that will actually nuke this type of bacteria.

3. They prescribed yet another antibiotic that is the #1 recommendation for filthy dog bites.

4. There was absolutely no reason for the guy at urgent care to have me keep using warm compresses, since the cut was closed. The only thing it would do is ease the tenderness, but it would not do anything for the swelling like the guy told me it would.

5. The doc also believes the hard area is severely inflamed tissue, and not an abscess, and thinks the warm rags only made it worse. Which I tried telling the guy at urgent care this morning but he didn’t listen.

6. If the cut had been left open to drain, and the right shot and the right antibiotics had been given to her on the day it happened, she never would have gotten so swollen or had to go through all this torture. I will be calling urgent care to have my money refunded, since they did nothing but make her worse.

6. He says she should be good to go now, with the proper meds, and wants to see her back to check everything out on Thursday.

Well, I’m glad you got better medical attention this time. Infuriating!

Thanks for the update. Hugs to you and your daughter.

Me too, @janbb I was pissed when he told me they had given her the wrong shot and wrong antibiotics.

I had no intent on downing you for not going to the ER. I understand how the wait and lines are there. Anyway, glad your mind is at ease now. I hope you read my email to you.

Kiss your baby and make it well for her.jp

@WillWorkForChocolate I’m glad you went to your doctor. Your poor baby is just all full of antibiotics :(. I’m glad it is not an abscess. I have had the point of entry of infections for cellulitis stay red and hard for a while even after the infection has cleared.

Did they prescribe Augmentin or Clindamyacin by any chance? Those are the ones that come to my mind for dog bites. When I have had cellulitis caused by other antagonists other drugs have been used like Omnicef and dycloxocillin I think? And, one other I took, I think it was another cephlasporin. I’m just curious about the dog bite for my own knowledge.

Augmentin. And apparently the Rocephin shot was a bad choice because it’s in the family of cephalosporins, which is not the proper medication for bacteria from dog bites.

You see? That’s why I don’t like to give medical advice on Fluther. The doctor that @WillWorkForChocolate saw said pretty much the opposite of what I did! That’s why you need to see a doctor and not rely on the internet.

@Rarebear I noticed that, LOL!

@Rarebear :). No, don’t say that. Your medical knowledge is always appreciated. You were not able to see the wound, and I bet half the doctors in America would agree with you on the course of treatment.

Just out of curiosity, what antibiotic would you have prescribed? Honestly, I think that is the most important thing in the whole mess.

Plus, she did not have an abcess, so the compress comment you made is moot, but you would have no way of knowing whether there was an abscess or not.

I would have given Augmentin, but it has a habit of making people puke.

Yeah, I was worried about that and diarrhea, but I’m hoping she’ll tolerate it. <fingers crossed>

Oh, and @Rarebear? You’re a great guy. Just thought I’d say that.

Aaaaaaaand, I’ll apologize for flying off the handle earlier in the thread. I was more agitated than I realized. I was also apparently really tensed up; now that I’m able to relax a little bit, I’m incredibly sore. My kind grandmother is picking up my daughter’s “superglue removal gel” and dinner for everyone, so I don’t have to go anywhere. This calls for wine.

Just to prove I’m not talking out of my ass, here is an article that says that on the face if the wound is clean and well debrided you can consider closing.
http://dl.dropbox.com/u/45642077/p1567.pdf

I would never say that you were talking out of your ass. Nobody is always right, you know…

Augmentin is my wonder drug for my chronic problem that I won’t get into here. I dread the day it stops working for me. Don’t be overly concerned.

@WillWorkForChocolate Give her some probiotics. Does she like yogurt? If she can’t swallow the antibiotic pills you can by “yogurt” packed with lots of good bacteria and add a spoon to regular yogurt and some more fruit or jelly to sweaten it up. Regular yogurt doesn’t have much.

There are chewable probiotic tabs that actually don’t taste too bad. Thanks for the update @WillWorkForChocolate.

@Rarebear well you know if you ask two doctors their opinion on something you always end up with at least three answers.

@JLeslie and @ccrow Yep, she’s on probiotics and aloe vera juice to protect her gut. Mommy’s all over this, LOL.

“Nobody is always right, you know…” —
I am. Just ask me.

So late to this discussion, but I just wanted to say I’m glad you got the proper medical care this time around. Hope your girlie is feeling all better, soon!

@Rarebear Oh good gravy! :D

Thanks, Auggie. Now that she’s had the shot in her system for a while, I’m starting to see a little bit of an improvement! Woohoo!

I’m very relieved that everything worked out, @WillWorkForChocolate. I was distressed reading through this question thinking about you and your little girl. I’m really glad she is improving.

How is she now?

And @Rarebear…does milk give cats diarrhea? (I just had to give him one more chance. He thinks he’s so great but he can NEVER answer MY questions! I had a cat that seemed to be having problems with labor and delivery and @Rarebear was worthless. Sniff.)

@bkcunningham Thanks!!

@Dutchess_III The hard area has shrunk a little, and the redness has decreased. I can’t tell you how relieved I am! Considering the sleepless night I had last night, watching her, then feeling so uncomfortable with what the urgent care guy said this morning… I was just so damn frazzled and confused, and upset. I may be sore and exhausted from being so tense and stressed out, but I can actually breathe normally and know that she’s going to be okay.

@Dutchess_III No. Give your cat lots and lots and lots of milk. Then leave for the weekend when Rick is home. I don’t recommend coming back for awhile.

@Dutchess_III And in terms of the cat, I told you to scream “PUSH!” at it, but you wouldn’t listen.

UPDATE- Now that she’s been given the proper medicine, the “regular” swelling is about 90% gone and the hard area has decreased by about 50%. YAY for that doctor!

And urgent care refuses to give any sort of refund. In fact, she (the office manager) went so far as to tell me there was going to be an additional bill for the “treatment of the laceration” mailed to me that we were not originally charged for (which is bullshit) and their one concession is to not bill me for that. We already paid for everything on the initial visit, so apparently they think it’s a good idea to make shit up, just so they can say they’re “making a concession”. Assholes.

I’ll PM you @WillWorkForChocolate regarding how to fight that bill. As for your update <whew!> I’m relived to hear your daughter is responding to the new round of treatment so quickly!

@WillWorkForChocolate Great news!

Write the state friggin’ insurance commissioner in your state, @WillWorkForChocolate. Explain what happened just like you did to us here. That takes a lot of nerve. The doctor is going to give you an additional charge after you spoke to them about what transpired? Wow. Will the payment be part of your deductible or co-pay? If not, your medical insurance will most likely pay the charge regardless of what you would say to them.

We don’t have insurance and paid for everything out of pocket.

You might have trouble because an antibiotic would not work in 12 hours or less to cause such a retreat in her symptoms, so probably the antibiotics prescribed before your regular doctor did help. You would have to demonstrate urgent care did not follow medical standard of care, which seems sort of up for grabs on this. If you bitch enough they might reduce your fee. Did you charge it? Put a hold on the charge and write a letter with the details. At minimum they should reduce their bill to only one visit or by the amount you had to pay your doctor I think.

@JLeslie I’m assuming it’s the shot from yesterday that caused the decrease in her symptoms overnight.

The shot at your doctor? Or, the shot from the second visit at urgent care? Overnight would stop the spreading maybe, but actually a 50% reduction? I doubt it.

I really don’t know though, I have never had a shot for cellulitis, just IV and PO. It does feel better faster than say PO for strep throat.

Her follow-up today was fantastic. The doc said he’s very pleased with her progress, and she should be clear to return to school and gymnastics on Monday.

@JLeslie I’m assuming it was the shot that reduced her swelling so quickly, as nothing else had seemed to be helping. She was slightly improved the day after the Rocephin shot, but she had also had a lot of ibuprofen for the pain and swelling, so I’m not convinced the Rocephin did a damn thing. I will also add that about two hours after she received the Lyncomycin, she stopped hurting, so I stopped giving her ibuprofen, so I know ibuprofen wasn’t affecting the swelling anymore. I really think it was her second shot that started kicking the infection out; by the time I saw her cheek yesterday morning, the shot had been in her system for about 16–17 hours.

I know medications frequently have a “time lapse” expectation, but it’s not always the case. When my oldest received a shot of Rocephin for a severe, and by severe I mean nasty ear infection, her ear was drastically improved only 8 hours later.

Would you be offended if I asked about the dog and the how the dog bite in the face happened in the first place, @WillWorkForChocolate? Because I am.

I’m so happy she is doing much better. No matter what I think you did the right thing taking her to your doctor. I don’t remember how fast my cellulitis would retreat, and as I said I never had a shot. I think mommy’s intuition is usually spot on, so I will go along with your assessment.

@bkcunningham No, haha, why would that be offensive? Our neighbor was “babysitting” his dad’s dog. My daughters were both playing with the dog. My little one apparently forgot that she wasn’t playing with our own dog, and leaned over to hug and kiss the dog. The dog got freaked out, I guess, and latched on to her face. He barely missed her eye. I’m so frikkin glad he missed her eye.

My neighbor who is one of the sweetest guys I’ve ever met would like to help with the medical costs, but he’s flat ass broke, and he doesn’t own the house so I don’t think he has home owner’s insurance.

Oh, dear God. I’m so glad it wasn’t worse, @WillWorkForChocolate. How scary for everyone involved. Poor girls and mommy. I would have freaked. Maybe he has renters’ insurance. I had a little boy actually shoot himself in the eye with a pellet gun when it ricocheted off a tree limb while he was playing in our yard years ago. Our renters’ insurance paid out for his medical and other legal action the family took.

I am so glad she is okay.