Question: I am a T12 incomplete paraplegic x30 years as the result of a ski accident. I also broke my right femur just above the knee in 1995. I fell Thursday night while transferring from the commode to my wheelchair. This morning I realized my right leg, in the knee area was swollen to about 4-5 times it's normal size all the way to the foot, and was red and very hot. I have a history of necrotizing fasciitis, so this is very scary for me.

I went to the local urgent care first thing this morning. I was seen by a PA, who never looked at the leg under my clothes. My bp was 90/56.He ordered an xray, which (apparently, I will obtain a copy and send it) shows a fx of the femur, but he can't be sure it isn't the fx from 20 years ago, so he sent me home to elevate and ice, and call my doctor if it isn't better in 10 days. . Swelling has not gone down at all, it makes a clicking sound when it moves, and is hotter and hotter by the minute.

I am attaching some pics of the swelling. I don't know what to do now, as an er visit will be too much out of pocket, as I'm sure I won't need to be admitted.Do you have suggestions? I am extremely fearful about infection

After two days in hospital, a ct showed a distal fx near the 20 year old one...displacement of 2.5 cm. Also an unknown infection, for which they dumped vanco, another ab i don't recall the name of, and then clindomycin. My leg was deemed inoperable, and I was sent home with an ill-fitting knee immobilizer, a week of antibiotics, a bottle of Norco, and a note to go to the ortho surgeon who essentially says my leg isn't as important to me as a walking person...in 6 weeks!! The hospitalist refused to give me my xray or ct scan studies, but I will get them from hospital administration tomorrow. The doctors who made the decision never did an actual exam (only looked at those studies and labs) to make their decision. I feel confident that you, too, can at least give me a second opinion. My lab work includes CBC w/ diff, CMP, and several others. I can also forward those to you along with comparisons to past results from annual physicals. I have pics of the changes since our last correspondence, too.

I look forward to your reply once I get all the information to you. I can't help but be uneasy when, as I was being discharged, more than one nurse apologized to me for the lack of quality care I received.