Rose Gardeners Disease

Posted by charlotterose79 @charlotterose79, Jul 17, 2022

My wife, Charlotte (age 79) recently pricked her hand on a live rose bush while pruning it. Within hours her hand swelled and became very painful. Next day we went to the St. Helens Legacy Clinic in St. Helens, Oregon and waited in agony for three hours to be seen.

She was finally seen by a Medical Assistant who injected an antibiotic and wrote a prescription for another antibiotic to be taken four times orally for ten days.

The pain that night increased and we were referred by the clinic to Emanual Hospital Emergency in Portland where we waited for 10 HOURS while she withered in agony. At each step we told of her extreme pain and was offered nothing but Ibuprofen which was largely ineffective.

When she was finally seen by an orthopedic MD after waiting for over 8 hours he sent her to imagining for an X-ray of her numb wrist joint and directed us to continue the antibiotic and wrote a proscription for for Vicodin. They also gave me one tablet of Vicodin for relief until I could have the proscription filled at our local pharmacy which opened at 9 AM the following day. Blood samples were taken, but just for basic blood work.

We have read the available literature on this type of injury and it mentions the possibility of a fungal infection which has serious long term consequences. The doctor said the chances of that were remote, but the swelling remains. She get some temporary relief from the applanation of Arnica Oil to the swelling.

She has an appointment with her long term GP next week, but it is only virtual and are concerned that this may be more complicated than diagnosed by the apparently dysfunctional existing system in our area. We are dismayed by the excessive waiting times, lack of diagnostic expertise and indifference to suffering displayed by a system that we support financially with very high insurance premiums, government and private !

We seek help with a more accurate diagnosis and are willing to travel to get it through the Mayo Clinic and its outstanding reputation.

Very sincerely,
Charlotte and Dennis Hart

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Sue, Volunteer Mentor | @sueinmn | Jul 17, 2022

Here is a description of "Rose Gardeners' Disease" from the CDC: "Sporotrichosis usually affects the skin or tissues underneath the skin. The first symptom of cutaneous (skin) sporotrichosis is usually a small, painless bump that can develop any time from 1 to 12 weeks after exposure to the fungus. The bump can be red, pink, or purple, and usually appears on the finger, hand, or arm where the fungus has entered through a break in the skin. The bump will eventually grow larger and may look like an open sore or ulcer that is very slow to heal. Additional bumps or sores may appear later near the original one." (https://www.cdc.gov/fungal/diseases/sporotrichosis/index.html#:~:text=Sporotrichosis%20(also%20known%20as%20%E2%80%9Crose,fungal%20spores%20in%20the%20environment.

As with most fungal disorders, it takes time for sufficient spores to develop for there to be any symptoms.

I would guess that it is more likely the thorn either broke off under the skin, or penetrated a joint, or the synovial sack surrounding a joint. Either can be very painful - it sounds like the x-ray in the emergency department MAY have ruled out a broken thorn. The pain level of a penetrated joint can be way out of proportion to the size of the injury, so I am thinking this is the likely scenario. If the pain doesn't resolve (without Vicodin) in a day or two, one of you may need to advocate (firmly) for her to be seen. The GP is actually the person most likely to have seen this type of injury before, so it is a great place to start.

Are you willing and able to call first thing tomorrow to arrange an in person visit to her GP?
Sue

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