Working Class Runner

Yesterday, I had to go on antibiotics for the first time in decades thanks to what apparently is cellulitis in my elbow. As usually happens with these sorts of infections, a weird chain of circumstances likely caused the condition.

A slight cut near my elbow in Vancouver wasn’t totally covered up. Though I cleaned it off regularly, I didn’t bandage it due to its awkward position (band aid style bandages would just fall off), not realizing until after the fact that a knuckle style bandage would have held on fine.

However, that little nick healed after a few days and there were no issues.

Saturday I was doing a bodyweight strength workout that at some point called for a standard elbow plank. I go to the floor and I felt like I leaned on a nerve in my right elbow. It didn’t feel good, but I adjusted and finish that + the workout with no issues.

The tip of my elbow was a bit sore a little later that night, like bursitis (which I’ve had before; that just goes away after you stop doing whatever’s causing it), which I didn’t pay much mind.

But then Sunday morning the elbow was real sore. I already knew then it wasn’t normal bursitis, further confirmed that night when my elbow felt rather warm to the touch… a telltale sign of infection. Knowing I cut that elbow last week, I suspected that bacteria got in and, after bumping it on the elbow plank, managed to work its magic.

I took a mild dose of NSAIDs and waited a couple days hoping maybe my decent immune system would maybe work things out on its own. But by the following night, even though the pain had subsided, the elbow was still warm to the touch, the redness was beginning to spread a bit and I realized I needed medical intervention.

My PCP couldn’t see me until next week, so Tuesday after work I went to a quick care center to get help. I gave them the whole rundown. After a X-Ray to confirm there was no internal damage (because of Saturday’s workout, when it started to hurt), they gave me a shot and a prescription for antibiotics to treat cellulitis, a typical culprit in these situations.

I hadn’t taken antibiotics since childhood, thankfully never being ill enough to require a doctor’s care let alone need a prescription. Times have certainly changed in the 25-30 years since. Today doctors and nurses all recommend you take a probiotic while on the meds, since an antibiotic by design wipes out bacteria throughout your body… including the good bacteria in your gut. Back in the 1980’s that sort of thing never crossed a doctor’s mind.

So, along with filling the prescription (featuring the awkward “hey, so I’ve never actually done this before, how does it work” conversation at a Walgreens pharmacy), I bought some probiotic pills and drinks since it turns out I don’t ever take probiotics either. Along with a strong immune system I guess I also have a tolerant stomach. But I realize the antibiotic could change that.

First, all of this nonsense could be a blessing in disguise. Sure I can rue not covering that cut up better (though that’s hindsight; at the time I didn’t realize I could bandage it up), or that spending $10 or something on overpriced Canadian bandages and bacitracin would have been cheaper than several hundred dollars at a quick care center, and certainly easier than two weeks of medicated treatment down the road. (And sure, that in itself is a lesson learned.)

But at the same time, the combination of antibiotics and probiotics (cycled around each other, of course: the latter is useless if you take them both at the same time because the antibiotics will just wipe the probiotics out) offer an opportunity aside, obviously, from curing the elbow infection.

– Resetting the gut

There’s a lot of bacteria good and bad that’s probably been living in my digestive tract forever. It’ll suck to lose the good ones, but this is an opportunity to clean out the bad ones and reset my gut, using the beneficial probiotics I take a few hours later.

It may effectively be a medical cleanse, especially because (to facilitate both items) I’ll be eating a real clean and somewhat bland diet.

– Clearing out any lingering bugs

Antibiotics are like a (much) lesser form of what chemotherapy does for cancer patients. Chemo kills a variety of cells with the goal of killing cancer cells in the process. Meanwhile, antibiotics serve to kill bacteria, and while the goal is to kill offending bacteria it will kill all relevant bacteria it contacts throughout the bloodstream.

In the process of (hopefully) healing my elbow, it will also knock out similar bacteria throughout the rest of my body.

So if I’ve got some sort of bacterial condition that affects my energy or my diet, and the antibiotic by design can kill that bacteria… that’s going to indirectly address that. Play my cards right and I could feel better in the long run in ways I hadn’t anticipated.

If, say, I have a much milder, even imperceptible bacteria-induced problem in my calves, or my shoulders, or my heart… it’s going to help remedy that as well. Once antibiotics are in the bloodstream, they don’t discriminate.

I don’t know if and where this is the case. But if bacteria is contributing to soreness, imbalance or other problems in other parts of my body, they may indirectly help with that.

– Cleaning out the colon

While hopefully my gut handles the antibiotic well, there is always some chance that it flips out, especially when I consume any fiber and there’s any presence of problem-causing c.diff bacteria that survives the antibiotic.

Still, that plus the inclusion of probiotics means I’d get an impromptu colon cleanse. There’s often lingering bacteria and problems in the colon, and any chance to sweep that out is… I don’t think welcome is exactly the right term, but you get the idea.

– The medication may forced an extended marathon recovery period

Along with that, I don’t know exactly what other side effects might result from the antibiotic and other dietary shifts. It could affect my energy levels. I also am not sure how my elbow will feel in the interim as it (hopefully) heals up.

This might mean I need to run less than I originally intended. I’m currently on the tail end of a two week easy recovery period from Vancouver. Since the antibiotic round will last 10 days from yesterday, that will extend about a week beyond that recovery period.

And that’s not necessarily a bad thing. My body feels mostly good 10 days after Vancouver, but there’s always imperceptible damage that’s still healing. If the meds make me need to slow down after the recovery period is technically up, that’s not necessarily a bad thing. Maybe the extra recovery would be welcome for my lower body.

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Also, it’s important to separate the antibiotic and probiotic doses, since the antibiotic by design kills bacteria and bacteria in the probiotic would just get wiped out if both were taken simultaneously. Something like this schedule works:

7am – Antibiotic w/breakfast
10am – Probiotic w/snack
12noon – Antibiotic w/lunch
3pm – Probiotic w/snack
6pm – Antibiotic w/snack
9pm – Probiotic + daily vitamins after dinner

This way, the antibiotic gets time to digest and enter the bloodstream before the probiotic is introduced to the stomach.

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Ideally, none of this is a big deal. Ideally, my gut handles everything fine, my elbow is fine in a week or two, and life goes on as desired (… plus, I’ll have a bunch of probiotics I’ll keep taking daily for the next couple months after the RX is finished).

There can always be setbacks, such as maybe the antibiotics don’t help the elbow because something else is the problem. But I’ll cross that bridge if I get to it.

And of course, I’d love to not have to deal with antibiotics again for at least another few decades. I work hard on maintaining my health so medical care isn’t necessary. But it’s nice for it to be there when you need it.