Is violence or force the way he/she usually solves problems? Does

Cellulitis (sel-u-LI-tis)

Cellulitis (sel-u-LI-tis) is a potentially serious bacterial infection of your skin. It appears as a swollen, red area of skin that feels hot and tender, and it may spread rapidly. Skin on the lower legs or face is most commonly affected by this infection, though cellulitis can occur on any part of your skin. The infection may only be superficial, but it may also affect the tissues underlying your skin and can spread to your lymph nodes and bloodstream. Left untreated, the spreading bacterial infection may rapidly turn into a life-threatening condition. That's why it's important to recognize the signs and symptoms of cellulitis and to seek immediate medical attention if they occur.

SIGNS AND SYMPTOMS

cer, athlete's foot or dermatitis, serve as the most likely areas for bacteria to enter. Certain types of insect or spider bites also can transmit the bacteria that start the infection. Areas of dry, flaky skin also can be an entry point for bacteria, as can swollen skin.

RISK FACTORS

Several factors can place you at greater risk of developing cellulitis: Age. As you age, your circulatory system becomes less effective at delivering blood — with its infection-fighting white blood cells — to some areas of your body. As a result, skin abrasions may lead to infections such as cellulitis where your circulation is poor. skin that can serve as potential entry points for bacterial invasion and infection. • Chickenpox and shingles. These common viral diseases typically cause broken blisters on the skin that can serve as potential entry points for bacterial invasion and infection. • Chronic swelling of your arms or legs (lymphedema). Swollen tissue may crack, leaving your skin vulnerable to bacterial infection

WHEN TO SEEK MEDICAL ADVICE

If you have a rash that's red, swollen, tender and warm — and it's expanding — try to see your doctor the same day. If a fever or pain accompanies the rash, or the rash is changing rapidly, seek emergency care. It's important to identify and treat cellulitis early because the condition can cause a serious infection to spread rapidly throughout your body.

SCREENING AND DIAGNOSIS

Cellulitis may result in skin that is:

Red Tender Swollen Warm

The changes in your skin may be accompanied by a fever. Over time, the area of redness tends to expand. Small red spots may appear on top of the reddened skin, and less commonly, small blisters may form and burst.

CAUSES

Cellulitis occurs when one or more types of bacteria enter through a crack or break in your skin. The two most common types of bacteria that cause cellulitis are streptococcus and staphylococcus. Although cellulitis can occur anywhere on your body, the most common location is the legs, especially near your shins and ankles. Disrupted areas of skin, such as where you've had recent surgery, cuts, puncture wounds, an ul• • • Weakened immune system. Illnesses that result in a weakening of your immune system leave you more susceptible to infections such as cellulitis. Examples of these illnesses include chronic lymphocytic leukemia and HIV infection. Taking immune-suppressing drugs, such as prednisone or cyclosporine, also can leave you vulnerable to infections. Immune-suppressing drugs are used to treat a variety of illnesses and to help prevent rejection in people who receive organ transplants. Diabetes. Having diabetes not only increases your blood sugar but also impairs your immune system and increases your risk of infections. Your skin is one of the many areas of your body that becomes more susceptible to infection. Diabetes may also lead to chronic ulcers of your feet. These ulcers can serve as portals of entry for bacterial infections. Chickenpox and shingles. These common viral diseases typically cause broken blisters on the The appearance of your skin will help your doctor make a diagnosis. Your doctor may also suggest blood tests, a wound culture or other tests to help rule out a blood clot deep in the veins of your legs. Cellulitis in the lower leg is characterized by signs and symptoms that may be similar to those of a clot occurring deep in the veins, such as warmth, pain and swelling.

COMPLICATIONS

This reddened skin or rash may signal a deeper, more serious infection of the inner layers of skin. Once below the skin, the bacteria can spread rapidly, entering the lymph nodes and the bloodstream and spreading throughout your body. In rare cases, the infection can spread to the deep layer of tissue called the fascial lining. Flesh-eating strep, also called necrotizing fasciitis, is an example of a deep-layer infection. It represents an extreme emergency.

The Shoeman's Prayer

I watched as the shoe man reached into his pockets so deep. I saw what was pulled out, what the shoe man put in Then I heard a soft "clink", as when silver hits tin.

My alarm went off, it was Sunday again. I was sleepy and tired, my one day to sleep in. But the guilt I would feel, the rest of the day Would have been too much, so I'd go and I'd pray.

The sermon really bored me, to tears, and that's no lie It was the same for the shoe man, for tears fell from his eyes. At the end of the service, as is the custom here, We must greet new visitors and show them all good cheer.

I showered and shaved, I adjusted my tie, I got there and sat, in a pew just in time. Bowing my head in prayer, as I closed my eyes, I saw the shoe of the man next to me, touching my own. I sighed.

Plenty of room on either side, I thought, why must our soles touch? It bothered me, his shoe touching mine, it didn't bother him much. Prayer began: "Our Father", I thought, The man with the shoes has no pride. They're dusty, worn & scratched, and holes on the side!"

"Thank You for blessings," the prayer went on, the shoe man said a quiet "Amen." I tried to focus on the prayer, my thoughts were on his shoes again. We're supposed to look our best, when walking through that door? "Well, this certainly isn't it." I thought, glancing at the floor.

Then the prayer was ended, and the songs of praise began. The shoe man was certainly loud, sounding proud as he sang. His voice lifted the rafters, his hands were raised high,

The Lord could surely hear the shoe man's voice from the sky. It was time for the offering, and what I threw in was steep. HOLLYWOOD

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But I felt moved somehow, and wanted to meet the shoe man So after the closing prayer, I reached over and shook his hand. But I thanked him for coming, for being our guest.

He said, "My names' Charlie, I'm glad to meet you, my friend." He looked quite sad, but he had a large, wide grin "Let me explain," he said, wiping tears from his eyes. "I've been coming here for months, and you're the first to say 'Hi.'"

"I know that my appearance is not like all the rest, But I really do try to always look my best." "I always clean and polish my shoes before my very long walk But by the time I get here, they're dirty and dusty, like chalk."

My heart filled with pain and I swallowed to hide my tears As he continued to apologize for daring to sit so near. He said, "When I get here, I know I must look a sight. "I thought if I could touch you, maybe our souls might unite."

I was silent for a moment, knowing whatever was said Would pale in comparison, I spoke from my heart, not my head "Oh, you've touched me," I said, "and taught me, in part, That the best of any man is what is found in his heart."

The rest, I thought, this shoe man will never know. Like just how thankful I really am, That his dirty old shoe touched my soul. (Author Unknown)

"He must increase, but I must decrease." -John 3:30