50f, 5'2" \~190lbs, nonsmoker, diagnosed with Lupus (SLE) over 20 years ago, very well controlled. I take vitamins and supplements but currently nothing for the lupus particularly. (Multivitamin, vitsB&D, calcium w/D, krill oil, methylfolate,)

The X-rays are from January and Sept of this year, respectively. The circle in the first pic is a sticker they put around the cyst. 

Cyst appeared on my right, big toe, maybe 2-3 years ago. Suddenly over the past year it got bigger much faster, and very "pointed." I was concerned it would rupture, plus I was having a lot of pressure in the joint, which I assumed was from the sack growing or pressing into the joint. My podiatrist agreed that the increase in size and loss of motion it would warrant removal of the cyst. Surgery was March of this year.

IMMEDIATELY after the wound healed the cyst returned. With a vengeance. Bigger, faster, more painful. I wore a newer pair of sandals over the past few weeks and the strap rubbed on the cyst and it was leaking some clear fluid. I thought/hoped this was a good thing. Maybe it would drain and release some of that pressure. 

Nope. Suddenly about 72 hours ago it swelled down past the first joint in the foot, and the pain got to the point I couldn't walk on it. Of course I started overcompensating in various ways, and then started having pains up that leg, including behind the knee. (A friend passed in her sleep several years ago from DVT, her kids found her when they woke up for school, and I have been terrified ever since. Also Mom and maternal grpa are diabetics and just went through wound care together for foot and leg wounds. I definitely DO NOT want to go down that road.) 

Yesterday I went back to the podiatrist who did the surgery. Honestly he was going to let me leave the office without doing anything at all. I had to say at least three times, "I am very concerned. Seriously, this pain is bad. I have a pretty high pain tolerance and this is almost beyond what I can stand." Before he tried to aspirate it (got nothing but Lots of blood. Tossed the needles, didn't submit any fluids for evaluation.) and prescribed doxycycline, 100mg bid for 7 days, and an order for an MRI. 

\*\*Also important, my husband recently changed jobs and our insurance won't be effective until 10/1, because life is hilarious that way. We're able to pay out of pocket if necessary, but I'd rather wait for the MRI if it's safe to do so. 

I left the office feeling very unsettled. Terrified to go home and fall asleep. And in more pain than I've been in since childbirth. I ate some lunch and polled a few friends and decided to go to the ER. 

CT, which basically confirms what we already knew, cyst, large sack, some mild damage to the joint, but no bone infection, recommended an MRI if there are further concerns. CNP gave me a script for Meloxicam and agreed with filling the doxy. Of course the pharmacy was closed by the time I left the ER, so I started doxy approximately 18 hours ago. 2 doses in so far. Pain is better controlled with Ibuprofen and Tylenol every 5-6 hours (I'd take them every 4 if I could, but I won't.) but still very sore and nearly impossible to walk on. Swelling isn't much better yet. Also my eye is turning red from the doxycycline. Side issue, but I always forget this is a side effect of doxy!! I'm not sure if that means I shouldn't take it?? 

I guess I'm wondering how long I can safely wait before moving to the next step? Can the MRI wait for another 9 days? What symptoms should I look for to  declare this course of treatment isn't working? Should it be this painful? The cyst prior to surgery was a nuisance, and the joint pressures was irritating, but it was never painful to walk. I guess I'm just looking for a third opinion. 

Toe swelling, VERY PAINFUL, 6 months after cyst removal