Learned something new today.........

[pomtzu]

Off and on for about the past year, I have been bothered by unexplained swelling in my right lower leg, ankle, and foot. Every time I bring it up to my doc, he bushes it off as "positional", since it eventually goes away, but to me, something was not right. These past couple of months the swelling has been pretty bad - to the point that I could only get flip-flops on my feet, you really couldn't even tell I had a slim ankle, and the skin on my shin looked like I had a bad rash, but it was red and blotchy under the skin, and not warm to the touch. Tried for 3 weeks to see doc, but first he was on vacation, and then booked solid for the next 2 weeks. Finally got in on Tuesday and he ordered blood work and an ultrasound of my leg, even tho the swelling is way down. He was looking to rule out a blood clot as the problem - this is what caused my brother's stroke - a blood clot from his leg, and of course the same for Captain Phil on Deadliest Catch.

So I went to the diagnostic center today for the testing - first almost a dozen vials of blood drawn, and then the ultrasound which took a good 45 minutes. I was really pretty apprehensive that the technician was taking so long, but she finally was done and said - "You can go - you don't show any clots." I gave her a questioning look and she told me that if she had detected a clot, that she couldn't release me, and I would have been transported directly to the hospital. Good thing I didn't know that beforehand!

So I was wondering - do any of you know if labs or diagnostic centers in your area, do the same? Thinking about it now - it's a darn good thing, since a clot can break loose at any time and without warning. I just never knew those facilities did anything like that - but I guess it's to protect themselves as well as the patient.

Well - she did say that I was negative for a clot, but also said she couldn't tell me her interpretation of the results - which leaves me hanging till my doc calls me when he gets them. So I'm still in the dark..... I'm just glad I'm not typing this from a hospital bed!

[MoonandBean]

They do it that way here too (I had a venous doppler because I had persistant pain behind my knee)...they told me before I left that there was no sign of a clot.

There are other possible things that could be detected but that wouldn't be reason to admit to a hospital would be, ie.. venous insufficiency (valves in the veins that don't work properly and can predispose to swelling, varicose veins, etc...)

Also, the "rash" sounds like stasis dermatitis.

http://en.wikipedia.org/wiki/Stasis_dermatitis

[pomtzu]

They do it that way here too (I had a venous doppler because I had persistant pain behind my knee)...they told me before I left that there was no sign of a clot.

There are other possible things that could be detected but that wouldn't be reason to admit to a hospital would be, ie.. venous insufficiency (valves in the veins that don't work properly and can predispose to swelling, varicose veins, etc...)

Also, the "rash" sounds like stasis dermatitis.

http://en.wikipedia.org/wiki/Stasis_dermatitis

Thanks! I learned more from you and Wikipedia than I did from my doctor! Thickening and darkening of the skin at the ankles (and the top of my foot), itching, foot and leg pain - especially at night - got them all.
Do I owe you a consultation fee???
Now I'm curious as to what my doctor is going to tell me..... If he still says it's positional, then I think I need a new doc!

[MoonandBean]

Thanks! I learned more from you and Wikipedia than I did from my doctor! Thickening and darkening of the skin at the ankles (and the top of my foot), itching, foot and leg pain - especially at night - got them all.
Do I owe you a consultation fee???
Now I'm curious as to what my doctor is going to tell me..... If he still says it's positional, then I think I need a new doc!

No consultation fee
Now by "positional edema", I think he means "dependent edema"

http://www.medical-library.net/content/view/234/41/

Dependent edema means edema (swelling) due to gravity and not due to an underlying medical problem such as kidney disease, liver disease, venous insufficiency, congestive heart failure, ovarian tumors (can block lymphatic drainage), etc...

Basically, it is a "diagnosis of exclusion" which means that anything serious has been ruled out and you are basically left with "dependent edema"

[pomtzu]

Yes - he was meaning dependent. But why I'm thinking this is NOT the issue, is that it's only in my right leg and foot. I don't cross my legs or otherwise restrict flow or movement in just one. When I'm sitting - both feet are on the floor with no legs or ankles crossed. So why one and not the other??
Well - guess I'll see what he says when the results are back - hopefully tomorrow.

[Karen]

Yes - he was meaning dependent. But why I'm thinking this is NOT the issue, is that it's only in my right leg and foot. I don't cross my legs or otherwise restrict flow or movement in just one. When I'm sitting - both feet are on the floor with no legs or ankles crossed. So why one and not the other??
Well - guess I'll see what he says when the results are back - hopefully tomorrow.

For now, get yourself a footrest so you can elevate that leg when seated - I doubt Mindy would appreciate beings used for one, but ... maybe a stack of books or a box under the table or desk where you most often sit ...

[MoonandBean]

I have found that if someone has back problems or a problem with one knee or leg, that sometimes the edema can affect that leg. Also, a cyst on one ovary can cause edema in that leg. Your doppler may end up showing that you do have venous insufficiency in that leg as well. As Karen said, elevation (if possible, above the level of the heart) is important. You can try to elevate the foot of your bed with a firm suitcase under the mattress. TEDS stockings are good too but in this heat, may not be too comfortable. Hope it all works out!

[sirrahbed]

How frustrating to have something wrong ....and not be able to learn what is is - just what it "isn't" - hope the tests gives you some news so you will know the best way to treat it! In the meantime, elevate

[pomtzu]

For now, get yourself a footrest so you can elevate that leg when seated - I doubt Mindy would appreciate beings used for one, but ... maybe a stack of books or a box under the table or desk where you most often sit ...

Actually, Myndi & Sparky lay under the desk a lot, and I always put my feet on them. They don't mind, but as little as they are, I don't get much elevation. Maybe I need a St Bernard??

I have found that if someone has back problems or a problem with one knee or leg, that sometimes the edema can affect that leg. Also, a cyst on one ovary can cause edema in that leg. Your doppler may end up showing that you do have venous insufficiency in that leg as well. As Karen said, elevation (if possible, above the level of the heart) is important. You can try to elevate the foot of your bed with a firm suitcase under the mattress. TEDS stockings are good too but in this heat, may not be too comfortable. Hope it all works out!

Rule out the ovaries - they've been long gone! It is the same leg tho that I have a titanium rod in from the fractured femur a couple of years ago, and that constantly bothers me. Just more speculation at this point. I do have the stockings, but in this weather, I don't think I could tolerate them. Maybe I'll give one a try and just when I go to bed when it's cooler.

How frustrating to have something wrong ....and not be able to learn what is is - just what it "isn't" - hope the tests gives you some news so you will know the best way to treat it! In the meantime, elevate

I'll give the elevation a try too. I just want answers, since I've told doc for a year that something just isn't right. These past couple of months have been the worst tho, and I will pursue it till I find out what's what. Sometimes doctors think patients (especially women), are just hypochondriacs and tend to brush them off.

[MoonandBean]

The history of the broken femur could definitely be the culprit.