And now we wait

This morning I had a CT Angiogram Abdomen Pelvis w/Long Leg Runoff w/Contrast, which is a lot of words that mean CT Scan of abdomen and legs using contrast. This is supposed to tell us what’s going on in the upper right thigh with its “pulsilating flow” that it shouldn’t have.

Results just posted on MyChart and I read through them several times. I have no real idea what they mean in regards to the thigh, which was the whole point of the test. I did read that I have diverticulosis of the sigmoid colon, which I already knew, and that the benign spherical mass in the right kidney has grown a bit. A follow up MRI is recommended. Hmmmm.

But no real answers in what I could see to the thigh. I have to wait to hear from the doctor for that. No telling when that will be. And if they messed up somehow and I have to go back to get the venous phase done, which was supposed to be done today, I will be more annoyed. So I don’t know if this was worthwhile at all.

More when I hear back from the doctor.

What the Doctor Said After Thirteen Months

Today was my final visit with my spine surgeon, thirteen months after my lumbar laminectomy last summer. I did my research and had my questions ready on the phone so I wouldn’t forget to ask anything important.

Biggest question – Is what I have now what I’m going to get post-op? Answer: Probably yes. He does not discount the power of prayer and continued hard physical work to see additional progress, but most of the improvement comes in the first year. I have good leg strength but my ankle has almost no improvement and there continues to be numbness, tingling, spasms, and pressure. That probably will not go away. He is very pleased with how much I progressed, which tells me that he may not have thought I could come this far, so I’m not complaining.

Will the stenosis come back? Answer: Not before 15-20 years if at all. My spine was very well cleaned out of compression and he doesn’t think it will be a problem. I do have some compression issues at other points (specifically S3) but have NO plans for any additional surgery, though I’ll monitor things to see if they change.

Should I plan to continue PT for the long term? Answer: No. It does the most good in the first 6-8 months, though help for specific functions (such as using the rollator) would warrant additional sessions. I must continue leg and arm exercises on my own, which I already figured out.

What about using a power chair? Answer: As long as I don’t overuse it, it should be helpful. But I cannot stop walking or I will lose the ability to do it. I should aim to use a rollator and manual wheelchair in my apartment, walk in the hallway for some longer distance practice, and reserve the power chair for longer distances to keep from straining and inflamming my arm and shoulder.

What kind of doctor should I be seeing for continued care? Answer: A physical medicine and rehabilitation specialist, usually found associated with pain management practices. But for the most part, I probably will not need to be managed. If my primary care or pain management doctors can’t figure out what I need, I could go to a specialist in my current pain management practice. Mostly I’m going now to manage SI joint pain with medication since I can’t have an injection due to blood thinners for the blood clot.

I like my surgeon and would recommend him, though I hope no one I know needs a spine surgeon anytime soon. I’m also glad to have graduated from his care. For now, I’m using my rented wheelchair until my Phoebe chair gets evaluated and fixed, hoping that will happen on site on Wednesday when the service guys come. There are things I don’t like about Phoebe but there are more things I don’t like about the rental chair and I want to get back to normal as soon as I can.

Today’s updates

Just got back from my first longish walk in two weeks (before the sprained ankle). I spent two days this week walking around the apartment with the walker, but today I went out into the hall, down to the elevators, and back again. It wasn’t as easy as it was two weeks ago but I only needed a few very short standing rest stops on the way back. I probably should have stopped at the fire doors instead of going all the way to the end of the hall but I’m not sorry I did what I did. But I’m also not going back out to walk the other half of the hall today, either.

Second, I’m seeing yet another doctor on Friday, a vascular specialist. They’ll probably do another ultrasound (of course) or two so they can check out the other leg as well. I’m actually glad for the referral since the right leg has been swollen and heavy for so long. I’m hoping the specialist will figure out what’s going on and come up with a plan to treat it.

I asked the office to email the registration forms so I could work on them at home. Being me, I converted them to fillable PDF forms so I could just type the answers instead of trying to write really tiny letters to fit in the too-short spaces. Bet they’ll be surprised when they get them.

Image credit: Photo 18832936 / Vascular © Qiming Yao | Dreamstime.com

Apparently I’m Not Eating Enough Apples

I’m eating strawberries and peaches, not apples, these days, which may explain the medical appointments that appeared on my calendar.

Today was my Medicare Wellness Visit where you get asked all the questions you already answered on their e-checkin system. My BP was 136/62, which is great. I got the “Remember these 5 words” test that Trump nailed so successfully (my words were banana, tie, pen, house, car). This is a long way from an annual physical; I guess they think that we old people on Medicare don’t need to actually be touched but just answer a bunch of questions. My doctor is leaving her current practice tomorrow and I’m grateful that I was able to see her before she moves on, though I plan to follow her. She renewed all of the medications that she manages for me, then Cliff the Phlebotomist did the easiest stick for blood that I’ve had lo these many years. Tomorrow I’ll know what those red drops of blood reveal. At least this didn’t happen at 4am the way it almost always does when you’re in a medical facility. Oh, and I also got a referral to physical therapy for some ultrasound on the sore ankle. I really can’t feel a lot down there so I don’t know whether it’s better or not.

But one unexpected twist was being sent for a STAT ultrasound of my lower right leg to rule out possible deep vein thrombosis. My leg from toe to groin has been extra puffy with edema which we’re treating with diuretics, but a “squeeze test” of the calf almost had me jumping out of the chair, so DVT had to be ruled out. It’s a good thing that I went, because I just got a call telling me that they found a clot in my foot. What??? He called in a blood thinner for me to take once a day for three months which will dissolve the clot. But wow. Good thing I’m seeing my own cardiologist in 2 weeks. Good thing my doctor sent me for the ultrasound.

Tomorrow is a trip to see the pain doctor to review SI joint pains that have been giving me a hard time sleeping at night. I know I’m not sleeping in the best position to relieve those, but I don’t have much of a choice – I’m flat on my back with the bed raised up at the feet and a little at the head. I would give anything to sleep in my side but that’s just not in the cards. I don’t know if this doctor will think an SI joint injection would help (they have before) or if he’ll want to do something else.

Maybe I should just try eating more apples.

Report from today’s doctor visit

I saw my primary care doctor today for the first time since mid-December to discuss bilateral upper arm/shoulder pain. As expected, I couldn’t get on the scale since there was nothing to hold on to, but that wasn’t a problem. Blood pressure was excellent (112/60) with slightly elevated temp. She concurred with my self-diagnosis of biceps tendonitis from overuse. Pain started after I got my new AFO’s which I put on every day with lots more walking, which puts extra pressure on the arms using the walker. I’m already taking a strong anti-inflammatory for arthritis which she wants me to continue, adding Flexoril to help relax the muscles, and she put through orders for additional therapy for the shoulders.

My earache is because of fluid on the ear but it’s not infected. It’s bad allergy season for me right now, which isn’t helping since I’m allergic to all the flowering things. I’m to make sure I take Flonase every day which I’ve been doing but not very regularly. The cough will also benefit from Flonase and a return to the hated Netipot.

I’ve also been prescribed Cymbalta as an anti-depressant, which I think is needed. This has been a very long eight months and I’ve had a harder and harder time staying positive and motivated. The medicine will help me get to a better place after I give it time to get in the system. I’m starting with the “old person” dose but it can titrate up if needed.

We also discussed a conversation I need to have with therapy about walking on my own in the apartment with a walker. I wasn’t allowed to do this before, but at some point, I need to be able to do it, so what needs to happen to make that possible? Feeding the cats and cleaning up their litterbox (and cat vomit) are best done from a chair to minimize fall risk, but walking to the kitchen or out to the porch shouldn’t be hard to do. I haven’t been close to falling and have been more worried about just being tired and needing to sit down. This shouldn’t be a problem in the apartment, unlike the hallway that has no chairs. Something for me to bring up with PT tomorrow.