Swollen leg update

This isn’t particularly exciting but I’m trying to keep track of what progress (or not) I’m making as I go through this recovery time.

As you know, I’m on Lovenox because I have a blood clot in my right thigh. I inject it twice a day on the left side in the mornings and on the right side in the evening for no particular reason except they need to be spaced out. No one mentioned several things that would have been good to know. First, I needed to get a sharps container for the discarded syringes. Amazon came to the rescue yet again. Second, those injections can and often do leave hard lumps under the skin, and with all of the injections, those lumps start to run together. I have one big lump about 4 inches long and 1.5 inches wide plus a few assorted scattered other lumps. Third, because this is a blood thinner, I’m ending up with lots of purple blood bruises. Bottom line is my tummy looks like someone beat me up except it doesn’t really hurt, it just looks bad.

It’s hard to tell if the injections are doing any good. Various medical people told me that the clot would dissove in about a month, two months, three months, or up to six months. So it’s really too early to tell if anything is happening yet since it’s just been two weeks. I do think my right foot isn’t quite as puffy as it was and in the morning, it looks almost normal. The leg is still very tight and swollen and there’s lots of pitting if you press the skin with a finger. But maybe there is progress.

I finish my 30 day supply of Lovenox before my next appointment with the vein specialist, so I need to call the office to see whether they want me to refill the prescription (at $252) or take Xarelto that I already have left over from the FIRST doctor to see the DVT. I know I have to keep taking something, just not what.

I would really like this leg to be normal. Beyond the clot problem itself is the heaviness of the leg because of all the pooled blood in the calf. I first noticed the difference between right and left about 10 days after my surgery last August, and it’s never completely gone away. Walking is more complicated because the legs don’t fell the same when they move. The right one feels big and clunky, as though it’s pulling through water. I’m hoping getting the clot dissolved, whenever that happens, will make the walking feel more balanced.

Image credit: Photo 58182878 / Sharps Container © Sherry Young 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.

Venturing Out for Solo Walks

This week I ventured out and took walks out in the hall by myself, without a trailing wheelchair in case I needed to rest. This was a first here. I’ve been building up to it by walking around the apartment with a walker instead of the chair. Obvious differences were distance and turns; the hallway is straight and the apartment has me making circles around furniture and turns into doorways. But it was still good practice and the living room looks way bigger without the wheelchair sitting in the way.

My first trips took me from my chair out the door, then a turn and down the hall to the first apartment, then turning around and going back to the chair. Today I upped the effort and went past the apartment to the fire doors before turning around and going back. Not sure how many feet that is, but it’s getting closer to the whole distance I did before with a trailing chair. My legs and feet weren’t tired, but my arms were. Note to self: more arm exercises are in order. I won’t push my luck, though, and will aim to do what I did today twice tomorrow.

I also called and made an appointment for my Medicare Wellness Visit with my primary care doctor, as well as researched local dentists. I really need to get my teeth cleaned but was worried about how to handle the visit in the wheelchair. Friends in my Facebook group for spinal cord injury rehab gave me some good tips and I will call this coming week to make an appointment. Hmmm. I also need to make an appointment with the cardiologist for my annual visit.

What bothers – not worries, just bothers – me the most is the amount of edema I have in my right foot and leg all the way from toe to groin. The left has some, but the right is really excessive. I’m already taking prescription diuretics balanced by extra potassium, drinking water, adding as much movement as I can. I sleep with my feet elevated as far as my adjustable bed will let them go. And I try sitting with legs elevated rather than the chair with legs down where that’s an option. So I hope one of the doctors has a good suggestion.

I did something else for myself this week: new granite countertops for my kitchen. I loved my new granite at the house sooooo much and then left it to move here, where the kitchen was nice but dark. I have warm wood cabinets, black appliances, and dark floors. I came to really hate the black patterned granite that always looked as though someone scratched it. I was really lucky to update my counters with granite remnants from a local company that were expertly cut and installed. They look fabulous and really brighten up the kitchen, especially with my pops of red on the counters. I lived in white apartments for so long that I learned how to perk things up to suit me, and my bright red Kitchen Aid mixer is a big part of the decor as well as a kitchen tool.

I don’t want to “adult” today

Both upper arms have been sore all week. Well, actually, for about 2 months but they’ve gotten progressively worse. Walking with a walker hurts because of the pressure applied with every step; standing up uses the same pressure on the wheelchair arms. Putting on my AFO’s hurts because I’m hauling the legs around using upper body strength to get them positioned into the brace and shoes. And using the NuStep also requires hauling the legs up into position on the pedals.

Physical Therapy decided I should not do any of those things this week (well, except standing; that’s necessary) to give my arms a rest while we figure out what’s going on. Instead of e-stim on my legs, I got e-stim on my right bicep followed by ultrasound, and I think it helped a lot. There’s still soreness, a deep ache, and arm weakness. So I’m off to the doctor tomorrow which is an adventure in itself.

My left thigh has been twitching and the neuropathy in the right foot is worse, or at least it seems worse. The “stocking” sensation makes it feel as though it’s in a cast. The right ankle hasn’t improved at all since August and my hip flexors are incredibly weak. I’m doing exercises, but my limits make it hard to get in a good position to work them properly. It’s very hard to pull my leg back and almost impossible to get it up on the footrest far enough to keep it from falling off. And my right foot/leg are very puffy from edema in spite of elevating them as much as I can and taking diuretics and drinking water. I think we’ll be talking about it tomorrow at the doctor.

And I’m feeling really fat, because I am. Although I can’t get on a scale, I know from the way clothes fit that I’ve gained back much of what I worked so hard to lose on Noom. Lots of explanations for that – obviously much less mobility, boredom, excellent food that I don’t have to cook, and needing comfort. Food has always provided that for me, much as I know it’s false comfort and that I’ll pay for it later. I’m really, really tired of feeling as though I need to diet and watch food all the time. I’ve done it my whole life and I’m still fat. Maybe I need to just accept it with its limits and move on. I did throw out most of the processed foods in the kitchen, which really wasn’t that much anyway, and am trying to make better choices. I know how to eat better; I just need to do it. Maybe that will be enough.

I don’t feel as though I have a lot of years ahead of me, which could just be that I just don’t want to have a lot of them with my limited mobility. I’m finding it hard to stay and be positive, and even harder to stay focused on doing more exercise. Sometimes it feels like that’s all I ever do now – exercise, go to lunch, and therapy. And this week, without the extra exercise, I feel like a slug. So today I’m just indulging in that and not adulting. I know for my mental and physical health that’s not good to do often but for today it’s fine.

Better at last

My body doesn’t hurt and hasn’t in over 24 hours. Yayyy! It started feeling good one day after finishing the 4-day tapered dose of Prednisone. Makes me wonder if taking the Prednisone sooner would have had the same result faster; I suspect yes, because I suspect the SI joint was inflammed and didn’t calm down on its own. One side effect of the Prednisone was serious water retention. My legs, especially the right one, were hugely swollen and my toes looked like little sausages attached to a water balloon. The combo of finishing the med and spending several nights in bed (finally! yayy!) with the legs more elevated now has them down to normal size and feeling much better.

I noticed today that I’m no longer having muscle spasms/cramping up and down the foot/leg. I’m not sure when that stopped, actually, though I was very aware of vice-like cramping while I had the burning leg pain. Now, though, there’s almost nothing except a little buzzing around the big toe. The ankle area still feels as though it’s in a boot and the ankle is still frozen in place; these are side-effects of spinal stenosis and is called “stocking paresthesia.” I can move the toes on the right foot up and down a little bit, but the ankle doesn’t move at all. After almost 7 months, this makes me sad, but the frozen ankle thing was happening for at least six months (probably more) before I had the spine surgery, and I am beginning to suspect it may be permanent.

The lack of spasming tingly sensations in the lower leg is actually weird now that I’m aware of it, because they started almost immediately after my surgery and went on for months. I assumed they meant the nerves were waking up and were a Good Thing, so I can’t help but wonder if it’s a Bad Thing that they’ve stopped. Something to ask my spine surgeon when I see him later this month. I’m also going to ask him about the incidents with pinched nerve/burning leg pain, because I need to know what to do when they happen again. Go to my primary care doctor for Prednisone earlier in the game? Go to him? Get SI joint injections? Something else completely? Better find out before I need to fix it again.

I slept in my chair for most of the last 2 weeks, which is a lovely option when I can’t get into the bed without crippling pain, but which doesn’t let my legs be as elevated as they need to be to keep them from swelling. It also raises the issue of where to put my CPAP machine, which got moved to the living room to use from the chair and just got moved back to my bedroom now that I’m lasting most hours in the bed. Last night was the first night when I could actually move the right leg after I got into my bed. I’m perilously close to the left side of the bed and in danger of falling off if I’m not careful, but least now I can climb on and use my bed’s adjustable frame to make it comfortable. It was not cheap to get, but I think it’s finally paying off.