Wednesday, March 28, 2012

How I learned to stop worrying

I think the artistic creation above is more attractive than a photo of my ankles, so you will have to imagine my peripheral edema.  Peripheral means on the outskirts of your body, usually your lower legs, as they sort of hang down all day, which encourages fluid to accumulate in them.  Edema is the visible swelling caused by that fluid.  I only make a point of this because I know many of you have a grandma in your life who has to go to the store in bedroom slippers, and you don't understand it.

Here's the thing:  it's not good when both ankles swell, but when just one is swollen, everyone worries.  So several weeks ago we saw my primary care doctor about it - this was on a Thursday - and he scheduled the soonest possible ultrasound, the next Monday, to rule out blood clots.  You really don't want a blood clot to form and travel to your heart or lungs.

But Friday night we noticed how bad the ankle looked, and Tom called our doctor's clinic about it, hoping for reassurance.  But the doctor on call said, of course we should go right to the ER and get it scanned, and not end up suing them for negligence. 

So we did, and this is getting to be a long story.  So I will skip the part about how they shut the ultrasound down at night and those people go home, so it was spend the night in the ER, having many other stupid tests done.  And finally the scan in the morning, and finally they said it was just fine.  I did not have a blood clot.

I'm trying to wind my way to now, several weeks later. We went back to primary care doc yesterday, because the damn swelling hadn't gone down, and I also suspected another UTI.  And this led to a thorough review of all the stupid tests done in the ER, which are right there on his laptop (!).  Blood draws, liver, kidney, and so on.  And everything looks fine.  This was a huge relief to us.  Nobody had told us to see him for a follow-through. This is modern American medicine at its best, unless you are very rich.

He explained that with age the arteries and veins can grow slack, and edema happens.  We could see a vascular specialist, but it was clear enough that the only thing that would accomplish would be to assure us further that nothing was wrong.  I should wear my compression stockings.

But most interesting, he had gone to some computer program with the extensive list of my medications, and returned with three pages detailing which meds are most likely to cause - guess what - peripheral edema.  When a doctor does things like this, you don't mind if he's wearing bespoke pants and Italian leather shoes.

And guess what?  One of the immunosuppressants (Rapamune) is a HUGE culprit in this, causing it in over 50% of the poor transplant patients who have to take it.  And furthermore, it commonly, their word, causes half a dozen other things, some of which I don't have yet, like headaches (but I'm thinking about it).  Nobody tells you these things.

You may have come to this post hoping I had a clue about how not to worry.  In a way, it's implicit in the story.  Identify the problem, take steps, get information, don't push it away.  It is easier to face your worries when you meditate; in fact, it is impossible not to, eventually.  Sometimes it's when the anxieties start to break through the bliss that people drop the practice.  But that's when it's started working.

[The image is me having fun with a recent photograph.  Now we're down to it - you can do so much with photography, the only reason to paint or draw is that you enjoy the feel and smell of the materials.  Which is a good reason, after all.]


  1. I've lived my entire life with primary lymphedema, both legs to the top of the each thigh - inguinal area. I wear Medivan compression from toes (toecaps) to my waist. I love the way the compression feels (think of a giraffe's neck and how compressed his neck skin must be to keep the swelling down). In summer one can get kinda warm with double layers. Yet in winter, and to look so fit and trim inside these super 'spanx' is kind of nifty. No cellulite for me! Well, I have it - it's that no one can tell I have it. Years ago (after having surgery for endometrial cancer) I had heard that anytime one has surgery, the lymphatics can/may become damaged and edema may result. At least you're over the worry for now and for now know what you're dealing with. That is good. I highly recommend the Medi hose are nice. I think they sell them over the counter at some pharmacies.

  2. Wow. I'm sure it gets hot - it's got me thinking about shorts, well, long ones. Yes, it does feel good. I have a higher-compression pair that feel even better but are very hard to get on. I'm going to look for Medi hose now.