There I was yesterday, with a distressingly swollen and tender shin, lurid bruising extending down to my foot, concerned I might have cracked the bone....
I made an appointment at the closest drive-through doc. We've got one in Broad Ripple again, and they've been businesslike and easy to deal with, the couple of times I've gone there.
They got me in quickly, checked my temperature, blood pressure (just fine -- the "white coat syndrome" that used to overwhelm the good effects of my blood pressure medicine at any doctor's office is doing better these days), and had a look at my leg. There was a fair amount of cogitation on the part of the doctor and nurse. The conclusion was that it was a sure-enough clot, and maybe rather more than might be expected from the accident as I described it. (I fell up the basement stairs and took the edge of a sturdy step right on that shin.) My left ankle was over twice as big around as the right.
The thing to do was to get an ultrasound -- and to go do so at an ER. I expressed doubt at going to the hospital over this. Say "stroke risk," and they bring out the fancy toys, much excitement, high cost--*
Oh, no, says the doc, not that. Go to one of the standalone ER/urgent care combinations. They're quicker anyway.
So I did. The closest place was halfway across town, a long drive with me thinking all the time how very interesting it will be if the big blob breaks loose and fries my brain, right there along Westfield Avenue or one of the crowded east-west numbered roads in the hundreds, where the northern suburbs have just continued Indianapolis street numbers past the county line. Got there with skull contents intact, boiled same slightly stuck in traffic gridlocked by dog-in-the-manger drivers and eventually checked in and got led back to a comfy exam room forthwith. Physical exam followed: "Yes, yes, probably a hematoma, but. Um, that's pretty far down on your calf, in front. The big veins are around back, and they're branched out and skinny that far down. I guess I see why they sent you but the risk is low. It's not that kind of clot."
Sonogram next, to confirm there were no chunky bits up where they'd make trouble. X-ray after that, and hey hurrah, the bone's okay. But there is a big, ugly splotch, a hematoma right on the bone, almost certainly under the layer of tissue normally next to the bone. "That's going to be a long time going down, weeks and weeks. And it's gonna hurt the whole time. Normal recommendation is compression, but as you already observed, it'll be painful."
He was talking about socks with that last line. I usually wear knee-high compression stockings; I'm an old lady on blood-pressure meds that make my ankles swell. The fix is easy, cheap and supposedly good for you, but I hadn't been able to wear them for a couple of days.
The doctor's conclusion was that I wasn't at any risk of a stroke from that clot. It was going to stay right where it was, slowly being nibbled away by the normal process of healing, and it was going to remind me it was there the entire time, all day and all night. I'm not a fan, but it beats having my brain scrambled by leaps, bounds and miles.
I took today off, to elevate my calf (also recommended), complain online, and, ouch, wear compression stockings. I peeled a set on last night and they can darned well stay on all day today. I'm in no hurry to slide anything over the big bruise again until I have to.
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* It also bugs me that you jump the triage line in a hospital ER with this kind of thing, at least for the initial diagnosis, and I worry that they're going to be poking at me and my stable situation when someone gets wheeled in, smashed up after an auto accident or whatever. I have been that person and I don't want to be the reason they have to lay there bleeding and hurting before anyone gets around to them.
Update
3 days ago
5 comments:
Glad it’s just a bad bruise and nothing is broken. Rest, compression, elevation, and time are your friends for awhile.
Is there such a thing as a footless compression sock - like leg warmers - that would do any good or must the foot also be compressed? Can you leave a sock on for 2-3 day at a time? (You can tell I'm completely ignorant on this sort of thing.)
I am happy that you are thoughtful of other folks who come to the ER for really urgent stuff. I will be even happier if your healing time is much less than you were told to expect. I am so sorry that you hurt so much.
Cop Car: I'm not sure if that would work. Times I have been in the hospital and stuck in a bed (more than I care to remember), they put me in compression socks with a kind of an opening at the foot end, but you don't let your feet or toes stick out of it. Instead, the stocking is positioned so there's an oval opening on the top of your foot, with the tips of your toes covered but the toes themselves are not squeezed as much as a full compression sock. I'd love to find some of those -- and the hospital left 'em on for a few days at a time, too. (It's not like I was walking anywhere in them, or at least not far.)
I'll bite the bullet and take mine off to sleep tonight, and see how that goes.
My lifelong clumsiness and poor vision seems to have put me in the hospital more often than most people -- a friend in his 70s was commenting on having to take an ambulance ride, and said, ruefully, that it was his second trip in a lifetime. I kept my mouth shut, but I've had four or five....
Could you just cut the feet off a pair of compression stockings, so you'd just get the effect on the calf?
John, that tends to make the feet balloon: blood gets in but has trouble getting back out. Ouch.
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