Anyone Have a good Idea why ths is Occurring? (Medical)

[warpedskydiver 0]

I was wondering if any of you Docs or Medical personnel would be able to shed light on why lower leg would start swelling so badly weeks after a Torn Achilles?

It has been doing this since March and getting worse.

The Achilles is not healing well, but the swelling is just absurd, the leg is purple and requires a TEDS.

Some pulsation or thumping feeling is felt at times in the leg.

Blood clots were ruled out.

I understand what the veins do to constrict and make the blood move out of the extremity.

Any ideas?

Yes I have a Dr. he is a former Demo Jumper as well.

He does not know exactly why either, next appt. 6 weeks.

[JoeQ.Public 0]

I can't help you but keep an eye on that. I have heard stories about swelling causing circulation problems along with nerve damage.

Very soon, an honest person will not be able to sing the last 2 lines of our National Anthem:::Practice safe dining....use condiments

[quade 4]

SIX WEEKS is f'in' insane.

GO NOW! OK, you probably can't get in Sunday but f'in' camp out at the DR's office and DEMAND to be seen on Monday. If HE doesn't know the reason ask to for a referral to somebody that might. From what you've described "I don't know. Come back in six weeks." is not an acceptable answer.

quade -
The World's Most Boring Skydiver

[warpedskydiver 0]

Relax it is the VA.

I know I need to be seen but that is actually fast in the ortho clinic.

I saw him last week.

There are other guys ahead of me plus one female with mangled limbs, they need help far worse than I do.

It is not like I got blown up or something.

Thanks for your concern though.

[skymama 37]

Is it just one leg or both?

My grandmother has been in the hospital all week because he legs were swelling and her BP went up. The Docs decided she has 2 blocked artieries but not bad enough to require a stint, so they told her to take a baby aspirin every day and that'll be enough. A baby aspirin, I was so surprised!

She is Da Man, and you better not mess with Da Man,
because she will lay some keepdown on you faster than, well, really fast. ~Billvon

[DavidB 0]

I guess they figured she couldn't afford the $3.50/day Plavix©® costs...

When the only tool you have is a hammer, every problem looks like a nail.

[kbordson 8]

Since you've already ruled out the DVT (deep vein thrombosis), which is the MAJOR medical concern, looking at other options comes next... which is what you're wondering

I tried to attach an article titled "Approach to Leg Edema of Unclear Etiology" from
Or just google "unilateral lower extremity edema" - you'll find multiple hits on vascular, lympathic and even zebras like [url "http://findarticles.com/p/articles/mi_qa3912/is_200412/ai_n9473037/">May-Thurner Syndrome

edit to correct formatting error

[warpedskydiver 0]

Quote

Is it just one leg or both?

My grandmother has been in the hospital all week because he legs were swelling and her BP went up. The Docs decided she has 2 blocked artieries but not bad enough to require a stint, so they told her to take a baby aspirin every day and that'll be enough. A baby aspirin, I was so surprised!

One leg.

[warpedskydiver 0]

Quote

Deep Vein Thrombosis
Deep vein thrombosis classically results in an acutely swollen, painful leg that may be discolored. However, the presentation can be more subtle with mild, painless, asymmetric edema. The physical examination is often unreliable and patients with acute edema usually require further evaluation, which may include a D-dimer determination and a Doppler study (Figures 1–5). Risk factors for deep vein thrombosis include cancer, immobilization (especially following surgery or an injury), and a hypercoagulable state.

This sounds logical, I do not know how they determined that there was no clot, I did not get a doppler.

I was told they did a blood test and that was negative?

I am unaware there was a blood test for clots/blockage.

I do however wonder if there is a possiblity that the large nodule produced by the tear of the Achilles is putting pressure on a vein or a few of them.

Quote

Deep Vein Thrombosis
An acute deep vein thrombosis is generally treated with low molecular weight heparin, such as enoxaparin 1 mg/kg/dose subcutaneously every 12 hours.50 Warfarin can be initiated simultaneously with heparin, starting with 5 to 10 mg daily for 2 days with subsequent dosage based on a target international normalized ratio range of 2.0 to 3.0. Heparin is continued for at least 5 days (10 days for severe iliofemoral thrombosis). When the international normalized ratio is between 2.0 and 3.0 for 2 days, the heparin can be withdrawn. A platelet count should be obtained on day 3 and day 10 of heparin therapy to rule out heparin-induced thrombocytopenia. The total duration of oral anticoagulation is reviewed elsewhere.50 If anticoagulation is contraindicated, an inferior vena cava filter may be an option. Thrombolytic agents are generally reserved for patients with phlegmasia cerula dolens, which is manifested by severe pain, bullae formation, and skin discoloration.

Although I am 25lbs overweight I would not consider that obesity, nor do I present in both legs.

The onset of this coupled with the injury is quite telling that there must be some sort of involvement.

[kbordson 8]

Quote

Quote

Deep Vein Thrombosis
Deep vein thrombosis classically results in an acutely swollen, painful leg that may be discolored. However, the presentation can be more subtle with mild, painless, asymmetric edema. The physical examination is often unreliable and patients with acute edema usually require further evaluation, which may include a D-dimer determination and a Doppler study (Figures 1–5). Risk factors for deep vein thrombosis include cancer, immobilization (especially following surgery or an injury), and a hypercoagulable state.

This sounds logical, I do not know how they determined that there was no clot, I did not get a doppler.

I was told they did a blood test and that was negative?

I am unaware there was a blood test for clots/blockage.

I do however wonder if there is a possiblity that the large nodule produced by the tear of the Achilles is putting pressure on a vein or a few of them.

Quote

Deep Vein Thrombosis
An acute deep vein thrombosis is generally treated with low molecular weight heparin, such as enoxaparin 1 mg/kg/dose subcutaneously every 12 hours.50 Warfarin can be initiated simultaneously with heparin, starting with 5 to 10 mg daily for 2 days with subsequent dosage based on a target international normalized ratio range of 2.0 to 3.0. Heparin is continued for at least 5 days (10 days for severe iliofemoral thrombosis). When the international normalized ratio is between 2.0 and 3.0 for 2 days, the heparin can be withdrawn. A platelet count should be obtained on day 3 and day 10 of heparin therapy to rule out heparin-induced thrombocytopenia. The total duration of oral anticoagulation is reviewed elsewhere.50 If anticoagulation is contraindicated, an inferior vena cava filter may be an option. Thrombolytic agents are generally reserved for patients with phlegmasia cerula dolens, which is manifested by severe pain, bullae formation, and skin discoloration.

Although I am 25lbs overweight I would not consider that obesity, nor do I present in both legs.

The onset of this coupled with the injury is quite telling that there must be some sort of involvement.

If they didn't do a doppler, they really SHOULD do a doppler to really rule out a DVT. I don't think that a blood test can definitively tell you "NO, you do NOT have a DVT."

Call to get it done SOONER THAN THE 6WKS!!!! (In fact, I would get it done in this next week before the holiday weekend!)

[lawrocket 3]

Often a DVT can be palpated.

Question - did you habe a surgical repair of your Achilles? I wonder whether there may be some infection that is causing swelling.

Also, if swelling continues to increase then compartment syndrome is a future complication. Fasciotomy I'd no fun.

My wife is hotter than your wife.

[warpedskydiver 0]

Interesting, because I do have Plantars fasciitis now.

This has been going on for several months.

[warpedskydiver 0]

Headed out to the ER in order to find out what teh hell is wrong.

I don't want to lose my leg to a stinkin clot.

Get it blown off fine, then I can show everyone what I got out of it.

Lose it to something I cannot even see, that would suck.

Then off to VR&E to get my laptop.

They alloted $1900 for a laptop for me.

Now I can quit using my daughters laptop,

[warpedskydiver 0]

The results of the Doppler were negative.

So it is either in my pelvis or it is just a result of my injuries and the failure of my calf muscle to pump the blood back up.

So I wait and see.

I cannot support myself on the ball of my foot nor raise it while weight bearing, but I am walking and trying to roll my foot.

[quade 4]

Glad you came to your senses and decided not to wait the six weeks.

Did your Dr. tell you it's ok to walk on it like you are?

quade -
The World's Most Boring Skydiver

[ltdiver 3]

Quote

The results of the Doppler were negative.

So it is either in my pelvis or it is just a result of my injuries and the failure of my calf muscle to pump the blood back up.

Good to know that the doppler was negative.

Also good to know you now realize that the gastrocnemius (the calf muscle) has a major action in returning fluid (including blood) back up the leg.

I opted out of posting anything in your thread until this truth was learned. Veins do -not- pump blood up the leg. The muscular action of the leg does that, specifically the calf muscles.

Oh, the blood vessel -valves- help keep the blood from pooling back down in the extremity once it's pumped out, but the veins have very little to do with getting the blood back up against gravity.

So, since your achilles tendon was damaged, your gastrocnemius couldn't contract and pump the blood back up out of the leg...

RICE is the best way to get the fluid out. If that isn't enough then perhaps a JOBST stocking and treatment. Or, if the tendon is healed enough now, get to pumping!
Happy Healing!

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon