Is WebMD a Bad Invention?

Been trying to decide since 9:30 pm last night if I should call the Resident on call and ask if they think I have a blood clot in my calf.

I have had some localized pain in my calf for the last two days and last night had a horrifically bad cramp (not fun when you can't move your ankle or massage your calf muscle). I did manage to get my fingers an inch or so down the back of my splint and my calf felt hot.

All of these can be explained away by surgery and being in a splint, or according to the internet, be symptoms of a blood clot in my calf. With no way to do a physical inspection I can't tell if my calf is more swollen then the first few day post-surgery, or how the skin color looks.

I also discovered that I am on less Lovenox then I was last surgery (Blogs are good). My first achilles surgery I was on 30 mg injection twice a day, this time I am on a 40 mg injection once a day. Does this make a huge difference?

And it's not like I can just go to my local ER as they may need to remove the splint to examine my foot, and I'm not certain I would trust them to get it replaced in a way that would make Dr. E happy.

Last night I held off calling because I simply didn't want an answer that might involve my having to go to the hospital that late at night. But with my history of clots, this is not something I should ignore.

I finally decided to leave a message with his service for the Resident on call. Will update later with the outcome.



90 minutes after my message with the service I got a call back from the doctor on call. He didn't feel I needed to worry about the cramping and pain, but said I know my body best and if I get too concerned, or start to have breathing issues, I should go to my local ER. He thought the ER doctor could do a doppler behind my knee without removing the splint. He also said the efficacy of 40 mg lovenox once a day vs. 30 mg twice a day is the same. (So why would any doctor prescribe two shots a day?)

So I sit and mentally note every periodic twinge, or pain in my body. And I definitely need to get my lovenox refilled today!

At What Point do You Worry?

Certain things trigger medical paranoia in people. Mine seems somewhat odd until you understand the context. I get worried if I have bouts of bloating and gas. Seems minor until you know they were originally the only symptoms of my mother's stage 3C Ovarian Cancer. Since that particular cancer runs in my family, I get concerned.

I've had the symptoms for the last three or four days and decided it was time to see if I needed to call the doctor or if they were simply side-effects of the Lovenox. While I didn't see it listed on the medication website I did find multiple sites with patients on the drug, especially women, complaining. What a did find on the site was a simple sentence that had me e-mailing Marco about something I hadn't even thought to concern myself over.

The sentence reads "It is important to contact your doctor immediately if you experience symptoms such as tingling, numbness (especially in lower limbs), and muscular weakness." I've had all of those and just attributed them to post-surgery. I've had one or two moments when my legs have felt like they were going to sleep and thought I was sitting badly and pinching a nerve in my back. Wouldn't have even thought to call anyone about it.

Marco's response was that my numbness and tingling may be related to swelling, and to call the office tomorrow. I'd buy that, except it feels like I've had almost no swelling. Within the first 72 hours the cast around my foot and ankle felt loose enough to shift around in and the spot where the top screw was removed from my knee has been getting irritated by the knee pad on the walker (especially today, but we'll go into that shortly). I've added a call to Dr. Hubbard's office to my To Do list tomorrow.

I was on the knee walker more today then I have been since my surgery. I baked. Almost home-made red velevet cupcakes - I decided I was not up to making them from scratch - and pink vanilla cupcakes. Not going to cook a four-course dinner until I can stand on my own two feet, but I can make treats for my Council meeting tomorrow. It was also surprisingly tiring. It seems sad that it is not yet 8:00 pm and I'm ready to hop (crawling's not an option at the moment) into bed.

Ouch

I have spent most of the week preparing my world for surgery. I ordered a knee walker and a shower stool; stocked up on supplies (both food and entertainment); re-arranged the loft to be more crutch and walker friendly; and caught up with meetings and editors.

I've been busy checking things off my list, trying not to think about the actual surgery. Until I got hit with logistics in a one, two punch. First came in the mail, the letter authorizing my surgery. A simple line in the Requested Services Summary, Description of Service Code(s). The first description I expected "Repair of achilles tendon". Strait forward explanation of what this surgery is for. It was the second description that threw me, "Part removal of ankle/heel". It made it sound like some sort of amputation, like I would wake up and all the bone under my tattoo would be gone. Not a phrase to inspire the belief that everything will be fine and I will be up and running quickly!

Before hyper-ventilating and calling Dr. H. (not a completely unreasonable reaction considering some of the strange dreams I've been having about this surgery - I don't remember any prior to my knee surgery.) I decided that he actually meant shaving the Haglund's deformities and the bone spur. (You can see both on the photo of the x-ray below.) But still, bad wording.

The second came in a phone call from Dr. Hubbard's office. My surgery is scheduled for 7:30 am, which means I have to be at the surgery center at 5:30 am. Sit and do the math and that means I have to get up at 3:30 ish to be showered and awake enough to get to Union Square. Does it even make sense to go to bed?

On the plus side, they predict I'll be ready to go home by 8:30 - 9:00 am (which doesn't make 100% sense if the surgery lasts an hour unless they are wheeling me straight from the OR to the car) and I have to believe I'm the first surgery of the day. Dr. Hubbard's assistant said I should be happy it's early, because it means I won't be hungry like later patients.

The doctor is still waiting for insurance authorization to put me on a blood thinner, Lovenox, to prevent possible blood clots with my leg being immobilized for so long. I had been told that the PA would be talking to my hematologist and was expecting a blood thinner. Then I went on-line - from drugs.com "Lovenox can cause a very serious blood clot around your brain or spinal cord if you undergo a spinal tap or receive a spinal anesthesia (epidural)..." Didn't even get to the websites partial list of side-effects before emailing Dr. H., my pre-surgery packet says that my surgery uses an epidural instead of general anesthesia. 


Maybe medical internet research IS a bad thing! In the meantime I'm left with four days to worry and obsess.