Tuesday, June 08, 2010
Back in the day when the television show "ER" first came out, I was talking to my father and he asked me in all seriousness:
"Have you watched that new show err yet"?
Now I've always had a love/hate relationship with that show. The acting was great and the personal stories were interesting, but the nurse in me just used to cringe at some of the unreality that the show portrayed. An ER physician doing a c-section in the ER? Hardly! AND the frequency that RARE conditions used to turn up and be diagnosed by the all knowing residents. Uh-huh!
Well lately I feel like a walking "err" patient. I got through the asthma flare-up, survived the severe allergic reactions to TWO antibiotics. I seemed to breeze through sinus surgery. Only to find new symptoms...
The weird swelling in my left ankle actually started last November. No foot pain or injury. No calf pain - but one of the drs. that I worked for had me get a doppler ultrasound to make sure that there wasn't a blood clot. There wasn't. To add to the weirdness, my sister has the same thing but we always thought that was because her left ankle was ran over by a bus when she was a teenager (don't ask...) Around the time the swelling started, my right hip and knee began hurting. I was running so I looked up sports injuries and diagnosed myself with ITB - ileotibal band syndrome - sort of like tendonitis in the tendons that run from the hip to the knee. Maybe my gait was off and THAT was making the ankle swell.
So I backed off from the running and got on with life.
Fast forward to three weeks ago....
I woke up one morning with excruciating pain behind my right eye. It felt like someone was trying to push it out of the socket with a hot fork. The inner corner of the eyelid seemed a little swollen, but the eye itself seemed fine. It definitely was coming from behind the eye. I took 800 mg of ibuprofen that I had on hand for when the hip barked too loudly, and the pain eased up. Maybe some sort of strange migraine I thought. I had the day off so I made an appointment to see the family dr. to discuss the eye and while there I'd corner her about the ankle and the hip and knee.
She encouraged me to see my optometrist to get the pressure in my eye checked and rule out rapid onset glaucoma although she said that is usually so painful and sensitive to light that those folks can't usually open their eyes and they have acute disruption in vision when they do. My vision was fine. She was mildly concerned about the ankle. She thought that I should see a vascular surgeon to rule out and venous insufficiency and/or groin masses or tumors.
Physical therapy for the correctly diagnosed ITB syndrome.
I got right in to the optometrist who dilated the eye and could find nothing obvious. She said if the pain persisted, that I should call the family dr. and have her order an MRI of the brain and eye socket.
Five days later I was still gulping the Ibuprofen to keep the pain at bay so I called for the MRI.
Now if you've ever had an MRI of the brain you will know where of I speak when I say it is miserable. An hour keeping your head frozen straight in a claustrophobic tunnel while you listen to LOUD jackhammer sounds. Before the last 15 minutes they come in and inject dye into your vein. Upon hearing that I burst into tears and sobbed how an allergic reaction to oral medication almost killed me and I couldn't take a venous injection without my husband with me. The very nice tech explained calmly that they needed to make sure that I didn't have a tumor or bulging aneurysm...
She promised to inject very slowly and she was true to her word. I was praying so hard I hardly heard her say that she was done. Not just done with the injection, but done with the MRI. I hadn't even noticed the last 15 minutes of jack hammer noises. Of course no report until the next day.
Well the next day I opened my eyes to the pain as usual which had the pattern of always being worse upon waking. I always assumed that the Ibuprofen had just worn off.
But this morning was different. This morning I had the pain AND everything was double. Nauseatingly doubled and trying to look up was an exercise in futility.
CRAP!! I felt panicky and knew that I needed to get to a bona fide ophthalmologist asap. Except for my load of patients scheduled that day...
My husband came walking back from the bathroom and asked how my eye was. In my attempt to temper the panic I tried a little levity. Looking at two of him standing there in his/their nakedness I smiled and replied, "Well you don't even know it but you just fulfilled a fantasy"...
He popped a cork when he heard about my double vision and even more so when I told him that I planned to drive into work so I could personally reschedule my patients and I'd go to the ophthalmologist as soon as they could get me in. I'd get my MRI results too. He said that he would call in to work but I figured out that if I patched my right eye I could see OK out of the left. I hadn't been wearing my contacts and I had been living almost a week with the pain. What was one more morning?
Driving was a little more complicated than I expected - not being able to check my right side blind spot with the right eye patched, but I got there and asked one of the drs. to get my MRI report. He lit a fire under the radiologist to read it quickly and he called and got me into an ophthalmologist BEFORE he chewed my butt for coming into work. My patients rescheduled without my assistance.
"Hmm..." The eye doctor murmured as he looked deep into my eye close enough to make me wish that I had a breath mint. "Very interesting -- I haven't seen a case like this in years"!
By now, I knew that my brain was normal without tumors or aneurysms on the brink of rupture. But there was severe inflammatory changes and swelling.
"Trochleitis". He spelled it out for the nurse. He patiently explained that it is a little muscular ring -- pulley-- that the muscles that move the eye up and down was inflamed and swollen, dragging the mobility of the eye. I could only slightly move the eye, thus the double vision when they eyes didn't track together. The treatment would be steroids. Sometimes long term, depending on the response. The side effects are sleeplessness, increased appetite, and irritability.
Yeah, yeah I know the drill. I've been a tired, hungry bitch before...
Thankfully, a week later the steroids are working. I worried a little when he said that if it didn't respond, the eye muscle could irreparably weaken, but the double vision is all but gone. The eye is moving better now and the pain is slight when the Ibuprofen wears off. I am sleeping well, have lost a pound, and I THINK I'm cheerful. Who wouldn't be? It could have been a lot more serious. I'll be on anti-inflammatory medication for a while but that's ok.
I saw the vascular surgeon and had an extensive ultrasound of the veins from the groin down the entire leg. No clots present.
"Hmm" she replied as she studied my now swollen lower leg...
A condition where the lymph cells are interrupted or damaged and they don't drain appropriately so fluid can accumulate in a limb. Sometimes the whole limb swells to huge proportions. It is more common in people who have had cancer surgeries or radiation to the lymph area. It can rarely be a hereditary condition due to some kind of gene mutation. She says that might be the case since my sister has it too. It could be that we have both had abdominal surgeries and if genetically our left groin nodes are already altered that might have prompted the symptoms later in life. Fortunately so far it's mild. It can progress if not treated. I have to be cautious not to get infection in the lower leg or foot because it might not heal well. No wonder that blister on my left foot from those cute but tight shoes that I bought, won't heal up.
I am now wearing compression hose that give me an aerobic workout just putting them on. I really only need them on the left, but particular as I am, if I can't make a fashion statement, I at least have to match. I can take the hose off in the evening and try to elevate the leg as much as possible. Don't sit or stand too long. Keep running. With the hose on if possible. Exercise is probably what has kept the symptoms in check thus far.
Massage can help. Now you're talking...
Physical therapy for -- oh yeah that pesky hip pain that persists like the literal thorn in the side despite the steroids and enough Ibuprofen to eat the lining of my stomach right out -- starts Thursday!
Geez! This hypochondriac gig is tiresome! I'm ready for a break. In the meantime I'm doing everything the drs. say to do and taking vitamins including extra C & D and fish oils capsules.
I called my 96 year old dad to try and explain why I haven't been to see him for a while at the Veteran's Home where he resides. He doesn't really remember anyway, but I feel bad. Real cheerful like he replied "That's ok, Kaye (my sister) you just get better"! Then he tells me:
"By the way, I watched the best gospel music on the 'bet' channel"....