~~ Rachel Peden
The past week has been a roller coaster, and I have needed the "serene philosophy of the pink rose".
My brother is fine, but we weren't sure he was going to be for a while. His surgery a week ago Thursday went very well. He was talking normally and ate a hearty dinner Thursday night. I stayed at the hospital with his daughter, my niece Kelly, that night until my sister P.J. got back to the hospital early Friday morning.
Around 9:30 Friday morning I got a call that he had seized and was in ICU. He had had his oxygen treatment and eaten breakfast; P.J. and her husband had gone down to get some breakfast, and Kelly had stayed in the room with her father. Right before they got back he started seizing. Kelly ran out into the hall, calling for help. When P.J. got into the room there was medical staff around him trying to get his mouth open. Phyllis walked up to his bed and said, "Brother, open your mouth!! Take a breath, Alton!" And he did!
After testing everything they concluded that his Dilantin levels were extremely low and that had caused the seizure. He has taken Dilantin regularly for many years. Every three months he sees his regular doctor, and the Dilanton levels are checked, among other things. He was due for his next appointment this past Tuesday, so apparently since his last appointment in March and this one his levels had decreased. The surgery and not getting his regular dosage on time at the hospital was, apparently, just enough to effect him.
He was in ICU until Sunday night, then they moved him back out onto the floor. He is doing very well, but he failed his swallow test miserably. So he is going to have to have speech (swallow) therapy. His vascular surgeon and the doctor who took care of him in ICU both have recommended that he have acute rehab there at the hospital for two or three weeks, just to get him stronger before he goes home. So that's what we're waiting on right now -- for him to be moved to rehab.
While all this was going on I was worried about Thomas. His left knee had been paining him and was slightly swollen last week. He has trouble with his right knee from an old sports injury, but had never had this kind of trouble with his right one. He took ibuprofen and tried Aspercreme, but nothing helped.
Then Sunday morning he got up with his left calf swollen. He mentioned to me, casually, that his leg was a bit swollen, but it wasn't until late that evening that I saw it. Oh my goodness! His left leg from the knee down was swollen at least three times the size of his right leg, including his ankle and foot. I just about freaked out! My first thought, of course, was "blood clot"!
He finally assented to being taken to an urgent care center, where they did an ultrasound and decided it was not a clot. Phew! They drew blood, gave him a three-day prescription for Naproxin, and sent him home. Then, of course, I got on the internet, and checked out all the things that could cause sudden extreme edema in one leg. You know, I frightened myself, 'cause that's what the Internet's there for, right?
Next day I called our doctor to give him a heads up, and the urgent care doc had already called to let him know what they'd done. I was rather impressed by that. I made an appointment for Thomas for Thursday, figuring the blood test results would be back by then. Tuesday I got a call back from the doctor's office saying the blood work was back, and could we come in Wednesday instead, because there were some abnormalities. Of course, it was the scheduling nurse calling, so she couldn't really tell me anything. So I had to worry all night Tuesday and all day Wednesday about what they might have found.
Cardio-Vascular? Kidney failure? Rhumatoid Arthritis? Infection of some kind? Tumor? Gout?
The Naproxin was helping with the pain, and then swelling had gone down, although the left leg was still a lot larger than the right one. Dr. T. was very thorough and very patient with us. He said there was nothing in the blood work that really concerned him. He said sometimes you can get cysts behind your knee that will press on the veins and keep the blood from going back up your leg like it should. So they took x-rays. The x-rays showed nothing. He said that the cysts could have ruptured, in which case they wouldn't show.
I said, "So there were no abnormalities in the blood test?" I didn't want to get the scheduling nurse in trouble, but she had said.... He flipped through them and then said, "Well, the uric acid is high. Actually, I'm going to have to back up and call it borderline."
Aha! High uric acid. I knew what that could mean. I hadn't tortured myself with the Internet for nothing. "So, gout is a possibility?" I asked.
It is a possibility, but we're kind of waiting and seeing. He did go ahead and prescribe a low dose of Allapurinol to take along with Naproxin. He is to keep the leg elevated as much as possible when he's home. There is no gout in his family as far as we know. He doesn't drink or overindulge in red meat or shellfish, either. The blood work did rule out RA, by the way.
His leg is still swollen, although it is much closer to normal than it was, and the medicine is taking care of most of the pain. I'm hoping it goes away and doesn't come back. But we'll be following up with the doctor to check on things in a couple weeks.
Yes, it has been a stressful week, not at all serene!