The Queen of Optimism

First up, Retinal Specialist.

Yes, I have tortuosity of the retinal vessels.  I have no leakage from the blood vessels or veins.  Therefore, I have

congenital retinal tortuosity.  The End.

The rest of my eye troubles are “probably related to my thyroid”.  Any reason it is limited to the left side?  “The thyroid can cause a lot of problems”.  The End.  This is good news.  I’d be lying if I denied the fact that I was hoping that this specialist could shed some light on my other problems.  Oh well.

Next up, PCP

The same day, I scheduled an appointment with my PCP so she could check on my leg.  It was on this day that I realized that everyone who works in my PCP’s office realizes I visit often.  I don’t even have to check in.  They see me from afar and wave, “Nothing’s changed with your insurance or address, right, Queen?”  Nope, not since last Friday!  Hahahahaha. Argh.

I was in so much pain.  The last couple of days I had been standing, walking, bending, lifting, up stairs, down stairs, driving, and carrying quite a bit.  It was the worst pain and most limited I had been since my muscle biopsy.  It’s times like these when denial sets in.

I don’t want to have this problem; therefore, perhaps I can pretend it’s not there.  I can disregard the possible consequences for doing as much as I needed to do over those days.  I can do anything it takes.  I am the Queen of Optimism.  Nothing’s ever kept me down.  I keep going, and going, and going even if I go with an AFO or cane.

During my appointment with Dr. PCP, I was able to provide more details than usual.  Starting in July, I’ve been

This is not my foot but this is nearly identical to my limited dorsiflexion.

keeping a pretty detailed log of my symptoms while also paying close attention to what is going on with my body.   I have a high pain tolerance and high ambitions so I can often block out the pain and symptoms to the point that I can’t clearly articulate them.  Not this time and dear Dr. PCP took notice.  “For about three weeks now, I started to gradually feel changes in my legs.  In the quiet hours of the morning, I take the time to examine what I am feeling.  It’s somewhat like a cramp, a Charley Horse, you know?  Not that short-term intense pain but the tightening and the inability to stretch out my foot.” I went on to describe the following:

• My left foot tightens up and I have an inability to fully walk heel to toe…my foot slides on the ground.
• The bottom of my foot will feel not only tight but painful, sometimes severely.
• I examine my foot dorsiflexion and it is impaired.  It’s not that I can’t lift my toes/foot at all but only about 25% as high as my right foot.
• From  my notes, I see that there are at least 5 instances in the past year, including approximately 3.5 weeks ago when my left leg began bothering me shortly before or on the day I begin menstruation.
• Pain increase if my leg is dangling from a chair and not able to touch the ground.  I also feel an increase in pain when my leg stays in the same place for a long time, like when driving.
• Sometimes, there is pain in my knee area and it is tender to the touch.
• My worst days are those when I do a lot of walking, standing, and stair climbing.

You have no idea how much I'm counting on you little pill.

Conversation:  Dr. PCP and Me

“Have you ever had an arterial doppler?”

“I had an ultrasound on my leg when it was suspected that I had a blood clot some 10 plus years ago.  It was repeated several times and I stayed overnight at the hospital.”

“That type of test doesn’t check the arteries.  I want you to get an arterial doppler.  With the relation to your menstruation, the effect of standing and your leg dangling, that can be because of your arterial blood flow.  It’s hard for me to find the pulse in your left leg.  It feels stronger in your right.”

“Ok.”

“Remember my intern?  She came up with an idea that you may have a vascular problem and if you have this specific problem, it would be very, very rare.  This test will tell us.   I’m going to have to write her a letter.”

“What do I do for the pain?  Now that I’m more in touch with what’s going on, I realize how badly it hurts.  I liked it better when I blocked it all out.”

“Aspirin.  Take low dose, 81mg, up to a total of 325mg/day.  If it’s what I think it may be, the aspirin will help the pain within 24 to 48 hours.”

I have a tentative appointment for my arterial doppler on Monday.  It depends on my ability to get authorization from my health insurance.  If I do get the appointment, Monday will be a triple header of doctors’ appointments.

My prescription for the doppler says “Diagnosis: Intermittent vascular claudication symptoms”. When looking up more information about claudication, it seems like a reasonable explanation other than the fact that this sort of thing typically does not happen to people in their thirties.

The optimistic side of me wants to feel like this is a breakthrough – at least something to go on.  The frustrated side of me is bracing for another disappointing conversation about how much of a puzzle I am.

What do you think?  Am I finally going to get some real answers?  I care about what you have to say. Share your self through comments.

Filed under: Uncategorized Tagged: | arterial doppler, congenital retinal venous tortuosity, doctor patient relationship, leg claudication, limited foot dorsiflexion