Tuesday, June 13, 2017

Well, Don't That Beat All....

I have had my last therapy sessions for my shoulder.  I have full range of motion and pain only now and then.  I'm sleeping a lot better.  I feel blessed to have gone to Bartlesville Physical Rehab for that reason and more.  One of the reasons is that their people are so kind and caring.  Oh, yeah, they laugh and say they just love making people feel pain but I found them to be as gentle as is possible, considering that pain is often necessary to open new areas to healing.  And you know, I think that's true of any pain, whether it's orthopedic, emotional, or whatever.  But I won't expand on that as I don't want to get off topic here. 

About midway in my therapy I mentioned to one of their non-therapist employees that I was trying to lose weight and one of the reasons (but not the only) was that I had gotten so fat in my shin area, just under my knees, and it's ugly as hell.  I mean, I just feel like I'm carrying a ham strapped onto each knee.  Let me state here that I am sturdily built; meant to be strong peasant stock, that's where I get my body type from.  So, even as a girl, I did not have delicate ankles.  The camera flash is kind of in the way here, but you get the idea.

Maybe these two will show better.....


DANG!!  Another camera flash in the wrong place. 

I'm a little older and heavier here, obviously it wasn't uncomfortable for me, then, to wear tight clothes.....  But even being in this curled-up position, no hams....

Then, as an adult, it seemed like every job I had required me to sit at a desk eight hours a day.  When I was in my mid-30's I started going home every day with swollen feet and ankles, and sometimes I would have pain and swelling behind my knees.  Employers provided chairs to sit in at those desks, but they were not ever very good chairs.  Some were too long in the seat and I'm sure reduced the circulation in my lower legs.  If I had it to do over again, I would've provided my own chair or at least put a pillow behind my back to keep me from sitting all the way back in the chair.  As it was, I started walking for exercise about then, mostly because I was suffering from depression because of some things that were going on in my personal life, but it helped also with the circulation in my legs.  I have always struggled with my weight and walking helped with that, too.  I noticed my swelling problems went away when I would get my weight down to normal. 

My dad's mother had big-time swelling issues in her feet and ankles and she had one of those hourglass figures.  It wasn't so when she was younger, but by the time I knew her, she was vastly overweight.  So when I gained weight and started galumping along on puffy feet and ankles, wide calves and thunder thighs, my mother's voice began to haunt me, "You're JUST like your Grandma!".  She would say this to me every time she was exasperated with me, which was often.  She and Dad's mom did not get along, and Grandma, for Dad's sake, put up with a lot of crap from my mom.  She knew Mom had the upper hand.  Wives always have the upper hand when it comes to their relationship with their MIL, because sex always tips the scales, and Grandma, having three sons, was well aware of this.  Grandma went to a nursing home when she was in her early 80's and I went to see her from time to time.  If I mentioned to Grandma something my mom had said or done, she'd just lean back and roll her eyes.  But anyway.

Aunt Viv, who was dad's sister, had problems with her legs, and obesity, too.  Aunt Viv had hip replacement and didn't get any kind of rehab, so she reached a point where she just had a hospital bed put in her living room in front of the TV and then she never walked again.  So sad, especially when you consider that Aunt Viv just loved to throw herself into her old car and go places.  I used to love to watch Aunt Viv walk, because she went with a purpose and her whole body took part: elbows pumping, head bobbing, usually she was runnin' her mouth the whole way.  It made me smile, but not in a hateful way.  I loved my Aunt Viv.  It was just part of HER.  She said what she thought, you always knew where you stood with her, and she didn't have malice behind anything she ever did or said.  She didn't carry a grudge unless you just drove her to it.  And my mom did that.  Sheesh.  But I found Aunt Viv refreshing and worth respecting. 

So, up until I started carrying hams just below my knee, I just thought my swelling problems were because I "took after" that side of my family.  Always before, when I got my weight under control I'd have normal-looking legs.  I'm sure the "hams" came on so gradually that I didn't notice, until one day I looked in the mirror and thought, "What the hell??"  Most recently I tried on some jeans I put away because I'd gotten too big for them, and found I was able to get them on, they were loose in the hips and the waistband, but were so tight in the calf that I knew I wouldn't be able to wear them for any amount of time.  So the mirror and my jeans told me there was something terribly wrong and different than ever before.  And yes, I am well aware of what I look like in the mirror.  I did a little research on the internet and for awhile I thought maybe I'd overstretched my calf muscles and caused shin-swelling.  That was a possibility, because since all this stuff with my knee, I haven't been able to kneel in the garden and I have been bending at the waist to plant and to weed. 



That's all me in those pants.  No wrapping or anything on those thunder-calves. 

All this leads up to the additional blessing(s) I have received from BPR.  Because that employee that I spoke to about my "hams" seemed well aware of my funny-shaped legs already, and she said, "I think you should show your legs to your therapist".  And then she told me about a thing that they see a lot of people with, that's called Lymphatic Edema, or Lymphedema.  Well, I took her advice and my therapist gave me more information, and then I came home and did some research on the Internet and then I got an appointment with my doctor.

Don't get me wrong, I am very fond of my doctor.  She has treated me for many years and usually she takes pretty good care of me.  But this time, when I told her about why I have come to suspect I have lymphatic edema, and how it is that BPR offers therapy for this, instead of handing me the prescription sheet for therapy she just ordered a bloodwork panel and a Doppler of my leg veins and said we'd go from there.  Then she went on two weeks of vacation, with appointments backed up such that it would be more like four weeks before I'd be able to see her again, and all the instructions the PA had was to call in a prescription for a diuretic!!  And yes, I know doctors desperately NEED their "down time" and I'm not begrudging her that.  It's just, it was an inopportune time for me in my situation.  Especially since I read on the internet that diuretics can actually make Lymphatic Edema worse.  I went to the doctors office and asked the girls for a copy of my bloodwork panel and the Doppler.  The bloodwork panel showed that, though all my blood chemicals were within normal limits, my potassium level was in the lower part of acceptable.  Like, that's ALL I need, to be taking a diuretic that is not potassium-sparing.  There are potassium supplements that can be taken but I really think it best not to tinker with potassium levels.  The Doppler was just fine.  My blood pressure and pulse rate are really good and she heard no abnormalities when she listened to my heart.

So I mentioned my predicament to my shoulder ortho surgeon when I went for my follow-up there, and showed him the copies of my Doppler and blood panel.  He smiled at me and said, "Oh, would you like me to order physical therapy for that?" and I said "Yes!  Please."  However, then we ran into a problem in that Medicare will not pay for more than three therapy sessions a week.  They don't care what it's for, though, as long as there are doctors' orders, so the therapists put their heads together and decided they could do two shoulder therapies and one leg therapy a week, with me doing shoulder exercises at home to make up for the loss of one of the therapy sessions.  This has worked out OK for my shoulder and they've made a comparison of the measurements of my legs and have found that I have become smaller there since getting therapy, it's just that it's not a big improvement, what with only one treatment a week when normally three are done.  But starting next week, I will get three treatments since my shoulder therapy will be finished.  I have a follow-up appointment with my GP in a few weeks and I want to be able to show her a big improvement so that I can make my case.  If she will take over ordering the therapy then when my visits to Tulsa for my shoulder are over, I won't have to KEEP going to Tulsa just to get the therapy ordered for my legs. 

An additional issue is that the therapist who normally does the therapy has hurt her shoulder, and I've watched her as she does her shoulder exercises with a real vengeance, and a lot of pain, so that she can get back to work as quickly as possible.  So much so that I've worried about her a few times.  But she knows what she's doing so she's in a position to know what's crossed over the line to "too much".  There is one other therapist who can do lymphedema therapy, he has been doing the work on me this past month and I like him well enough, but he is not as experienced as she is and, well, you know how it is, we tend to want the person with the most experience.  It turns out that BPR is the only physical therapy group in this area that does lymphedema therapy.  At the orthopedic doctor's office, they told me that they don't know of anyone else, not even in Tulsa, although they have some massage therapists they sometimes send people to, if they do not want to come to Bartlesville for treatment.  Thus the blessing in my being sent to BPR for my shoulder.  Otherwise none of this would've unfolded and I'd still be thinking these hams on my legs were just wacky fat distribution. 

Lymphedema is different than just ordinary edema.  The lymphatic system does not have "pumps".  It depends on the movements of muscles and joints, so if you are sedentary and you have it in your family, that's a double whammy.  You can have it in your legs or in your arms, generally people who have it in their arms have it because some of their lymph glands were removed or injured during breast surgery.  People who have it in their legs could have it because of damage during surgery, but if it is in both legs, it's probably hereditary.  Here is a good explanation of how the lymphatic system works, and it certainly was new information to me.  Apparently this is not something that many medical doctors have had in their medical training, either.  Considering how much of our population is forced to sit at a desk all day, there are probably a lot of people walking around that have it and just think their legs are fat.
http://www.lymphnotes.com/article.php/id/151/
There are lots of YouTube videos available.  Just go there and enter "lymphatic system" in the search box if you're interested. 

Since the job of the lymphatic system is to remove fats, wastes, toxins, and cancer cells from your body, this is an important part of your (and my) anatomy, and is the best reason that I know of, at least for me, not to be sedentary.

Of course, all this has made me super-observant, now I'm seeing people's legs first and I've seen several who have legs like mine.  I'm never sure what to do.  Should I, a stranger, walk up to them and ask them if they know they have lymphatic edema?  I mean, I really appreciated being told.  But not sure if I would get that same reaction....

Next best thing:  those of you who are reading this now:  go to your mirror, look at your legs.  Do you have legs like mine???  Do your friends have legs like mine???

If you don't, THANK YOUR LUCKY STARS!!!  If you do, now you know why.  Maybe where you live, you can find someone who does lymphedema therapy.  If you can't, there are some things you can do.  Eat clean and healthy.  Walk, at least every other day.  Lotion and rub your legs in an upward motion from ankles to knee.  Lose weight if you need to.  If you can get a good pair of compression stockings, wear those.  Otherwise, it's helpful to wear stretchy yoga pants.  I'll be getting compression stockings made to fit my measurements after they get all the lumps out.  Because here's what happens, untreated:  The fluids in your lymphatic system dry out and form something similar to a gel, and that becomes lumpy places and big areas of extra thicknesses that build up over time.  I'm told this can get very painful, but I have not had much pain at all.  They tell me I'm not nearly as bad as some they have seen, and that with the proper treatment and management, I can be normal again.  (Now, don't that beat all, I've never been normal before......  Oh!  They mean my legs.  )  Heh.  I've even seen on the internet where they say that lymphedema causes the cellulite that every woman hates if she discovers it in the back of the thighs.  Not sure if that's right, but I'm going to ask them at BPR.  I've already asked them if lymphedema is the same thing as Elephantitis, and they say it's not.  I'll keep you posted how I do. 

May you all know the blessings of God, may you hear His little whispers and discern the thoughts He puts in your head, and the words of people He puts in your path.  May you use your afflictions and blessings as a way to reach out and help others.  We're all in this together, my dears.  Let my story be a blessing to you.  If you are not taking the best care of your body you possibly can, then you really must change your ways so that you can be a healthy and vibrant old person.  It might not make much difference to you now, but later on, and believe me, those years pass quickly, it might make the difference between independence and The Nursing Home.  Regardless, all the best to you.  You continue to rock on wherever you are, and I will do the same.  Hugs xoxoxo

4 comments:

  1. Thank you, Ilene for posting this. New information for me. My legs tend to swell some during the day, but are slim in the mornings. I've done physical farm work most of my life; my daddy always told me, "You're gonna make an old woman out of yourself." Right now, after this cataract surgery, I'm not allowed to get out and do my regular chores.

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    1. Charlotte, you will be up and at 'em in no time at all. And you'll be seeing better too! Do remember, if your vision gets cloudy again, the capsule that your new lens is in may be the culprit, and you will have to go back in and get a YAG laser. It's a simple in-office procedure. Sometimes that happens very quickly, other times only after a long time, or not at all. I haven't had it happen to me yet.

      I'm kinda thinkin' that farm work is what's keeping you young. Just don't overdo and tear a meniscus or a rotator cuff. NOT FUN. The older we get, the more conscious we must be of every move and how we're doing them, so as not to injure anything. Hubs and I are trying to learn tai chi, which is good for us old people in lots of ways, anyway, that's what they're telling us. So far he is better at it than I am. Good to hear from you. Hugs xoxoxo

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  2. Glad your shoulder is better and that you found out info on your legs.

    Bless you and your hubby ~ FlowerLady

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    1. Thank you Lorraine. Bless you, too... Hugs xoxoxo

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