My Left Leg is Almost Okay -- Which Is Very Good!

When I saw my Medical Oncologist (that's the chemo guy...) yesterday for a regularly scheduled visit, he seemed perturbed at what took place in the ER for me the previous Sunday. About the blood-clot thingy.

Perturbed inasmuch as the results of Sunday's sonogram clearly stated that my upper left leg had shown no signs of blockage. (My lower left leg was not examined by the sonogram tech. When I asked her why not, she said they don't ordinarily do that, since the readings from the lower leg are not all that clear. Also that the blood vessels there are much smaller, so that blockages there do not present the danger that blockages in the upper-leg vessels do.)

In other words, no Deep-Vein-Thrombophlebitis, or DVT. In yet other words, there was no life-threatening blood clot in my left leg. So why, my doc asked rhetorically, did they put me on Lovenox and Coumadin? (Deb and I had attributed this action to the ER staff being of the "Sooner-Safe-Than-Sorry" School of Medical Practice, but hey, what do we know?)

The ER report also mentioned the results of the d-dimer test, which my doc dismissed as being irrelevant. (As mentioned above -- rhetorically, of course -- what do we know?)

He (the chemo guy), seemed to feel certain that there was no serious health issue at stake here and so he wrote a scrip (That's medical shorthand for "prescription." See all the neat stuff you learn from this blog?) for a follow-up sonogram to be done as soon as possible. Because sometimes a sonogram can miss something and a second one might see it. And that sonogram took place today. Friday. The 30th. This afternoon.

At my doc's suggestion, I mentioned to today's sonogram technician that he (the doc) would appreciate an examination of the lower leg as well as the upper leg. At least, please extend the exam to below the knee. And the technician took the suggestion to heart. She (the tech) spent at least twice as much time sonogramming me as the tech did last Sunday. And she spent most of the time below my knee -- almost down to the ankle.

In fact, she spent very little time on the upper part of my leg -- which one could attribute either to her having found something serious there and moving on to see what else she could find... or not having found something serious there and moving on to see if she could find something... Hey, what do I know? I kept telling myself that her quick departure from the upper leg was probably a good sign. But every time I did that, she returned to the upper leg for just one more quick probe. Geez.

But boy, did she spend a lot of time on my lower leg! (When the Doc says take a look, by George, she's going to take a long look!) During the test, I'm watching her face as carefully as I can for any sign of "Hurray! Good!" or "Uh-Oh... Bad." And part of me is half-expecting her to say "Wow! You don't see one of those very often!" as she looked at her screen -- you know, just to break the tension... But she gave absolutely no hint of what she was seeing.

If she's not playing poker on her off evenings, she's missing a great money-making opportunity.

At the end of the test, I asked her, "So, can you tell me anything about what you saw?" -- expecting a curt "We-have-to-wait-for-the-radiologist-to-examine-the-results" answer, but no! She wrinkled her face a bit and said "Well, the veins in your upper leg are clean, but there is some blockage in the lower calf." And then she said "We have to wait for the radiologist to examine the results more thoroughly."

I asked her, "Do you have any idea how great that makes me feel?" And she looked surprised. I guess for someone in her position, she can't identify with the results -- good or bad. And I'm sorry for that. I liked her and hoped she could celebrate the good news with me, but it's understandable she would close off her personal reactions. I guess I would, too.

Here's some of the official wording -- provided for your medical edification:

"Findings: Within the left posterior tibial vein in the proximal calf, there is echogenic material completely filling the lumen of the vein, which is noncompressible. [Translation: there's a blood clot on the inside of the patient's calf.] Absence of color-flow is documented with color Doppler imaging. [Trans: there's no blood flowing there.] The peroneal vein on the left however is normally and completely compressible. [Trans: there is blood flowing on the outside of the patient's calf.]

"On gray scale imaging, there is normal, complete compressibility of the left common femoral, superficial femoral, and the popliteal veins. These vessels fill completely with color Doppler and demonstrate normal venous flow characteristics on duplex Doppler. [Trans: there's no blockage in the patient's upper leg. None whatsoever.] No Baker's cyst is visualized. [Feel free to Google "Baker's cyst." It explains why the technician spent so much time probing behind my left knee. The cyst not a good thing to have, and I don't have one. So that's a good thing.]

"IMPRESSIONS: There is occlusive thrombus seen in the left posterior tibial vein. The remainder of the deep venous system on the left is patent however. ["Patent" means it's working properly. I had to ask about that to find out. But it's the magic word -- it means that there's no indication of DVT at all. None.]"

I was told to continue taking the Lovenox and Coumadin until told otherwise, which will have to wait until Monday, I guess. But maybe, just maybe, I can stop shortly after that.

And that, my dear friends, opens up all kinds of possibilities. Like doing a dino hunting trip this summer. And playing around on my unicycle again. And/and/and/and...

I would love to celebrate this wonderful development by sharing a nice bottle of wine with my darling spouse. But I'm not supposed to indulge in that way when on blood thinners.

So I have to wait to celebrate. But you don't have to.