Compressionable

I understand that to some people, writing a blog is extremely self-absorbed. There is truth to this to be sure. I have said many times that I write for myself and if others choose to read it and find interest in it, so be it. I do not focus on my readership statistics despite every effort by my blogging service to tell me who is reading me and how much they are reading me. Recently I wrote a blog or two that offended someone I care about. I didn’t do it on purpose, I was just telling my story the way I was experiencing it. I am smart enough to stay away from directly insulting people (except, of course, my arch-nemesis, Donald Trump), but I also know that everyone sees the world through their own eyes and that they can read offense into things that I never intended to be offensive. Call it collateral damage. Call it mild insensitivity on my part. Call it a desperate and sad need to express myself. Call it what you will. I know that my choice in the world is either to write a lot less or simply accept that the risk of offending people exists and from time to time will occur. I may be quick to apologize and try to make amends, but once the word is in writing, the damage has been done and there is no putting the toothpaste back into the tube. So, I need everyone who reads this to understand (acceptance is totally up to you) that I will occasionally write something that is so self-involved that it either turns off someone or offends. Therefore, this morning, I simply must write yet another story in the saga of my lower extremities. I began the tale with Dropsy and followed-up with Waisting Away. I believe today’s Compressionable will round out the story and with any luck be the end of the telling as far as you’re concerned.

In case you haven’t realized it, I put a lot of stock in my titles. I incessantly amuse myself with my titles and love nothing more than a cute turn of phrase when the spirit moves me. I also like making up words. Why not? Someone had to make up every word that exists, right? For almost ten years now, my primary physicians have told me that the secret to my edema is elevation and compression. I have generally considered that advice to be about as helpful as a doctor saying “take two aspirin and call me in the morning.” It has always struck me as a palliative for a doctor who doesn’t know what else to say in the face of a condition like edema that is so hard to address. Well, in the last 24 hours my overall impression and world as I know it has changed and I feel there is information content value to sharing this with everyone who wants to listen. That impression has mostly to do with compression.

I have already written about my improved understanding about diuretics and the amazing impact a change in my daily diuretic and dosage has made. I am now a committed diuretic taker and believe that my system benefits tremendously from taking the right diuretic twice a day, excess bathroom visits notwithstanding. As a result of my visit to the urgent care center in Brooklyn two weeks ago, I booked an appointment to a wound care center here in Escondido. The earliest appointment available was for yesterday and despite the recent improvement in my lower leg wound (it has almost completely healed), I followed through with the visit, mostly to learn how to prevent another similar sore on my edema-prone ankle. I arrived at 8am and was at the clinic for most of two hours, almost entirely in a treatment room with my own personal wound nurse named Beth. I also spent a good ten minutes with the wound physician. It was perhaps the most comprehensive and informative medical process I can ever remember having for over thirty years. So, to start with, hats off to the Palomar Hospital Wound Center. I have come away with a comprehensive (and written) program for treating my edema, and even more importantly, I now have a much better understanding about what is going on. I had no idea, but it seems that the most common and difficult wound to treat is, in fact, the exact sort of edema wound that I have been suffering. It’s good to know that someone has taken on the challenge of understanding and addressing this problem as they have.

In fairness, it was my GP who changed my diuretic prescription and who ordered up the exact same venous scans that I will have in two weeks and which the wound doctor said are exactly the tests I needed. I just wish my GP had come on all this on her own as recently as several months ago when I last saw her and not because my condition got to an uncomfortable point of an open wound and a request by me for treatment. Nevertheless, it has taken the explanation by the wound doctor to finally explain to me exactly what is happening in my lower legs and why my veins are not doing their job sufficiently to keep the swelling and fluid accumulation in check. I guess if you see enough edema you get good at explaining it. Thank you Malcolm Gladwell (a not so subtle reference to his book Outliers).

The bottom line is that this wound doctor has told me that I will likely have edema to some degree the rest of my life (the aging process does not easily allow for big reversals) and that I can reduce its impact on me rather dramatically with several palliatives. There is the chance that the venous ultrasounds could reveal a need for vein surgery, but he suspects that since I do not have apparent varicose indicators, that is a less than likely outcome. Otherwise, taking a daily and effective diuretic, keeping my weight as low as I can, being mindful of elevating my legs to the level of my bellybutton as much as practical (i.e. while watching TV) and wearing compression socks should do the trick. This sounds a lot like what my doctors have told me, but it is amazing how clarity and completeness of communication can make that all the more meaningful. He has specified that I should wear 20/30 mm/Hg compression socks whenever I am upright and not prone. I have a few pairs of Duluth compression socks but I went online and specifically ordered the best compression socks on the market that are specified as 20/30 mm/HG, which means they are higher compression at the ankle and lower in the calf.

I left the wound clinic looking like a WWI soldier with my lower legs wrapped with four ace bandages. I was told to use them if I didn’t have the right compression socks. I kept the ace bandages on as long as I could, but rather quickly changed them out for my Duluth compression socks, which I found somewhat uncomfortable. I was relieved to take them off for the night and even more relieved when Amazon delivered my new top-quality compression socks at 6am. This morning I put on the new socks and was amazed. The amazement occurred on several levels. I was amazed how much more comfortable they were than the Duluth ones. I was amazed how good they made my legs feel (almost energized). I was amazed how much my ankle swelling had subsided in one day (Kim says I actually have ankles now). And I was also amazed to get on the scale and find that I have dropped another four pounds of weight (making new adult lows…almost back to my college entry weight at age 17).

I will still go through all the prescribed venous tests. I will revisit my wound doctor and my GP in the next several weeks. I will keep taking my diuretic religiously. And I will wear my new compression socks each and every day. They actually look quite hip as I understand that many performance athletes are now wearing them because they improve lower leg performance. I have always been a very impressionable sort of person, who pays attention to things in life. What I can now say about myself is that I am also a very compressionable person as well.