Friday, August 26, 2016

Swollen Ankles

While bathing and dressing my mom on Monday, I noticed swelling around her ankles and feet. We've had some home assessments this summer from nurses and one of the things they always checked was her ankles. So when I noticed the swelling, it was a red flag for me. The swelling goes around the perimeter of her feet, but that part is minimal. What concerned me most is that on the front part of her feet (between the ankle and center of her foot) there is a round "pocket" of swelling. It's hard to describe, but it resembles somewhat of a golf ball, except instead of being hard to the touch, it is soft and gel-like. As Murphy's Law would have it, a social worker from a home health company came out to the house last week, assessed mom and closed the case since physically, there is nothing wrong with her. So I put a call in to her doctor, hoping he might call me back and discuss the swelling before we were tackled the difficult task of taking her in to the office. I was hoping to bypass a doctor visit and instead, have a house call from a nurse again. We have not had great communication and call backs from the doctor in the past; I was afraid I would be sitting around waiting for 3 weeks before we made contact so I decided to call the home care company and see if they could reopen the case. Unfortunately, they said we would have to start the process all over again at ground zero (referral, assessment, etc). Fortunately, the man I spoke with was able to call the doctor's office and received a call back quickly. Within two hours of his call, he had an order for a home nurse to come and assess mom.

To make a long story short, the nurse came by yesterday and agreed that the swelling looked very odd, and then admitted that she'd never seen anything like it. She said that it looked like a fatty tumor but she'd never seen it on an ankle before. So...there wasn't much resolution to the visit, other than the nurse reporting her findings to the doctor (we're waiting to hear back from him on whether or not he wants to see her, based on the findings) and the nurse is going to put in a referral for physical therapy for Mom, due to the fact that she's had a couple of falls (and couldn't get up) over the past two months. We'll see if that referral goes anywhere and if Mom would even mentally be able to participate in physical therapy. In the meantime, we are waiting to hear from the doctor on whether or not we need to take her in. Honestly, I'm not sure what he will be able to do if we took her in. A biopsy? Fat chance in getting her to cooperate with that. And anesthesia isn't a risk we want to take at this point.

I know some of you reading might ask:

Could she have twisted her ankle? It's possible, but unlikely that is the cause because it's in the same place on both ankles.

Could it be her medication? The nurse checked the interactions of each medication and no red flags showed up. She did start taking a new medication beginning of July (trazadone), but you would think side effects would've shown up sooner. The only medications she takes are trazadone, Ativan, and methyl-something-with-a-long-name (a hormone to stop her menstrual cycles).

Is she drinking enough water? She seems to be drinking at least 32 oz. a day. It's been the same for a long time...no sudden drop in her intake of fluids.

Is her blood pressure okay? Last week it was slightly elevated, but she was also very agitated with the cuff around her arm. Yesterday, it was in the normal range (110/80).

Maybe it's the socks? My Aunt (who is a nurse) suggested it might be the socks creating a tourniquet effect. I changed her socks right away; that was on Monday and today is Friday and there is no change.

Sooooo....I guess we wait for a call from the doctor and go from there!

3 comments:

  1. Possibly a ganglion cyst? http://www.footvitals.com/skin/ganglion-cyst-foot.html

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    1. The might be it!! It's a little higher on her foot than in the picture (it's almost parallel to the ankle, in front, where the foot bends). But it sounds like that might be the culprit. The question now is what to do about it. She cannot comprehend any directions, so the only way to treat it would be to put her under anesthesia which presents a whole new set of risks, especially to someone with dementia. Hmmm...hopefully it won't become too problematic for her.

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