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On legs, Hugos, and maybe other sundry stuff.
Since last I posted about my leg, I've been to see the doctor. He basically checked out that the swelling and redness seem to have gone down, gave me some more context on the fluid pocket in my calf, added a potassium supplement to my prescription regimen, and told me to come back in a week, at which point he might renew the antibiotics if they look necessary. I don't have to use the cane if I don't feel like it. It's still handy to have around, though.

I also saw Dr. Sholls diabetic socks in Target. They claim to not have a constricting top, to allow for better airflow, better drying, etc. They were $10/2 pair. I think I'll pick up a pack next time I'm there.

As to the mysterious fluid pocket: According to the radiology/sonogram work, it is either a low-density mass or fluid (both are transparent to X-Rays), and is about 10x7x2cm. I liken that to the side of a deck of cards, but honestly it could be much smaller, as it's likely thinner at the edges, rather than a square block. It is possible that it's a ruptured Baker's cyst which can form behind the knee and when it bursts dumps synovial fluid down the calf. The description on the Wikipedia page of the possible result is very consistent with what I felt.

I will bring this whole issue up with the orthopedist on Monday.

I've been following, mostly via the Making Light blog, the recent kerfuffle regarding the hijacking of the 2015 Hugo Award Nominations. There's a lot that's been written about it, but I'd like to link to Philip Sandifer's essay Guided by the Beauty of Their Weapons, about the personalities behind the "Sad Puppy" and "Rabid Puppy" slates.

I guess there wasn't any other sundry stuff.

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I'm more than a bit puzzled by the apparent attitude of your doctors. They don't know what the thing in the back of your knee actually is/was, but they don't seem to be particularly interested in finding that out. I would think they'd do everything in their power to figure it out, to determine how urgently it needed attention, and what kind(s) of attention. Instead, they're throwing industrial-strength antibiotics at it, sort of blindfolded. (A burst Baker's cyst isn't even an infection; NSAIDs and/or corticosteroids would be more to the point.)

IANAD, yadda yadda, but if I were in your position, I'd argue with them :-(

The ER doctor/PA was looking at my leg in ways I couldn't (i can't look at the back of my leg) . When I turned face-down on the ER bed and exposed both my calves for comparison purposes, starsplattter exclaimed "Oh my god" at the apparently very visible and bad inflammation/infection process going on.

I think the IV antibiotics were not so much intended to deal with the fluid pocket, but with what they viewed as heavily-infected skin. In fact, I was already receiving a bag of Vancomycin when I got sent for more imaging of the pocket to try to figure out what it was.

The fluid pocket showed up during an ultrasound to rule out DVT. The ER staff were concerned about what it was, and had a few possibilities (pus, synovial fluid, haematoma, etc), but while there were some "most likely"s and "probably not"s, there was no firm conclusion based on the ultrasound as to what was in the pocket. They didn't know if it was a cyst, an abscess which would require them to admit me to drain, or just a pocket of fluid that would be reabsorbed by the body.

So they sent me for a CT scan. There they found the size of it (and probably the shape), that it wasn't radio-opaque, etc. This gave them a better idea what it was, but didn't narrow it down to one thing. If it is an abscess, it's not large enough to require immediate draining, but it might if it grows. Nothing else would require immediate treatment, but should be observed to see what it does.

My PCP seemed to think, after reading the ER reports, that this was reasonable, and was able to palpitate the fluid pocket himself so he knows where it is. He agrees we don't know what it is, and agrees with my characterization that it is consistent with a Baker's cyst rupturing, even though we both know we have no concrete evidence of a Baker's cyst in the first place.

I have not talked to the orthopedist yet about it, as I have not met with the orthopedist yet. But I will.

Edited at 2015-04-22 11:17 am (UTC)

*sigh* That's why I included the usual disclaimer ("IANAD")...

Not everything is known or even knowable. They have determined that it isn't cancer, and the list of things it could be don't require immediate action. Wait and see is the best course of action right now. If it gets worse they might have to take other actions. But it might just go away. A surprising number of things do.

I have a bunch of ganglion cysts on my finger. I find them annoying but unless they start hurting or interfering with my finger's movement my insurance won't pay to have them removed. A pocket of fluid where it shouldn't be is not a medical emergency.

Well, technically they have not ruled out cancer yet, but it isn't acting like a tumor so it is not a high priority assessment. If it starts doing something unusual (I swear to ghod it sings and dances, just not when anyone is looking at it!) they will be more concerned.

So, yeah, what you said.

A pocket of fluid where it shouldn't be may not be a medical emergency, but what caused that fluid to accumulate where it shouldn't could be an emergency. The cheap meat suit just loves to play tricks on its owner :-(

Thanks for the links.
I'm enjoying Philip Sandifer's defense of postmodernism.

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