How beautiful you are, my darling! Oh, how beautiful! Song of Solomen 4:1

To all who mourn, he will give a crown of beauty for ashes, a joyous blessing instead of mourning, festive praise instead of despair. Isaiah 61:3

Tuesday, October 23, 2012

Do I Have A Deflate Button?

Where to begin.

Simply put: swelling is terrible.

Taking care of patients, I have seen my share of swollen feet, legs, etc. When I worked in the telemetry unit, I witnessed this in my CHF (congestive heart failure) patients. Then, when I moved to rehab, I saw swelling from surgery or injury to knees, hip, legs, etc. 

I then started to experience it first hand, in my own body.

What was causing all the swelling in my case?

Heart, liver, or kidney disease. Sometimes swelling can indicate a problem such as heart, liver, or kidney disease. Ankles that swell in the evening could be a sign of retaining salt and water because of right-sided heart failure. Kidney disease can also cause foot and ankle swelling. When kidneys are not functioning properly, fluid can build up in the body. Liver disease can affect the liver's production of a protein called albumin, which keeps the blood from leaking out of the blood vessels into the surrounding tissues. Inadequate albumin production can lead to fluid leakage. Gravity causes fluid to accumulate more in the feet and ankles, but fluid can also accumulate in the abdomen and chest. If your swelling is accompanied by other symptoms, including fatigue, loss of appetite, and weight gain, see your doctor right away. If you feel short of breath or have chest pain, pressure, or tightness, call 911.

Ascites is another form of swelling I saw quite a bit of at work. I quickly beacame a little more familiar with it once it "hit" me. It was a bit more personal.

Ascites is excess fluid in the space between the membranes lining the abdomen and abdominal organs (the peritoneal cavity). http://www.webmd.com/digestive-disorders/ascites-medref

When I first noticed the swelling, before my diagnosis, it was pretty minimal. Pitting edema, as I shared about here, started to appear, and then it slowly started creeping up to my thighs. This caused me to feel as if I were growing out of my pants. The term "bursting at the seams" became oh so real. The swelling began worsening after my IV steroid treatments. Frustrating. I thought that was going to be my quick cure all. HA. 

My ankles were slowly getting "lost" somewhere in my leg. My legs were so filled with fluid that I had kankles. :) 

What are kankles? 

Kankles are calves that become feet without taking an ankle break. 

During this time, I had asked my nephrologist if I could double my dose of lasix (the water pill that helps you dispose of extra water). He agreed that it would be fine, considering I would take it first thing in the morning and by 1:00 in the afternoon I would be unbelievably swollen again. At the time, I really didn't think the lasix was doing a thing because I was SO swollen. When I look back on that time, I'm sure it was indeed helping. I can't imagine it being worse, but I'm sure it would have been if I hadn't been taking the lasix. 

When my swelling was at it's worst, oh my did it control my life. I experienced swelling for about 8 looong weeks. 6 of those weeks were filled with some serious swelling (no pun intended ;) 

I couldn't sit or stand for more than an hour without my feet and legs blowing up. This caused my feet to be too big for my shoes. If I was planning of going somewhere, doctors, church, (that's about the only places I went besides families houses), I would have to lie on the floor, on my back, with my butt up against the couch, legs over the seat, plus multiple pillows under my legs to make them even higher. This would push my swelling up to my abdomen and pelvis. Oh what a sight I was. 

Another position that I found highly effective was lying on the couch on my side with my legs propped up and my upper body somewhat upright. Like a V. This pooled all the fluid to by abdomen. The best place for it to go I guess. It was already stretched out from pregnancy anyway. Thank you Elin! ;)  

Remember this picture? 
The one on the right is of me pregnant. The one on the left is me swollen. I gained 35lbs during my pregnancy and 30lbs from the swelling. Oh yes. 

Can  believe I only had one person ask me when I was due? Gotta love the receptionist at the eye doctor. I was expecting it. I knew I looked like I was going to give birth. I had a huge belly plus I had swelling to my feet. The poor lady was so embarrassed (as well as all her coworkers who witnessed the awkward conversation). I could tell she wanted to crawl under the desk. I explained to her that no, I was not pregnant, although I wished I were, and that I had just been diagnosed with lupus and was on a high dose of steroids. Yah, maybe I didn't need to go into detail. But hey, I'm a nurse, that's what we do. And maybe, she will not ask someone else who may be in the same boat as me and who may be a bit more sensitive than I. Ok, I guess I was a little sensitive. I did go to the car and shed a few tears wondering if I would ever look "normal" again.

The other day, I was telling Jared how I was working on a blog post about when my swelling was so bad. We were remembering how bad it was and couldn't help but laugh a little. As I said above, the best place for the swelling to go was to my abdomen and pelvis. I was telling Jared how I was having a hard time figuring out how to describe the swelling happening to my "lower" parts. So, I asked him to help me out. Lol. His response? "Umm, you were puffed shut." I laughed and laughed! Yup. He was exactly right. Puffed shut for a month. Poor guy. Need I say more?

 Here is Elin. Chillin' out in her car just like her mommy had to! She's much cuter though!

This is how I looked whenever I would have to drive somewhere (well, my right leg on the peddles of course). My left leg would be up at the window. If I would have to go multiple places, I would allow myself extra time so I could recline and put both my feet up to decrease the swelling.

When I was younger my mom would NEVER let us put our feet on the dash. This time, I was able to get away with it! She let me! Lol. I remember one time she was driving me somewhere when I needed to have my legs up. She said, "you know Rach, I've been learning a lot from you lately, and I won't look down on another person with their feet up on the dash again. Who knows what they are going through!" I laughed and thanked her again for letting me put my feet on the dash. I know it was tough for her to let me. ;) 

There were days where I resorted to wearing my support hose and tied my shoe laces very tightly when I had to go out to push the fluid up. Other days, my flip flops were my best friend. Even in 40 degree weather.

My current status: I no longer have swelling. And no longer have to take lasix. It lasted much longer than I thought, but praise the Lord I am no longer living as if I were pregnant again! That was an awful time for us, and I am so grateful it is over. 

2 comments:

  1. You did well Rachey - it's hard when these autoimmune things affect ALL (hee hee) parts of our lives!

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  2. Thanks J :) You are right. No limits!

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