OPINION: Lower Extremity Pheripheral Edema May Be Cellulitis

CONROE, TX -- Any of us at times may be subject to edema (swelling) in our calf muscle areas, and if you ever injure your shin bone (tibia) by bumping into something that doesn’t flex, or if you have cuts, scrapes, surgical wounds, bug bites, punctures, or any number of things that disturbs the skin, and it doesn’t have to be in your lower legs. But for years, I experienced swelling in my skin areas, in which I was struggling for a diagnosis. It was so bad that I didn’t even consider wearing shorts in the summer, for the scars and reddened areas on my shins, to a point just as hideous as the crisscrossed scars on my abdomen. Of course any areas of disturbed skin needs to be investigated, to the point of having a doctor check it out, and even then not all doctors put two and two together, for it took me years and years until a solution presented itself.

I have a bad, or possibly good habit of taking naps in my home office chair, which is quite comfortable, and a 40-wink siesta can go for two, or sometimes three hours; depending on how tired I am.

And being a war veteran, on occasion notable daytime slumbers without the influence of my nighttime concoction of meds to keep the bad dreams down, can bring ‘flashbacks’ of scenes that best should have never been seen in the first place. When heavily pressed for time, or I’m on something of a writing binge, my bed may not see me for two days, so missed medication opportunities to relax muscles and mind may go untaken. Which doesn’t set well for my skin bones. The realization of a flashback for me results in a jerking motion of my body. In my office chair, my legs fly up and with my thick boarded L-shaped desk, when my skins fly up, it at times would leave one or both shins bruised. Of course, there are other ways to bruise your shins, but for me, it was my shin being bruised and/or bloodied that caused my problems.

In my hospitalizations this year, I had the time to thoroughly investigate my swelling concerns. I asked my surgery team while they were working to resolve my diabetic ketoacidosis (DKA), if I could get a consult from a vascular, or vein specialist. I had thought the swelling may be from chronic venous insufficiency (CVI), or leaky veins, where the blood pools in your lower legs causing the swelling, but the doctor took one look after palpitation of the veins, and the viewing of previous scans. He determined the veins were healthy, with a strong pulse, and went about his business. After that I didn’t think that much about it, since I was still able to write OPEDs from my hospital bed.

Once my gallbladder was yanked out and my DKA cleared, I went home to recover. I had noticed that my lower leg edema was uneven, with the right leg reducing slightly. I use an adjustable bed, so my legs are always raised, allowing for any fluid to drain overnight; but once I rose in the morning, the uneven swelling would continue. I asked about it, and if the swelling would have been consistent with my legs raised during sleep, then I would have had vascular issues that would have required a vascular surgeon.

About a month and a half ago, I had a particularly bad flashback, and my left shin hit particularly hard on my desk, causing a 4 inch gash. I immediately cleaned the wound and used triple antibiotic ointment to start the healing process.

After a few days, after waking in the morning, I started feeling pain in my left shin. The pain each day began to escalate, and I could literally feel the sensation as it ran down my left leg, along with the extra blood that was slightly inhibited in flow due to my legs inclined. There was a painful numbness and just being able to walk on my left leg took 2-3 minutes before everything equalized and I was able to put pressure on my foot making my way to the restroom. After a week, I had had enough, and decided to go to the Emergency Room. I would have gone earlier, but since I wasn’t experiencing a bowel obstruction, I decided to take the pain. Incredibly, I can only recall only about 6 times or so, in which I went to the ER without requiring dozens and dozens of nasogastric tubes, shoved up my nose on its way to my stomach. lol. There was that time I aspirated a bay leaf, a few covid episodes, an eye injury, a suspected broken arm, a bad sprained ankle during Operation Desert Shield, and some broken skin during Operation Desert Storm, and maybe something else, but I consider myself a professional bowel obstruction patient.

In the ER, the doctor saw the wound starting to heal as well as the swelling, and immediately thought of Cellulitis, promptly prescribing Clindamycin 150 MG Cap 2 times every eight hours. So I started taking the antibiotic, and within days, I noticed the pain subsiding and my left leg resolving its morning issues much quicker before my mechanics of nature call. After a week to 10 days the pain was negligible.

Incredibly, before the end of the first week, I noticed my right ankle had returned to its boney self, as if a frog turning back into a prince. My left leg has more than halved itself in regards to its abatement, and continues its slow journey to normalcy. So I’m here to say, never give up in regards to your health journey. Since all this has happened, when I feel drowsy at my home office desk, I move back from danger, just in case of a flashback.