So a few days ago, I developed a club foot. I think it’s fairly obvious, but if you can’t tell it’s my left one. Actually, it’s my ankle & calf too. My left foot feels twice as heavy as my right one.
It doesn’t seem fair. I’m certainly no workout fanatic, but I don’t let a SINGLE day go by without doing my share of walking.
I called my PCP (rather, my PCP’s replacement) at Mercy Hospital in uptown Pittsburgh. I talked to one of her nurses who wanted to know what was going on before she had the doctor return my call. “She’s covering for Dr. Marvi you know.”
I said yes, once upon a time Dr. Marvi was my PCP. But then she went on maternity leave, then the pandemic hit, and now she’s on maternity leave again. And for someone’s who’s been my PCP since January 2018, I’ve only met her twice. I met with Dr. Nevratiti on August 17, she put me on another hypertension med called Amlodipine, and now one of my feet are swollen and looks like an asp bit it.
An hour or so later, Dr. Nevratiti returned my call, asked how I’ve been doing since she last saw me and in case I was wondering, got my “asp” reference. (An asp is an Egyptian cobra, and when we first met I told her she reminded me of Queen Nefertiti.) She asked me to send her a picture of my foot so I sent her a couple, including the one above with my other foot for comparison.
She said “I can see your foot and ankle are swollen, what makes you think this is a result of the Amlodipine?” I said “Well, after I saw you a couple weeks ago, I told a few people about the new blood pressure med, and my friend Gigi said she’d once been prescribed amlodipine for her hypertension—but it made her foot swell up, so she was switched to something else.”
The doctor said “Well, it is true that a potential side effect of this drug is fluid retention, but if this was the case it would cause swelling in both legs. Your right one looks normal.”
I said “Doctor with all due respect, don’t you think the timing is a little too much to be a coincidence? I just started this second drug a couple weeks ago.” She said “Douglas when do you take the amlodipine?” I said between 10 and 11am daily. She asked “And you’re still taking the Coreg, correct? When do you take that?” I told her right before I go to bed. She said “What! Why??”
I said “According to Reader’s Digest, studies have shown it’s 50% more effective if taken before you go to sleep, and reduces heart attacks & strokes 60% more effectively when compared to morning pill poppers.”
(It’s true, you can read about it right here.)
Dr. Nevratiti said “Alright, I’m going to ask you to do a couple things. First, I want you to stop reading Reader’s Digest.”
WHAT! If I hadn’t just swallowed my drink, I would’ve sprayed it all over my phone. I said “That’s the most un-American thing I’ve ever heard!” For some reason she thought this was amusing, and said “Douglas you’re giving me the hiccups. Fine, but I don’t want you referring to Reader’s Digest for medical purposes anymore.”
I said “Okay, but you make it sound like I’m checking the Farmer’s Almanac for the next full moon or something before I take my medicine. It’s Reader’s Digest.”
She said “I also want you to start wearing some compression legwear to improve circulation and reduce swelling. Do you know what I’m talking about?” I said “Nope. Do you mean like a truss? I don’t know what that is either, but I see ads for them in the back of Reader’s Di—certain magazines. Doctor, what about my foot?”
She said “What do you think we’re talking about? I don’t want to take you off the amlodipine, you may need longer to adjust to it. In the meantime, I’m going to have Gina send you some compression leggings that can help reduce swollen feet and ankles. Do you think you’d be more comfortable in an over-the-knee or under?”
I kind of went silent as this wasn’t going as I expected. I thought I’d be switched to another BP drug. She said “Nevermind, let me know if they help or you experience any discomfort. Many people enjoy wearing them daily, I think you will too.”
I got a manilla envelope on Saturday with 9 “knee-highs”, along with a brief note: DOUGLAS TO BE WORN DAILY ALL DAY. REMOVE BEFORE BATHING AND BEDTIME.
They’re snug alright, but not uncomfortable. This is my third day though, and I see no improvement. I’ll have to see what Reader’s Digest has to say…
My mother had to wear those for water retention in her legs. They were a nightmare to get on and she found them really uncomfortable. Don't remember them helping with water retention either. Still I suppose it solves your issue about what socks to wear with sneakers. :D Sorry, I shouldn't joke.
ReplyDeleteJoe thanks for sharing and I'm sorry about your mom, they are difficult to get on and off! And don't apologize, I need all the laughs I can get. You are right you know, they pretty much go with everything 🙂
DeleteOh dear Dug, I'd switch doctors. Her dismissal of your knowledge and her approach is uncomfortable for me. (Old Cranky RN on amlodipine too, but gonna have doc change it.) Many folks have one foot swell more than the other. I'm willing to bet you sleep on your left side, i.e. gravity doing it's evil deed when you sleep. The fluid retention side effect happens throughout the body: my hands feel puffy, and my knees. So, there's more fluid causing pressure on internal parts too.
ReplyDeleteYes, compression socks will help, but don't solve the cause of the problem. Ask the doc to change the darn med! You have the right to refuse certain, any, or all aspects of care. If she doesn't think it's the amlodipine, what does she think caused the swelling? Sometimes it's the heart starting to be a bit weaker, but she isn't mentioning that, nor how to determine such. Physical Therapists, or medical supply stores, have a double-coat hanger looking device that helps with putting on socks. You put the sock in it's frame, then slip your foot into it and remove the frame. Instead of gathering or rolling the socks to put them on, try folding them down in sections. (Kindof of like the way boys' jeans were folded up at the ankle in the 1950s.) After getting your foot in, it's a bit easier to "unfold" the prepared sock to pull it up over your calf than to unroll it. Do NOT let the compression sock gather up or roll at the top of the ankle nor at the top of the sock. They can act like a partial tourniquet if they aren't kept smooth. Compression socks are expensive, I think about $20-40 these days. They come in different sizes and different compressing strengths. Hand wash them.
Keep reading Reader's Digest. It at least sparks questions to ask a doc....
Linda in Kansas
My gosh, thanks very much Linda! It's always great to hear from an RN, especially the ones you know & like :^)
DeleteI am surprised she dismissed your concerns so casually. What would be the harm in changing meds? Listen to DrumMajor. I am dealing right now with two meds I take that are fighting eachother and no one caught it for years except a pharmacist. They basically cancel eachother out. Readers Digest, a friend or the Internet, we use the information we have. Let us know what happens.
ReplyDeleteThanks very much Patti, geez I'm sorry you're dealing with a med issue too, I sure am glad your pharmacist spoke up. (I just got a new one who's very chatty, but I love it) :^) Yes I am definitely listening to Linda -AND- I'm not blowing off Reader's Digest either! They're not a tabloid!
DeleteMy wife would shudder too hearing your Reader's Digest and my neighbor told me self diagnosis stories. You are a liberal Doug. You are supposed to believe your scientist Doctor over your neighbor and right wing mags like Reader's Digest! Hah!
ReplyDeleteEd, hahahaha! Darn it I can't stop laughing! Well, Reader's Digest says Laughter is the Best Medicine!
DeleteI too agree with Linda and she's given you great advice about how to put on the compression sock. Although I love your story and the repartee made me smile, I don't like the way she brushed off your concern. One of my friends had a swollen leg and foot; it was red and painful too. (don't know if yours is)His doctor put him in a compression sock and ignored it. I asked him if it could be a blood clot. And that's what it turned out to be. P.S. I didn't check Reader's Digest but my late husband had some blood clots so I knew how they manifested, in his case his arm/hand.
ReplyDeleteThanks Margaret, and truth be told it is a little hot, and sore. Gulp, I know about those blood clots and how dangerous they can be. Well, this is definitely not over. :^(
DeleteHot and sore? Insist on some kind of scan. ASAP!
DeleteWell margaret, I wrote that after coming back inside from a 25 minute walk and that foot has always gotten hot and sore afterwards. I appreciate your concern!
DeleteI would be freaking out if that swelling happened to me, Doug. If it doesn't return to normal soon, I'd get a bit more firm in requesting a change of meds! Is this condition mentioned in the drug's side effect literature? Perhaps another talk with your chatty new pharmacist as well.
ReplyDeleteFlorence it is mentioned in the drug's book "visible fluid retention in extremities" and the chatty pharmacist IS a good idea, haha :^) I'm sure I'll be fine, it's not terrible or anything and like Linda said above, this does happen a lot with older people. Ah well!
DeleteHi Doug, so sorry to read that your leg is swollen. Like LL Cool Joe my Mum wore compression stockings for water retention....for I think two days, they drove her nuts. So much good advice here but I will chime in and say that worries me that your doctor dismisses your asking about the new drug causing the swelling.
ReplyDeleteBy the way, my Mum passed along her compression stockings to me. Never know, I might need them!😆😆
Take care.
Robin
Robin, thanks for the chuckle with your mom--seriously, 2 days?! I guess I'm doing pretty good then, I'm on Day 4! Anyway, you're right there is lots of good advice here and I am very appreciative. As I am for your comments, always :^)
DeleteOk, please make note of your hot foot after walking. If the compression sock makes your leg hot and sore, that's not good. You may have a circulation issue, further triggered by the common swelling side-effect of the amlodipine. (And most docs prescribe that you wear both socks...alot of reasons.) Please consider calling that office, asking for a different doc and an in-person appointment with the new or returning doc asap, as in this week. It looks almost like cellulitis, where the skin gets puffy, red, and sunburn-like, with prickly specs, but is an under-skin infection. Yes, amlodipine helps with blood pressure, but probably at least a third of the folks initially prescribed it have too much swelling to make life comfortable. Keep taking it until they switch you to something else. Stay on top of this, dear Dug; do not tolerate the changes just because it "happens with older people." Linda in Kansas, with years as cardiac, oncology, chemo and hospice nursing.....FYI: some docs made As in med school, some made Cs, some are listeners, some demand things from people, some are polite jerks. Be careful. Sometimes Readers' Digest makes more sense....
ReplyDeleteLinda, thank you again, I very much appreciate your input--I actually didn't wear the sock walking (but you're right, I've only been wearing one inside my home). I think that picture at the top was a little too heavy in the contrast, my leg isn't great, but not that severe. I'm just going to take it day by day for a week, but if its get painful or anything I will get proactive. :^)
DeleteDug, I would keep a close watch on that swelling... and would have probably stopped taking those meds immediately. But that's me. I really don't like meds unless absolutely necessary and have found that most cause some other bad reaction (but again that's me). You know what works or doesn't for you. But like Patti, I don't like the way your doctor dismissed your concerns.
ReplyDeleteThank you Rian, and well said--honestly, I don't like being on pills either but when I was in the hospital last month for kidney stones, they told me I had to see my PCP right away as my blood pressure was too high (and I was already on medication). So I feel like I need to stick this out awhile longer before I look to make changes. But I appreciate your feedback, I always like what you have to say.
DeleteHi Doug, yep, that is definitely swollen. It can be caused by the amlodipine and it can cause it in just one foot because it's done that with me - but mine was not swollen that much. Please keep a watch on it and do see a doctor (maybe a different one?) if it is not better very soon. That kind of swelling can be a symptom of other problems, one of which is heart trouble. Yes, it could be the amlodipine but you don't want to take chances. It's better to be safe than sorry! Okay, I'll stop acting like a bossy Mama now! As you can tell with these comments, your friends just want you to be safe!
ReplyDeleteI hope the past week has been a good one for you. Have you run into Meira any more? Maybe you two can sing a duo in the laundry room! There might be good acoustics in there!
Bonnie, a big thank you for sharing that because I've heard from a couple others it can happen in one foot. I do know it can be several things though, if it doesn't improve soon I will be going back to the doctor. And you're not a bossy Mama, haha! I need all the input I can get! As for Miera, yes I have run into her once more but I am thinking she is seriously kooky :( I'll be sharing more on that soon!
DeleteI hope you get the issues of your new med and swelling in your foot resolved. I've worn compression socks in years past on those occasions when I traveled by air to visit family as I had read that could be recommended for someone with some of my med issues. Putting them on was a skill to learn but they were comfortable. Glad you're taking care to control that BP.
ReplyDeleteThanks for sharing Joared, I'm surprised how many people are familiar with compression socks (and the work it takes to get 'em on). I don't mind though, getting MY BP down is my first concern right now.
DeleteI wouldn't be trusting Reader's Digest on any medical matter, you might as well take advice from Jerry Seinfeld!
ReplyDeleteWhat is the 'coreg' for? Perhaps it should be taken at a different time? Perhaps it shouldn't be taken with amlodipine? anyway, something has to change, since you have worn the compression socks for three day now and have no discernable improvement.
I'm happy to say I don't have any fluid retention problems from my Amlodipine. Nor from anything else.
Are you diabetic? That might mean something regarding the meds and fluid.
After reading all the other comments, I think your best option is to see a doctor in person and have the issue examined thoroughly to discover the cause. It may be the meds, it may be anything else. Leave no stone unturned.
ReplyDeleteThank you River, if the swelling doesn't go down soon I will be going back... I'm just taking it day by day for a week or so.
DeleteHi Doug. As a retired nurse, I can't help but worry about a blood clot. The presentation of unilateral swelling is concerning. That's just my two cents. Hope you get this figured out, and that you stay safe!
ReplyDeleteCarole
Thank you very much Carole, I appreciate your input. The clot possibility scares me too, if I don't see a change soon I'll be asking for someone to take a look.
DeleteYour leg is definitely swollen, for whatever reason, I'd look for another opinion, sooner rather than later. It could be a blood clot, and anything that happens in one leg and not both is concerning. I hope it's getting better. I'll be watching for an update.
ReplyDeleteThanks for your concern DJan, I'm sure it's the new medication (it's No.1 symptom is swollen ankle(s). But if it gets any worse or painful... I'm not exactly the quiet type! :^)
DeleteWell first off, sorry to hear about these complications. But any advice you get from a magazine is going to be general, and may not pertain to your particular situation. I'd follow the advice of your medical professionals as long as you trust them. P. S. I take my blood medication in the evening after dinner. Hasn't killed me yet.
ReplyDeleteHey Tom, it's nice to hear from you. Well, to be honest I still have more faith in Reader's Digest latest medical articles than doctors who presume they know best. Maybe I'd feel differently if I didn't keep getting interns! :^) Anyway, I am compromising and taking one early, and the other after dinner like yourself. I'm glad you're hanging in there.
DeleteOh, this is just awful and so unnecessary. As you said in your post, I was on Amlodipine for a month and experienced swelling of my ankle and calf so much so that I could not bend my knee. My calf got really hard like stone. So much discomfort. One of my blog readers in India advised me to try Telmesarten, and I had my PCP write a new prescription. The swelling subsided immediately. I might have to increase the Telmesarten, though, because my BP has been spiking. But, at at least, I no longer have edema, which is what the swelling is called.
ReplyDeleteAnd it was my right leg that was affected, not my left.
DeleteThanks Gigi, I was hoping you'd see this. Well, I've been on it for 3 weeks now and yes, my one calf is very hard--but maybe my swelling wasn't as bad as yours? I can still bend my knee just fine.. anyway, thanks for sharing this, if mine gets worse I can share your newer drug with my doctor and see what she thinks. And I'm sorry yours has been spiking, hope you get that managed soon.
DeleteI wouldn't be waiting to see if it gets worse or better. In my opinion the first three days is long enough, I would have been at a hospital or doctor clinic on day four. With a list of all current medications and their strengths.
ReplyDeleteI appreciate your input River, I'm still going to wait a week or so before reaching out again--I actually had something similar to this 2-3 years ago, but it went away after a couple weeks.
DeleteYou are too funny! Art uses compression socks when we fly long distances. I had some too, but was told they were too loose. They have to be really tight apparently. Art says it takes him 15 minutes to wrestle them on. I don’t know if he’s exaggerating. Now you’re making me wonder if mom’s foot is swollen. I think I looked at it the other day and it was fine. Besides, she would tell me. Hmmmm… I’d better check when mom takes her Amlodipine.
ReplyDeleteI just looked it up because mom said she takes it in the morning.
ReplyDelete“ https://www.drugs.com/medical-answers/best-time-amlodipine-besylate-677326/“
It said anytime but should be taken about the same time every day. Mom’s feet were not swollen but she only takes 5 mg. a day.
Kay I looked that up too and got the same info. Anyway, I'm glad your mom's feet are doing okay. Well, I'm taking 10mg (and Cored, another BP med) but I have a feeling it's going to be changing soon--I can't seem to get my old foot back. BTW, Art wears compression socks too? So does my brother in law (who is skinny like Art). Wow.
DeleteHe only wears compression socks when we have long flights to the east coast to visit our son. That is worrisome about your foot though. I would consult with your doctor again. Another person good to talk to is the pharmacist.
DeleteMy period stopped when I was much younger and my doctor put me on Clomid. When my period still didn’t start, I talked to the pharmacist who asked if I’d gotten a pregnancy test. Nope. Doctor never tested me for that. Turned out you should absolutely NOT take clomid if you were pregnant, which it turned out I was. Sheesh! Good thing I didn’t miscarry or my wonderful daughter would not be here. Anyway, the point is, pharmacists are a wonderful fount of information.
Thanks for sharing that Kay, I WILL be seeing my pharmacist in 2 days and I'm going to ask him. That was scary about Tiffany, my gosh!
DeleteI took a drug once. Within the hour, I had one of the most violent headaches I've ever had in my life along with some pretty severe body aches. It was just awful. I had to go to the er, and two shots of morphine didn't help. After being there for hours, they finally sent me home because they didn't know what to do with me. At my follow-up appointment with the oncologist, I told her about my reaction. She said, "That is not one of the usual side effects of the drug."
ReplyDeleteI told her that I wasn't going to take the drug again. Ever. It was not a coincidence that the symptoms came on within an hour after taking the drug. They gave me a different medication that did the same thing, and I had no ill effects.
Tell Nefertiti to give you a different bp medication. If your swelling doesn't resolve she can laugh her asp off.
Debby I'm sorry you went thru that, but thanks for sharing that. I think I'm going to have to let them know, when I get up in the morning my leg & foot are okay, but swell up during the day. Haha about laughing her asp off! :^)
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