26 August 2014

Zoolander Syndrome... of the arm

My mysteriously swollen neck mysteriously deflated in late December and early January. The doctors never figured out what exactly was wrong, though they did notice a lovely case of lymphodema in my left arm. Well, duh, thanks for the newsflash.

Any activity more vigorous than typing is likely to make my arm swell. The more prolonged the activity, the more swelling. Just for fun, flying also causes swelling. The solution is a compression sleeve. Not one of the flashy ones that basketball player wear, but an actual medical version. Translation: it costs $90 instead of $20.

Nearly 10 days ago, Matt and I wasted a week of perfectly good vacation days to move all of our belongings out of the rental house and into our garage. Because we just had to move everything across the street, we naively decided to do it ourselves. However, due to scaffolding and other construction detritus, across the street became down the street, around a 180 degree curve, and down a steep hill.

My left arm and hand started to swell on Thursday, and on went the sleeve. The sleeve stayed on all night and all day Friday, as the swelling increased and increased. By early Friday evening, I could barely bend my fingers or elbows.
Puff, the magic hand, dangled from my arm. And wallowed in the extra lymph that wouldn't move along.

Poking any spot was incredibly painful, while at the same time, my entire arm was cold and tingly. Not just cold to me, but cold to the touch. Oh, and my fingers were starting to turn purple. Time to call the on call doctor!

I described my symptoms over the phone, and the doctor sent me to the emergency room. No big surprise there.

I told the doctor that I was suffering from a lovely case of lymphodema. The doctor decided to be all responsible and not immediately believe me. A vascular technician was called in to scan my veins and arteries for possible blood clots, which would explain the cold tingliness.

The ultrasound showed no problems with blood flow, though that wasn't good enough. The next step was a CT scan of my lungs, as a blood clot there could cause my symptoms. In order to inject the IV contrast, my right arm, which was feeling a bit neglected, received an IV.

Anyone who has spent as much time as me getting imaging done knows the drill. Lie perfectly still for the first round of zapping, get dosed with contrast, and remain in the exact same position for the second round of zapping. The whole not moving thing is incredibly important to get good results. That's why, when the IV detached during the contrast diffusion, I didn't move. My heart, on the other hand, kept pumping blood. SQUIRT! SQUIRT!

It turned out that the little screw that attaches the line to the plastic tube inside the vein wasn't screwed in all the way. When the pressurizing by the contrast injecting machine, it came completely apart. Thankfully, the contrast was clear. Regrettably, my arms were above my head so all the blood and contrast were soaked up by my hair.

Once the mess was cleaned up, the whole imaging process had to start over. All in all, a ten minute study took the better part of an hour. Matt was worried about what might have happened to me, then confused as to why my hospital gown magically changed from green to blue.

After all of that, around four in the morning, the doctor declared me to have lymphodema and sent me home with instructions to see my doctor. Apparently my worries about a giant needle being used to drain my arm were unfounded; lymph swells every cell individually, and a giant needle would be very imprecise to drain them individually.

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