Wednesday, 30 April 2014

Pitting Oedema

Physiotherapy has started. I thought it would hurt like heck, but remarkably, she was very gentle.

After reviewing all my particulars, she said our primary focus was reduction of swelling and improvement in range of motion. My foot below the ankle is still pretty swollen, and she helped me understand the state I was in.

Swelling (oedema) results from the buildup of fluid in the tissues. Initially fairly liquidy, the fluid causing the swelling, over time, becomes more viscous if the swelling does not subside. The goo in my foot is about the thickness of toothpaste, so much so that my current state is called "pitting oedema". Push into it with your thumb, and the impression (the "pit") stays there for minutes. A few days ago, I took the ice bag off my leg, and it left a noticeable dent. I was worried I wrecked something, but apparently, it's kinda "normal" with the degree of swelling I have.

The fluid build up in my foot is a result of a thick band of tissue that crosses the ankle that holds down the tendons and ligaments. The only way fluid can escape is under this band, but the fluid is so thick, and the space so small due to swelling, it won't drain.

She took measurements of my swelling, then treated my foot like the bottom of a toothpaste tube, endlessly squeezing the toothpaste out past my ankle and up to the lymph nodes in my calf. Lymph nodes get rid of guck like this, though I'm kind of overloading them these days.

In 15 minutes, my swelling was reduced by 40%. I think she could get the last drops out of a tube of anything.

With less swelling, she went after my ankle range of motion. 15 minutes of stretching and rubbing, and I got a 15° increase in flexion, and 10° in the extension range. That moved me from about 5% of "normal" range of ankle movement to 50%.

She taught me 4 new strengthening exercises, and 4 new stretches to add to the regime started in the hospital last week.

Something tells me not all sessions will be that dramatic, but it's a start. Now all I have to do is actually do my exercises.

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