All right, so there were unexpected developments. On Tuesday, 3 days ago, Marina awoke to find that her left leg and foot were swollen. Since we know that swelling could be a sign of blood clots, we called the clinic and were told to come right in.
In Dr. Misakian's absence, we saw Dr. Patel, who was sufficiently concerned to call in the senior doctor on duty, Dr. Daniels* who ordered an immediate sonogram.
"Immediate" turned out to mean three days, and even then we had to ask Dr. Hu to use some influence -- and she got Marina into the hospital's vascular lab in short order.
The finding, this afternoon, was that there are no blood clots, but there is an "anatomical variation," which means that of the two small veins that should be seen in the ankle, one is very very tiny and the other is not there at all.
The lab nurse had no notion of what this all meant, and whether it might be new or a long-term situation, or whether it could relate to the continuing leg pain. She faxed the report to Dr. Daniels, and there is an appointment for next Tuesday, Monday being a Holy Day.
Meanwhile the leg pain is definitely less, and Marina has increased the Effexor dose to 1 1/2 tablets, and will go to 2 tablets a day shortly, and begin cutting down on the Norco. Unless, of course the Anatomical Variation turns out to be something to fret about and deal with.
The good news for we who prepare little meals at 1 and 5 in the morning, to take the Norco with, is that Effexor is a once-a-day medication, taken at any time at all.
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* Based on the dozens of staff portraits on the wall, he is the only African-American doctor in this division of UCSF.
Posted by John Bear
at 4:50 PM PST
