Addendum to Leg ulcer getting worse but treatment is still primitive…

Checking the circulation in my leg is likely to be futile.

I do have circulation problems, but they originate in my heart, not my leg. I have heart failure, that’s a given even if the cause is uncertain. That’s because I have two conditions that can cause heart failure, a calcified and, in consequence, narrowed, aortic valve which, I suspect, is responsible for the persistent cramp in my hands and feet as it can impede blood flow to the extremities. And I also have COPD.

So, the chances that any restrictions in my circulation are linked to either or both of those are, I believe, far higher than the chances that I’ve developed a third, more localised, condition. Occam’s Razor territory – the simplest answer is probably the correct one.

It’s possible to replace the aortic valve, and I’d go for that option like a shot if I were otherwise fit and well, but I’m not. This is why (in no particular order; those marked * are likely to kill me):-

(Yes, I know I keep reposting this list, but not everyone reads every post.)

FMS, Cervical spine arthritis (found out from my GP the other day that this is audible several feet away, not just to me), Osteoarthritis, Long-term damage from being struck by lightning (details here)*, M.E.,  COPD*, Heart failure*, Aortic valve calcification & stenosis*, Angina, Bilateral Lymphoedema (chronically infected)*, Primary Addison’s Disease* but less likely than the others if well managed.

I’ve already outlived my doctors’ predictions by 30 years, mainly by getting, and staying (until the lightning nailed me), as fit as I could possibly be and – worst-case scenario – I could die tomorrow.

One night last August, for example, I went to bed perfectly well, regained consciousness three days later in the stroke unit in hospital, covered in bruises and full of needle holes. I’d been hauled away, unconscious, with a temperature of 41C, and damn near died.

In November, I was admitted with out-of-control MRSA (it took 7 litres of i-v Vancomycin, over 10 days, to knock it down, by the end of which I barely had a working vein left in my arms), and I found out only recently that I almost died then, too.

I can’t have that many chances left, especially as I never fully recovered from either of those two events, and with my current state, coupled to my history, it’s doubtful I’d even be considered for surgery – surgeons take a dim view of patients who might die and make them look bad (as, indeed, do GPs!).

And to be honest, even were the operation a success, I sincerely doubt it would advance my life expectancy much beyond its current level as there is just too much else wrong, in which case it’s simply not worth all the pain, or the attendant risks of infection simply from being in hospital.

There’s also another risk – one most people never even consider – x-rays.

Modern x-ray film is very fast, and exposure (for the patient), very brief, but for most of my life that hasn’t been the case at all. I once ran the numbers. I can’t recall exactly what they were now, but by the time I hit my 40s I’d had enough chest x-rays, plus loads of others, including whole-body skeletal surveys, MRIs and CT-scans, not to mention an angiogram that went on for what felt like hours, to bring the risk ratio of x-rays to cancer occurrence down to double figures. At that point I called a halt to the regular x-rays I’d had all my life since the age of 2 and made them emergency only – which still left enough to jack up the risk even more.

And that was 30 years ago – I don’t want to think about what it might be by now. I’m probably lucky I don’t glow in the dark!

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