How we got here . . .

For those that haven't heard the whole story, here it is. It's long, so bear with me.

On Mother's Day, Cindy tripped over the baby gate we use to keep Abby (our 6 mo old lab puppy) in the kitchen. She landed on her left knee, and other than being a little sore there seemed to be no problems. Two days later, she began having pain in her right ankle and calf. The next day, the pain had gotten considerably worse, so she went to a minor med office and was diagnosed with a deep bruise in her calf and possibly a sprained ankle. X-rays of the ankle were negative. Ice and elevation didn't really help, and by Sunday, May 17 the pain was worse than ever and we went to the ER. An ultrasound of her calf revealed a DVT (deep vein thrombosis) in the peroneal & popliteal veins of her calf & knee. Treatment was started with Lovenox and coumadin.

Over the next couple of weeks, she improved and was able to walk off of her crutches and go back to work. By the weekend of June 6, though, the ankle and calf were swollen again. On June 11, Cindy had an MRI of her ankle which showed disrupted (i.e. detached) ligaments in her ankle. She was back on the crutches and scheduled to see an orthopedic surgeon on July 1.

In the meantime, we continued regular visits to our internist to monitor her coumadin. At one of these visits, Cindy asked about a persistent dry cough she'd had for a while. A chest x-ray in the office was negative. The doctor was concerned that there might be a blood clot in her lung (a pulmonary embolism) and scheduled a CT angiogram of her chest on June 22. We went in for the angiogram at 7 am. The radiologist noticed something irregular and wanted to do an abdominal and pelvic CT as well. We went up to the internists office, and he told us that the scan showed that there was a clot in her lungs, but that wasn't all. They had also discovered a 10cm mass on one of her ovaries. While the meaning of this news sunk in, we set up an appointment with a Gyn-Oncologist.

Our first visit with the Gyn-Oncologist - Dr Linda Smiley from the West Clinic -was on Friday, June 26. She reviewed the CT scan with us and confirmed our suspicion that Cindy would need surgery to remove the mass and would also likely undergo a total hysterectomy. Because of the existing blood clot in her leg, an "umbrella filter" needs to be placed in her inferior vena cava before surgery. The purpose of this device is to catch any part of a clot that broke off from her leg before it could reach her lungs. Luckily, this can be done as an outpatient and we'll be at Baptist Hospital tomorrow morning (July 2) for the procedure.

Right now, Cindy feels OK most of the time. She does have a low-grade fever that comes and goes, and when it hits she feels pretty lousy. She's also still hobbling around because we haven't been able to do anything about her ankle yet. Because of all the upcoming procedures, she's been switched from coumadin to Lovenox to treat the blood clot. Lovenox is an anticoagulant that's injected subcutaneously (like insulin) in the abdomen twice a day. It also happens to be the drug that I've been educating health care practitioners about for the last 9 years.

That's where we stand right now. Today, we have a follow up appiontment with Dr Smiley to review some more test results and schedule the surgery. We also get to meet with the orthopedic surgeon. Originally, we assumed that he would do surgery to reattach the ligaments in her ankle, but that seems unlikely now, at least for a while.