Sunday, October 7, 2018

My story : A Journey reflux

I was trying to think when did it all begin? When did these feet/legs of mine that did so much work change beyond recognition? Though not very regular, I used to go for a foot reflexology once in a way. I did yoga occasionally and meditation most regularly. Whatever problems I had with my feet those days, I believed were sankaras that were coming out and I observed them with equanimity. May be I was mistaken. Maybe they were the initial signs of what was to follow.

My earliest memory was in January -February 2016. The previous year I was using the em-tech machine for my arthritis. It is a machine that emits various forms of heat. Em tech Wellness centers are located in many places in Singapore and it is supposed to be very effective in curing or ameliorating many conditions. So impressed I was after trying out at the wellness center for one month that I bought one and started using it at home regularly.

Sometime in the end of January and beginning of February 2016 I noticed a rash on my left foot just below my toes. I went to my Ayurved doctor at Ayush and she gave me a cream and some medicines. Very soon my foot started becoming red and swollen and I suspected the area under my toes to be infected. I went to a skin specialist in Jurong Ketchil and he diagnosed it as Cellulitis and put me on a course of antibiotics. I recovered from it and from then on would regularly moisturize my feet. I stopped using the em-tech machine.

I had some intermittent problems thereafter with the foot which I would respond to with temporary remedies. I remember asking the doctor about the discoloration that had begun and his response was "You should be glad it is not on your face". A very unsympathetic and unprofessional response.  It wasn't until July 2017 that my feet screamed for attention again. I was sitting a 10day course in Dhamma Vipula, on Belapur Road, Mumbai and they were burning a lot making it difficult to sit through the course. Later in August that year I conducted a 10day course in Penang and had problems again.

I decided to visit the doctor at the polyclinic this time hoping there would be a better diagnosis and treatment for my aching, burning feet. He was the first doctor who said it might be due to varicose veins and compression stockings could be a possible solution. He gave me medicines for the immediate relief from pain and I looked up Guardian Medicals for over the counter compression socks and started using them. It was only much later that I learned there are many kinds of compression socks and I should have got the medical grade compression socks. Anyway to move on with the story..

I was wearing the compression socks regularly and to my dismay found I had a blister coming up. Problems seemed relentless and no sustained help available. I googled for doctors still under the impression that its probably a skin issue probably due to the use of em-tech machine. I found a doctor at Mt.Elizabeth and she told me I had an ulcer and taught me how to take care of it and nurse it back to normal. It took a long time to heal and meanwhile I was consulting doctor friends and everyone in the know for solutions. One doctor friend in Hyderabad did advise me to consult a vascular surgeon. I had not heard that specialization till then and was wondering how to get to one in Singapore. This was end of December 2017.

The ulcer healed finally and with great enthusiasm I earnestly began to learn swimming. But not for long as I started getting small ulcer type eruptions on my feet and also what I now know to be "atrophe blanche" where in the skin seems to split giving it a ridged appearance one stage before ulcer formation. I applied soframycin, an antibiotic cream I had got from India, along with some organic haldi (turmeric). There was some relief from the blister type of irritation. I decided to re-contact my Mt. E doctor but I got an appointment only for Jun13th 2018. I left for India in May 2018 after my Spring semester and consulted a doctor in Mumbai who re-affirmed that the issue was due to varicose veins. He gave me some ointments, but nothing really helped as very soon I had anothe ulcer coming up.

This ulcer was really painful as I could barely walk properly and was in constant pain. I looked up for a vascular surgeon at SGH as a private patient to get an earlier appointment. The Mt. E skin specialist suggested that I get a biopsy of the skin around the ulcer done at the National Skin Center and my appointment there was for the 8th of August..this was in June 2018. Through strange combination of incidents, I landed in  Ng Teng Fong Hospital, Jurong where I was admitted and suddenly I was taken seriously and all tests conducted swiftly.

Skin Biopsy report as well as Ultrasound Doppler test on my legs confirmed that I had venous insufficiency /venous reflux which meant that the blood that returns to the heart by the veins was not doing its job due to faulty vein valves. Therefore the blood returned to the feet thereby releasing free radicals and other proteins destroying the tissues and causing ulceration.

As the reflux was from both superficial as well as deep veins, surgery was not considered. Surgery is normally done only on the superficial veins and not the deep veins I was told. This surgery involves clipping and sealing off of the refluxing vein. Deep veins carry 95% of the blood back to heart and so it is too dangerous to perfom surgery on them.

 So now the solution was to wear compression bandages which would enable the blood to move upward in the correct direction. Once the ulcers healed I would have to wear compression stockings forever. Ofcourse, I can take them off if I am resting by keeping my feet elevated above the heart level.

Thus I continue getting on with life. One semester came and went and I pretty well got used to life with compression stockings. No more painful ulcers but the skin is dry & scaly and needs to be kept moisturized.

I used to look down on my feet before, now I look up to them more often 🙂

Tuesday, September 4, 2018

When life turns upside down

When life turns upside down, I have learned to start working upside down.

Yes, my current condition is called venous insufficiency / venous reflux which means that blood from the veins is not getting circulated back to the heart due to the malfunctioning of venous valves in the legs. So they flow back to the feet and slowly start damaging the tissues in the feet giving rise to painful ulcers.

The solution is to wear compression bandages till the ulcer heals and then compression stockings to ensure proper circulation and prevent ulcers. Compression bandages have to be changed twice a week at the hospital where trained nurses would dress me  with the bandages. Stockings are better in the sense they are self managed.
Exercise such as walking and flexing of feet,  keeping feet elevated (above the heart level) are other ways to manage this condition.
I am told that people whose jobs require long hours of standing or sitting are likely to suffer from this condition.

Life has certainly changed with this as I am more often lying on my back with legs elevated. The yoga posture.. viparita karani is very helpful. This is the posture where the legs are at 90 degrees to the body and the wall serves as support to the legs.

So my life turns upside down literally. Having been upright (pun intended) most of my life I now lie almost upside down. While initially it was inconvenient as I wondered how to get my work such as marking papers or reading or art, I have now learned to do all this in this new posture.
I even meditate in this new posture.
Meditation has helped me a lot. I live moment to moment sinking into the pain and discomfort, observing it with equanimity.
As awareness increases there is less and less tendency to complain.
Ofcourse I am not saintly all the time. My family has seen me lose my cool a number of times as I snap at them or scream at them.

But on the whole its been a journey towards greater wisdom, developing gratitude for whatever good I have been given.

Time to give the legs the rest they deserve. When life turns upside down, I learn to work upside down.