OpenHealth Q&A

Concerns About My Husband's Leg: Testing Has Not Provided Clarity

Age: 34 Gender: Male BMI is within normal limits, currently not taking any medications, and does not use tobacco. His medical history includes a decade of severe alcohol abuse, with a recent relapse occurring just two days prior to the incident detailed here. He continues to consume alcohol. On November 30, my husband suffered a fall down the stairs leading to our basement, resulting in him hitting his head against the wall and then landing on the floor below. I was alerted by the sound of his fall and quickly rushed to his side. He was alert but incoherent when I reached him. An ambulance transported him to the hospital where they measured his blood alcohol concentration at 302. A CT scan of his head, along with X-rays of his upper body and spine, were conducted, but his lower body was not examined, and he was discharged just a few hours later. In the weeks following, he displayed clear signs of post-concussion syndrome, including headaches, disrupted sleep patterns, mild paranoia, and issues with memory. Medical imaging, however, revealed no significant findings related to these symptoms. Although many of these symptoms have since subsided, he continues to experience a slight stutter, some forgetfulness, and drowsiness. Contrarily, the condition of his leg appears to be deteriorating. It shows significant swelling, redness, and warmth to the touch, with visible changes in the skin. Elevating the leg offers some relief, but prolonged walking or standing exacerbates the situation. I have noticed a slight improvement when performing lymphatic massages, although it’s insufficient for a complete resolution. He reports that there’s no pain associated with the leg—initially we considered whether the alcohol might be masking discomfort, but he claims there’s no pain when he wakes, nor does he experience any discomfort at night. The only time he mentions mild discomfort is when he frequently bends his knee. He describes a heavy sensation in his leg accompanied by pressure but insists it’s not painful. He does report some itchiness, which seems reasonable given the current state of his skin. Recently, he met with his primary care physician, who ordered numerous tests, including lab work, an EKG, a stat venous ultrasound, and X-rays targeting the knee, leg, and ankle. While the results have been documented, they indicate nothing significant other than elevated liver enzymes related to alcohol, along with low platelet counts and high monocytes. The physician mentioned the possibility of complex regional pain syndrome after excluding a blood clot and a few other conditions. A referral was made for a neurology consultation. He has a follow-up appointment with his primary care provider scheduled for next week, yet it remains frustrating as we haven’t received any concrete answers, and CRPS seems inconsistent with his reports of minimal pain. What could be alternative explanations for his symptoms? Thank you for your assistance and insights!

Answers (1)

3/25/2025, 1:50:54 PM

OpenHealth AI

It sounds like you're understandably worried about your husband's condition, especially given the complex interplay of symptoms following his fall. His leg issues, particularly the swelling, redness, and warmth, warrant careful examination, especially as those can indicate potential underlying problems.

Several possible explanations could account for his leg symptoms:

1. Post-Traumatic Inflammation: After the fall, inflammation can develop in response to injury, even if it doesn't cause severe pain.

2. Lymphatic Issues: Given that you mentioned some relief with lymphatic massages, it's possible there may be lymphatic drainage issues causing fluid accumulation, especially if his mobility has been reduced.

3. Complex Regional Pain Syndrome (CRPS): While CRPS usually presents with pain, it can also manifest in changes in skin temperature and color, swelling, and stiffness, even in the absence of severe pain.

4. Dermatological Concerns: Redness, swelling, and itchiness could indicate a skin infection or another skin condition that could need treatment.

5. Vascular Issues: Although tests like the venous ultrasound have ruled out major clots, other vascular issues could be considered, especially given the history of alcohol use, which can impact circulation.

Next Steps:

1. Monitoring Symptoms: Keep a close eye on any changes in the leg's condition, especially increasing redness, swelling, or the development of pain. Document these changes to discuss with healthcare providers.

2. Follow-Up with Neurology: Since a neurology consultation has been scheduled, it's vital to attend this appointment. They can further investigate neurological causes for his symptoms.

3. Dermatology Referral: If skin symptoms persist or worsen, consider asking his primary care provider for a referral to a dermatologist. They can evaluate for skin infections or other dermatological conditions.

4. Lifestyle Considerations: While your husband is dealing with alcohol use, encourage him to stay hydrated, and consider advocating for a support system as he addresses recovery. This can have a significant impact on overall health and healing.

5. Self-Care Techniques: Continue with lymphatic massages, and include gentle movements or stretches if he feels comfortable, assuming they're not exacerbating his symptoms. Elevating the leg can also help manage swelling.

6. Diet Considerations: Support his liver health by encouraging a balanced diet with plenty of fruits, vegetables, and lean proteins while minimizing processed foods and alcohol.

I hope this gives you a clearer path forward and offers some reassurance. It's understandable to feel frustration during a time of uncertainty, but there are avenues for further exploration and support. Please keep documenting his symptoms, as this information can be invaluable for his medical team.