Bleeding, Clotting, & the Stocking Stuffer

I am going to share a little something about myself—not to brag, but it will KINDA help to lead into my next discussion (this next topic is a tough one!)

I have always been a very conscientious student. I won eight spelling bees in my 6^th grade classroom (I was terrified to be in front of crowds and refused to participate in a school-wide spelling bee.) I was a FAST speller—my teacher would always tell me to slow down so she could make sure I was spelling the word correctly.

Many years later, while I was assisting my own child with his spelling words, he was attempting to spell “refrigerator.” He was stuck on the letter “g” and began to sound it out. “Juh…juh. Mom, is it G or J?” So, I asked, “What do you see?”

Kid: “HUH?”

Me: “Like, in your head. What do you SEE?”

Kid: “Mom, I have NO clue what you are talking about. Sometimes the G and the J make the same sound and I get confused. Which one is it?”

Me: “Wait a minute. You can’t see the word “refrigerator” in your head?

Mind. Blown.

I couldn’t believe it. I was an adult, married with three children, I had been through nursing school, was working on my bachelor’s degree, and I had NO idea that people did not spell this way. My entire life, I have been flipping through a rolodex in my head when I needed to spell a word, and I read it off a card (hence my quick spelling skills.) Who woulda thunk non-weirdos spelled phonetically!

This is why you normal peeps should NOT be afraid of medical terms. Most are spelled EXACTLY as they sound. And they are named for the area of the body where they are located, or for the person that discovered them.

There’s a point.

September is ITP awareness month. Not gonna lie. I totally had to look it up. ITP stands for Immune Thrombocytopenia. That’s a big word! Super fun to say! Thrombo-relates to the clotting of blood. Cyto-relates to the cells. Penia-means “lack of” or “deficiency”. In short, this is a condition in which the body’s immune system attacks cell fragments called platelets-the cells that help blood clot-making their count dangerously low. Reduced blood clotting means increased bleeding issues, such as frequent nosebleeds, bleeding gums, excessive bruising, blood in urine or stools, and unusually heavy menstrual flows. Children can develop ITP after a viral infection, whereas adults with other autoimmune diseases (like rheumatoid arthritis and lupus) tend to be more at risk. You will want to contact your doctor if you are experiencing these symptoms frequently. Bleeding in the brain is a serious complication of ITP and can be fatal.

The human body is incredible as it works every minute of every day to maintain what we call homeostatis, or balance. The body doesn’t do well with a platelet deficiency, and it responds negatively (as above) when it cannot achieve that balance. Opposite the shortage of platelets is the rare clotting disorder of thrombocythemia, or too many platelets. There are many other more common reasons that the blood clots, and one of those occurs when circulation is compromised. I’d like to address just one of those.

If you have had surgery where rest is required for healing, you probably woke up with gorgeous, smooth, long stockings STRANGLING your legs, wondering just how they got there and just how something SO tight could do anything but CUT OFF the circulation to your entire lower body. Lying around in bed after surgery is really bad for circulation, since muscle movement makes your heart pump more and stimulates the flow of blood back to your heart (venous blood flow.) The compression stockings apply gentle pressure that tapers up the legs and encourages “venous circulation,” or blood flow back to the heart, even when you are not moving. And as long as blood keeps moving, the risk for a blood clot remains low. That’s the goal!

Now, my loved ones know that being related to me grants me license to lovingly exploit (can those two words be used in the same sentence?) any atypical ordeal they might encounter. My poor momma is the winner winner chicken dinner for the month of September.

I was sneaky and surprised my mom and my sister, your Friday Financial Blogger, with a visit after mom's total knee replacement just after Labor Day this year. When I arrived, she was sporting those exact snow-white strands of snugness I have been talking about. As a nurse, I have assisted patients in putting on their knee-high compression stockings, and it’s no picnic. But my mom’s stockings went all the way up to her…um…her gluteal SMILE (because gluteal fold does NOT sound quite as cheery.) Oh yay. That job was done before I arrived. I was off the thigh-high hook!

And then my sister handed me the discharge instructions. It’s like a compulsion. I MUST read them from cover to cover. And DARN IT. Six weeks.

My mother must wear thigh-high compression stockings for six weeks.

Could she birdbath it that long? Carey, that’s not very nice. How would you feel?

For just a moment before reality hit, I wondered what a bar of soap would do if she rubbed it really hard against the stockings…

The stockings must come off. And when the stockings must come off, new stockings MUST GO BACK ON. I think my sister "peaced out" at that moment and went to…go catch and bathe…then neuter and spay the feral cats…or something…

Mom was excited! I tried to be excited for her, all the while knowing the reapplication of the stockings would not be comfortable for her and would be like WWF wrestling for me.

Stocking number one came off the good leg without a hitch. Then came the bad leg. I have never seen a limb swell up so quickly—like a party clown blowing up one of those really long balloons—and picture the balloon changing colors while it happens! The bruising dispersed rapidly down through her ankles and toes, and all mom did was give a sigh of relief that her leg was no longer being smothered. Mom got her long-awaited shower, while I wondered if the lean and lanky sock in my hand was going to go over the leg that was now twice the size from when we started.

Mom is now squeaky clean, so we throw her on the bed, as we decide this is the best place to do this. She has a little X on the top of her foot.

Mom: “Oh look. They marked my limb for surgery.” 

Me: “Um, nope. That is where they checked for your pedal pulse. Your foot was so fat after surgery, they had a hard time finding it. They marked it so they knew where to go back to find it again.”

HAHA. I have no idea why I found that so funny.

Now.  THIS. DARN. SOCK. For those of you with young daughters or granddaughters, there IS no sitting on laps. There IS no gentle gathering of the cute little flowery nylons with your fingertips and reaching around and poking the toes in, quickly pulling them up, lifting the child and DUMPING them in them, like a pillow in a pillowcase. You must align fingertips with the hole at the bottom, pull the sock AAAAAAALLLL the way up your arm, do all kinds of fancy folds, and then face the mother! From here, your only focus? Get it over the heel.

C: “Ok, toes are in.”

M: “Good job, dear.”

C: “We haven’t even started, Mom. We have to get it over your heel.”

M: “Ok, what do I do?”

C: “Just hold still.” Tug, pull, swish fingers around, stretch sock, pull some more. “Well, now the X is covered. I need some resistance, Mom. Can you do that?”

M: “I will try.”

LAME. EFFORT.

C: Laughing. Sarcasm. “I mean, you had surgery less than a week ago. You would think you could do SOMETHING.” Tug, stretch, swish fingers around sock, back and forth some more. Five minutes later, the heel is in. “THERE! We got the heel!” If this wasn’t difficult enough. Now mom is perspiring. Ever tried to put a wet noodle through a straw? I recommend you try it.

M: “Can you turn up the fan and point it this direction?” Gladly. Need a little less spaghetti.

C: Swish and stretch. Swish and stretch. Not fair. Hospital nurses did NOT have to deal with the swelling. “I am sorry this is taking so long. I just gotta…get it...up…to…the knee…” My voice is straining as I tug, trying not to leave any wrinkles behind. I need a drink. Her fan. And a nap.

M: “This part is NOT comfortable, sweetheart.” She’s so sweet about it. I would have just screamed OOOOOWWWWW.

C: SWISHANDSTRECH! SWISHANDSTRETCH! SWISHANDSTRETCH! Speed demon now. “I’m sorry mom I’m sorry mom I’m so sorry so sorry so sorry gotta get it up…and…THERE!” After 15 minutes, we are over the impressive scar on her knee, now mid-thigh, and in the home “stretch.”

M: After her eyes were shut tight, probably in pain, she opens them. “Oh, VERY GOOD, HONEY!” Felt like kindergarten, all over again. She was proud of me. I was pretty proud of her too.

I let her pull them to the “smile.” And that’s the story of leg number ONE (exhausted SIGH.)

We are recognizing bleeding issues (ITP) this month, but it’s also good to revisit clotting issues, as those are much more common. I enjoy educating very much. I am glad I can help you! But this month, I am especially glad that I could help my momma to…

Be Well!