Dr. Seyedaidin Sajedi
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hi doctor,
My ankles were tied extremely tight for a period of 5 to 7 days when I was in a coma due to my preexisting PTSD flaring up while gaining consciousness but not lucidity, and not understanding where I was or why I was tied up (they had security with me 24/7). This happened again 3 years later when I was induced into a coma due to a brain bleed. Ever since, I have had darkened skin like a diabetic, swelling after walking for 5 minutes that does not go down for a month, resulting in skin tears and phantom pain like lightning in my feet. As I am aging (52 years), this is getting worse. A former doctor said there is nerve damage in both ankles. I spend months with swelling and pain in both feet before it slows and stops, only to flare up again randomly after another walk that seems no different from other walks I go on without the swelling happening. As an aside, I have damage in each wrist causing numbness due to the same restraints at the same incidents from damage to ulnar nerves. As I age, it is getting longer, and the swelling is from calves to and including feet. CBD oil seems to lessen the sharp stabbing pains, but I cannot figure out how to decrease swelling faster and am worried about possible amputation in my future if I cannot find a possible treatment or diagnosis. Since I recently moved to a small area, there is a 5-year wait for a general practitioner, so I am in limbo. The current medications include Venlafaxine, Wellbutrin, Quetiapine, and Trintellix.
Kindly help.
Hi,
I appreciate that you have chosen icliniq.com for your medical needs.
I am here to give you the best care possible.
I understand your concern. I saw the image of your feet (attachment removed to protect the patient’s identity), and the visible swelling, dark crusted wounds, and scattered ecchymosis on your feet and shins are concerning. Such lesions cannot be explained solely by the history of being tied up. You need an extensive workup, including blood tests and an electrodiagnostic study (a test conducted by a neurologist to assess the health status of limb nerves). There are some diseases that can affect multiple systems in our body. For example, there are inflammatory diseases that can affect nerves (causing pins and needles or shooting pain), skin (causing wounds, rash, patches of ecchymosis), joints (causing pain and swelling), kidneys (causing foot edema), and even the brain (causing various psychiatric problems) simultaneously. Vasculitides and diabetes are some such diseases. Without proper evaluation, their diagnosis would not be possible.
I understand that you are in an area with limited medical resources; however, you need the mentioned evaluations to determine the diagnosis and treatment. As a final point, I noticed that three drugs in your current medications have serious interactions with each other, including Venlafaxine, Wellbutrin (Bupropion), and Trintellix (Vortioxetine). It is worthwhile to consult with a psychiatrist to review your current medication.
I hope this has helped you. Please feel free to reach me again, in case of further queries.
Thank you.
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Neurology
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