NXR7
Recycles dryer sheets
ERD50 said:Can you provide more specifics on the bolded part? Where on the ankle do you press? How long is "snap right back" (2 -3 seconds?)?
Sure. First off, I should have checked to assure the grading system is still the same nowadays and it's not. If you google pitting edema you'll see the new one. Nevertheless, simply telling your doc how long your skin stays dented in seconds is fine. They'll do their own test. We would report any denting, even one second.
Where on the ankle doesn't really matter because the fluid will fairly evenly disperse. I do it about 3" or 4" above the bone that sticks out on the inside, the medial malleolus, because there's more tissue there than down lower.
When I wrote "snap right back" that's what I meant. The instant your finger is off the skin it should be back to normal. Any type of dent that's still there is a potential concern.
The "blanche test" may take a bit longer, maybe a second or two to return to normal color. That tests the capillary refill ability and is affected by temperature. Try it on your cold fingernail.
When someone had a leg or foot injury we would always press down on the top of the foot near the toes to see how fast the area returned to normal color. If the area remained white and it was not outside temperature-related, it could mean the injury had impaired circulation past the area of injury. We also would feel for a pulse in that area.
When I worked on the National Ski Patrol, the blanche test was not real valuable after we removed someone's ski boot because their feet usually were cold anyway.
Pitting edema is something that does not occur and then go away without treatment. If it's there one week it's there the next. It's an accumulation of fluid in the lower extremities, usually do to a circulatory problem, and those do not come and go.I'll also do some measurement of right vs left over the next few weeks to see.
Or were you referring to left and right arm blood pressures?
Yeah, no kidding, same here in a few of my careers. I get that a proper sample size can be extrapolated to a much larger population but still...As someone who spent (invested?) much of their career with measurement systems, it bugs the heck out of me that decisions are made on a single reading once/twice a year in a doctor's office. You really need more data points when the measurement is variable.
I think the problem is that a set of simple guidelines is needed that could be used to "ring the alarm bell" and cause further investigation, guidelines that can be reasonably applied to almost anyone. The guideline chosen was the maximum and minimum pressure under a defined set of circumstances.
But really, does anyone believe if I do not sit in a chair with both of my feet flat on the ground that it's going to make a material difference in my blood pressure? Or I am not sitting with my back against the chair? What about people with scoliosis? Can they not ever get an accurate blood pressure?
I'll give you a personal example. This morning I lay awake in bed for about 20 minutes checking the news. I then got up, walked to a chair in the room, sat down, and checked my BP with an Omron machine. Right arm, first time: 116/81 pulse 78.I also have the same question posed earlier - is the 'at rest' measurement the best indicator?
It's never been that low.
Another time I had to stay overnight in a hospital because of cardiac symptoms. (A later echo showed all was well.)
When I awoke the next morning the nurse told me I caused them some concern overnight because my pulse rate dropped to 41 and set off the alarms. They watched me for a while and my color was OK and my breathing rate was OK so they let me sleep and the next morning my pulse rate was back to normal. I don't know if they took my BP, though. Probably but I do not recall.
That's about as "resting" as one could get.
Ray
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