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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22878
Experience:  Over 20 yrs of Family Practice
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left foot is very swollen and painful to walk on

Customer Question

I am having a lot of swelling in my left foot and ankle which seems to be spreading up my leg and becoming larger and painful. I do not specifically remember any injury happening nor is there any signs of trauma. Honestly I have not moved around a lot in the past 3 days as I am working almost 16 hours a day to build and grow my company. I work sitting down at the computer and I first realized my foot was swollen and painful yesterday night. I went to head downstairs into my room and fall asleep (my home office is upstairs) and when I stood up from my desk at about 4am the pain in my foot caused me to buckle. I hobbled downstairs and went to sleep hoping it would go away but it is now about 24 hours later and the pain has only gotten worse. There are no cuts or bruises or bite marks or anything except for the massive swelling. I can send pictures but I can't figure out how to upload them (instructions are wrong)
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Hi--are you saying that the swelling is now also in your lower leg? Any change in skin color?
Customer: replied 1 year ago.
Im sorry, that was incorrect I guess I wrote that poorly. The swelling has not really gone into my lower leg at all, it is almost exclusively in my foot area. I guess what I meant to say is that the swelling is getting worse and so it feels like more sides of my foot are swelling up.
Expert:  Dr. Chip replied 1 year ago.
OK--any change in skin color? Does it hurt to flex your toes?
Customer: replied 1 year ago.
sorry i was on my mobile just got back to my desk. my toes feel strangely fine/unaffected and it doesnt hurt to flex them. skin color...well i want to say unchanged but it is of course red/pink from the swelling. no drastic colors anywhere though
Customer: replied 1 year ago.
i need to amend my answer before - when i looked again at my pictures it appears like my leg is also swollen. it is very noticable in the picture when compared to my other leg but i did not notice it when you asked me, i.e. it doesnt feel swollen?
Expert:  Dr. Chip replied 1 year ago.
OK--and we can continue after this if you need. My first thought is a bad bout of tendonosis--tendon inflammation. Another possibility but since there isn't much in the way of redness it is less likely would be a gout attack. My major concern especially when you say you haven't been moving around a lot lately is that you may have a deep venous thrombosis--a clot in a major leg vein--and that could lead to a life-threatening pulmonary embolus. I wish I could give you an exact diagnosis but I can only give you the differential here. My major point, though, given the possibility of the DVT, is that you really need to see a doctor about this today without any delay. I would examine you and get blood work, an MRI of the foot and lower leg, and I would also get Doppler flow studies of the leg to look for the possible DVT
Customer: replied 1 year ago.
thanks for your help - although obviously it is not what i was hoping to hear. i was hoping you were going to see it was some kind of cellulitis but maybe that requires an open wound or cut to be valid? in any case i have been taking pictures since this started, maybe they will help? here are links to each one (3 in total, starting when i noticed the problem yesterday at 3am and the latest one i just took a minute ago)
1. http://nomadads.com/1yesterday3am.jpg
2. http://nomadads.com/2yesterday6pm.jpg
3. http://nomadads.com/3today4am.jpg
*forgive my hideous ugly feet and the poor quality but hopefully they will help you somehow?

secondly, i wanted to add some background information since my situation is sadly unique and these two disclosures may be relevant? the first thing i wanted to say is that i had about 5 years of IV drug use occurring from 2005-2010. the last time i used any drugs was in february, 2010 so i have been clean since then - however my addiction caused me to essentially ruin/burn out all of my veins in my arms and feet. i guess i am telling you this because im worried that i might have somehow clogged one of my veins or half-clogged it during my addiction period 3 years ago, but would it be possible for the symptoms to wait this long to manifest?

thirdly, sometime in 2009 i recall developing a swelling not all that different from the one currently occuring in my foot except it was happening in my left hand at that time. the swelling got worse and eventually i saw a doctor who eventually diagnosed me with MRSA (the meth-resistant staff infection). i went on 10 weeks of IV antibiotics every day to cure myself of this but is it possible that it has somehow decided to reoccur in my foot 3 years later?

finally: i am currently in a period of no insurance coverage right now - my previous employers policy ended last month and my business policy begins on june 1, 2013. would you still recommend i bite the bullet and seek treatment immediately or could i theoretically try antibiotics from a walk-in clinic and see if that helps? what should i look out for, i.e. what will i feel if its getting worse and what should i look out for as an indicator i need to goto hospital asap?

thank you so much for your help and im sorry to take up so much of your time i hope you dont mind too much and i will of course compensate any costs for all this additional info/questions. thanks
Expert:  Dr. Chip replied 1 year ago.
Thanks for all the extra information and I fully understand about the insurance thing. Congratulations on your being clean and sober for these 3 + years. I looked at your photos and there is some erythema there so this could be cellulitis but I'm concerned about the amount of pain you have without there being a fulminant, bright red skin change. The swelling isn't extreme here but the DVT thing worries me the most. The biggest problem here is that I can't examine you. My suggestion is at least get to a walk-in clinic today and let a doctor actually evaluate this. It could just be cellulitis and all you need is some antibiotics but I just don't feel comfortable telling you not to worry too much about this and not have it looked at today

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