Left Lower Leg swollen 8 months post-op

[db0o]

It was found that I had a soft tissue mass on my lower left leg, medially, below my knee. After various tests, venous complications were ruled out. I saw an orthopedist and a vascular surgeon, who ultimately referred me to a plastic surgeon to have it removed (it was causing pain). I had it removed in August 2014, surgery went well, and the doctor advised me it would take a few weeks to heal. Well it is now April 2015, and my leg is still swollen, and the bruising has never gone away. The scar looks great, since he is a plastic surgeon, however there is now an indent under my knee where the original mass was- hard to see in the photo however it is indented in the area of the darkest bruising, just medial to the scar). Additionally, there is swelling (it is soft and feels as though it did prior to surgery, which originally made me believe the mass was not fully removed). In the photo, I have cupped the swollen area with my fingers for a better idea.  The swelling is below the indent and also spreads laterally. To compare, I would say the circumference of the area of swelling would be close to that of the circumference of a baseball. There is still a large black-and-blue surrounding the scar, which has not improved. It still hurts to touch the area with any kind of pressure, and additionally it hurts to be standing/walking/jumping for too long. This is also impacted workout routines in the gym- I also cannot lean on it, such as to sit on the calves with knees bent.

After telling the surgeon who performed the surgery about these issues 3 months post op, his answer was too wait it out another 2 months, which I did. He then sent me for an MRI which was unremarkable for any concerns. At that point his nurse told me there is nothing else they could do. I went back to my orthopedist, who sent me for a doppler and an MRI w/ and w/out contrast. Doppler was unremarkable and the MRI revealed "post op swelling", which he said should have subsided. He asked me to give him a couple of days to ask other doctors and colleagues for opinions, as we were in "no man's land" at this point. I was advised to call him in a week. That is where I stand now.

Does anyone have ANY information that might help? Can anyone agree that 8 months should be enough time for swelling to subside? Should I see a different specialist? What can I do? I am at a loss for solutions.

Thanks in advance for any feedback!

[jemma116]

The homemade natural yogurt should be fine.  The only thing is it may be cheaper to buy it.   Get the one that is set, it is much thicker than the runny yogurt.   I don't think your mother-in-law to be would appreciate her yogurt not being eaten.  Do be aware that if the "bruising" is caused by the leaky veins, the yogurt won't help.  It only helps if there is inflammation, pain and normal bruising.  It still may help to reduce the swelling and is still worth having a go.  You will need to try for a few days, but you may notice a difference in a day.  

Any dry light cloth will be fine.  You can apply it to your leg before bed time and sleep with it on.  The yogurt does dry out.  Wash it off in the morning.

With you mentioning that you have the little spider veins forming, the vascular surgeon should help with that.  The yogurt won't do anything to remedy this.  

I have a similar thing with the little spider veins that formed on my leg.  It happened over 5 years ago when I was stung by a huge bumble bee that flew under my long skirt when I was in the garden.  Initially it was a huge swelling and red area and when that settled, I have been left with the thin vein marks and anyone that does not know the history, thinks it is a bruise.

I think these are referred to as leaky veins.  My doctor has seen it and I have been offered with no medical remedy.  When you press on it, it spreads out more like a bruise.   The area on your leg is much larger than mine.  

Hope the vascular surgeon can help you.  

Best wishes.

[db0o]

Thanks for your response! I know it could be taking longer than usual, which is also frustrating.

I received the written report of the MRI (w/ contrast) today, you can read it above, as I typed it to "philnoir".

I am not currently taking any medications, aside from the homeopathic remedy of "arnica" which was originally suggested by the surgeon, as it is known to help with swelling post op.

I have not heard of the natural set yogurt remedy, however I am interested to try it. Do you mean to just use homemade yogurt (this will be easy as my fiance's mother makes it frequently)? Then wrap it with a facecloth?
I currently elevate my leg at least 2 hours/day.

As I mentioned above, I have an appointment with a vascular surgeon next week, just to cover all grounds, and since tiny spider veins are forming all around the swollen area.

I am patiently waiting for a break in this case! :) Thanks again for your time and suggestions!

[db0o]

Thanks so much for the suggestion! I actually used the Arnica cream ALL THE TIME for maybe 2 months post op- then became discouraged with no results. Lately, I have been taking the arnica tablets from Whole Foods, 5 every 3 hours. Nothing seems to be working. The latest MRI reads (I requested a report today):

"There is a region of patchy increased T2-weighted signal in the anterolateral subcutaneous soft tissues of the proximal leg. There is corresponding mild post contrast enhancement. The area of edema and enhancement is irregular with with reticular morphology suggestive of scarring and measures up to 4.5cm transverse x 1.3 cm AP x 7.6 cm craniocaudal. There is also increased T2-weighted signal within thin rim enhancement at this site which measures approximately 16mm x 3.5mm and is compatible with small amount of subcutaneous fluid. No drainable fluid collection is identified. No signal abnormality or enhancement is seen directly adjacent/deep to the skin marker.

Findings: Region of edema and enhancement. This likely represents postoperative  changes including scarring. The extent of signal abnormalities has increased since the prior study of 4/11/2014. In the appropriate clinical setting. cellulitis can have a similar appearance. "
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My orthopedist is seeking advice from his colleagues, however I have an appointment with a vascular surgeon next week, just to cover all grounds, and since tiny spider veins are forming all around the swollen area.

Thanks again for your time and feedback!

[jemma116]

I agree with you that 8 months is a long enough time period for swelling after an op to have subsided.  Having said that my swollen tendon that was damaged whilst using a treadmill took 9 months to heal.

Are you taking any medication like Ibuprofen?  
I had a problem with a swollen leg and doctor advised me to stop taking Ibuprofen because it can cause oedema. Sure enough with stopping the medication the swelling slowly subsided, but it did take a few months.  I still have problems with my leg, but at least it is not badly swollen and red.

What I suggest you do is to elevate your leg as much as possible.
A good natural home remedy to help with bruising and inflammation is to apply natural set yogurt.  Put on quite a fair bit and wrap it lightly with a cloth.  Do this as often as it is needed.  Make sure to elevate your leg as much as possible.  Don't do anything to aggravate it, this will just prolong the healing time.

If things to not settle after a few more weeks and you notice the "mass" increasing in size, book an appointment to see your doctor for another referral to the specialist.

Wishing you a speedy recovery.

Best wishes.

[philnoir]

I have had remarkable results in reducing bruising and inflammation with a homeopathic preparation of arnica montana.

It comes in a cream or oil infusion which can be rubbed into the contusion, but I've discovered that the sublingual tablets are very effective, sometimes reducing a bruise overnight.

Here's some information on arnica:

http://umm.edu/health/medical/altmed/herb/arnica

You can find these in a health food store supplement section (like Whole Foods), or online.

The purple tube seems to be the best formulation: (http://www.vitaminshoppe.com/p/boiron-arnica-montana-1-m-md-75-pellets/bi-1121)