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100% blockage in right leg, 50% in left, pain in neck
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100% blockage in right leg, 50% in left, pain in neck

100% blockage in right leg, 50% in left, pain in neck

My step mother was having pain in her legs, neck, and feeling dizzy and other symptoms.  She is in her 70’s and would not go to emergency room so we setup a visit with her primary physician, he ordered a “sonogram” which required driving to another facility and waiting two days for results.  Before she left he prescribed pain medication and muscle relaxers.  The test results came back as 100% blockage in the right leg and 50% blockage in the left.  Interestingly, he did not have any tests run on her neck and this was brought up he stated that nothing was said about her neck so another test was set for Monday.  

Does this sound normal? If someone has 100% blockage in their leg and potentially some blockage in their neck it seems logical that the doctor should have referred her to the emergency room immediately.  I’m not a doctor, all I have is my opinion but I am looking for other opinions.  Does this sound right?

Is it not true that 100% blockage in right leg and 50% blockage in left leg could result in pulmonary embolism if some of that calcium breaks off and travels to the lungs?

If she has blockage in her neck, potentially, could that not lead to a stroke?

I understand that it is doctor discretion whether or not to have her admitted and this just seems like something that would result in immediate referral to emergency room – what am I missing?

She has Medicare/Medicaid; does anyone feel like this could have something to do with the doctor being “disinterested”?

He made the statement that she is “not in any immediate danger”; how can you make that assessment considering her age, blockage in both legs, dizzy, shortness of breath, pain in neck?

She is scheduled for “stints” in both legs on Tuesday.  He prescribed opiates and muscles relaxers to keep her quiet until Tuesday unless something changes on Monday with the “sonogram” - which to me does not seem appropriate testing.

Does a “sonogram” have the ability to show the entire picture?  Is this something that deserves a MRI or “CT Scan”?

At this point, my wife and I [and other family members] would like to take her to the emergency room at a different hospital that has an established brand and known for hiring “best of the best” and the latest technology.

My stepmother is of sound mind and feels she trusts this other doctor and wishes to wait.  At the same time, it is her life and she is entitled to her decision.

The only way I’m going to convince her otherwise is if I can get something in writing stating that this is a critical situation and standard procedure or best practice or something other than “doctor discretion” stating this is automatic “admit” to hospital.  

In other words, if you have 100% blockage in one leg and we take her to the ER at this other hospital it would be absolutely no doubt they would admit her to the hospital because it is absolutely a LIFE threatening situation.

It is not my intent to use this against the doctor, to alleviate any concerns.  I just want to make sure this is not a life threatening situation and if it is have something I can show her and the rest of the family stating that it is a life threatening situation and she needs to be admitted.  

Assuming all the family agrees with this information then I’m sure it will not be an issue to convince her that she needs to go now to the emergency room.

Or, my wife and I are wrong and this is not life threatening – which would help us to back the decision.  If a majority state this is common and waiting for surgery on 100% blockage is acceptable then I’m glad we are wrong and we can all sleep better.
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Q:Is it not true that 100% blockage in right leg and 50% blockage in left leg could result in pulmonary embolism if some of that calcium breaks off and travels to the lungs?

>>Yes, there is a risk with clots, but many clots are desolved by the body system,  It would be wise to be on anti-platelet medication.

Q: "He made the statement that she is “not in any immediate danger”; how can you make that assessment considering her age, blockage in both legs, dizzy, shortness of breath, pain in neck?:

>>>The probability is high there are other vessel blockage and that includes the heart and vessels to the brain.  The Doppler ultrasound (sonogram) is a special ultrasound technique that evaluates blood flow through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs and neck.  I had a doppler ultrasound to evaluate blood flow through the heart and veiw the valves for any insufficiency.

Hard plaque that breaks away from a coronary vessel and cause a heart attack is not the major concern for occluded vessels...the major risk for heart attack is associated with the soft plaque within the layers of the vessel that breaks through to the lumen that causes a blood clot and then possibly a heart attack from the clot migrating to a vulnerable location..  

It don't believe there is a major risk for a heart attack from the clots (can happen though!) A higher risk may be getting an infection in the affected limbs, and the body may have a hard time fighting the infection, and if severe blocked blood flow can cause gangrene (tissue death). And In very serious cases, this can lead to leg amputation.

Hope this provides a perspective that will enable you to have a rewarding consultation with the doctor.   take care,

Ken
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