Tuesday, 15 December 2015

Bleeding Toes McBride

I'm laying on my bed, sort of half sitting up, my shoulders slumped against the headboard. The purpose in this position is to keep my foot elevated, in order to give my toe a chance to stop bleeding. Cutting my toenails is an adventure, one almost certainly to end up in a failed clip at some point, snipping a piece of skin, producing blood. It\s not just when I do this myself. So far at least two of my care workers have snipped me. Katherine had that pleasure today.

It happens for two reasons. First of all, my toes don't hold position at all when someone goes to clip a toenail. They move, ever so slightly, from the simple pressure of gravity, or perhaps from a shake within my upper body. Regardless, my toes fail to present a steady platform for snippage. Secondly, my toenails themselves are curved, especially on my left foot. This happens because my toes themselves are forever curled over these days, like the claws on a bird's foot, unable to straighten without muscle effort, something I don't have. So determining the end of the nail underneath that curve can be nearly impossible.

I've clipped myself more than once when doing them myself, so I know how difficult it is. I hold no ill will towards anyone else trying to accomplish this task, failing to make a clean getaway. It's just one of those things that happens now and again. The problem is the bleeding.

My feet are almost constantly swollen, engorged with blood pooling in them, thanks to gravity and the failed muscles in my upper legs, the muscles which would normally push the blood back up. The blood elevator in my legs only goes down; it don't come back up. So there is this extra blood pressing into my toes. Not only does it make them swollen and purple, it adds volume to a bleeder. On top of that, I take an anti-coagulant to ensure blood clots don't form in my upper leg; I want to avoid another DVT. This means when I get a cut, it takes a while to stop bleeding.

Put together extra blood pressure, more blood volume, and slow coagulation; it explains my my toes bleed so heartily. The best way to stop this is to keep my toes elevated for a while, taking the blood volume and pressure away. That way what limited coagulation power I have can do its job. End result? I get to sit in bed for another hour. It's not all bad.

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