With CAD, treating injuries from a simple misstep can be harder to do

I am feeling better by the week. I can’t always tell from one day to the next, but there seems to be a steady improvement in my energy. For the first time in about 14 months, I hosted a party at my house. I’ve also been weed-eating the Queen Anne’s lace and goldenrod that are blooming in my gardens, as well as slashing through that horrible greenbrier that slithers its way across the ground and up into trees. My muscles paid for my enthusiasm.

Enthusiasm is often my downfall. This time, it literally was my downfall. I had a tree next to my driveway that, as it grew, pushed one segment of the pavement 4 inches higher than its neighbor. I forgot about the drop-off, and as I pushed the wheelbarrow to the street for weed pickup, I missed my step. My right ankle twisted, my left knee popped, and my left wrist mistakenly thought it could protect me from the damage.

Even without my cold agglutinin disease (CAD), such a fall is never a chosen activity. I sat on the driveway for a while, yelling to my absent neighbors that what I did was not fun, that everything hurt, and other general invectives against the universe. At 70 years old, I do not bounce.

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CAD and healing

With CAD, I don’t heal, either, at least not without serious bed rest, slow and careful steps in the house, and promises to myself to start watching where I put my feet.

This doesn’t seem like a CAD problem. It is definitely an absent-minded, klutz problem, but it could be a CAD problem as well.

CAD causes anemia. That doesn’t mean a person is simply tired. It means that they don’t have enough oxygen-carrying red blood cells (RBCs) to help those overstretched and abused muscles heal. If my right ankle is sprained, it may take twice as long or more for healing to occur. So, for a grade 2 sprain, healing could take four to nine weeks of hobbling around, due to the need for oxygen at the injury site.

All of the first aid manuals I’ve seen call for the RICE method: Rest the injured area, Compression of the area to help reduce swelling, and Elevation to prevent the gathering of excess fluid. But if someone even mentions Ice, I start screaming.

For someone with CAD, ice applied to a twisted ankle, a torn meniscus, or a sprained wrist will more than likely start hemolysis, the destruction of RBCs. These concerns ricocheted through my brain while I sat there hollering out in pain.

No one came to help. My husband was off at the store. My nephew, who lives at our house, was out of town, and my neighbors didn’t hear my cries of anguish. After about five minutes, I groaned, twisted around, and limped into the house. Slowly and carefully, I lay my wounds to rest.

All of this happened last Wednesday. I rested all day and worried all night. Thursday was awful. By now I felt sympathetic pains in the opposite joints. The lumbar region of my back joined the agonized chorus.

Surely, Friday would be better. Surely, it was not. I couldn’t walk without yelling again. Not even my prescribed muscle relaxers helped. I just had to wait it out.

If my gardening was the only plan affected, I wouldn’t be complaining so much. But Saturday, my husband and I began a week of travel, first to a supporting church, then on to Kansas to be with our daughter. However, with me “stoved up” (a Southern phrase meaning “stiff, sore, aching, or physically worn out”) and twisted like a pretzel, such a journey would be more of a problem than a joy.

I remained in bed all Friday, making my husband miserable with my grumbling. I kept watching my joints carefully for redness, swelling, or heat, all signs of an internal infection.

Saturday, I cautiously moved about and packed my suitcase. I was still sore and tender, but better.

It is now Sunday, and the joints that caused the most clamor have almost all quieted down. I think it’s safe to say that a crisis has been averted. All in all, it was a painful reminder to temper my enthusiasm with more situational awareness, both in my body and my environment.

Note: Cold Agglutinin Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cold Agglutinin Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to cold agglutinin disease.