Lisa’s Turn: Henry’s Feet Appear Wrinkled. Will I Sleep Tonight?

While getting ready for bed a few hours ago, Henry walked into my home office in his bare feet.  Strange.  Usually he’s plodding around the house in his worn plaid slippers his deceased wife, Sylvia, gave him decades ago.  His two big toes have worn through the slippers, yet he refuses to part with them.

“Lisa, remember to bury them with me,” he’s told me many times.  “They’re a gift from Sylvia.  We had matching pairs.  I always want them to be with me.”

Henry’s devotion to Sylvia, despite her passing from Alzheimer’s almost two years ago, has not wavered.  He proposed to her within the first 48 hours of meeting her over 70 years ago.  He delights in telling the story, and I love hearing every version.  It’s an impressive thing to witness.  My heart tugs but I manage a small smile.

I’ve asked Henry what couples did in the 1940s and 1950s when they were having problems in their marriages.  When I’ve asked about marriage counseling, his eyes widen in disbelief.

“Marriage counseling?” he retorts.  “Are you kidding?  Couples just learned to work things out.”

I suspect Henry and Sylvia were one of those lucky couples able to work things out between themselves.  I also suspect they were in a small minority.  Much like today.  Marriage is work.  If you’re lucky, you’re matched with a partner who believes it’s more important to work things out rather than always being right.

Back to Henry’s feet.  Both of them appeared a little swollen.  What really caught my eye were his ankles.  Where Henry’s athletic socks had covered his ankles, each had left circular, ribbed imprints in his skin.  It looked odd.  I had never noticed anything like that with Henry before.  It appeared to me his ankles were retaining water, or a combination of blood and water.

“Lisa, why are my feet wrinkled?” he asked me, truly puzzled.  For a minute I felt he was a child, dependent upon me for his care and security, asking the same question of me after soaking in a long bath.

I asked Henry to sit in his recliner, where I’d be able to take advantage of good lighting.  He could prop his feet up so I could take a closer look.  His feet and ankles looked as though they’d gained considerable thickness, yet his weight was within his normal range.  I checked his blood pressure.  Normal.  Then onto the oximeter for a reading of his oxygen saturation level and pulse.  Both were good.  Yet when Henry tried to slip on a pair of loafers, his feet wouldn’t fit.  Something had changed.  Something was off.

Despite his reassuring readings, Henry’s feet and ankles appeared to be holding onto excess blood and/or water.  He had no pain.  But because I have seen the beginnings of heart failure many times with other clients, I felt uneasy. How many times have I seen an older person’s feet and ankles begin to swell?  It becomes time to make compression socks part of one’s new wardrobe.  Then add a diuretic to help the body release more water through urination.  But in losing that water, add a potassium pill or two to make up for the loss of salt.  Hope the diuretic doesn’t strain the kidneys too much and dehydration doesn’t follow.  The potential in the elderly for a negative domino effect to take hold with just one small change in the body is something no one should ignore.

I know I won’t sleep well tonight.  First thing in the morning I’ll place a call to Henry’s internist.  She will have to confirm my suspicions by examining Henry and make a determination as to a proper diagnosis and treatment plan for him.  Until then, I don’t want Henry to worry.  When you’ve reached 101, I believe you’ve worried enough for one lifetime.

“Looks like a little water in your ankles, Henry,” I tell him as casually as I can manage.  “It’s common with age.  We’ll let your doctor know about it and she what she says.”

Henry seems content with my response, and resumes getting ready for bed.  It’s after midnight now.  I can hear Henry’s light snoring down the hall.  I’m blogging because I can’t sleep.  If Henry has edema (water retention) in his feet and ankles, it’s not critical in itself.  But it does point to his body finally beginning to become affected by the common conditions of aging.

At 101 years of age, it’s finally happened.