Hello and thanks for your query.

I can understand how you must be concerned regarding your husband's current condition. Let me try to provide you with some good information and reassurance so we can try to get to the bottom of this.



We have to consider the most likely cause of your husbands Bruz to be some drama. While he does not remember any obvious trauma or fall this is certainly the most likely cause. Sometimes we do traumatize our arms or legs during the day without remembering it as the trauma may not be so painful.

One very important piece of information which you put in your query is that your husband does drink alcohol. If someone drinks quite a bit of alcohol. It can affect the coagulation system. This essentially affects the coagulation system. This makes the blood a bit thinner and more sensitive to trauma.

We have to consider the most likely cause of the area which you have seen on his leg is that he has developed a hematoma. As you know a hematoma is a collection of blood under the skin which is similar to a large bruise. It is concerning that he has had an expansion of the area.
I would like you to monitor the swelling and the bruising that you have perceived very closely over the next few days. The itching is very likely a side effect of having some blood under the skin. Again as I mentioned if he is drinking quite a bit this only makes it more likely that he will have more bleeding than usual.

Again I thank you very much for your question. If you have additional follow-up questions I am available to address them. I wish you and your husband good health in the future.

Sincerely,

Dr. Robert.

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Hi XXXXXXX and thanks for the followup.

I would expect it to have improved at least to some degree in a 2 month period. sometimes, however, particularly if one is prone to bleeding due to use of aspirin or perhaps to mild liver dysfunction in your husband's case - it may take quite a bit longer. One thought I did have is that there is a remote possibility this could be a lyme's type rash - unlikely but remotely possible. Have you or he had any exposure to the outdoors where you may have been exposed to tics?

As for the shaking - yes, zoloft could cause this if the serotonin level is too high. This coupled with the dextroamphetamine could be synergistic. If he has not had a good panel of screening bloodwork including a CBC, CMP and also an INR - a good assessment of the liver function as the coagulation factors are produced there - I would recommend you pursue that somehow. He could try a lower dose of the Zoloft - perhaps half of a tablet daily and see if the shaking improves.

I am still available for any followups if you have some.

Sincerely,

Dr. Galamaga

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