From the "mistakes were made" file:
Post-op patient comes with multiple bypass procedures on one leg. The surgical leg had no pulses before surgery, even by doppler. The non-surgical leg had pulses that could be detected by doppler. Coming to me after surgery, the pedal and post-tibial pulses on the surgical leg are easily dopplered, though. The surgeon came with the patient and dopplered a popliteal pulse, pointed it out, and said that was the one he was concerned with.
Later in the evening, the patient's non-surgical leg pedal pulse disappears. The foot is warm, and the post-tibial is present. Probably not a good time to call. Then the non-surgical pedal pulse returns and the surgical pedal pulse disappears... erh?!
After some mucking around, it appears that turning the patient side-to-side causes the pedal pulse on one side to disappear and on the other side to re-appear. What gives? I don't know. Nobody else knows.
Judging either foot, the situation does not warrant a call to MD. However, the patient also has a swelling that appears to be a supremely enlarged mons pubis. It feels hard underneath. I'm thinking, hematoma?
Looking at the whole context, does the positional nature of the pedal pulses tell us anything about a possible hematoma in the pelvis?
Apparently, the answer is no. If you want to feel like an idiot, explain this theory to the surgeon at about, say... 4:00 AM.
