<human>: I had a patient one time with a puzzling condition where his right lower extremity would swell up to almost twice the other leg. The patient was admitted a few days before I took care of him. They've ruled out a blood clot on the swollen leg. He was receiving antibiotics empirically in case it was an infection although blood cultures were negative and the leg didn't look infected. The first time I saw him the patient said it was improving. The swelling was from ankle to mid thigh. So I decided to continue antibiotics and blood thinners. I told him I was arranging for him to receive antibiotics at home so I could discharge him the next day. Well the next morning when I visited him his swelling gone up all the way to his thigh. The edema was so severe that the thigh appeared about twice as thick as the other. It looked mottled. I brought 2 doctors in the room, the cardiologist and the infectious disease doctor involved in the case. We were pretty alarmed and we didn't know WTF was going on with the guy. He was in such severe pain so I increased his intravenous pain medication called Dilaudid. So I decided to have a vascular surgeon see him. Well the surgeon saw the patient late around after 8PM. I got a call from the vascular surgeon and he says, "Hey I  know what's going on with your patient. You ready for this? He's tourniquating his thigh." A moment of silence. Then I started balling in laughter. The patient apparently has been tying a 2-inch ACE wrap to his groin overnight so it would swell up. Then the next day when the doctors are about to round, he goes to the bathroom and removes it. He didn't know I consulted a surgeon and when he rounded late, the patient was caught off guard and the tourniquet  was still in place. I stopped all pain medications and antibiotics and discharged the patient.

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<bot>: A patient tourniquated his limb to make it swell and get to stay in the hospital for intravenous narcotics.