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Where can I go for help for swelling of the feet, ankles and legs?


Sent to Health Experts October 05, 2006 12:26 p.m.

I am a 62 year old female with chronic swelling of the feet, ankles and legs. This problem started when I was 45. At the time I was very active and living in southern California. I moved to northern Nevada at the age of 49. When I was 26 I had an ovarian cyst that ruptured and I hemorrhage. A year later the same thing happened on the opposite side. At 30 they removed an ulcerated uterus. Also at age of 45 I was diagnosised with under active thyroid. I wake up in the morning with relative small feet but by midafternoon my feet and ankles are starting to ballon up. I am under a physican care for pain management. Twice a year I recieve an epidural. What a tremendous difference the epidural makes. I have no swelling in the legs or ankles for a good month. Once the epidural starts to wear off the swelling kreeps back in. What is the corrulation between the swelling and the epidural?
Side note: My physican for pain management harps on exercise, exercise and exercise. Through out the last 10 years I have tried to keep walking but it does help tshe swelling. How can I exercise when my ankles and legs are swollen and I am in too much pain??? Desperately seeking some new advice and direct.
Nancy

Optional Information:
Female , Age: 62

Already Tried:
Pain management physician, diet and walking.
Customer (name blocked for privacy)
Status: Closed   Value: $8   
Answer
October 05, 2006 1:03 p.m. (36 minutes and 20 seconds later)
REPLIED Check Mark

If you have swelling of legs and feet then you need to have a check by a cardiovascular doctor.

There are a variety of reasons for swollen ankles and feet including high blood pressure, cardiovascular problems, circulation problem, kidney problem and something putting pressure on a major vein (the Inferior vena cava)

Transient swelling could be related to prolonged immobility causing calf muscles failing to pump fluid back into the circulation. Other causes include varicose veins, side-effects of some drugs and being overweight.

A mild diuretic would be the first action, together with compression hosiery.

Keep your legs elevated at a high angle when you can to encourage drainage and if you have a sedentary job ensure that you get up and move around every hour.

Avoid caffeine drinks, but do continue to drink water. Reduce your salt intake too.

I've tried to look at the effect on epidural and water retention. Steroid epidural injections have some sort of relationship with water retention, but tend to cause water retention, not relieve it. I cannot say more without knowing what was in the epidural. A simple explanation may be that with the decrease in pain, you are able to move about more therefore reducing statis in the lower limbs.

Does this answer your question?



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PicturePauline  -- Pharmacist -- 99% Positive Feedback on 2919 Health Accepts
MRPharmS. Worked as Community pharmacist for 14 years. Undertaking a second degree in medicine.
4/30/2008 to 5/7/2008
Reply to Pauline
Sent October 05, 2006 1:55 p.m. (52 minutes and 20 seconds later)

I don't know what other medicine might be in the epidural, but my doctor gave me the same answer that you just did.
I can have compression garments on and the swelling still happens. I went to Reno Vein Clinic Reno, NV. and had ultra sound on the veins and they show no blockage. I also had an ultra sound done of the major veins that ordinarily show signs of hardness of the arteries and the results showed that I had less narrowing of the arteries than a normal person of my age.
One of the things that is so perplexing is that the swelling can and does last for ten days and up. Moving about does not reduce the swelling in any way. Walking and standing to much are one of the contribution factors to the swelling. As well as sitting to long such as in air flight. After arriving at my distintation the swelling does not abate by resting and putting my feet above heart level.
I do not drink caffine beverages. My family physician tried a diuretic and all I did was go to the bathroom more. I drink approximately 96 ounces of water daily.
I did have an electrocradio and the tech said that I had a mild back flow but nothing to be concerned about, normal for my age.

IS THERE ANY DOCTOR OR FACILITY IN THE UNITED STATES THAT I COULD GO TO TO SEEK HELP?
Customer (name blocked for privacy)
Answer
October 05, 2006 3:12 p.m. (1 hour and 16 minutes later)
ACCEPTED Check Mark

Its good to know you have had a lot of cardiovascular check ups. The gravitational oedema would be helped if the right combination of diuretics were found. I know the initial side effect of passing a lot of water was a nuscience however it showed that there was water imbalance to be sorted out. It can take a while on diuretics so I would go back and try again with them.

In terms of who else to see, I cannot recommend a specific doctor however some other tests which may be useful would be albumin levels, liver function tests and kidney function tests.

Something really simple is to ensure you wear wide, flat shoes. Footwear can make a difference especially in people who are on their feet all day. I see it a lot with shopworkers.

Regards



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If this answered your question please click ACCEPT, use reply if there is something else you need to know regarding your question.Positive feedback or bonus is very much appreciated.
PicturePauline  -- Pharmacist -- 99% Positive Feedback on 2919 Health Accepts
MRPharmS. Worked as Community pharmacist for 14 years. Undertaking a second degree in medicine.
4/30/2008 to 5/7/2008

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