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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 33081
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I have had undiagnosed edema chronic ,,in legs and feet for

Customer Question

I have had undiagnosed edema chronic ,,in legs and feet for 6 yrs it never goes down except when I get a lumbar block and it will reduce some what is this connection
JA: What seems to make the symptoms worse or better? Have you noticed any swelling?
Customer: In my question already
JA: Anything else in your medical history you think the doctor should know?
Customer: I still have Nichols and possible mesh left inside me from a bladder tac but most was removed,herniated and bulging disc,as well as Ddd and neck fusion ,fibro and kidneys functional 45%
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 4 months ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Expert:  Dr. Arun Phophalia replied 4 months ago.

What is your age?

Were your all investigations pertaining to kidney, liver, heart, arteries, lymphatic and veins normal?

Expert:  Dr. Arun Phophalia replied 4 months ago.

It seems that you are offline so I am writing you the initial answer. You may ask follow up questions, if you have any.

The lumbar block, acts as a sympathetic block. This is known to act as following;

1) Facilitate the venous and lymphatic flow from the limbs to the main circulation.

2) Autonomic nervous system effect on the overall tissues of the lower limb including muscles, ligaments, tendons, skin, subcutaneous tissue etc to direct the intracellular fluids (water and salts in between the cells) to intravascular (in the blood vessels) fluid. That reduces the edema.

Please see the reference:

http://www.medcentral.org/Main/LumbarSympatheticBlock.aspx

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 4 months ago.
Everything has been checked on me ,and is normal ,,thus ,,undiagnosed edema ,,and the block is the only time it goes down any am on oasis ,,it does nothing
Expert:  Dr. Arun Phophalia replied 4 months ago.

Thanks Tammy.

I wrote down the possible physiological mechanism which decreases the edema by lumbar block. Hope you saw it.

Your edema or swelling is suggestive of idiopathic edema. Unfortunately, the cause is not clearly known. Idiopathic edema may be a multi-factorial disorder that has not been completely delineated. The postulated causes are;

1) secondary hyperaldosteronism,
2) primary abnormalities of the hypothalamus,
3) Abnormalities of thyroid,
4) dopaminergic release (related to autonomic nervous system)

The underlying cause seems to be due to fluid leaking out of the small blood vessels called capillaries into the tissues. Why this occurs in some people is not clear. One other possible explanation is the retention of salt. When the body retains salt it also holds on to fluid and thereby may cause some edema. Idiopathic edema is characterized by impaired water excretion also, particularly in the upright posture. Indirect evidence has shown that antidiuretic hormone is involved in this disease.

Your doctor should get plasma prolactin levels done (if not yet estimated), which may be increased and responsible for the edema. It has been seen in some studies that urinary excretion of kallikrein and kinin were reduced significantly after water loading in the upright position. Thus, prolactin and urinary kallikrein-kinin system might also contribute to water and sodium retention in idiopathic edema, directly or indirectly through this is due to the augmentation of the action of ADH and of aldosterone. It is suggested that the increased vascular permeability and endocrinological poly factors play a role, in a cooperative fashion, in the mechanism of this disease.

Thus you may discuss all these with your endocrinologist who may work up the various hormones we had discussed. Please read this authentic resource on idiopathic edema;

http://www.uptodate.com/contents/idiopathic-edema

It is privilege assisting you.

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Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 4 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

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Expert:  Dr. Arun Phophalia replied 4 months ago.

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