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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I have had swelling of my right foot, but the ER drs do not

Customer Question

I have had swelling of my right foot, but the ER dr's do not have any idea as to what it could be. I have had a X-ray - no stress fractures, an ultrasound - no blood clots, blood work - no Diabetes. I am only 31 years old, there is no circulation issues. The swelling is fluid, since it leaves pit marks when pressed against it. There is pain on the top of my foot, not by the ankle. I have had no injury to my foot. The swelling goes down slightly when I elevate my foot. This swelling has been like this for over 8 weeks. The ER dr had recommended a half boot, but that just made the swelling worse. I am out of options, I do not know where to go from here. My foot swells so severly that even my crocs won't fit. Any ideas please!
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

neuromd2012 :

Hello

neuromd2012 :

welcome to Just Answer

Customer:

hello

neuromd2012 :

Hi

neuromd2012 :

so this is only one foot correct?

neuromd2012 :

nothing on the left?

Customer:

i do not know why this came to the neurology section, as I had posted a question after reading something similar

Customer:

correct, only on the right foot

neuromd2012 :

there is no podiatry section

Customer:

o ok

neuromd2012 :

I am an internist, and a neurologist

Customer:

o good

neuromd2012 :

so there are things like RSD

neuromd2012 :

reflex sympathetic dystrophy, which is now called CRPS

neuromd2012 :

complex regional pain syndrome

neuromd2012 :

and you can get lymphedema

Customer:

what causes that?

neuromd2012 :

from that problem

neuromd2012 :

lymphedema is really weird

neuromd2012 :

it can come on if there is an increase in your vascular osmolality

neuromd2012 :

or the ionic change in your serum

neuromd2012 :

very strange problem

neuromd2012 :

there are lymphatic channels

neuromd2012 :

and it is run by the autonomic nervous system

neuromd2012 :

there are special clinics for lymphedema

neuromd2012 :

and you wear special hose at night

neuromd2012 :

called Job's hose

Customer:

what should I ask my dr to test for?

neuromd2012 :

well this is tough. there is a test called a sympathetic block

Customer:

lymphedema? and will it ever go away on it's own?

neuromd2012 :

well for example

neuromd2012 :

women with breast cancer post mastectomy get

neuromd2012 :

lymphedema in their arm and

neuromd2012 :

it lasts for life

neuromd2012 :

hang on

neuromd2012 :

and I will get you a webpage on that

Customer:

ok

neuromd2012 :

http://emedicine.medscape.com/article/1087313-overview

neuromd2012 :

here is a webpage on lymphedema

Customer:

do headaches have anything to do with this as well?

neuromd2012 :

the truth is that often we do not know what causes lymphedema

neuromd2012 :

do you take meds for headaches?

Customer:

I think the headaches are just stress induced, but I've had a persistant headache for a few weeks

Customer:

Ibprufen 800mg, only because that is what I have that seems to work

neuromd2012 :

I see

neuromd2012 :

well you are sounding like under some stress with your lifestyle

neuromd2012 :

so I would expect tension type headache

neuromd2012 :

is it squeezing or pounding?

neuromd2012 :

unilateral or bilateral?

Customer:

just a ltlle, hehehe, three kids added to the mix doesn't always help

Customer:

pounding, usually at my temples

neuromd2012 :

hey, I am in the same boat

Customer:

what were we thinking, right?

neuromd2012 :

I have no idea on that one

neuromd2012 :

anyway,

neuromd2012 :

what about migraine?

neuromd2012 :

headaches with menses?

Customer:

I do not know what you would call a migraine, I just know it hurts, and I'm sensitive to light. Yes on the headache with menses

neuromd2012 :

so you probably have migraine as well

neuromd2012 :

light sensitivity,

neuromd2012 :

feel it coming on

neuromd2012 :

pounding

neuromd2012 :

nausea?

neuromd2012 :

and you best bet is a trial of a triptan medication

neuromd2012 :

like imitrex

neuromd2012 :

so you could ask your doctor about that

Customer:

I think if I were to give you all the symptoms to all of my issues you would run screaming... not to often on the nausea

neuromd2012 :

he has samples

neuromd2012 :

I see

Customer:

ok, I will discuss in 6 weeks with my next appointment

neuromd2012 :

well lymphedema is a strange problme

neuromd2012 :

problem

neuromd2012 :

it comes on for unknown reasons

Customer:

So I just ask my dr to test for it, and go from there?

neuromd2012 :

yes

Customer:

could it be something else if the test is negative?

neuromd2012 :

you need someone to do look at your and consider this diagnosis

neuromd2012 :

well , vascular problems are the most common, but you said you were checked

Customer:

yes

neuromd2012 :

you can consider reasons for bilateral foot swelling

Customer:

like?

neuromd2012 :

if you have kidney disease

neuromd2012 :

or cardiopulmonary disease

neuromd2012 :

or your serum osmolality is off

neuromd2012 :

from liver disease

Customer:

not as far as I know

neuromd2012 :

then you can bloat

neuromd2012 :

all of that is checked with routing blood work at your physical exam

neuromd2012 :

so it is unlikely

Customer:

I do not drink, I had my galbladder out last year, which they had a heck of a time finding, apparently my organs are not quite where they belong

Customer:

1.5 hr surgery turned into a 4.5 hr surgery

Customer:

Thank you I will ask my dr to test for lymphedema

neuromd2012 :

I see

Customer:

I appreciate the input, at least i will now have a starting point. Just one more question is Lymphedema very serious?

neuromd2012 :

well maybe that is a significant issue

neuromd2012 :

not lifethreatening

neuromd2012 :

but there is no great way to stop it

neuromd2012 :

other than compression hose

Customer:

ouch, that stinks, since I live in Florida and it is about to get very hot!

neuromd2012 :

but maybe your lymphatics are blocked somewhere

neuromd2012 :

due to the anatomical change?

neuromd2012 :

ask you doctor ok?

neuromd2012 :

look at that webpage

neuromd2012 :

and get back to me if I can help

Customer:

I;ll ask the dr, and yes I'll look at it right after this, thanks

Customer:

appreciate the intput

Customer:

Have a good night

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and 3 other Neurology Specialists are ready to help you

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