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DrRussMD, Doctor (MD)
Category: Health
Satisfied Customers: 64984
Experience:  Practice Director
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My feet. ankles (and sometimes my calves) become extremely

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My feet. ankles (and sometimes my calves) become extremely swollen at times - yet there's no predictable behavior/activity that causes this to happen. For example; sometimes the swelling follows prolonged standing or walking - but at other times, these activities cause little to no swelling. The same thing applies to prolonged sitting; sometimes my feet blow up like balloons - yet at other times, nothing. An increase in sdium intake can make it worse - but not always. I do think the problem may be more prevalent during summer months - but it occurs all year. Both the inner and outer ankle swells (the latter can swell to the size of half of a baseball) - and my calves can become rock-hard.
Last night - and again today, I felt a sharp pain in my head - along with a popping sensation in my ear - when I bent over at a certain angle. I'm just getting over the flu(?) - so I may still be a bit congested, which may be the culprit. I also noticed some strange 'dot-like' bruising on my upper arm - possibly along a vein. I guess it's possible I banged my arm - (I do bruise easily). However, this particular area of bruising looks a bit odd.
My info: I'm a female in my early fifties, post-menopausal. I have a history of migraines - and GI problems (nothing serious). I appear to have 'white coat' high blood pressure (it usually goes back to normal - or near normal - when taken a second time, although I still think it's a bit higher than it should be). I have no history of heart disease (ekg's normal, echo cardiogram about a year ago was 'better than normal' - according to my doctor). I don't experience swelling in other areas - although my eyes get very puffy (and have since I was in my twenties).
My internist (whom I've known and respected for years) doesn't seem particularly concerned about the swelling. Essentially, he's advised me that this is fairly common - and suggested that I reduce sodium intake and when necessary, use compression socks. Diuretics are certainly a short-term option, but I have some other conditions (like dry eyes) that make this a less than optimal choice.
No disrespect to my learned physician, but this doesn't seem 'normal' to me. Recently, I've taken upon myself to peruse other women's ankles - and I just don't see this level of swelling.
Is this normal? Assuming I don't have heart disease or high blood pressure, what can be causing this? Other than the measures I've already detailed, what can I do to reduce/eliminate swelling?
Submitted: 6 years ago.
Category: Health
Expert:  DrRussMD replied 6 years ago.
have you had a doppler ultrasound study of the legs
Customer: replied 6 years ago.

Yes; it was normal.

Expert:  DrRussMD replied 6 years ago.
does the swelling dent if you press a finger into it?
Customer: replied 6 years ago.
When it's very swollen - yes, there's pitting edema.
Expert:  DrRussMD replied 6 years ago.
Bad veins...even though not severe on ultrasound

Heart problems, especially right side.
Kidney problems

Heart and kidney should be ruled out easily enough by the doc

The vein problem is treatable with weight loss
compression stockings

As far as natural treatments
grape seed extract was shown in small studies to improve this.

good luck

Let me know if you have further questions

Customer: replied 6 years ago.

Well - there's no indication of kidney problems (other than a history of stones). I assume we've done all of the relevant tests.....

I suppose I may have a heart issue of some kind that's escaped detection. If I have "bad veins," they can't be too bad - since all tests have been normal. Given the extent of the swelling, I'm assuming if veins were the cause, it would have been apparent by now (BTW: I'm not overweight ).

What significance (if any) is pitting vs. non-pitting? Is the fact that I wake up and the swelling is gone 'diagnostic?' I wonder why my own doctor isn't that concerned about this.......

Expert:  DrRussMD replied 6 years ago.
everything is consistent with venous stasis, and the swelling going over night is almost diagnostic.
non-pitting would be lymph problems or angioedema from allergy or immune dysfunction.
dopplers won't show mild vein problems but a venogram would
good luck again

Customer: replied 6 years ago.

There's good news! I'm very allergic to iodine -based contast dye.

If it is venous stasis, why do I experienced prolonged periods without swelling? Why wouldn't the same behavior (like walking, prolonged standing/sitting) always produce swelling if there's a blood flow issue?

If it turns out that I do have this condition, other than surgery (or a lifetime wearing compression stockings, what's the treatment?

I forgot to mention that I'm always thirsty and am constantly drinking (no alcohol). I've been this way since I was a child (no, I'm not diabetic). Can excessive fluid intake cause - or exacerbate - this condition?

Expert:  DrRussMD replied 6 years ago.
It varies because it is mild.
Veins are influenced by muscular action as well.
In rare cases surgery can be done.

To see if this is the case, I suggest a vascular surgery consultation.

Customer: replied 6 years ago.

Can building up the muscles in my legs help? I used to dance - was more active in the past.

If surgery isn't indicated, what else can be done? Just the hose??

Expert:  DrRussMD replied 6 years ago.
Just the hose.
Exercise helps.

Customer: replied 6 years ago.

Does excessive fluid intake have any effect on this condition?

Expert:  DrRussMD replied 6 years ago.
not unless you have renal impairment
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