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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4058
Experience:  BSN, MSN, CNS
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Every morning when I get up my legs from mid shin down to

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every morning when I get up my legs from mid shin down to soles of feet are bright red but the under sole of my feet are almost purple. I am quite inactive due to sciatica on one side. Also feet quite swollen and hurt all day. Do use circulation machine but does not seem to help.
You definitely need to see a vascular doctor. If your feet are blue it is very dangerous, that would not cause sciatica. Better safe than sorry.

Thank you for requesting me. I am sorry that I was not available when you were on the computer.

What you are describing sounds very much to be venous insufficiency.

The valves in the deep leg veins keep the blood flowing back to your heart. When the valves are damaged this can cause the veins to stay filled with blood, especially when you are standing. The bright red color is due to the oxygenated blood being unable to travel away from the lower extremities due to the venous insufficiency.

The standard treatment for this condition can include

Compression stockings (such as TED hose

Avoid long periods of sitting or standing or little movement. (Moving the legs frequently should help the blood in your veins return to your heart.

For severe cases surgery (vein stripping) and other treatments are recommended.

You can read more details about the condition and treatments by double clicking HERE

Because sometimes these symptoms could be caused when veins develop clots, it is important that you see your doctor. If you do not have compression stockings, your doctor can help measure your legs and assist you with getting a pair. You may require the help of a home health nurse to put the TED or compression stockings on in the beginning. Sometimes medications may help if your venous insufficiency is due to chronic high blood pressure. Of course if clots have developed, you will need anticoagulant medication.

Have you seen your doctor recently about this problem?

Customer: replied 4 years ago.

I do have compression stockings and TEDs but find them too difficult to get on and off. I am told I have the biggest size compressions but as I am not abnormally fat I cannot understand how people I see in hospital OPDs manage to get them on when, being realistic and not nasty, they are probably a few stone heavier than myself. If I manage to pull the TEDs on I find it hard to pull them off and know I should not sleep in them. I do admit to being very inactive but the feet really hurt if I stand or walk too much. Maybe I just need to persevere. I have been assessed in the vascular clinic at Charing Cross where I worked until last year. They did not think I had a major problem. I realise the left sided sciatica has nothing to do with the discoloration and swelling, it is the reason I am not very active as it causes me to lose balance which caused me to fall and break my shoulder on the right and I am now terrified to go out without an escort. Guess I am just a mess and must persist with the TEDs at least. I live on my own so dont have anyone to help me put them on and off.

I'm sorry to hear of your situation, and although I am not as familiar with the health care system in the UK, I would expect that you should be able to request a home visiting nurse and physical therapist to provide lessons and short term assistance in putting the hosiery on and to help you find a way to be more active in a safe manner. In the U.S. those on medicare/medicaid can at least get an initial home evaluation by a physical therapist and nurse to assess your abilities and living situation for safety. Then recommendations for modifications if needed, to your home can be made so that you feel safe to ambulate (even if it is initially assistance of an individual therapist until you get a bit stronger and more confident). There are tools that can be provided to help you put on the hose, etc. Because you are at risk for falling, this is usually something that the government or health system will pay for, as it is preventative and can keep you independent, instead of needing to be in a hospital or care facility. Especially since you have suffered a fall before, this should justify the cost of getting you a walker and short term assistance at least. You are worth asking your doctor to see if you could have a home evaluation. Let them know of your fear of falling and difficulty applying the hose, so that they can order a home evaluation and possible short term physical therapy training and assistance.

Here is a series of diagrams showing the correct way to put on the hose, perhaps this might help in the short term: Double Click HERE

I understand that the pain from the sciatic and your feet can discourage you from walking. But walking and exercise is so very important to our basic physical functioning (it keeps the heart strong; helps to pump fluid from the extremities back to the heart, etc.) that it is very important that you do persevere in practicing some sort of movement. Perhaps consult with your doctor on a pain medication, or even consider taking an over the counter pain medication about an hour before exercising, as this may be all you need to make it easier. Even if you can only do some flexion or mild 'bicycling' exercises with your legs while laying in bed a few times a day, over time this will help some with the swelling, but more importantly, will help to keep the muscles from wasting, not only your legs muscles, but your heart muscles. Don't pressure yourself to do too much in the beginning, but do a little each day, and you will start to get stronger and be able to do more, and eventually you will see more and more results from your effort.

If there were a way for you to do swimming, this would be an ideal form of exercise for you. If there were a way for you to participate with others in a similar situation as you, in an exercise program, this too could be very motivating and encouraging for you.

Sometimes too, when people have these sorts of pain issues and history of falling that results in them being fearful of trying new things, a medication such as an SSRI can help to get you motivated to start moving again. Not only can it help you to over come your fears, but it has been discovered that these medications, which were developed originally for depression and anxiety, also help with nerve and peripheral pain (which of course sciatica is a nerve which is irritated, and your feet pain may be nerve related peripheral pain. You may want to ask your doctor about this as well.

Let me know if you have any questions about any of these suggestions. I hope that this discussion will help you to ask for more help from your health care providers. You might not be aware of some of the programs that are available to help you. Often one has to be assertive and even a bit demanding to get the help that is their right.
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4058
Experience: BSN, MSN, CNS
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