Tag Archives: Edema

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #61: EDEMA (SWELLING)

Swelling of the ankles becomes increasingly common as you get older. This swelling can be caused by thrombophlebitis, or skin infections which have been discussed in previous articles. Otherwise it is usually part of a condition called edema.

Edema is commonly caused by problems in the cardiovascular system, kidneys, or liver. Edema can occur in the face and abdominal cavity or elsewhere, But because of gravity and the fact that we are  usually upright-on our feet, it is usually is most prominent in the legs, especially the ankles. Edema can be caused by a normal pregnancy. The developing baby puts quite a strain on the heart and circulatory system.

Chronic accumulation of fluid in the tissues usually occurs because of heart and blood vessel problems, liver disease (albumin lack), diet (excess salt intake), kidney disease (deficient salt excretion), vein problems (valve malfunction), and lymphatic problems (surgical lymph node excision).

Obesity contributes by impacting the heart and liver primarily. Proper sleep, diet and exercise help in most of these areas, and edema is rare in healthy people.

I have always considered sugar(obesity, cardiovascular effects) and salt(hypertension, cardiovascular and  kidney load) as poisonous. I discovered the valve incompetence in the veins of my left leg because it became more blue than my right leg. With good exercise, sleep, diet program and compression stockings, edema never occurred.

The swelling and stretched shiny skin in the ankles that I see in many of my overweight friends makes a tempting target for germs of all kinds. and small skin sores often follow.

If you developed swelling in your ankles or other areas, it’s best to check with your doctor to get an explanation.

—Dr. C.

HEALTH: “COMPRESSION THERAPY” REDUCES CHRONIC CELLULITIS & LEG EDEMA

New England Journal of Medicine (Aug 13, 2020) – In this small, single-center, nonblinded trial involving patients with chronic edema of the leg and cellulitis, compression therapy resulted in a lower incidence of recurrence of cellulitis than conservative treatment.

The researchers have conducted a single-center, randomized, nonblinded trial that aimed to find out an association between the compression therapy and controlled incidents of chronic edema of the leg and people with cellulitis that can be defined as an infection of the skin that involves subcutaneous tissues or the innermost layer of the skin. Cellulitis can be caused by trauma or scratching of other lesions due to animal or human bites that result in fever, extreme pain, and redness of the skin.

Read more

Read NEJM Study

COMMENTARY

I have been using compression stockings for decades, since the discovery of the difference in color of my feet. An evaluation by a vascular surgeon revealed incompetence in the valve of my left popliteal vein. It wasn’t long before I developed small varicose veins.

Comfortable with PREVENTATIVE MEDICINE after a career in ALLERGY, I started wearing Jobst compression stockings, with 30-40 mm of constrictive force. After a decade or so of daily wearing, my big toes started to overlap my second toes, and I began using toe-spreaders; scissor-toe and hammer-toe were my worry, and I wanted to prevent this discomfort.

After a while, I began to notice that the Jobst stockings tended to bunch my toes together. Also, with the developing arthritis in my fingers, it was increasingly hard to get the 30-40mm stockings on without straining my arthritic hands. I now wear OPEN-TOE 15-20mm compression Medi stockings, which are easier to get on, and don’t bunch up my toes.

I still use the visco-elastic toe spreaders. Now, back to the compression stockings for treatment of cellulitis complicating ankle swelling. Of course it works. Beta Hemolytic Streptococci and Staph aureus like nothing better to feed on than a warm pool of interstitial fluid, which is the juice that comprises the ankle swelling.

And BLOOD CLOTS tend to form in the stagnant pools of blood which aggregates in varicose veins, particularly when you are sitting for a long time, such as during a long airline trip. By all means, use compression stockings if you have ankle edema, or even a condition predisposing to ankle edema like varicose veins. Don’t wait for the complication to develop. Be PROACTIVE, and STAY HEALTHY.

–DR. C