Swollen Ankles & Fluid Retention Part 2
The feet and ankles are the most common areas for swelling. This week, I discuss swelling that can be due to more serious medical conditions.
Oedema caused by Congestive Heart Failure
Congestive Heart Failure (CHF) is more common amongst the elderly affecting 6 to 10% of over 65’s. Average age of diagnosis is 76. It is the leading cause of hospital admissions in over 65’s, accounting for 20% of hospital admissions in this age group. Heart failure is often a cause of swollen ankles. This is because the heart is unable to pump blood as efficiently causing it to stagnate (due to gravity) in the lower extremities of our body. Ankle swelling is caused by heart failure that is occurring on the right side of the heart. Unlike the heart failure that occurs on the left side of the heart which causes fluid to drain into the lungs, congestive heart failure that occurs on the right side sends fluid to the legs, feet, and ankles.
Treatments include diuretics such as furosemide which reduces fluid volume and blood pressure medication such as ACE inhibitors (e.g., Ramipril, Lisinopril) which dilate blood vessels allowing blood to flow easier, beta blockers (e.g., Bisoprolol, Nebivolol) which regulate heart rate and digoxin which increases the strength of heart muscle contractions and can also slow down heart rate.
Other symptoms of heart failure include Fatigue; Shortness of breath, especially with activity or when lying flat; Weight gain over a short period of time i.e., days; Loss of appetite and abdominal swelling; Dizziness or near fainting episodes; Irritable cough, sometimes producing frothy sputum; Sudden severe breathlessness waking you from sleep and Confusion or difficulties in concentrating. If experiencing any of these symptoms you must seek medical advice.
Oedema caused by kidney or liver problems
Kidney disease can also cause foot and ankle swelling. When kidneys are not functioning properly, fluid can build up as our kidneys are the body’s fluid extraction system. Liver disease can affect the liver's production of a protein called albumin. Albumin keeps the blood from leaking out of the blood vessels into the surrounding tissues. Inadequate albumin production can lead to fluid leakage. With liver disease, gravity causes fluid to accumulate more in the feet and ankles, but fluid can also accumulate in the abdomen and chest.
Oedema due to infection
Swelling in the feet and ankles can be a sign of infection. People with diabetic neuropathy or other nerve problems of the feet are at greater risk for foot infections. Diabetics are more at risk of minor skin irritations, blisters or tears developing into serious infections quickly because diabetes causes nerve damage (diabetic neuropathy) that means you may not feel pain in that area and a problem can escalate before realising it. Diabetics tend to have poorer circulation which can make infection more likely. Diabetics must inspect feet daily for blisters and sores because nerve damage can blunt the pain sensation and foot problems can progress quickly without the person realising it.
If a diabetic notice a swollen foot or blister that appears to be infected, they must seek immediate medical attention and not be tempted to self-medicate as over the counter medicines can irritate skin of diabetics. Ask your pharmacist if not sure. Whelehan’s Pharmacy has a chiropodist in store on Tuesday’s and Thursday’s who can advise on diabetic foot care and offer treatments; Tel 04493 34591 to book.
What is BPro Cardio Screen Service?
BPro Cardio Screen measures stiffness of your arteries to identify risk of blockages and risk of cardiovascular disease and circulation problems. BPRo is placed like a watch on your wrist and is pain free. A pulse wave reads and calculates a wave signal that indicates the elasticity of large, small, and peripheral artery walls as well as tests for stress, central blood pressure, heart rate, and more. It is now €35 (was €50); it only takes about 15 minutes. The next clinic is Saturday March 27th (from 9am to 5pm) at Whelehans Pearse St. Book by calling Whelehans at 04493 34591.
To be continued… next week.
For comprehensive and free health advice and information call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).