Swollen Ankles (Part 2)
Posted by Eamonn Brady on
This is the concluding part of last week’s article in the Westmeath Topic on swollen ankles and fluid retention.
Lymphoedema
Lymphoedema is another cause of fluid build-up in the body's tissues. It occurs when the lymphatic system is damaged or disrupted. The lymphatic system is a series of glands (lymph nodes) around the body connected by a network of vessels similar to blood vessels. Lymphoedema usually affects the arms or legs, although in some cases there may be swelling in the chest, head and genitals. Lymphoedema is mainly caused as a side effect of cancer treatment, especially breast cancer treatment. Approximately one in five women suffer from lymphoedema in their arm after radiotherapy or lymph nodes are removed due to breast cancer treatment. Once lymphoedema occurs, it is permanent; however it is manageable with proper care. 30 to 50% of people with lymphoedema suffer from pain in the affected area. Maintaining a healthy weight and lifestyle including regular exercise is the best way of controlling lymphoedema and preventing complications like infections. Physiotherapy and the wearing of especially measured compression garments is also part of treatment. Lymphoedema weakens the immune system of the affected limbs making infection like cellulitis in that area more likely. Skin must be kept clean and moist. It is recommended that a low pH skin lotion that contains no perfumes or other irritants be applied to the skin and nails in the affected area daily to prevent bacteria, viruses and other infections.
Blood clots
Blood clots that form in the veins of the legs can block the flow of blood from the legs back up to the heart; this can cause swelling in the ankles and feet. Blood clots can be superficial, occurring in the veins just beneath the skin. However a more serious condition is a deep clot, known as deep vein thrombosis (DVT). Deep clots can block one or more of the major veins of the legs. DVTs can be life-threatening as they can break loose and travel to the heart and lungs causing a potentially fatal clot in these important organs. DVT’s most commonly occur below the knee, especially in the calf. It is most commonly caused by immobility, which explains why it is a risk during long haul flights and after surgery. Other risk factors for DVT include obesity, pregnancy, dehydration, the contraceptive pill, cancer and heart failure. If you have swelling in one leg, along with pain, a hot feeling in the affected area, an overall mild fever and possibly a change in color of the affected leg, you must get immediate treatment. Treatment with blood thinners may be necessary. Compression stockings can prevent them if you are at risk, your pharmacist can measure you for them.
Self-help
Some lifestyle changes can be made to prevent fluid retention, especially in the ankles and feet. Self-help tips include losing weight (if overweight); raising your legs three-to-four times a day to improve your circulation; avoiding standing for long periods of time; keeping active by walking or other physical activity as immobility can make swollen legs worse; elevating the affected leg three to four days a week while in bed (eg) a pillow under the leg to raise it while in bed; wearing comfortable well-fitting footwear; use moisturising emollients such as aqueous cream or emulsifying ointment regularly, the motion of rubbing in the emollient boosts circulation; wearing compression bandage if advised. Your pharmacist can measure for and advise on compression stockings. Compression stockings for the prevention of swollen legs are usually below knee in length rather than thigh length. A compression stocking should be changed after 6 months as elastic wears after this time. More information on DVT is available at www.whelehans.ie or in store; ask our staff for a free copy.
Diuretics
Diuretics may be prescribed to help reduce fluid build-up. Examples include furosemide (Lasix®) or bumetanide (Burinex®).They work by increasing the amount of urine produced by the kidneys thus reducing excess fluid. Not everyone can use diuretics and in some cases they can make things worse. They can also cause dehydration if you do not take care while taking them. They are mainly used to treat people who develop oedema as a result of heart failure.
Why do ankles tend to swell in hot weather?
Ankles puff up in higher temperatures, when there is more blood is drawn to the skin by heat to help regulate your body temperature. In winter, people who sit and heat their legs in front of the fire also tend to get swollen legs, ankles and feet.
What is BPro Cardio Screen Service?
Whelehans has a cardiovascular health check called BPro Cardio Screen. It measures the stiffness of your arteries to help identify risk of blockages and your risk of cardiovascular disease and circulation problems. It 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 to get checked. The next clinic is Thursday April 26nd from 9am to 6pm at Whelehans Pearse St. Book by calling Whelehans at 04493 34591 or message us on facebook.
BPro Cardio Screen is not meant as a substitute for proper medical assessment with your doctor and should not replace prescription medication
Written and researched by Eamonn Brady (MPSI), Whelehans Pharmacy, 38 Pearse Street, Mullingar. Enquiries 04493 34591; www.whelehans.ie