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Hi, 76, Diabetes , High Bp , Plaque In Arteries.

Posted on Fri, 18 Sep 2020

Question: Hi, 76, diabetes , high bp, plaque in arteries. All Under medical control, last treadmill was excellent. Have swelling in feet , Small. Problem in right foot until recently. Had ultrasound 2 years ago . no clots. Recently more of a problem. In both feet. I am supposed to get another ultrasound but very concerned about c19 exposure. My question is what types of medical problems could cause current issue, feet are basically ok when i What up but by end of day they ate swollen . What medical issues Could be causing this. Putting Perscription strength steroids Helps.... I do not know what type of dr I should sees. I usually stand to work an d walk for exercise i s this bad. Should keep my legs elevated during day? I try to keep my legs eleated at ighlegs

Answered by Dr. Panagiotis Zografakis (2 hours later)

Brief Answer:
could be related to diabetes

Detailed Answer:
Hello,

there are certain disorders that may cause leg swelling. Please keep in mind that the following list is not exhaustive:
- diabetic nephropathy: patients with diabetes mellitus who develop leg bilateral leg swelling should be checked for proteinuria. A simple urinalysis should suffice in most cases. If the urinalysis reveals proteinuria then a quantitative test will have to be ordered (24h urine albumin).
- thyroid disorders: checking the TSH is usually enough to detect such disorders, particularly those that are severe enough to cause swelling.
- side effects: certain antihypertensive drugs (like amlodipine) may cause leg swelling. Your doctor should review your treatment plan and make the necessary amendments.
- vein insufficiency: an ultrasound scan of the leg veins will diagnose failing vein valves.
- heart failure: an ultrasound of the heart (echo) is important to diagnose heart-related problems of this nature. Exertional dyspnea may accompany this disorder.

Until the cause is determined you can try to keep the legs elevated whenever swelling develops. Try to avoid too much salt in your food. Standing may worsen the symptoms. Sitting for too long may promote swelling. If you have to sit for long you can try to get up and walk for a couple of minutes every so often (at least once every hour).

Please contact me again, if you have more questions about this situation.

Kind regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (52 minutes later)

I usually take a 30 min walk in the evening. Should i shorten the walk. My dr gave me a container for a 24 hr urine test. I really appreciate the support i get . Its much mire extensive. Than my internist-marty

Answered by Dr. Panagiotis Zografakis (2 hours later)

Brief Answer:
walking usually helps

Detailed Answer:
Walking usually helps as the contracting muscles promote blood flow. The 24h urine test has been ordered to detect abnormal levels of protein in the urine.

I'm glad you're finding this service useful. Please let me know if you need further assistance.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (9 minutes later)

Dr.thank you very much. If the walking helps does this provide any information about the cause. It seems the swelling mainly affects the right foot. I have an ultrasound of my legs scheduled in about a week. Thinks, XXXXXXX

Answered by Dr. Panagiotis Zografakis (4 hours later)

Brief Answer:
no

Detailed Answer:
You're welcome!

No, it does not provide any clue about the cause. If you had unilateral swelling the ultrasound scan would have been more urgent (suspicion of thrombosis). Since it's bilateral the cause is probably related to other causes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (20 hours later)

I took a long walk and my foot was much better. Thank you very much. I do not know why I was not told to do this by my DrOctetS. XXXXXXX

Answered by Dr. Panagiotis Zografakis (41 minutes later)

Brief Answer:
great!

Detailed Answer:
I'm glad it helped. Walking surely helps. You shouldn't do more than your body and feet can take to avoid injuries. Short walks seem to me like a better idea.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (2 minutes later)

Thanks, i will follow your advice. I wish you practiced in S. California

Answered by Dr. Panagiotis Zografakis (7 minutes later)

Brief Answer:
you're welcome

Detailed Answer:
You're welcome,

Take care!

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar