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Suffer for major swelling in legs and feet. Taking medication for blood pressure, diabetes and cholesterol. Concerned?

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Internal Medicine Specialist
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Hi, My mother is 88 years old and has major swellings in her legs and feet. She has had an EKG and blood tests to rule out heart problems and blockages in her veins, all negative. The swelling is so severe that it is impairing her ability to walk. She is taking medications for blood pressure, diabetes, cholesterol. blood thinners including Coumadin and Dilantin for seizures. She lives in a retirement home, is ambulatory and participates in programs there. Should we be concerned about this causing other health problems? Her doctors are at a loss as to the cause and only suggest that she wear support hose as often as possible. She does not wear the stockings every day and claims they provide very little relief. Any suggestions?
Posted Tue, 10 Sep 2013 in Medicines and Side Effects
 
 
Answered by Dr. Ram Choudhary 19 minutes later
Brief Answer:
provide brief details and reports

Detailed Answer:
Hi XXXXX,
Welcome to healthcare Magic!
Will you please furnish a bit more detail how long she is having all this particularly the leg swelling.
Also provide the details of current and recent medicines.
Load the reports with the follow up query if feasible. I think all this feedback will serve a purpose.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by
 
Follow-up: Suffer for major swelling in legs and feet. Taking medication for blood pressure, diabetes and cholesterol. Concerned? 3 hours later
Dr. Choudhary, Thank you for your quick response. Mom has had some swelling off and on for awhile. But during this past year the swelling has gotten much worse, to the point where her legs are as big as they were when she had the DVTs and it never goes down completely, not even in the morning or after wearing support hose all day. She is on the following meds, Warfarin Sodium 4, Furosemide 40 mg, Isosorbide MN ER, Levocetirizine 5, Levothyroxine 50, Metformin XXXXXXX 500, Klor-Con M10, Aricept 23 MG Tab, Phenytoin Sod Ext, Simvastatin 5 mg. I believe that the Levocetrizine is an allergy pill which she was taken off of three weeks ago, at my request because she has no symptoms. She also takes a multi vitamin for seniors daily. I hope this information is sufficient. Thank you again. XXXXX
 
 
Answered by Dr. Ram Choudhary 16 hours later
Brief Answer:
Try these measures to control swelling

Detailed Answer:
Hi XXXXX,
Welcome to healthcare Magic!
Such persistent leg swelling can be due to low albumin levels in serum, to build which to normal levels is recommended. increased protein intake is helpful for albumin levels.
You should get her leg vein and inferior vena cava doppler and imaging to rule out any physical obstruction as a cause.
Low cardiac output may be a cause and cardiac ECHO should be done to rule it out.
Sometimes a parasitic disease called filariasis can cause such swelling and it should be checked for in the 2AM BLOOD SAMPLE.
When she goes to bed she should keep legs on some soft quilt to get an elevation of whole lower limbs of about 30 cms above heart level.
I think the current medicines are worth to continue.

I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by
 
Follow-up: Suffer for major swelling in legs and feet. Taking medication for blood pressure, diabetes and cholesterol. Concerned? 1 hour later
Thank You Dr. Choudhary. I will discuss your suggestions with my mother's Dr. and the facility in which she resides. I believe that she has had the ECHO in the past year. Your other suggested causes are new to me and to my knowledge not yet considered. Is the only way you can check for filariasis is by a 2AM blood sample. That my be a problem without having her hospitalized. XXXXX
 
 
Answered by Dr. Ram Choudhary 9 hours later
Brief Answer:
some steps further

Detailed Answer:
Hi XXXXX,
Welcome to Healthcare magic.
if the problem has appeared or worsened recently than an year old ECHO is not relevant today, it needs to be reviewed.
the filariasis larvae come in blood at that weird hour in maximum numbers so it needs to be done at night. some laboratories provided booked doorstep sample collection, you can find one around and get their service.
I hope it should help.
Above answer was peer-reviewed by
 
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