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Swelling in legs, done blood work, painful. History of gastric bypass. Taking vitamin B12, folic acid and iron

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Practicing since : 2005
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I have had some severe swelling in both my legs off and on since Dec 2011. Had blood work done and was in need of transfusion. level was 7. I have been taking B12, folic acid and iron. My legs still swell a little but they are VERY painful. Been to 3 doctors and no one knows what this is. I had a gastric bypass 18 years a go and they told me I was mal nurished because of that but it had nothing to do with the swelling and they don' t understand or believe that I am in the pain i am in because of my legs.
Posted Sun, 16 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Shanthi.E 5 hours later

Thanks for posting your query.

There are two possibilities coming to my mind here. You probably have a pathology primarily in your legs that is causing the swelling and pain or there is a systemic condition, which is manifesting itself as the pain in the legs.

Let me try my best to confirm the probable reason.

The symptoms are present from Dec 2011. Hence, a chronic problem is present for some time now.

You did have low Hemoglobin of 7 and had to take blood transfusion and are now on B12, folic acid and Iron. Please continue them.

One general cause for the swelling and pain in the legs is Hypoalbuminaemia. Did you get your serum albumin tested at that time? Malnutrition is one of the causes for Hypoalbuminaemia where you would require good nutritional support to overcome the swelling.

In addition, you have just undergone a pelvic reconstruction 3 weeks ago. There is a fair chance of having a thrombo-embolic phenomena with the embolus lodging in one of the blood vessels in the lower limbs and increasing the swelling and pain.

It is better to review with your operating surgeon regarding this.

A Doppler study of the blood vessels in the lower limbs or legs can help us in identifying a DVT (Deep Vein Thrombosis). The pain here is excruciating.

There are few more causes of pain and swelling of the legs like cardiac cause, renal cause and thyroid cause.

Having said this, there has to be a cause for your symptoms, which need to be addressed by a skilled specialist.

Keep your legs elevated when you sleep using two pillows, taking painkillers for a long time is not advisable.

Please right back with other relevant symptoms that you are experiencing currently. It would help me in suggesting you specifically.

Awaiting your response.

Above answer was peer-reviewed by
Follow-up: Swelling in legs, done blood work, painful. History of gastric bypass. Taking vitamin B12, folic acid and iron 4 hours later
They said I was not producing albunim. Had the doppler for DVT. It was ok. I will speak with my surgeon on 9/5. As for the pain killers. They don't even begin to touch this kind of pain in my legs. It is also mainly from the knees down. What kind of specialist should I ask to see for this
Answered by Dr. Shanthi.E 1 hour later

Thanks for writing back.

I guess I was right in suspecting Hypoalbuminaemia in you. You can ask your primary care physician to give you few sessions of albumin and protein IV infusions like Astymin. These would really help you in decreasing the swelling and pain in the legs. It will bring back the serum albumin to normal.

It is good that you do not have DVT. I am glad about it.

An XXXXXXX Medicine specialist should be able to help you in this.

Meanwhile, consume high protein XXXXXXX foods like egg, animal meat, and liver, milk and milk products. Your general health will improve this way and gradually the pain and swelling will disappear as well.

I wish you quick recovery.

If you have no further queries please accept my answer and write a review.

Take care.
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