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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hi, I have developed unilateral edema of my left foot-lower

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Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 3129 Questions

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Posted on Mon, 14 Jan 2019 in Accident and Emergency
Question: Hi,
I have developed unilateral edema of my left foot-lower leg/ankle. I also noticed a fairly sudden increase in weight <10lbs. I am type 2 diabetic and overweight (male-65 years old) and am hypertensive-all pretty well controlled now... I had some severe back pain and was taking the XXXXXXX dosage of Ibuprofen previous to the weight gain and edema. I am on Lasix and HZTZ... Additionally I am on several other medications such as Lisinopril and metoprolol and metformin... I have been Diabetic for 20 years and also use CPAP... I think that is it... Thanks, XXXXXXX
doctor
Answered by Dr. Prasad 1 hour later
Brief Answer:
Need evaluation...

Detailed Answer:
Hi,

What you describe is grade 1 oedema of the left limb (oedema restricted to below ankle). To understand the condition better, I need to know a few other details.
1. Since when did you notice the swelling / oedema?
2. Do you have pain around the leg / ankle? Were you hurt?
3. Is it tender? If it isn't tender does it pit on pressure (apply deep pressure using the thumb finger for 10 sec and release; do you notice a pit at the area where pressure was applied)?
4. Do you have any other associated complaints like breathing difficulties, cough, chest pain, abdominal pain, urinary complaints, jaundice and so on?
5. Do you notice swelling in other parts of the body especially the face and abdomen? (especially when you seem to be putting weight)?

In presence of diabetes and chronic use of Ibuprofen, it is important that we do not take this odema lightly. It should be evaluated to rule out renal and cardiac causes.

I will be able to take this discussion forward after I get the aforementioned details. Do consider answering all my questions.

Awaiting response...
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prasad 4 days later
Dear Dr. XXXXXXX

There is no pain associated w/the swelling/edema and no injury... I have noticed some abdominal swelling on occasion. My weight seems to fluctuate considerably week to week. There is no difficulty breathing or cough... My Doctor evaluated me for my annual physical and there were no changes in my EKG since the last few... The edema in my ankle and foot-at times both- seems to continue even though I am currently dieting... Due to the Menieres Disease and and high BP, I am on a very reduced sodium diet as well... I limit my sodium intake to <1500 to 2000mg per day. I am also on a reduced fat diet and limit my calories to <2000 per day... I will follow up w/ a urinalysis and blood work as well-Complete metabolic panel-BUN, creatinine etc. My previous blood work was normal and my diabetes glucose levels are slightly elevated... Hope this info helps. Thanks, XXXXXXX
Ps, I have been far less active since the advent of the Menieres disease. but hope to change that over time... I will see a specialist soon for Menieres...
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Follow up: Dr. Prasad 26 minutes later
Dr., Oh yes, the pitting goes away in @ 3-5 seconds... Thx
doctor
Answered by Dr. Prasad 34 hours later
Brief Answer:
You need further evaluation...

Detailed Answer:
Hi,

Apologies for the late reply. I was away from internet during the weekend.

Based on your description, this seems to be pitting oedema but probably milder one. Since you do not have any other associated complaints I am unable to narrow down on the cause. In this circumstance, I would rely on investigations to arrive at the cause.

I am glad you are getting blood work done. If the test don't reveal anything significant, you may also need a doppler scan of lower limb blood vessels. Also a physical examination of the limb is necessary to rule out dermatitis; a probable cause of unilateral lower limb swelling.

I prefer to perform tests systematically. So lets wait until blood tests reports are obtained.

Hope this helps. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prasad 9 hours later
Dear Doc,
Thanks for the input and follow up... No worries regarding the delay... I will follow up w/my PCP and see what the results of the blood work are. Thanks again. Best, XXXXXXX
doctor
Answered by Dr. Prasad 38 hours later
Brief Answer:
Welcome...

Detailed Answer:
I am glad I was helpful. The blood results will direct you towards managing this problem. So follow up with your doctor.

I will be available here if needed to guide you further.

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