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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for swelling of the ankles after prolonged standing

Answered by
Dr. Sagar Makode


Practicing since :2013

Answered : 1754 Questions

Posted on Mon, 13 Mar 2017 in Hypertension and Heart Disease
Question: Hello, I have swelling in my ankles when I sit or stand sometimes for long periods and sometimes not. I am very concerned and don't want any type of heart failure or things like that. I have also had a cough that comes and goes, especially when it's cold weather or if Im around any super air conditioned room. It is a concern to the point that one of my mentors wondered if I had asthma or been tested for heart failure. My EKG was normal, but I read that that is not a reliable test when it comes to ruling out CHF.

I have had a myomectomy in the past and my physician at the time said he didn't know if he had "gotten all of it and it may grow back" which it did. The fibroid is suspected of causing my anemia, but at the same time, my last CBC showed that my iron and ferritin levels were in the normal range and that my hemoglobin/hematocrit/ and WBC count was in the low range. When I asked him about it he said that it was normal for individuals of my ethnic group (African American).
Before these concerns, I hardly got sick except for the occasional cold which was rare but when it did come it was tough.
Answered by Dr. Sagar Makode 47 minutes later
Brief Answer:
See the description

Detailed Answer:
First don't worry, you don't have any reason for heart failure. Swelling in the legs especially in females is a very common condition and has multiple reasons.
Now, the probable reasons in you are, fibroids and anemia. Also, its occurs in many females due to excessive salt and water retention. The enlarged fibroids cause compression over inferior vena cava which carries blood and water away from your legs. So it leads to accumulation of water in legs. Also, low hemoglobin especially if less than 10 can cause this. Also, you are right, EKG is not sufficient to rule heart dysfunction, but you need echo to rule it out. So get it done, just to rule heart dysfunction.
For treatment, you should consume low salt and water diet, leg elevation during rest. Also, you need to be on water pill like torsemide 5 mg once a day in the morning, which you can get prescribed from local doctor. Get your hemoglobin corrected if low and also fibroids treated.
Regarding, cough, it's probably a sensitivity to cold which leads to constriction of airway leading to shortness of breath and cough which can occur in otherwise normally. Try avoiding cold. Also, no need to worry about it. If symptoms are severe, you can use MDI Asthalin 2 puffs whenever needed to relieve constriction.
Most importantly, don't worry doesn't appear to be any serious condition. Get back if you have any doubts.

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Sagar Makode 29 minutes later
With the coughing comes a lot of phlegm...yellow to white in various degrees. When the dr listens to my lungs Im told they are clear...there is a tingly feeling in my throat...below my tonsils and causes me to cough A LOT sometimes to the point of almost vomiting and some chest discomfort.
Sometimes my ears will feel stopped up.

It is causing me great concern.
Answered by Dr. Sagar Makode 13 minutes later
Brief Answer:
See the description

Detailed Answer:
again, I would again say don't worry, this must be causing you symptoms but not a serious problem.
This basically occurs due to two reasons, one is acid reflux which irritates the throat and some acid enter the lungs leading to cough and sputum production. Do you also have upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes these are the other symptoms. In that case, you should avoid fatty, oily and high spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. Elevate head end of bed during sleep. You can get prescribed tab Pan DSR 40 mg beforebreakfast once a day for 2 weeks.
Second possibility is of allergy, which again can irritate the throat and lungs leading to your symptoms. Do you also have recurrent rhinorrhea, sneezing, itching, increase in symptoms on exposure to dust etc, if yes these are the points in favor of allergy. In that case, you can get prescribed some antiallergic medicine like tab Montair LC bedtime for two weeks and protect yourself from precipitating factors like dust etc. Just see in which scenario you fits better, and you can infact try both the things as both very safe treatment.
You mentioned your lungs were clear, in asthma doctor will find wheezes on auscultation. Get back if you have any doubts.
Above answer was peer-reviewed by : Dr. Yogesh D

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