Edema problems

Carl Sundquist said:

I am predominately sitting while at work. After work when I strap down
my cycling shoes, I can barely get the tongue to overlap the side of
the upper. If I put the shoes on in the morning, I get more than 1/2
inch overlap. The swelling also affects my lower legs. At the end of
the workday, the skin around my calf is too tight to be able to squeeze
a pinch.

This phenomena is nothing new. 10-20 years ago, I'd always try to get
the bulkhead seat on flights so I could elevate my legs. It's not due
to being sedentary and a lack of pumping action either. On days when I
am standing a lot, the same problem occurs, and if I walk a fair
distance (such as a mile), I can even feel my fingers and hands getting
puffy. If I'm wearing a ring, it becomes more difficult to put on and
take off.

Anyone else experience this? Support hose would cut down on it some (it
still happens even if I wear laced up shoes), but not alleviate it
entirely. Suggestions?

Simple. Douche the mangina. Oh, sorry wrong post. I thought it was
titled "Enema Problems" and was posted by Papai-hole.

Sorry, carry on with the race related banter.

DA74, M.D. (Male Gynecology)

DA74 said:

Simple. Douche the mangina.

Miracles ! Is there anything mangina douching can't cure ?

Carl Sundquist said:

Anyone else experience this [swelling] ? Support hose would cut down on it some (it
still happens even if I wear laced up shoes), but not alleviate it
entirely. Suggestions?

My other half is a former RN, now a CRNA (Nurse Anesthetist). Not a
specialized MD, IOW. She says this sounds like it's lymphatic, given
that you had the same problem while competing (true?); edema happens
with heart failure but that probably doesn't apply to you. She's not
sure that anything can be done, other than wearing support hose-- heavy
duty compression stockings (esp. at work, etc. while seated for long
periods) and to keep the stretched skin moisturized to prevent
breakdown. Massage that helps lymph fluid drainage might also help.
This is from a person who is the first to give the MD's their just due
for the years and years of study they do beyond her RN and CRNA
training, where they earn the right to prescribe.
--D-y

Quoted message said:

DA74 said:

Simple. Douche the mangina.

Miracles ! Is there anything mangina douching can't cure ?

Apparently it doesn't work for these ailments: Protruding abdomens,
obessive eating disorders, laziness, and blind faith in false heroes.
-Dr. DA74

Carl Sundquist said:

I am predominately sitting while at work. After work when I strap down
my cycling shoes, I can barely get the tongue to overlap the side of
the upper. If I put the shoes on in the morning, I get more than 1/2
inch overlap. The swelling also affects my lower legs. At the end of
the workday, the skin around my calf is too tight to be able to squeeze
a pinch.

This phenomena is nothing new. 10-20 years ago, I'd always try to get
the bulkhead seat on flights so I could elevate my legs. It's not due
to being sedentary and a lack of pumping action either. On days when I
am standing a lot, the same problem occurs, and if I walk a fair
distance (such as a mile), I can even feel my fingers and hands getting
puffy. If I'm wearing a ring, it becomes more difficult to put on and
take off.

Anyone else experience this? Support hose would cut down on it some (it
still happens even if I wear laced up shoes), but not alleviate it
entirely. Suggestions?

This does not sound good. Have you seen your physician? Not to alarm you
but it could be PVD (peripheral vascular disease). What most concerns me is
your comment that when walking a mile you feel your hands and fingers
getting swollen.

Here's a website with some info:

http://www.americanheart.org/presenter.jhtml?identifier=4692

Your doc can do a hypertension work up, a cardiac sufficiency workup and
prescribe diuretics. Do you wear support sox all the time? Do you wear them
while cycling? If not, I would suggest it, but ask your doc about it - the
amount of compression would be one element that he'd suggest.

Do you have 'pitting edema'? (That means you press on your leg near the
front of the shin, for instance and it leaves an impression of your
finger). Varicose veins? History of diabetes in your family?

If yes to several of these, I'd schedule an appointment with your MD
without delay.

It could be as simple as the need to cut back on salty food, or increasing
your physical activity, and wearing support sox. However it could be more
serious than that.

(IIRC, you posted several months ago about a rather serious medical
condition, but can't remember what it was.)

I'm not a doctor, so the best I can suggest besides a Dr's visit is that
you read up on it, etc.

HTH,

-jet

If you notice it in your hands as well as feet, definitely see a good
internal medicine doc. Dependent leg edema alone usually has a benign
cause (venous insufficiency) in people who otherwise feel well and are
healthy and active with no systemic medical problems. This can be
confirmed with a simple test - venous duplex (ultrasound) and doesn't
reqquire anything more than a good support stocking (these can actually
be custom fit with regards to size, sequential pressure applied, etc.
with a prescription and a trip to a surgical supply house.) No
disprespect to the poster below, but you assuredly don't have
lymphedema - this is almost never systemic and usually has an obvious
cause, such as lymph node removal with cancer surgery. It also isn't
remotely possible to be PVD as suggested below; swelling is not a
prominent symptom of that problem. Maybe he/she was confusing it with
DVT - venous clots, which are possible but unlikely in the absence of a
specific triggering event.
In any event, no matter what our backgrounds, we're all coming to the
same conclusion - find a sharp internist - he/she can narrow it down to
a couple of good possibilities with a history and physical exam and
nail it with an appropriately focused test or two.

Lou D'Amelio
([censored] Cat IV / C 'cross racer but pretty good surgeon)

Carl Sundquist said:

I am predominately sitting while at work. After work when I strap down
my cycling shoes, I can barely get the tongue to overlap the side of
the upper. If I put the shoes on in the morning, I get more than 1/2
inch overlap. The swelling also affects my lower legs. At the end of
the workday, the skin around my calf is too tight to be able to squeeze
a pinch.

This phenomena is nothing new. 10-20 years ago, I'd always try to get
the bulkhead seat on flights so I could elevate my legs. It's not due
to being sedentary and a lack of pumping action either. On days when I
am standing a lot, the same problem occurs, and if I walk a fair
distance (such as a mile), I can even feel my fingers and hands getting
puffy. If I'm wearing a ring, it becomes more difficult to put on and
take off.

Anyone else experience this? Support hose would cut down on it some (it
still happens even if I wear laced up shoes), but not alleviate it
entirely. Suggestions?

First of all Carl, I want you to disregard all professional medical
advice and just listen to me.

Since these symptoms are systemic rather than local, we can pretty much
rule out DVT (http://www.dvt.net/signsSymptoms.do). The surgeon is more
right than the nurse.

MY DIAGNOSIS: Nothing. Everyone experiences the same swelling/edema
during the day. If anything, you might have a slight hypertension issue
and I would suggest to cut your salt intake and get your BP monitored.

I think as an athlete you might just be hypersensitive to your body's
normal daily changes. But in reality, they happen to the sedentary
freaks sitting in the office next to you as well, but they just don't
care, or don't notice.

When you talk about swelling, you're talking about fluid (water). Gotta
go with the old NaCl link and blood pressure increase. There's no need
to sift through JAMA articles at this point.

Add a diuretic (caffeine - i.e. coffee) to the mix to help [censored] away the
Fatty Arbuckle look. See what happens.

But I'm not convinced there is anything 'wrong' at thhis point unless
the swelling is obscene and makes you look like a Jenny Craig customer.

Dr. Magilla, M.D.

Carl, do you have vericose veins as well? This is a problem for which
you should consult a doctor.

http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9883.html

I'd just as soon you know what you're dealing with rather than
guessing.