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Kassia

Asking Dr. Hive - swollen ankles (not pregnant)

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We were on vacation last week and, by the end of the week, my ankles got very puffy and swollen - they looked like I had fractured or sprained ankles because they got so big.  Since we returned home, the swelling has gone down a little, but they are still puffy and swollen.  Any ideas on why this would happen?  I have intestinal issues and my abdomen frequently gets distended and I experience shortness of breath, but I don't know if they are related.  I'm actually having intestinal surgery on June 1st to hopefully take care of those issues but now I suddenly have this ankle swelling.  

Should I call my surgeon about the ankles?  I go for pre-surgical testing on Wednesday and could ask the nurse to take a look I guess.  I think it's a good sign that the swelling has gone down some but I think the surgeon would want to know if there is still swelling/puffiness there.  I wish I knew what caused it.  

 

 

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Edema is something to be checked out ASAP. Something is not right, perhaps with the intestinal issues you are not absorbing protein, which is needed to keep fluid in the blood vessels rather than leaking into the tissue. Or, worst case, there is a cardiac issue causing ascites. You really need to talk to a doctor ASAP, this can be a serious symptom. 

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That happens to me almost every time we go on vacation (started about 2-3 years ago).  For me, I think it is too much salt in restaurant (or cruise) food. I'm also allergic to sulfites and it seems to be worse if I have gravy or soup that has sherry/wine in it.  I have to lay down with my feet up higher than my head for an hour or so each day on vacation to keep it in check.  

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15 minutes ago, Ktgrok said:

Edema is something to be checked out ASAP. Something is not right, perhaps with the intestinal issues you are not absorbing protein, which is needed to keep fluid in the blood vessels rather than leaking into the tissue. Or, worst case, there is a cardiac issue causing ascites. You really need to talk to a doctor ASAP, this can be a serious symptom. 

 

Thanks!  I am planning on calling the surgeon tomorrow morning.  I should have called this morning but the swelling did go down a little so I thought I'd wait.  DH was really freaked out about my ankles last night.  They are still swollen and puffy, but not as bad as they were.  I just feel bad about calling if it's getting better on its own.  

 

8 minutes ago, Pink and Green Mom said:

That happens to me almost every time we go on vacation (started about 2-3 years ago).  For me, I think it is too much salt in restaurant (or cruise) food. I'm also allergic to sulfites and it seems to be worse if I have gravy or soup that has sherry/wine in it.  I have to lay down with my feet up higher than my head for an hour or so each day on vacation to keep it in check.  

 

Thanks!  How long does the swelling last for you?  We left Saturday morning and I am still swollen/puffy.  I thought that maybe it was from the heat/humidity but now I'm not so sure.  

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2 hours ago, Kassia said:

We were on vacation last week and, by the end of the week, my ankles got very puffy and swollen - they looked like I had fractured or sprained ankles because they got so big.  Since we returned home, the swelling has gone down a little, but they are still puffy and swollen.  Any ideas on why this would happen?  I have intestinal issues and my abdomen frequently gets distended and I experience shortness of breath, but I don't know if they are related.  I'm actually having intestinal surgery on June 1st to hopefully take care of those issues but now I suddenly have this ankle swelling.  

Should I call my surgeon about the ankles?  I go for pre-surgical testing on Wednesday and could ask the nurse to take a look I guess.  I think it's a good sign that the swelling has gone down some but I think the surgeon would want to know if there is still swelling/puffiness there.  I wish I knew what caused it.  

 

swelling of lower extremities without shortness of breath could be  kidney issues but you mention intestinal issues if you had a large hernia/mass or something preventing adequate circulation in you legs then swelling would be a symptom

My concern is the shortness of breath and swelling is almost always a cardiovascular issues.  The aorta is in the abdominal region so if your intestinal issues are putting pressure on the aorta this could be leading to the shortness of breath and swelling.

I would contact your surgeon most likely they would want to do a cardio work up before surgery if the shortness of breath and swelling is new to them

I hope all goes well for you.   

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if you poke the meaty part of your leg - does it return to normal color quickly -or stay "white" compared to the skin around it?

it sounds like you have edema- several things can cause that - including liver which can be associated with digestive issue.

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2 hours ago, Kassia said:

We were on vacation last week and, by the end of the week, my ankles got very puffy and swollen - they looked like I had fractured or sprained ankles because they got so big.  Since we returned home, the swelling has gone down a little, but they are still puffy and swollen.  Any ideas on why this would happen?  I have intestinal issues and my abdomen frequently gets distended and I experience shortness of breath, but I don't know if they are related.  I'm actually having intestinal surgery on June 1st to hopefully take care of those issues but now I suddenly have this ankle swelling.  

Should I call my surgeon about the ankles?  I go for pre-surgical testing on Wednesday and could ask the nurse to take a look I guess.  I think it's a good sign that the swelling has gone down some but I think the surgeon would want to know if there is still swelling/puffiness there.  I wish I knew what caused it.  

 

 

And yes, this is another thing that could be hypothyroid-related. :-) I once went for a very long time without my thyroid meds (long story) and eventually my ankles blew up like balloons. Also, air hunger (aka shortness of breath) is a common hypothyroid symptom. I still have it once in awhile.

Have you had thyroid labs done?

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Possibly your soleus muscles — sometimes called the second heart — may be having difficulty pumping interstitial fluid and venous blood back to your heart. The soleus muscles are deep in your calves.

Maybe something to do also with potassium?

Definitely let the surgeon know what you’re experiencing.

 

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My guess is the same as Pink and Green Mom--that you ate more salt than typical while you were on vacation. And yes, extra salt + heat and humidity means  it can take several days to clear. I'd make sure to drink a ton of water today and see if that starts flushing things out. Shoot, one big restaurant meal that adds water weight to me usually takes three or four days to clear. That's the "when you hear hoof beats think horses, not zebras" answer.

But also ditto Ellie. I was diagnosed with hypothyroidism a few years ago and that's the only time in my life my ankles have ever swollen. Two pregnancies--nothing. But hypothyroidism made me swell like a water balloon in lots of places--face, eyes, abdomen and ankles were the worst. But for me that was a very gradual thing that came on over months. Not in a week. And my ankles were the last things to swell. So I'd still think fluid retention from extra salt intake is most likely.  But to muddy the water even more--when my thyroid was in the process of wonking out the extra fluid in my abdomen caused LOTS of distention, and I had intestinal issues that got me an IBS diagnosis that I really think were all symptoms of hypothyroidism. The abdominal fluid retention did make it hard to breath at times. Or maybe the SOB was unrelated to that. IDK. For several months after I was medicated I had to know where every bathroom was because I was going ALL the time getting rid of all the retained fluid. I was trying to lose weight, but I'm pretty sure I lost at least ten pounds of fluid. And I'm a small person. But again--for me those were all symptoms that came on gradually and once I had them they stayed. There weren't times when the symptoms came and went. So . . . back to thinking your fluid retention is most likely from salt/heat/humidity.

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Drink 3-4 liters of water throughout the day today.  Try to keep your feet up.  I might try compression hose or leggings also if you have some or if you live close enough to a store or pharmacy that carries them. If the swelling isn't dramatically down in another 24 hours you should call your surgeon.

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9 hours ago, Cafelattee said:

swelling of lower extremities without shortness of breath could be  kidney issues but you mention intestinal issues if you had a large hernia/mass or something preventing adequate circulation in you legs then swelling would be a symptom

My concern is the shortness of breath and swelling is almost always a cardiovascular issues.  The aorta is in the abdominal region so if your intestinal issues are putting pressure on the aorta this could be leading to the shortness of breath and swelling.

I would contact your surgeon most likely they would want to do a cardio work up before surgery if the shortness of breath and swelling is new to them

I hope all goes well for you.   

This is exactly what I was going to say. 

Please call your surgeon today.  

 

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10 hours ago, Kassia said:

 

Thanks!  I am planning on calling the surgeon tomorrow morning.  I should have called this morning but the swelling did go down a little so I thought I'd wait.  DH was really freaked out about my ankles last night.  They are still swollen and puffy, but not as bad as they were.  I just feel bad about calling if it's getting better on its own.  

 

 

Thanks!  How long does the swelling last for you?  We left Saturday morning and I am still swollen/puffy.  I thought that maybe it was from the heat/humidity but now I'm not so sure.  

It usually lasts about 4-5 days, but does get better if I keep my feet elevated for an hour or so a day and drink lots of water.  I live in FL where it is almost always hot and humid and it happens to me when we go on vacations to other hot and humid places but never at home.

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I called the surgeon's office and they are closed until next week (he's on vacation).  I didn't think it was an emergency so I didn't call the service.  I did leave a message with my GI doctor and expect to hear back from him.

I have had some thyroid bloodwork done by my family doctor but she wasn't thorough.  I do have a lot of hypo symptoms, though.  

Thank you for all the responses!  

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My mom has had this and went to the ER once with it. She was on some strong medication to get rid of an ulcer. The main concern is your kidneys.  Everything was fine after a lot of tests.  She was told: 

drink LOTS of water 

soak your feet in Epsom salts

elevate your feet

wear socks made for improving circulation 

walk around at least 10 - 15 minutes every hour 

I also got her some naturally diruectic foods - watermelon, fresh fruits, salads, all organic, and made sure her salt intake was low...

Her edema subsided after two days of this. Use common sense and monitor it carefully. Watch how much urine you are producing. 

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I heard back from my GI doctor and he said I should contact my primary care doctor about the swelling.  I sent her a message but I don't have much faith in her and have not found her to be thorough at all.  I will ask someone at the hospital to assess the swelling in my ankles when I am there tomorrow for the pre-surgical testing.  

I'm still experiencing shortness of breath but now I'm so anxious about the whole situation that I don't know if it's from anxiety or if it's a true physical issue.

Thanks again for all the responses!  

 

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10 minutes ago, Katy said:

Has the swelling gone down at all?

 

Yes, they were both extremely swollen Friday through Sunday - they looked like I had broken ankles.  Now I would say they are more puffy and not grotesquely swollen if that makes sense.  

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1 hour ago, Kassia said:

I heard back from my GI doctor and he said I should contact my primary care doctor about the swelling.  I sent her a message but I don't have much faith in her and have not found her to be thorough at all.  I will ask someone at the hospital to assess the swelling in my ankles when I am there tomorrow for the pre-surgical testing.  

I'm still experiencing shortness of breath but now I'm so anxious about the whole situation that I don't know if it's from anxiety or if it's a true physical issue.

Thanks again for all the responses!  

 

I am thinking about you and praying this is nothing to worry about.  You are wise to follow up at the hospital tomorrow.  Do not let anyone blow you off either.....you be polite, but insistent that you are evaluated thoroughly. 

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20 minutes ago, peacelovehomeschooling said:

I am thinking about you and praying this is nothing to worry about.  You are wise to follow up at the hospital tomorrow.  Do not let anyone blow you off either.....you be polite, but insistent that you are evaluated thoroughly. 

 

Thanks so much!  The support and advice here mean so much to me.  After being healthy with no issues for a very long time, this past year has been extremely tough and stressful for me.  I feel like an entirely different person - always feeling lousy and scared.  

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Hugs, Kassia. I'm sorry you're going through this stressful situation. I hope the ankles turn out to be nothing serious and that your surgery is a success.

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47 minutes ago, Selkie said:

How are you doing today?

 

Very well, thank you!  I saw a PA at the hospital for part of the presurgery appt. and she said my ankles looked good and I didn't have anything to worry about.  So I am very relieved about that.  Now I am coming down with a cold - DH and dd both have it.  I'm never ever sick and have to be well for my surgery next week!  Hopefully I'll fight it off and be fine for surgery.  Always something!  ?  

Thank you to everyone for your concern, advice, and support!  

 

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51 minutes ago, Selkie said:

Hey Kassia, just thinking of you! I hope your surgery goes well tomorrow!

 

Thank you so much!  I am very touched that you thought of me.  

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3 minutes ago, Tiramisu said:

Thinking of you, too, and looking forward to a post op update.

 

Thank you!  Heading out in a few minutes for surgery!  Won't be able to post for about a week since I have no idea how to access the forum from my phone and that's all I'm bringing to the hospital.  

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I am home (so happy to be home)!  Surgery went well and I am recovering nicely.  Thank you for everything!

 

 

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