Feet and Lower Leg Swelling / Pain

[canthai55]

Quite a recent occurrence. Diminishes overnight but still not gone and increases during the day. Web search reveals information overload.

Which Doctor would you recommend to diagnose - GP or a specialist ?

Thanks

[sanuk711]

I'll leave it to the cat lady for a more detailed analysis, but isn't it usually water retention ?

Do you sit at your computer for long periods

If you take a morning walk do you find it lessons the swelling ?

Have you ever taken a diuretic ?

[canthai55]

Kind of a catch 22 - if I walk the swelling increases. As does the pain. If I sit I still have the swelling but the pain lessens. Pain confined to the muscles in the back of the leg - calf area.

Never taken a diuretic.

[sanuk711]

5 minutes ago, canthai55 said:

if I walk the swelling increases.

And so ends my extensive medical knowledge......

I'm sure Sherly will be able to direct you to someone in your area.....good luck with it.

[sanuk711]

34 minutes ago, sanuk711 said:

I'

 

Edited November 17, 2017 by sanuk711
double post......sorry

[carlyai]

Quite a recent occurrence. Diminishes overnight but still not gone and increases during the day. Web search reveals information overload.
Which Doctor would you recommend to diagnose - GP or a specialist ?
Thanks

Is it perceived swelling or actual swelling?
I know with my back problem it sometimes feels like lower leg and foot swelling and sensory changes, but coming from my back, and no visible swelling.

So is it a back problem or not?

For some relief elevate and put on some ice packs.




Sent from my SM-J700F using Tapatalk

[Sheryl]

Swelling in the legs that improves overnight and worsens when you are up and about is often an indication of a heart problem but is not usually accompanied by pain.

 

You need to see either a really good GP (rare in Thailand, only ones I can recommend are in CM and Bangkok) or a cardiologist.

 

Where in Thailand do you live?

 

And have you had a stress test or echocardiogram and basic labs (lipid panel etc) in the past year or two?

[canthai55]

Live near Chiang Mai. Pain might be a stretch - ache would be closer to the truth.

Just completed Halvone treatment, which pulled blood each month primarily for viral load. Had complete blood work last year, nothing found.

This just started - maybe a week ago. Stress test - never. And never heard of one. Is living to be my age not prima facie proof that I can handle it 555

[canthai55]

7 hours ago, carlyai said:

Is it perceived swelling or actual swelling?

Real - my shoes fit tight and skin around ankles tight like a drum

[watcharacters]

 

 

YOU might be well served by first checking into the condition of your heart..

[carlyai]

Real - my shoes fit tight and skin around ankles tight like a drum

I'd go down the Cheryl path.

Sent from my SM-J700F using Tapatalk

[tonray]

You have chronic hepatitis  ? (viral load test) 

 

If unlikely candidate for heart failure I would look at kidney issues due to hep involvement 

[Sheryl]

I assume you mean Harvoni treatment for Hep C?  Blood work for that would nto be relevant to your heart.

 

Stress test is test of cardiac function.

 

I suggest you consult either::

 

1) Dr Patarapong Keelapang,

Chiang Mai RAM Hospital

053 920300

http://www.chiangmairam.com/searchdoctor1?major_id=120&doctor=25

 

or

 

2) Prof. Thanawat  Benjanuwattra or

    Prof. Rungsrit Kanjanavanit

    Sripat - http://sriphat.med.cmu.ac.th/en/home

 

Second will cost less but entail more wait time etc. You are going to need a physical exam (listening to your heart and lungs etc), some basic blood work  and probably chest Xray, possibly stress test and echocardiogram.

 

 

 

 

[canthai55]

Thank you for the recommendations. Will book appointment soonest

Yes - Harvoni - should of stayed in school !

[dddave]

Foot and leg swelling exactly as the OP describes was my first indication that I had cardiovascular problems.  Next came chest pain/pressure, even when walking moderate distances.

Ended up with by-pass surgery last year and now all those issues are behind me.

[NancyL]

Dr. Thanawat also practices at Bangkok Hospital - Chiang Mai now also.  I'm not certain he's still at Sripat, he may have retired from CMU.  It's been the practice of Bangkok Hospital - CM to sign on some of the really good CMU/Sripat professor/doctors when they are "turfed out", i.e. forced to retire at age 60.  The O.P. will find it easy to access services at Bangkok Hospital - CM.  

 

Dr. Apichard is also a good cardiologist at Bangkok Hospital - CM.

[canthai55]

Appointment Monday 1000. Fingers crossed

[1FinickyOne]

I was told to lie down with my feet elevated as it is a "valve" problem, tiny valves in my legs... and this does help. I also have some discoloring, sort of freckling and dark spots in my feet and lower leg near the heel...

 

you pains could be incidental. 

 

But, good luck at the doctors visit. 

[NancyL]

Yes, when someone has cardiac problems and this type of swelling an afternoon nap, or at least a time sitting with the feet elevated can help.  I find an afternoon swim to be of great value in reducing/eliminating swollen feet/ankles.

[KiChakayan]

6 hours ago, dddave said:

Foot and leg swelling exactly as the OP describes was my first indication that I had cardiovascular problems.  Next came chest pain/pressure, even when walking moderate distances.

Ended up with by-pass surgery last year and now all those issues are behind me.

Great to hear that..

[canthai55]

It's weird - yesterday the swelling was diminished. Ankle half what it was the day before - I could see my shin bone. Also pain in calf muscles reduced. The mind boggles ...

You would think that if the arteries were clogged, and this was the cause, they would remain clogged. Maybe heights of the tides, phases of the moon, alignment of the planets.

If this visit not a cure will find a doctor with a bone in his nose 555

[Old Croc]

My leg/foot edema is related to kidney disease. My feet swell whenever they are on the ground for a length of time. I take diuretics daily.

Make sure you have blood and urine tests for CKD as well as checking your cardiovascular system.

[NancyL]

3 hours ago, canthai55 said:

It's weird - yesterday the swelling was diminished. Ankle half what it was the day before - I could see my shin bone. Also pain in calf muscles reduced. The mind boggles ...

You would think that if the arteries were clogged, and this was the cause, they would remain clogged. Maybe heights of the tides, phases of the moon, alignment of the planets.

If this visit not a cure will find a doctor with a bone in his nose 555

This is something to tell the doctor when you go in for your tests.  It could be that the swelling is related to cardiac problems and you had a "good day" with your blood pressure under control.  I find that when I eat salty foods my blood pressure soars and I have more foot and ankle swelling.  If I have several days of a low salt diet and exercise, then no swelling.

[canthai55]

More info - just visited a friend with diabetes. He has one of those poke-your-finger machines to spot check blood sugar.

Normal - under 100  Mine - 233

Maybe related ? Had complete blood work aprox 16 months ago, nuttin'...

[KiChakayan]

43 minutes ago, NancyL said:

This is something to tell the doctor when you go in for your tests.  It could be that the swelling is related to cardiac problems and you had a "good day" with your blood pressure under control.  I find that when I eat salty foods my blood pressure soars and I have more foot and ankle swelling.  If I have several days of a low salt diet and exercise, then no swelling.

Are you guys exercising? I mean more than just a stroll around the block. I found out that I have a sweet spot around 230/250 Km cycling a week where I feel 15 years younger. Less has no effect, more tends to wear and even lower libido. Also my weight only drops when I am riding more than 250k. When I have a holiday where I don't exercise blood pressure goes up by 1 to 1.5 points with a matching weight gain. 

Just to say how directly exercising affects our health. And you guys have no excuse, you can walk up to Doi Suthep every day.

[Sheryl]

More info - just visited a friend with diabetes. He has one of those poke-your-finger machines to spot check blood sugar.
Normal - under 100  Mine - 233
Maybe related ? Had complete blood work aprox 16 months ago, nuttin'...

That norm is for fasting blood sugar. You need to have eaten nothing and no fluids but water for 8 hours before.

Since you did this while visiting a friend I suspect not the case.

If the complete blood work was a general check up it will certainly have included a fasting blood sugar or Hb2ac but as it is over a year you might like to recheck.

It will also have included test of kidney function.

The swelling is most likely due to either a heart issue or circulatory issue.

Are you significantly overweight and have you gained weight recently?


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[NancyL]

1 hour ago, canthai55 said:

More info - just visited a friend with diabetes. He has one of those poke-your-finger machines to spot check blood sugar.

Normal - under 100  Mine - 233

Maybe related ? Had complete blood work aprox 16 months ago, nuttin'...

Edit:  oops, didn't see Sheryl's reply above.  I basically said the same thing about fasting blood sugar.

[canthai55]

2 hours ago, Sheryl said:

Are you significantly overweight and have you gained weight recently?

bought a new fridge yesterday - got a free scale. Weight 100kg. I am 184cm

And since Hep C treatment stopped I have been gaining weight - but maybe 5kg max

Endocrinologist - Dr. Natthapong Kosachunhanun.

Will see him after cardiologist tomorrow

Edited November 19, 2017 by canthai55

[Sheryl]

Unless that blood sugar you mention was done fasting or you have another problem not mentioned, no need for an Endo.

Even if fasting, any good internist can manage type 2 diabetes.

Unless you have unusually large percentage of muscle mass you are about 14 kg overweight which is of course a risk factor for diabetes, heart disease and also circulatory problems.


Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[canthai55]

As always - you are most helpful. We are very lucky to have you take on this task.

Many Thanks.

I have been dieting. Usually only eat twice a day, no pop, chips, candy. Until this recent I have been eating most veggies raw, and lots of fruit. But rethinking the pineapple and oranges. Told they pack lots of sugar.

Will post back when I learn what the good Doctor says tomorrow, Inshallah