Whitesburg KY

Swollen ankles



DEAR DR. DONOHUE: I am a diabetic male, age 96, with many aches and pains but no high blood pressure. I have low cholesterol and am in control of my diabetes. In the past few weeks, I’ve noticed swelling of my ankles and feet. I have been taking two water pills a day for it. I never use salt or eat salty foods. What can you suggest for me? — S.S.

ANSWER: That swelling is edema, and it has many causes. One is sitting for long periods with the legs dangling down. With the legs in that position, gravity pulls fluid from the legs’ blood vessels. Treatment for this kind of edema consists in elevating the legs. Every hour, lie down for 10 minutes with pillows under your legs and feet so that they are above heart level. When sitting, squeeze the leg muscles over and over. Muscle contractions stop the oozing of fluids from the blood vessels. And take a morning and afternoon walk. Elastic hose can keep fluid in blood vessels and out of the surrounding tissues.

Dilated leg veins — varicose veins — promote edema. A clot in a leg vein is another cause. That’s usually quite painful, and you’d be aware that something is going on if you had a clot. Liver ailments can lead to edema. The liver makes a blood protein, albumin, that keeps fluid in circulation. With a low production of this protein, fluid leaks out of vessels. Kidney failure is another reason why edema occurs. Medicines can lead to it. The popular nonsteroidal antiinflammatory medicines such as Advil and Aleve are two examples. So are medicines called calcium channel blockers, such as nifedipine and verapamil. If you increased the dose of your water pill on your own, you shouldn’t. You can develop a potassium deficiency from overuse of water pills.

Try the things I mentioned. See if they bring down the swelling. If they don’t, you’ll have to consult your doctor.

A much more important cause of ankle-foot edema is heart failure, something that your doctor must check you for.

The booklet on edema and lymphedema explains this kind of swelling in detail. Readers can obtain a copy by writing: Dr. Donohue — No. 106W, Box 536475, Orlando, FL 32853- 6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.


DEAR DR. DONOHUE: I’d been on Ambien for three years. I’m off it now. I take melatonin. It works better. What are the good things and bad things about it? — R.M.

ANSWER: The pineal gland in the brain makes melatonin, a hormone-like substance that contributes in regulating our internal clock. Melatonin is secreted at night and signals the body to go to sleep.

The benefits ascribed to melatonin are amazing: quelling inflammation, acting as an antioxidant, bolstering the immune system, preventing cancer. The evidence for these benefits is not overwhelming. It does, however, prevent jet lag and foster sleep. Long-term side effects and safety are not known

Chronic insomnia is best treated by consulting a sleep specialist.

Readers may write Dr. Donohue or request an order form of available health newsletters at P. O. Box 536475, Orlando, FL 32853- 6475.

©2012 North America Synd.

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