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 Post subject: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 4:01 am 
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Or rather: question for my grandma.

My grandma's 90.5. Tiny, cute, pretty sedentary because her knees and left hip give her too much pain, but she still goes up and down our house stairs 3-4 times a day "to keep fit", which I think is great. However: her legs swell. Sometimes it's almost nothing, sometime's it's like the past 2 weeks, and her calves and toes (and feet!) are completely swollen like over inflated balloons. (My sister's words; she lives with grandma and I'm more than a continent away.)

This happens on and off for the past 2-3 years. Grandma's been to Kaiser 8 times, but they don't really know what's happening and don't have solutions beyond "cortizone shot" (ineffective, imo) and "put those feet up" (also ineffective). After grandma's heart attack last April (4/11) I went home and had her on a vegan diet for a month which seemed to help grandma's ... everything, but old habits die hard and after I came back to NL, she resumed her omni ways. My sister's managed to talk her into eating vegan again, so they've been doing that for about 2 weeks. My sister also massages grandma's legs 2-3 times a day for 10 minutes. After the cortizone shot, grandma's legs started leaking (from the shot-entry-point) and my sister tries to squeeze the swelling out of it. Sometimes it works. I don't know how I feel about that - like, it seems like it could be helpful (like a pimple!) but also like it could convince the body to go into overdrive. My sister just started massaging the legs with ayurvedic antiseptic cream and an essential oil (eucalyptus), which might be working (??). If there's another oil or cream we could use, I'd love to hear about it.

Because: Solutions! Things to investigate! Things to try! These are all things I'd love to hear. I hate that my grandma has to suffer because of this, and am pretty annoyed that Kaiser isn't willing to spend the time to find an actual solution. Grandma finally seems like she might accept some other methods. If it were me, I'd see an accupuncturist, but that's not a grandma-friendly option. So .... if any of you have ideas for what could be causing this intense lower leg swelling, or what else we could do to try to keep it in check/diminish it, I'd really, really love to hear.

eta: Herbs are also not options. If it's something we could add to her food to "flavor" it, that's ok, but anything like herbal or ayurvedic medicine isn't something she's willing to try. (A shame, because I can think of two my sister has which could also be helpful.)

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 6:03 am 
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what about compression bandages/diabetic sock type things?

swelling in lower extremities in someone with heart issues could be congestive heart failure, so i hope the kaiser people have that figured out. is she on meds to thin her blood after her heart attack? maybe they need to be adjusted.

if she were my gram, and god bless her for being so fit, i wish my gram were.... i would see if your sister could get her out for walks, nice gentle ones, to see flowers in the park, to visit people. just to get blood flowing. and more massages. and elevate the feet.

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 6:51 am 
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well, hopefully the docs can figure it out. it's pretty common in people of that age but it's usually do to some heart or other issue. i don't know if she eats a lot of sodium, but cutting back on sodium might be helpful to ease the swelling, though it wont fix the underlying problem by any means.

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 8:52 am 
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If there is fluid coming out when she gets the cortizone shot, it sounds more like edema (swelling caused my a build-up of fluid under the skin). I'm not a doctor, so I have no idea what to do about edema, so this really wasn't a very helpful post.


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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 9:09 am 
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But, it did provide a word I can google!

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 9:44 am 
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I was also thinking congestive heart failure with associated retained fluid/swelling of the legs. Does she get out of breath easily? I also second the idea of compression stockings, elevating her legs above heart level, and if not already, she may need to take diuretics (I.e, "water pills") to help decrease the swelling. FWIW.


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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 9:47 am 
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She's already on water pills, and has been for years. They don't really help with this swelling. I'd completely forgotten about the link between swellnig and heart failure - thanks for that reminder. Are these the kind of stockings people have in mind? https://www.google.nl/search?q=compress ... 80&bih=923

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 10:03 am 
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lutin wrote:
She's already on water pills, and has been for years. They don't really help with this swelling. I'd completely forgotten about the link between swellnig and heart failure - thanks for that reminder. Are these the kind of stockings people have in mind? https://www.google.nl/search?q=compress ... 80&bih=923



Yep, those are the stockings.


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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 10:40 am 
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Yeah, it really sounds like edema, but in case it's not, there is one other issue I know of that causes swelling like this, and that's certain auto-immune diseases. If I were you, I'd have my sister go to Kaiser with her and mention these two things, see what they say.

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 11:13 am 
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i get edema from time to time. it's so painful and awkward.

i get it when i forget to drink enough water and eat too much sugar. (i know it doesn't make sense, drinking water would assuage a buildup of water. but it's to flush out the excess of sugar (or salt) in our kidneys so they can be more effective in removing it from the rest of us.

there was one time where it was absolutely awful, and i did a master cleanse. oh man, that helped immensely. (i know, drinking maple-y lemonade to flush sugars out? i dunno. but it really helped.) the manual also recommended sitting in a bath tub with epsom salts covering your legs to extract the fluid. (no water in the tub, just you and the salts) i'm not sure whether it was the cleanse or the tub sitting, but i felt better so quickly.

either way, the more fresh vegetables and the fewer processed foods the better.

good luck to grandma!

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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 11:27 am 
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The compression stockings you can buy off the shelf won't be strong enough to combat that type of swelling (unless in the states you can buy stuff >25 mmHg off the shelf). Before getting anything stronger, someone should check the blood flow to her legs because putting compression onto legs with poor flow (any sort of arterial disease) is contraindicated, as is compression for someone with congestive heart failure (unless it's very well controlled). Some signs of arterial disease: worse/pain with elevation, really gross looking toenails, hairlessness/shiny skin, cold feet. You can specifically ask for an ABI (ankle-brachial index).


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 Post subject: Re: intense swelling? (question from my grandma)
PostPosted: Fri Jul 06, 2012 11:39 am 
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I am going to write a whole bunch but I mean well having seen this before.
I have to wonder due to your grandma's age if Kaiser is not being as vigilant about getting a diagnosis to avoid having to pay for her care. Which can expensive.

I agree this sounds like edema. I had brother who had edema which was caused by congestive heart issues unfortunately he passed last year. While his death could have just happened anyway we did discover after his death he was not taking his medicine properly. He may have even stopped taking it.

The medicine helped as well but he hated that it sometimes kept him running to the bathroom a whole lot to the point of disturbing sleep and at work (which I gather his employer was not fond of) When he did wear his stockings it helped a great deal. The stockings run $40-$60 a pair. I'd suggest keeping a minimum of 3 pair so they can be rotated. Insurance usually only pays for one pair every 6 months. I guess they think you really want to hand wash them every night.


Have they done an ultrasound of her heart? That is the minumum they should do. There are better more sensitive tests for this. How are her kidney values? Find what % her kidneys are working at. Get her whole diagnosis for each disease thoroughly explained and how one can effect the other. Depending on how one organ is working the others may not work very efficiently causing another not to work efficiently.

Two other issues that can cause swelling are diabetes and Rhuematoid arthritis but I lean heavily toward edema since she has a had a heart attack. The other thing they might need to consider is a different "water" pill or different dosage. If her heart and kidneys are working less efficiently then she would hold more fluids. Please go to the doctor with her and be very insistent they find out why this is happening if you have not done so already. I'd see the cardiologist and Rheumatologist when making the appointment be sure to mention the intense swelling and you want to get her in quickly. Otherwise they might schedule you a month out.

My brother had mild mental disabilities so I'd go to his doctor appointments with him. We'd have a list of questions made ahead of time. I'd let my brother talk and only say something if he forgot to mention some information or a symptom or if the doctor didn't address what we needed. I'd suggest both you and your grandma and sister make a list of questions and concerns so you can get the most out of your visit. Many doctors these days try to hurry through the visit and in the end you don't get things taken care of. My brother actually asked me to start coming with him because he felt like he was not getting taken care of properly. I kept a constant eye on the size of his legs because it told me how well his medication was working (if he'd tell me whether he was taking it) and whether he needed stockings ect.
My brother was a grown man and he just would not tell people things sometimes because he only wanted his life managed only so much. Independence was really important to him as it would be to anyone.

I hope this helps. It seems like you and your sister are doing a wonderful job of caring for her.

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