DEAR DR. DONOHUE: By the end of the day, my feet are so swollen that I can’t keep my shoes on. My ankles are swollen, too. In the morning, they are back down to normal. What’s causing this? What can I do for it? — N.W.
That swelling goes by the name “edema.” It’s fluid that has leaked out of blood vessels. The greatest leakage occurs in the vessels of the lower leg and feet.
Causes? There are many. Varicose veins are one cause. Not the varicose veins that you can see beneath the skin, but the varicose veins that are deep in the tissues, buried from view. Blood pools in those veins, and the fluid part of blood is forced out.
Heart failure is a more serious cause of edema. Here a feeble heart pumps only a little blood out with each heartbeat. Blood backs up in the circulation. Pressure within the blood vessels rises, and once again fluid seeps out into the tissues. Fluid seeps into the lungs, too. It makes it hard for people to get enough oxygen when they’re active. They become short of breath on slight exertion.
Peripheral artery disease is another edema cause. Here obstruction in the leg arteries encourages fluid to escape from them.
If only one leg swells, a likely cause is a blood clot in the veins of that leg. Obstructed lymphatics are another cause of single-leg swelling. Normally, some fluid escapes from the circulation to feed cells. That escaped fluid finds its way back into the circulation through lymphatic channels. If they’re blocked, tissues swell.
The only one who can identify the cause of your edema is your family doctor. While you’re waiting to see the doctor, do some things that can help control swelling. Elevate your legs many times during the day. By elevate, I mean that your legs have to be higher than your heart. You can do that only by lying down with your legs propped up on pillows.
DR. PAUL DONOHUE is a syndicated columnist with North America Syndicate Inc., P.O. Box 536475, Orlando, FL 32853-6475.