Swollen legs. They just make a person want to sit down and rest.
Why do legs swell anyway?
Normally the arterial circulation and venous circulation are in balance. The same amount of fluid that reaches the legs via the arteries is removed on the return trip, through the venous (and lymphatic) circulation. Proper circulation is also a matter of pressure: the external pressure (air pressure) should be counter-balanced by the internal pressure (pressure in the circulation).
When these things get out of balance, legs swell.
Common causes of leg swelling include:
- Bad veins (varicose veins, damaged veins, missing veins, clotted veins)
- Obesity (which may squeeze veins flatter than they should be, like a hose)
- Congestive heart failure (the blood is not pumped strongly enough)
- Medications (such as those that dilate blood vessels or affect the kidneys)
- Excess salt intake (ham especially)
- Insufficient external pressure (high altitude)
- Anemia (which makes the heart have to work harder)
- Low protein (which allows fluid to leak out from the blood stream)
Some of these causes are easily correctable, some are not.
If your veins are bad, elastic compression hose may be all you need, a $20 investment.
If your veins are compressed by a big belly, weight loss should decrease the problem considerably. (Think of all the money you’ll save on food.)
If your heart is not pumping effectively, you may benefit from a diuretic, an ACE inhibitor, or digoxin, all which are available for as little as $4/month. Most patients with congestive heart failure don’t understand their disease as well as they should. Medication helps, but so does not smoking, weight loss, avoiding salt, using compression hose, and optimizing your health in other ways.
If you are on blood pressure or arthritis medications (including ibuprofen and naproxen), ask your doctor if they might be causing swelling. Ask whether you could change your medication rather than add an additional medication to treat swelling.
If your legs swell due to low air pressure, such as when you go on an airplane, support hose or stockings are usually sufficient to counter the decrease in pressure. You don’t necessarily need water pills (diuretics), though sometimes taking a water pill for a day or two after a flight is useful.
If your legs swell when you eat salty food, just don’t do so!
If your legs swell due to anemia or low protein, the answer is to correct the underlying condition. You’ll need to consult your doctor for this problem.
When you see your doctor, make sure you have a thorough understanding of why your legs swell and what you can do about the situation. Often it involves more than one of the above options.
Why not print this out and take it to your next appointment to discuss further?
© Cynthia J Koelker, MD – All rights reserved
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