Monday, March 12, 2018

Troubled by leg swelling? Read this


By Dr Lugano Wilson

I have encountered many women, young and old; with this problem—swelling of the lower limbs.

Many of them say, they had sought treatment in vain.

They are keen to know what’s amiss with their legs and feet but none has clear answers, though. They are awaiting treatment for their problem.

Having gone through a series of medical tests; the heart and kidneys have been declared fit. Findings are normal. They have been advised to cut down on salt consumption which they did, however, their condition persists.

More than 80 percent of the lower limb swelling patients that I have encountered are women.

Many have been told that it’s a sign of heart or kidney diseases.

Why are most of them female? Why not men?

Swelling of foot, leg or ankle when fluid gathers therein, it’s medically termed as peripheral oedema.

Causes are many but doctors can endeavor to trace the source of the problem, however in a lot of rural hospitals in Tanzania, the true diagnosis can barely be made. This is due to lack of important diagnostic tools.

Scientifically speaking, fluid buildup (edema), happens when the tissues or blood vessels in your legs hold more fluid than they should, according to WebMD.

This can happen if you simply spend a long day on your feet or sit for too long, but it may also be a sign that you are overweight or don’t get enough exercise or it could mean you have a more serious medical condition. Again, inflammation can also be the cause, here it happens when tissues in your leg get irritated and swollen, and it’s a natural response if you break a bone or tear a tendon or ligament but also, it could be a sign of a serious inflammatory illness like arthritis.

A myriad of specific causes can be expounded as follows.

I have diagnosed many women complaining of lower limb swelling as the case of what doctors abbreviate as DVT (Deep Venous Thrombosis). This condition means that there is a blood clot in a vein in your leg, here doctors in Tanzania are very circumspect.

At any given time, this clot can break off and travel to your lungs. When this happens, a more serious condition is likely to occur, it’s called pulmonary embolism.

There is a less similar condition, known as thrombophlebitis. Here, the clots form closer to the surface of the skin and aren’t likely to break off.

One of the initial symptoms of DVT or thrombophlebitis is having a swollen leg, as the blood accumulates in the area.

Consult your doctor right away if you have a swelling in one leg or any of these other symptoms: leg pain, tenderness, or cramping, skin that’s tinged or blue, skin that feels warm.

So in the event of oedema happening on one side it, doctors will suspect DVT and can diagnose this in a short time.

A woman at the hospital asked, “Daktari, mbona sina mimba sasa kwanini miguu yangu ina vimba ?” (Why are my legs swollen whilst am not even pregnant?)

All women are aware that it’s during pregnancy that their limbs may swell.

But many pregnant women are oblivious of the fact that by the third trimester a growing baby puts pressure on their veins in their legs.

This slows that the circulation of blood causes fluid to build up; calumniating into mild swelling

Yes it’s true that it can be a heart problem, this happens when your heart is too weak to pump all your blood your body needs, hence fluid accumulates in your legs especially in heart failure patients. However, other symptoms of heart failure include shortness of breath, tiredness and cough.

But mind you, eg swelling is not always a sign of heart or blood circulation problem or kidney disease.

One may experience swelling owing to fluid build-up from being overweight, being inactive, after sitting or standing for a long time or wearing tight stockings.

Some medicines can also cause leg swelling.

What doctors call varicose veins, is what happens when valves inside a person’s leg veins do not keep the blood flowing up toward your heart.

Have you ever heard the so called premenstrual edema? Some women experience premenstrual edema and weight gain.

It’s generalized and tends to occur few days before beginning menses and vanishes when the menses begin.