Dear Dr. Garner,
My ankles and feet have been swelling each night. It seems to have gotten worse during the past mini-heat wave we had. I can’t fit in my shoes, and when I press on my ankles, it leaves a mark.
I am a healthy 78-year-old. I do have thyroid problems, and I take several blood pressure medications.
I have occasionally had swollen feet, but this is the worst it has ever been. It doesn’t hurt, but it is annoying not to be able to wear my shoes.
What do you think I can do to alleviate this problem?
Swollen Feet and Ankles
In Ridgewood
Dear Swollen,
Before I answer your question, I want to wish all of our loyal readers a happy and healthful summer.
It is a great time to get out there and exercise. Remember, walking is even better than running.
I hope to get away for a short while for our annual trip with the Grisafis and Carneseccas to Manchester, Vt. This is a great town, and I highly recommend it. It has outlet shopping, Broadway-quality shows, great paths for hiking and shooting clay targets.
My wife and I also look forward to taking our grandchildren to Coney Island. They may not be ready for the Cyclone but maybe the Wonder Wheel (not the moving car)?
While away, we will run some articles from the past which you may have missed.
Now, back to your question. Your problem is not an uncommon one. I was just discussing this with my good friend Dr. Ron Soave. There are many different causes for the condition, and treatment is aimed at correcting the underlying cause. Therefore, one-size treatment will not fit all.
Usually, swelling of the ankles and feet is not serious. It may be caused by prolonged standing, hot weather, vein problems, hormones and medications, such as blood pressure pills, antidepressants and Motrin-like medication.
On occasion, it may be a sign of a serious underlying condition, such as heart, liver or kidney disease.
Here are some of the more common causes of swollen feet and ankles:
• Pregnancy – The uterus can block some of the blood vessels causing the blood to stay in the area of the feet and ankles within the veins. Usually wearing compression stockings and drinking fluids is helpful. It is also good to lie on your left side as this speeds blood flow back to the heart.
• Injuries – A sprained ankle is one of the most common causes of swelling. It usually responds to elevation of the foot and ankle, compression, bandaging, ice and avoidance of walking. If swelling persists for more than a day, see your doctor.
• Lymphedema – This occurs because of problems within the lymph vessels, which carry the fluid that helps to fight infection in the body. Due to infection or cancer surgery, lymph vessels can become swollen and cause build-up of fluid in the feet and ankles. You should notify your doctor if you notice swelling of your extremities after cancer surgery.
• Venous insufficiency – Normally the veins help keep blood moving upward from the feet to the heart. When they are damaged, the blood stays in the foot and ankle veins and causes swelling.
• Infection – Swelling of the feet and ankles can be related to an underlying infection. This is most common in diabetics with nerve problems. If you are a diabetic, or have nerve problems with your feet, see a doctor immediately if your feet or ankles swell.
• Blood clots – Blood clots in the veins of the leg can block blood flow from the legs back to the heart. It is important to have your doctor check for possible clots that can extend into the lungs and can be deadly.
Swollen ankles and feet can range from being very serious and even life threatening to being a benign nuisance-type condition. It is always a good idea to limit salt intake, exercise, drink fluids and avoid water pills, especially if not prescribed by your doctor.
Thank you for your question, and I wish you a wonderful summer.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.