Are your legs or feet swollen persistently, or does swelling appear in your leg at the fag end of the day after office hours? Or did you have an episode of sudden appearance of swelling in one or both legs a few months or a few years back, but you found the swelling reduced though , but still persisting. Do you suffer from recurrent swelling in the leg as well as difficulty in walking and get tired early? Do you develop breathing problem while walking with a swollen leg?
Have your swollen leg recently developed red or blue patches on its skin surface, or eczema or ulcer? If yes, please do not sit idle. Consult a vascular or cardiovascular surgeon immediately.
Why does leg swelling occur?
There are several reasons of leg swelling:
Chronic Venous efficiency
The problem of Chronic Venous efficiency (CVI) tops the list of causes of leg swelling. In this disease, the mechanism of carrying back desaturated blood with a very low content of oxygen from the legs to the lung gets slowed and deranged. This leads to an accumulation of deoxygenated blood into the leg and feet.
As a result of a lack daily walk habit, most young males and females fall victim of this disease. With a steady emergence of new vocations every month, the problem of CVI too keeps catching up. The root cause of this problem is the uninterrupted prolonged sitting hours from morning till evening in offices of various multinational and other private organisations .
Blockade of leg veins
Leg swelling is also caused by a disease of the vein called Post Thrombotic Syndrome (PTS) whereby old blood clots are permanently stationed inside the vein, and thus affect the drainage system of the legs. Patients suffering from such problem must consult a cardiovascular surgeon and start treatment under his or her guidance.
Blockade of lymphatic channels
Our body has two types of liquids, one is the blood and another lymph, which is full of proteins. When due to any condition, the channels carrying lymph develop blockade, this results into an accumulation of lymph in the legs and feet , thus leading to swelling in the feet-this becomes deformed in due course if prompt and effective treatment is not initiated in time. The existing lymphatic channel of the leg may get blocked due to infection, or an old injury or a cancer.
Congenital abnormality of the veins
Sometimes children are born with structural abnormalities of leg veins which are not obvious at the early stage. As their age advances, these congenital abnormalities become noticeable and impart abnormal shape to the legs.
Certain medicines
Atimes leg swelling appears after use of some medicines. Drugs used for controlling blood pressure, hormones, and medicines meant for inflammation and mental illnesses contribute to leg swelling.
Where to go if you have leg swelling?
A detailed study of leg swelling requires a battery of some latest investigations like Doppler study, venography, lymph scintigraphy and ventilation perfusion scan. One should always go to the hospital where these modern investigations are available. Before entering any hospital make sure to find out whether a full time vascular or a cardiovascular surgeon is available there or not.
Treatment options
Operation is not required in most leg swelling cases. Initially some specific non-surgical treatment like medicines, special exercises and intermittent pneumatic compression are used to control the swelling .Sometimes special surgical procedures such as venous bypass surgery, debulking operation, lymphatic channel surgery and lymph node transplantation among others are employed.
Precautions to take in cases of leg swelling
1. Avoid postures or occupations that involve prolonged standing or prolonged sitting because this will aggravate the resistance to easy venous return as well as lymph from the leg.
2. Avoid excess weight and obesity. Shedding excess kilogram takes unnecessary pressure off the drainage system of your leg. Keep an eye on your legs. Fibrous and low calories diet is essential .
3. Avoid jogging; skipping, aeorobics and other exercise which involve repeated impact on knee joint. It can do more harm than good. Gentle stretching exercises are helpful.
4. Avoid tight clothing around your waist. These tight clothing will restrict circulation.
5. Avoid high heels. Low –heeled shoes work calf muscles more, which is better for veins.
6. Leg evaluation is very beneficial. In an informal place or while watching television at home, keep your legs elevated. Keep the foot of your bed elevated by between 6 -12 inches. It will facilitate drainage of legs at night.
7. Do daily morning walk for at least 6-8km with leg stockings. Remember no walking without wearing stockings. Walking without stockings does aggravate the problem rather than solving it.
Walking is the best exercise for you, as it will encourage blood circulation in your legs.
8. Doing yogic exercise involving postures where legs remain elevated for a few minutes are helpful.
9. Do wear graduated compression stockings daily from the time you get out of bed until you retire at night. Stockings promote circulation and help limit gravity’s downward pull thus preventing leg swelling syndrome.
10. If at any stage, you develop ulcer or eczema on your swollen legs , consult immediately your vascular or cardio-vascular surgeon.
Dr Pandey is a Senior Vascular and Cardiothoracic Surgeon at Indraprastha Apollo Hospital, New Delhi, India, and can be reached on drpandeykk@gmail.com
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