Pitting Oedema

[lizzie66]

Can anyone tell me the difference between 'Pitting Oedema' and Lymphoedema please? I have struggled with swollen feet/ankles and left leg for many years now and have seen 4 different GP's about this as I have moved and changed surgeries. Not one gave me a diagnosis and the only advice I received was to keep my feet up above my heart every evening, all evening. I see a Rheumatologist now as I have severe Osteoporosis and 3 forms of Arthritis. At my last appointment I asked him to look at my left leg etc and he pressed his thumb into an area of the leg above my ankle then waited to see how long it took to fill. He then said I had Pitting Oedema and needed a surgical stocking made to measure and he would write to my surgery. Well, he forgot and his letter only contained updates of the other matters. I am puzzled to be honest as I have never heard of pitting oedema, hence my question to anyone who knows the difference between this and lymph.

[Lynora]

Pitting oedema is generally caused by interstitial fluid pooling in the skin of the lower legs feet, hands, arms and other parts, often as a result of poor venous return, and can be alleviated with elevation, use of diuretics and anti-inflammatory meds - and low grade compression (Class 1 is often enough).

Lymphoedema is caused by a a failure in the lymphatic system above the area affected, and any pitting is generally at the milder stage of the condition - once pitting is not possible, the limb (usually just one limb in primary lymphoedema) becomes hard and fibrotic. Lymphoedema does not respond to diuretics or anti-inflammatory meds - these can make the condition worse. Lymphoedema needs much higher grade compression - often as much as Class 3 or 4 (and a small army of strong men to apply it!)

[lizzie66 in reply to Lynora]

Thank you Lenora. Why on earth can't the GP's or Rheumatologist tell a patient this? It is nearly 10 years now since I first started looking for a diagnosis and help with this condition. Diuretics have been tried on 3 or 4 occasions but did not help me at all. Anti-inflammatory meds I have been told not to take but am unsure why. The reason has got lost in the mists of time. In the warm/hot weather my whole left leg swells until I am unable to even twirl my foot. The pooling around the ankle is so intense that the outer ankle throbs. The skin on my leg up to my knee gets lumpy and red and at its worst fluid starts to leak out. I use Balneum Cream to moisturise but am unable to reach my feet as I have lumbar issues having 2 or 3 crumbled vertebrae. I was diagnosed with breast cancer last year and had a left mastectomy and lymph node removal. So, am doing my best to avoid any nicks or cuts on left hand or arm where bacteria can get in as have been warned that it is possible to get lymphoedema in that arm and hand. Based on the foot/leg information do you believe that a Class 1 compression stocking would be the best thing for me and easier for me to put on myself as I live alone? Is there a gadget that you know of that would help me to put this on myself?

I am sorry to ask these questions but even though my Consultant diagnosed pitting oedema he gave me no information that would be helpful to me in dealing with it and totally forgot to inform my Doctor. I don't see him again now for 11 months. Perhaps other members could chime in on this if there are any who have similar problems.

[Lynora in reply to lizzie66]

Whereabouts are you? I could find an independent therapist who would be able to advise you and assess you for the right form of compression.

[GabbiD in reply to lizzie66]

My lymphoedema specialist said diruetics actually make it worse because it removes the water and leaves the thicker lymph fluid. It makes it harder to reduce. Hopefully you find a specialist that can get you custom garments. I havent taken diruetics since wearing compression. Good luck.

[lizzie66 in reply to GabbiD]

Thank you GabbiD, good to know!

[lizzie66]

I now live in Leicester, just 3 miles out of City centre in West Knighton. Thanks Lynora.

[Lynora]

Lizzie - I sent you a PM - the little speech bubbles at the top of the page should have changed colour.

[AnneBury]

Have you looked at the website of the Lymphoedema Support Network lymphoedema.org ? They also have a telephone helpline (details on website).