Oedema?

[wishbone]

A recent immunology report stated I have 'mild pitting ankle oedema'. I've read that being active can help lessen the swelling, but in my case swelling increases after I've been on my feet a while. When I wake in the morning after the usual 'bad' night's sleep there's less swelling and ankles don't ache so much. Is this normal behaviour for oedema as it does seem a bit odd if being active is supposed to help?

[hawker955]

Hello Wishbone. There is a battle between gravity and your muscles. Gravity pulls fluid down of course and muscular activity drives it back up again. Ideally I suppose, lying on your back while pedalling your legs up in the air would be the best option but might be impractical!. Standing still is the bad option. Walking or cycling are better to force fluid to move around. Warmth is better than cold, because coldness reduces blood flow warmth increases it. Most of the fluid of the oedema has to be carried away by the blood-stream so hence do not decrease blood flow. That is just part of why moving the legs helps.

I hope this helps.

[wishbone in reply to hawker955]

Thanks hawker, very enlightening.

Up until the recent immunology report I had not paid much attention to my ankles as I thought the swelling was caused by RA inflammation. I stopped taking aspirin approx 6 moths back due to acid reflux. Could this be related to the oedema?

[dwsurquhart]

I quite regularly have pitting edema in my lower legs due to inflammatory poly arthropothy. That is what the docs are calling my condition now.

If I spend a bit of time on my feet or drive more than an hour I have very warm legs and the edema is quite bad. I have started taking furosemide. It is a diuretic so I pee a lot around an hour after taking 10mg. I find that within 3-5 hours, my edema has gone away.

I am currently on tocilizumab IVq4weeks and I find that the edema is the worst for a week after the infusion. I tend to be like a sponge and absorb fluid like crazy.

I have tried the compression stocking and the swelling or edema just moves up to above my knees and causes even more issues. I have tried laying on the floor with my legs elevated and also with compression stockings and this does not seem to work either. Riding a bicycle works a little for the hour I ride my bike then it seems to come back even more.

Hopefully you find something that works for you.

Scott

[wishbone in reply to dwsurquhart]

Thanks Scott,

Riding a bike, laying on the floor with elevated legs are alas, out of the question. As are most physical activities, even swimming, which is supposed to be beneficial and not too strenuous for people with RA. Feet are not good so walking is limited to not much more than a hundred yards. Seems like inactivity could be the main cause of my oedema.

Anyway, it's nowhere near as bad as yours and doesn't really trouble me. If the immunologist was concerned I think he would have asked me to visit my GP.

Hope you stay ok.