Swollen ankles

[NEPatriots12]

I have been experiencing episodes of swollen ankles, worse on left. No pain just swelling.

Is this a PMR symptom? It does get better with putting feet up.

Thanks

[SnazzyD]

Hello,

If it’s new, it might be worth getting it checked out because there can be a few different reasons for it that need ruling out. However, it could be the veins, or rather the valves in them, are struggling to stop the blood flowing backwards due to gravity. Pred can make your veins a bit feeble and the ones in the leg have a particularly hard time due to gravity and pressure from above. The distended veins leak water from the blood into the tissues. Usually people have one side worse than the other and t can be made worse from sitting or standing for long periods. Putting the feet up is good and wearing support socks. Usually it is better in the morning before getting out of bed. A doc needs to do a few checks to make sure there are no other factors at play, causing the excess fluid.

[Daisychain12 in reply to SnazzyD]

Hmmm could that be why my legs look fat? Xx

[SnazzyD in reply to Daisychain12]

Might be. Can look similar to fat but if it is only on the lower legs it is probably fluid. If you press your finger around your ankle it and it leaves an indentation it’s probably fluid, especially if the skin looks stretched and shiny. Fluid also goes more quickly than fat once the cause is addressed, as we all know, fat loss requires more effort! Salt can cause fluid retention when on steroids so is an easy thing to try.

[Daisychain12 in reply to SnazzyD]

Thank you. Just been madly pressing and I think it’s fat!!😳

[PMRpro Ambassador]

I have it occassionally - usually in hot weather or when I have eaten out a few times in a row and eaten food that is far saltier than I am used to. My right leg is almost always worse than my left. It always goes down overnight and sitting with my feet up helps too - so the doctor isn't worried (not that I find that entirely confidence inspiring!).

Snazzy has said everything I would...

[NEPatriots12 in reply to PMRpro]

Thank you all for your insights, I will mention it at my next appt.

I appreciate your help.

[piglette]

I have swollen legs, feet and ankles caused by water retention from pred. A lot of friends seem to be getting swollen ankles who do not have PMR recently from the weather.

[Grants148]

I have swelling above my knees and swolen ankles,both are painful.l have mentioned this several times to a doctor ,one said it was the Pred,the others seemed to ignore it.l am beginning to lose faith in the doctors at my practice.l had an appointment this morning because of my recent PMG flare.,it is my second appointment and each with a different locum.l have increased my dose of Pred to 5 mg,from 3 mg,and l am still having problems with my legs and the ‘pulse’ like tinnitus which the doctor said was probably vasculitus,as it seems to be in rhthym with my pulse.l have been told to keep on 5 mgs.,Pred and it would probably be a few weeks before things settle down.l was told that if l experience missed beats in my head and pulse it is nothing to worry about,and l got the impression that she thought l was being paranoid about it as it is tinnitus and there is nothing they can do about that.l am seriously thinking of going to the A & E GP service if nothing improves in the next week.l wondered if anyone on this forum agrees with the doctor ,am l being over anxious or do l have reason to worry.l have had ECG’s and heart monitors and the problem in my pulse did not happen when l had those,and l think they probably think that l imagine it! I know that tinnitus cannot be cured,but if there is inflammation in the blood vessels in my neck,surely something should be done about it.Sorry for the long ‘rant’.

[PMRpro Ambassador in reply to Grants148]

To some extent I agree with the doctor - but she hasn't communicated well at all.

"Missed" beats aren't anything to worry about unless you feel very dizzy because the gap between beats was too long. Then you need to speak to your GP. But a single early or late beat (which is effectively much the same thing) now and again really isn't a problem.

Does this help?

hrsonline.org/Patient-Resou...

It is very common to "hear" your heart beat like that - often it is how you are lying in bed or something as simple as that. Not even vasculitis.

I doubt the OOH GP service would be much help - they'll just tell you to see your GP and they can't refer you to anyone.

[Grants148]

Thankyou for your reply,it is through the tinnitus that l am made aware of the missed beats,sometimes several times a minute.The same thing is happening when l put my finger on the pulse in my wrist and to my heart rythem.This has happened again recently and seems linked to the flare l am having.l have a constant pulse like beat in my right ear which never goes away,if l did not have that l would not be aware of what is going on.My husband did detect this happening in my pulse too when he was still with me.lt does hopefully calm down eventually.Inflammation was detected below my ear and my GP said that it was probably pinching the blood vessels in my neck,and this causes the problem ,not my heart. Fortunately l have not had any dizzy spells,but last week l had dreadful brain fog and blurring vision in the mornings before the dose of Pred kicked in.l shall have to trust the doctor for now.

[PMRpro Ambassador in reply to Grants148]

If you are experiencing blurred vision in the mornings before the pred then I would say you might need a higher dose of pred - and you need to see a rheumy. Have you seen one at all?

And I would take my husband with me as back-up and insist on seeing a senior doctor, although a locum sometimes can turn up trumps they also often don't have as much interest as the practice senior. Unless they have lost interest - which seems common these days.

[Grants148]

I was referred last year to a Rheumy because of pain and stiffness in my legs PMR pro,they wrote back to say that as l was on a low dose of Pred., they did not think an appointment was necessary.l just carried on and sometimes felt OK,but this last couple of weeks my legs are worse than ever,swelling above the knees and extremely stiff and pain mostly around my ankles which are also rather swolen.l,did point this out to one of the locums,but was just told to take an extra l mg of Pred.l,did ask if maybe it was something different than PMR,but got no reply.l am beginning to lose faith in the practise,sadly my husband passed away last November,two doctors at the surgery said his painful shoulder was a pulled muscle,one week later he had a major heart attack.He was on warfarin and l think they thought it would not be a blood clot,as did my husband when l suggested it could be his heart.He should have been advised to go to A & E.l shall try once more to see the GP who has usually dealt with my PMR,he has been on leave but is back now,trouble is it takes about three weeks to get an appointment with a chosen GP. I could ask for a phone call instead.The locums were very nice and did not rush me at all,but the practice must have lost doctors there ,unless they are on leave too.Thankyou for your advice,it is much appreciated.

[PMRpro Ambassador in reply to Grants148]

If you have blurry vision - do make it clear to them. They will probably blame pred - but if you get nowhere with them it might be worth trying 111 and asking for help.

But if you get ANY visual loss at any time call 999 - because that can be a sign of a TIA or stroke and they will respond to you as an emergency (if they aren't all picking up drunks on a Friday night...). Paramedics in Yorkshire are taught to consider and recognise potential GCA - which is probably more than many doctors are!

[Grants148]

Thankyou PMR pro,my vision has improved since l increased the Pred.,l seem to have good days and bad regarding my legs,depends on how much walking l have done.l was much better before l lowered the Pred and wish l had stayed on 3 mg. l am taking 5 mg now but it does not seem enough,the doctor said to give it a week and see how things are.

[PMRpro Ambassador in reply to Grants148]

Good - hope it continues.