[Kwag_Myers]

At first, I thought it might be the Lyrica, but I've been off of that for a couple of months. It comes and goes on my right side, but pretty consistent on the left. My physical therapist suggested compression socks. Has anyone had something similar? Suggestions?

This post has been edited by Kwag_Myers: 11 January 2008 - 03:21 PM

[edlee]

I don't know if it's the same as mine, but I've had mine since the injury.

Mine was my lower half at first, but diminished until now it only involves my calves, ankles and feet.

I've used the compression socks, and they do seem to work to some extent, tho the swelling comes back as soon as they are not used for a day. They don't do much around the ankles because they aren't tight enough there, I guess.

Keeping them elevated at night helps. It was also suggested by one doctor to elevate them when ever possible during the day. I haven't noticed much difference doing that , due, I think, to having my shoes on and not being able to tell if it helped or not. There was no difference when I took them off at night.

I doubt I've been much help. Just wanted to let you know that I'm in the same boat as you.

If you find something that works, let me know.
ed

[Apparelyzed]

Hi,

I think this should be of use to you:

http://www.apparelyz...p?showtopic=201

Regards

Simon

[kewlcatkez]

Hello,


I am sure that Simon's link has been very useful. I would just like to mention a few other causes of swelling. I am pretty confident that swelling in those of us who use chairs for long periods is due to gravity and restricted movement/circulatory process ( including venous return).

Someone posted a very similar post to yours (hers was one leg too) at the beginning of the month. I have modified my answer to her, so that its of hopefully more use! ( see Other thread for those posts).

If there is any doubt, then it is essential to rule out an emboli and fractures. That done, it narrows down the possible causes.

By far the most common cause (DVT excluded) in those of us who use a wheelchair for long periods is peripheral Oedema caused by Gravity, and lack of leg movement. Pressure stockings (Hose) and 'flying socks' can be used to encourage the blood to remove the excess fluid back to the heart. Some people wear TED's ( anti embolism socks) however, these should be used with caution as they are usually tight and can cause pressure areas to increase, plus they don't tend to apply enough pressure at the ankle area. Stockings should aim to apply more pressure at the ankle to aid in the removal of oedema. Drs also advise that you elevate your legs whenever you can and that you massage am and pm, and moving your legs ( by hand) periodically. They also advice to drink 8 glasses of water a day to assist in the water removal process.

Other reasons for leg oedema include: some women find that at the time of their periods, they also have increase lower limb swelling. Also, some of the medications used to control Diabetes called thiazolidinediones can cause Peripheral oedema, these drugs increase your body's sensitivity to insulin. ( Interestingly, Lyrica has swelling listed as a side effect. I am not sure if it would be an issue this long after finishing with Lyrica, but if the swelling was significant, I would think it possible).

Venous insufficiency may also lead to peripheral oedema when linked to Deeep vein Throbosis.

Other causes include, Heart Failure, Kidney disease, Cirrhosis and Sometimes if a person is taking Diuretics, it may be an indication that they are not being effective.

Have you ever injured your leg before? Which leg is it?

Legs which have had past fracture or injury, you can have oedema ( edema if you are from the uSA) due to the interruption to the body's usual fluid removal processes. This is more likely if the oedema is in one leg only, however other causes can also mean just one leg involvement, although it is less common than bilateral.
The above type of oedema can also be due to removal or interruption of the 'nodes' in the groin for the leg just like the armpit for the arm.
Lower leg Oedema is usually referred to as being Peripheral.


I hope that this helps and you resolve it as far as possible,
To completely rule out DVT ( clots), a Doppler scan and/or dye test, venogram are usually used. If this can not for some reason, then monitoring can be done with a tape measure to keep an eye on the swelling (by marking the leg with pen to ensure same spot each time) and prophylaxis treatment of blood thinners.


I hope that this is of some use and that you get sorted!

Take care,

K

[Cheshire]

My right leg and foot swells off and on. I've noticed that it got slightly better over winter holiday break when I was using lotion once to twice a day. I was using the lotion to help with skin elasticity and the like, but I think it was the light massaging action of putting the lotion on that helped a little with the swelling...not so much the lotion itself (though my cracking skin thoroughly enjoyed the attention!)

I've also noticed that days I'm up and running all day long have much more swelling than days I lie down for a little while (15-30 min) once or twice as a break.

[Kwag_Myers]

Thx, everyone. Very helpful information from all of you.

I probably should have mentioned that I have regained the use of my legs and haven't used my chair for some time. I'm a bit uncomfortable stating that fact too much because I realize so many of you have not been as fortunate.

Kewlcatkez, I think you're on to something with the injury angle. I have dysplasia in both hips and broke my left hip 12 years ago. Yeah, I was two weeks away from having my first hip replacement when I injured my spinal cord.

Cheshire, I'll try the lotion. I have really dry skin, so I should be using it anyway.

[cate]

Kwag_Myers, on Jan 14 2008, 03:53 PM, said:

Thx, everyone. Very helpful information from all of you.

I probably should have mentioned that I have regained the use of my legs and haven't used my chair for some time. I'm a bit uncomfortable stating that fact too much because I realize so many of you have not been as fortunate.

Kewlcatkez, I think you're on to something with the injury angle. I have dysplasia in both hips and broke my left hip 12 years ago. Yeah, I was two weeks away from having my first hip replacement when I injured my spinal cord.

Cheshire, I'll try the lotion. I have really dry skin, so I should be using it anyway.

Hi
Just thought you maybe should look into lymphodema, which is not the same as odeama, my daughter has this, can be bought on by trauma, also Cancer patients, it is to do with the lymphnodes, and compre3ssion stockings have to be worn, thiese are made to measure, and compression stockings will vary. we have good sites here in the UK, you do also have site in USA called Lymph people., my daughter is c5/6 also a walker, One thing if it is lymphodema, water tablets( duretics) are not a good idea, unfortunately not lot of doctors seem to be aware about that, swollen limbs is usualy thought of as water retention, but it is to do with the protein in the veins, is worth looking into.
Cate

[Kwag_Myers]

My Physiologist seems to think it's a circulation issue, too. So, I'm going to give the socks a try for a couple weeks and see what happens.

Thx again, everyone, for your input.

[kewlcatkez]

cate, on Jan 14 2008, 06:32 PM, said:

, One thing if it is lymphodema, water tablets( duretics) are not a good idea, unfortunately not lot of doctors seem to be aware about that, swollen limbs is usualy thought of as water retention, but it is to do with the protein in the veins, is worth looking into.
Cate

Hi,

Lymphoedema usually has a root cause. This can be prior injury to the veins from say a fracture, from disruption of the Lymphatic system by removal or sampling of Lymph nodes due to Cancer, or cosmetic/health required breast surgery. In this case, you are partially true regarding the fact that diuretics are not helpful, and can cause added issues. The best treatment of this and led swelling due to 'gravity' in chair users, is to drink plenty of fluids ( water content) and massage and use gravity to encourage the movement of the fluid out of the tissues and into the circulatory system.

Unfortunately, there is no way of knowing whether the leg oedema is due to gravity alone, "protein" or water retention. If you think it is 'protein' then I urge that you get a U&E and LFT blood panel drawn. the protein in the veins issue is far less dangerous. If you ignore true water retention which is due to CCF etc, then you run the risk of winding up with Fluid around the Pleural sack of the lungs. As a RN I nursed multitudes of people who refused to take/took too low dose of diuretics. Others didn't drink enough water whilst taking them.

It is important to get monitoring of the situation, esp if you are taking diuretcis or medications which have a diuretic effect.

HTH

Take care,

K

[kewlcatkez]

Kwag_Myers, on Jan 18 2008, 01:21 AM, said:

My Physiologist seems to think it's a circulation issue, too. So, I'm going to give the socks a try for a couple weeks and see what happens.

Thx again, everyone, for your input.

Hi Kwag Myers,

Glad you seem to have the answer, and hopefully the solution. Don't forget to drink plenty of fluids and massage and elevate your legs.. Let us know how things go..

Take care,

K

[darrel]

Kwag_Myers, on Jan 11 2008, 03:20 PM, said:

At first, I thought it might be the Lyrica, but I've been off of that for a couple of months. It comes and goes on my right side, but pretty consistent on the left. My physical therapist suggested compression socks. Has anyone had something similar? Suggestions?

I am on the baclofen pump and just tore a back muscle back on the 21st of Dec. and they increased my pump then and with the lack of spasms and bed rest I ended up not moving my feet very much and the lack of blood flow caused my feet to swell huge, I ended up wearing ted hose and also having my fiancee rubbing my feet for about a half hour a night and the swelling went down I did have to use my therapy band(big ass rubber band) and that helped me move my foot while lieing around...with the movement I have finally been able to get the swelling under control. so, if I were you and had a thera band I would try getting some movement (it also gives you a chance to do some curls) the more movement the better. good luck.

[Motor]

darrel, on Jan 18 2008, 08:19 PM, said:

Kwag_Myers, on Jan 11 2008, 03:20 PM, said:

At first, I thought it might be the Lyrica, but I've been off of that for a couple of months. It comes and goes on my right side, but pretty consistent on the left. My physical therapist suggested compression socks. Has anyone had something similar? Suggestions?

I am on the baclofen pump and just tore a back muscle back on the 21st of Dec. and they increased my pump then and with the lack of spasms and bed rest I ended up not moving my feet very much and the lack of blood flow caused my feet to swell huge, I ended up wearing ted hose and also having my fiancee rubbing my feet for about a half hour a night and the swelling went down I did have to use my therapy band(big ass rubber band) and that helped me move my foot while lieing around...with the movement I have finally been able to get the swelling under control. so, if I were you and had a thera band I would try getting some movement (it also gives you a chance to do some curls) the more movement the better. good luck.

Hey Guys!

I had swelling issues as well. I had to invest in a craftmatic bed so I could elevate my feet at night. That usual solves my swelling issue. I do wind up swollen by the end of a long day in the chair. Been lucky having a big but stopped me from having bed sores. Only had them on heels first few months since then..knock wood none. Funny story while in hospital a nurse usually rubs my buttocks down with cream to prevent sores. Well one night some brain surgeon coverd my butt and scrotum wih BEN GAY. She didn't smell it. Thank god I didn't feel pain..Ouch!

[Kwag_Myers]

kewlcatkez, on Jan 18 2008, 06:08 AM, said:

Hi Kwag Myers,

Glad you seem to have the answer, and hopefully the solution. Don't forget to drink plenty of fluids and massage and elevate your legs.. Let us know how things go..

Take care,

K

Hey Kewl,

Actually, I had to cut back on my fluids a bit. It was either that or cathing more often (I currently cath every four hours during the day).

Anyway, I got a pair of compression socks where I buy my cathing stuff. They're rated at 15-20 mm compression and they cost about $23.00. I should mention that they're dress socks (so I can wear them to work). My wife did some looking around and found that Meijer's has them for $13.00. Only these are 20-30 mm (kind of hard to get on and off).

I noticed a big difference, even after I took the socks off for a while. The morning after I wear them my ankles aren't nearly as swollen. The down side is that the toes aren't compression, but more like a regular sock. So, when I take them off my feet look like I have someone elses toes stuck on.

darrel, on Jan 18 2008, 08:19 PM, said:

...I did have to use my therapy band(big ass rubber band) and that helped me move my foot while lieing around...with the movement I have finally been able to get the swelling under control. so, if I were you and had a thera band I would try getting some movement (it also gives you a chance to do some curls) the more movement the better. good luck.

I use thera bands for my physical therapy, and I agree, it's a good way to exercise your ankles.

[kewlcatkez]

Kwag_Myers, on Jan 29 2008, 01:07 AM, said:

kewlcatkez, on Jan 18 2008, 06:08 AM, said:

Hi Kwag Myers,

Glad you seem to have the answer, and hopefully the solution. Don't forget to drink plenty of fluids and massage and elevate your legs.. Let us know how things go..

Take care,

K

Hey Kewl,

Actually, I had to cut back on my fluids a bit. It was either that or cathing more often (I currently cath every four hours during the day).

Anyway, I got a pair of compression socks where I buy my cathing stuff. They're rated at 15-20 mm compression and they cost about $23.00. I should mention that they're dress socks (so I can wear them to work). My wife did some looking around and found that Meijer's has them for $13.00. Only these are 20-30 mm (kind of hard to get on and off).

I noticed a big difference, even after I took the socks off for a while. The morning after I wear them my ankles aren't nearly as swollen. The down side is that the toes aren't compression, but more like a regular sock. So, when I take them off my feet look like I have someone elses toes stuck on.

darrel, on Jan 18 2008, 08:19 PM, said:

...I did have to use my therapy band(big ass rubber band) and that helped me move my foot while lieing around...with the movement I have finally been able to get the swelling under control. so, if I were you and had a thera band I would try getting some movement (it also gives you a chance to do some curls) the more movement the better. good luck.

I use thera bands for my physical therapy, and I agree, it's a good way to exercise your ankles.

Hi Kwag,

I would like to point out that cutting back fluids is a very dangerous game. If you are needing to cath more often etc etc, then perhaps you should talk to a Urologist/dr about medication/upping existing meds and for investigations ie Urodynamics etc as cutting fluid intake may mean you aren't having accidents, but it could damage your kidneys.

What people fail to realise is that in order to flush fluids from the legs etc, they need to drink plenty to aid osmosis etc.

Take care,

K

[Kwag_Myers]

kewlcatkez, on Jan 29 2008, 05:14 AM, said:

Hi Kwag,

I would like to point out that cutting back fluids is a very dangerous game. If you are needing to cath more often etc etc, then perhaps you should talk to a Urologist/dr about medication/upping existing meds and for investigations ie Urodynamics etc as cutting fluid intake may mean you aren't having accidents, but it could damage your kidneys.

What people fail to realise is that in order to flush fluids from the legs etc, they need to drink plenty to aid osmosis etc.

Take care,

K

Here's the thing: My doctors expect me to regain control of my bladder and are concerned that if I let my bladder get too full (like over 450 cc) then it gets stretched out and prolonging the return of control. 450 cc's is less than 16 ounces. So, for the time being, I try not to drink more than 16 ounces between cathings.

My Urologist has me experimenting with urecholine, but I keep having some really bad reactions to it. It also makes my cath levels go crazy - for a few days they're really high, like 700-800 cc, the next few days they're really low. Oh, and the only time I have accidents is when I'm on the stuff.

[kewlcatkez]

Kwag_Myers, on Jan 29 2008, 01:10 PM, said:

kewlcatkez, on Jan 29 2008, 05:14 AM, said:

Hi Kwag,

I would like to point out that cutting back fluids is a very dangerous game. If you are needing to cath more often etc etc, then perhaps you should talk to a Urologist/dr about medication/upping existing meds and for investigations ie Urodynamics etc as cutting fluid intake may mean you aren't having accidents, but it could damage your kidneys.

What people fail to realise is that in order to flush fluids from the legs etc, they need to drink plenty to aid osmosis etc.

Take care,

K

Here's the thing: My doctors expect me to regain control of my bladder and are concerned that if I let my bladder get too full (like over 450 cc) then it gets stretched out and prolonging the return of control. 450 cc's is less than 16 ounces. So, for the time being, I try not to drink more than 16 ounces between cathings.

My Urologist has me experimenting with urecholine, but I keep having some really bad reactions to it. It also makes my cath levels go crazy - for a few days they're really high, like 700-800 cc, the next few days they're really low. Oh, and the only time I have accidents is when I'm on the stuff.

Hi,

I understand the difficulties of having to cath more frequently etc. However, its important to drink plenty and cath more often to prevent those high volumes stretching your bladder. I can relate since I don't leak I just have a bladder which backs up to my kidneys, so I have to cath more frequently.

urecholine as you know, is used when the bladder isn't emptying fully. When cathing, sometimes pockets of urine can prevent fully emptying. Also you are supposed to take plebty of fluids whilst taking this medication, or risk kidney damage,.

The idea is to drink plenty and control and prevent big volumes by cathing more frequently. I know its difficult, but maybe you need to speak with your drs about this.

Curtailing fluid intake is advised in conditions such as Diabetes Insipidus and Renal problems which require dialysis etc. However, usually cutting back fluids is a dangerous game to play. There have to be other options than limiting fluids.

16 ounces is two small glasses of fluid etc. So its not too little an amount, but I would still say that you need to discuss this with your drs.

I myself am a terrible example as I struggle to drink enough I just forget and have to push myself to remember. I think its all linked to when I was working and unable to drink so I just don't get thirsty. This has led to my having chronic and frequent Pyelonephritis, something which I have been warned can lead to scarring and more issues later on.

Ultimately you are an adult and its your call, I just want to point out the facts, so that you can make an informed 'call'.

Take care,

K

[john S.]

Kwag_Myers, on Jan 11 2008, 10:20 AM, said:

At first, I thought it might be the Lyrica, but I've been off of that for a couple of months. It comes and goes on my right side, but pretty consistent on the left. My physical therapist suggested compression socks. Has anyone had something similar? Suggestions?

You must wear compression socks and leggings or you will get a blood clot. Blood clots can break loose and kill you, or leave you without a desire to live. you might get lucky and just loose a foot but still, it kills that balanced in the chair look a lot of us shoot for.
As your muscles atrophy and you stop walking, your lower legs can't force blood back up your leg on what little push your heart produces at that distance. You can get some good socks at almost anyplace that sells shoes, or shoe depending on when you're getting this.
They have an air filled massage boot that fluctuates the air pressure around your foot and leg to help improve circulation, but socks are about all the better our technology has gotten while sitting in the wheelchair.

Good luck
john