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What Causes Ankle And Feet Swelling When Suffering From Diabetes?
Question: Hello, I am concerned about my 89 year old Mother. Her feet and ankles have been swelling for about 7 days now. We saw a doctor at the XXXXXXX Clinic on Fri. afternoon. He to her to stop the norvasc and she did. Last night her pressure was 152/80 which is not abnormal for her, a little high on the upper. This morning about 1 hour ago she got up and her BP was 184/122/55 so she took a clondine and we are going to check it in about 30 mins. She has been on Diovan and norvasc and atenolol for some time. She used to be on a diauretic but a while back she dehydrated and spent the night in the hospital so they cut out the diuretic and she has always taken a diuretic with long term BP. She also is in stage IV kidney disease that has been stable but was a bit worse on her last blood work. Of course it is Sunday and the clinic is closed. She has an eye appt. tomorrow at the clinic and the doctor on friday gave her some blood work to have done tomorrow. Would you have any advice? Thanks! XXXX
Brief Answer:
Avoid diuretics
Detailed Answer:
Hi,
I am Dr. Prakash HM and I would like to answer your query.
The blood pressure is fluctuating heavily probably due to the variation in anti-hypertensives. (Medication norvasc being stopped)
Norvasc, if it was started recently could be the cause of ankle and leg edema. But if it was started prior to two months, then it could not be the cause and you need to continue. You can discuss with your doctor regarding that.
An anti-hypertensive cannot be stopped without adding another or increasing the dose of other drugs being used for treatment as blood pressures will start rising.
Over the counter diuretics are not advisable as it can cause dehydration unknown to you and also increase the load on the already severely low functioning kidney. In this condition avoid diuretics and try more of centrally acting ones like clonidine.
Limb elevation can be done for ankle and leg edema in sleeping position. You can keep two to three pillow below the legs so that it is above the cardiac level.
Continue the medications for anti-hypertensives and avoid adding any diuretics at present.
All the hematological parameter and lipid profiles are near normal levels.
Renal function tests are elevated and if it rises still, she might require dialysis in future.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Avoid diuretics
Detailed Answer:
Hi,
I am Dr. Prakash HM and I would like to answer your query.
The blood pressure is fluctuating heavily probably due to the variation in anti-hypertensives. (Medication norvasc being stopped)
Norvasc, if it was started recently could be the cause of ankle and leg edema. But if it was started prior to two months, then it could not be the cause and you need to continue. You can discuss with your doctor regarding that.
An anti-hypertensive cannot be stopped without adding another or increasing the dose of other drugs being used for treatment as blood pressures will start rising.
Over the counter diuretics are not advisable as it can cause dehydration unknown to you and also increase the load on the already severely low functioning kidney. In this condition avoid diuretics and try more of centrally acting ones like clonidine.
Limb elevation can be done for ankle and leg edema in sleeping position. You can keep two to three pillow below the legs so that it is above the cardiac level.
Continue the medications for anti-hypertensives and avoid adding any diuretics at present.
All the hematological parameter and lipid profiles are near normal levels.
Renal function tests are elevated and if it rises still, she might require dialysis in future.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Prasad
Mother had more blood work yesterday. The doctor told her to take half of the Norvasc and added Hydralazine 25 MG tablet twice a day. Her GFR was 39 and it has been as low as 20 but usually stays around 31-32. My father was on dialysis and it was really an awful experience. Mom says she won't do that, but I am sure if it comes to that she will try. Her nephrologist told her about a year ago that she probably would never need dialysis, that something else would get her first.
Thanks for your continued support. I am sure this will be by last followup.
XXXX
Thanks for your continued support. I am sure this will be by last followup.
XXXX
Brief Answer:
Reinforce & prepare her mentally towards dialysis.
Detailed Answer:
Hi,
We are here to support you in every step. Hopefully the swelling has reduced. If the GFR stays at that level, nothing to worry for now.
Dialysis is not such a bad experience as it is made out to be. It is one of the best thing to happen to renal patients. Reinforce her confidence and prepare her mentally.
Other values are extremely good for the age, and I do not find any reason for her survive for long.
If you do not require any further clarifications, you can close the discussion and rate the answers.
Dr. Prakash HM
Reinforce & prepare her mentally towards dialysis.
Detailed Answer:
Hi,
We are here to support you in every step. Hopefully the swelling has reduced. If the GFR stays at that level, nothing to worry for now.
Dialysis is not such a bad experience as it is made out to be. It is one of the best thing to happen to renal patients. Reinforce her confidence and prepare her mentally.
Other values are extremely good for the age, and I do not find any reason for her survive for long.
If you do not require any further clarifications, you can close the discussion and rate the answers.
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Prasad
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