Discussions By Condition: I cannot get a diagnosis.

Pitting Edema

Posted In: I cannot get a diagnosis. 11 Replies
  • Posted By: jchurch79
  • March 22, 2009
  • 09:49 PM

I am a 30 yr old female that has had severe, constant pitting edema in my right foot/ankle for over 3 yrs. It was a sudden phenomena that was not induced by any trauma. I have been to many doctors with no answers. The most "concrete" result has been that I have a very low white blood count. I also have a dull, aching pain in my calf and a dull aching pain in my right abdomen that is moderate to severe at times. There are other factors that I am not sure are related or just a mental manifestation of "what if" because of all the unlcear answers thus far. It seems my right side just feels out of whack and painful. I have been living with this for 3yrs and can not just "live with it" as I have been told in the past. I would appreciate any insight anyone may have to present to my current Doctor. Please help me before Summer. It is so severe in the summer that my skin feels as though it may crack.:mad:

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11 Replies:

  • What has been ruled out? What examinations have you had? Have you been evaluated by a vascular surgeon? Have the ruled out deep vein thrombosis?
    Felsen 510 Replies Flag this Response
  • Are you currently taking any medications including bc?DOM
    acuann 3080 Replies Flag this Response
  • What has been ruled out? What examinations have you had? Have you been evaluated by a vascular surgeon? Have the ruled out deep vein thrombosis? I have had several dopplers under one dr., but did not find out for a year later after visiting another doctor that it was suggested I have more. The vascular surgeon I saw saw me for literally 2 seconds and w/o examining me said I will "just have to live with it." I also had an abdominal ultrasound done because they thought maybe I had a growth that was blocking the blood flow. I do have ovarian cysts, but they said they were not large enough to cause the blockage. i don't know if dvt has been necessarily "ruled out." From my understanding, that is the only guesstimate thus far. I need some time of suggestion, b/c like today, some days it is fairly painful. I was prescribed a water pill at one point in time to contain the swelling, but I don't take them b/c I feel that that is just masking the nderlying problem I also am not sure if it is related, but for awhile now I have had a pain in my lower right addomen as well as some unusual menstrual cycles. I do not know part of this is b/c I am 30 or what.
    jchurch79 2 Replies Flag this Response
  • Are you currently taking any medications including bc?DOM I do not take any medication. I had a tubal done when I was 25.
    jchurch79 2 Replies Flag this Response
  • I think that the pain in your right lower abdomen is connected to the swollen right ankle. Since the problem showed up suddenly, I think that it was due to deep vein thrombosis in your right common iliac vein. Your vascular surgeon obviously lacks the most basic knowledge in the field. You need to see a better vascular surgeon. Here is a suggestion, what it is all about. By the way, are you in US? There is a condition called May-Thurner syndrome. It is when the right iliac artery compresses the left iliac vein against the spine. This causes the blood to congest in the left leg because it can not normally pass the compression on its way back to the heart. It does not necessarily results in the pain at the compression site (if it does it gives a lower back pain); most often it causes pain or swelling or both in the left leg and/or buttock/lower abdomen. Sometimes the anatomical structures are different and this can happen on the right side, this is what I think you have. If you have a compression like this, after a while your circulatory system is trying to develop alternative veins. They are called collateral veins. Most often there are transpelvis collaterals (horizontal ones from left to right in pelvis, or in your case from right to left), but some patients can develop them near the spine or even inside it. Then it can give pressure on nerves and give numbness and tingling sensation in legs. Another typical symptom is ambulating pain, the pain moves around depending on where the pressure is high at the moment. Also, the pain subsides when you lay down. After a while the compressed vein is starting to produce a sort of scar tissue, which even more prevents the blood flow. Eventually a thrombosis forms at the compression site. This condition is vastly underdiagnosed. It is impossible to discover with ultrasound and even difficult to discover with venography (phlebography). The only certain way to discover it is by means of intravascular ultrasound (IVUS) where the probe is inside the vein. The best research has been done by Neglén and Raju in Jackson, Miss. The treatment is dilate the compression site and to put a stent inside the vein. The typical patient is a young – middle-aged woman, previously healthy where the doctors have not found other explanation for the symptoms. Could this possibly help? The best of luck! :)
    Felsen 510 Replies Flag this Response
  • It's me again. I just wanted to summerize my post by saying that in my opinion you have in your common iliac vein, either a compression, a deep vein thrombosis (probably partly recanalized) or both. Good luck!
    Felsen 510 Replies Flag this Response
  • I meant in your right common iliac vein... ;)
    Felsen 510 Replies Flag this Response
  • Well, I don't have the cause of your edema, but I do know what will help. You can only do this if DVT has been ruled out, however. There is a type of massage known as lymphatic drainage. You can google it. It uses very, very light pressure (a nickel's weight) to activate your lymphatic system to remove the fluid. It's very effective, my clients who have chronic knee swelling love it. It is time consuming and tedious for the MT, but it should feel very relaxing to you. It is normally done on women with breast cancer who fill with fluid after a mastectomy, but it works on all edema. You do have to find someone very well qualified....check your local cancer treatment center for a MT with experience doing this. You also want to be certain that you do not have a thrombosis, any massage can dislodge the clot causing embolus. But, this helps many with edema, I don't see why it wouldn't help you.
    Harmonium 322 Replies Flag this Response
  • Hi I was wondering if you have found a solution to your problem? I have very similar symptoms. I am 27 and for about four years I have had pitting edema in my right foot/ankle/calf. DVT was ruled out and my doctor just gave me compression stalkings to wear. I feel like there must be something else going on... I have an appointment with a cardiologist in a few weeks. I have read about insufficient veins but it seems to only happen to older people. Anyways...we seem to have a similar situation and if you have found any resolution please share! Thanks.
    Anonymous 42789 Replies
    • September 11, 2009
    • 06:46 PM
    • 0
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  • I'm sorry to hear about your pain. Have you gotten any new information about what may be wrong? I know someone who also has pitted edema in only his left foot. It has been going on for 5 years now & is very painful. He also has pain in his left side. He didn't experience any trauma that brought this on. It just started happening one day. He has been through so many tests at the Mayo Clinic & they have found absolutely nothing wrong to date. I was hoping to reach out and see if anyone else has found an answer or could help in any way.
    April73 1 Replies
    • December 9, 2010
    • 09:20 PM
    • 0
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  • I'm confused and would appreciate enlightenment. I have loved salting my food all my life. In 1998 I discovered that both my ankles were swollen. I felt very poorly in the ensuing days and called my doctor. He asked me to squeeze the swelling around my ankles and whether it left a pit. When I confirmed this my doctor told me this was "pitting edema" and it was either caused by heart, kidney, or liver failure. A fasting blood test and urine test showed that my liver and kidneys were fine. A pair of cardiologists ran the gamut of tests on me, including electro-cardiogram, echo cardiogram, and stress test. One of them asked me whether I salted my food and I replied, "How did you know?" I was told that I had LVH (left ventricular hypertrophy). But three other cardiologists disagreed with this diagnosis and told me my left ventricle was normal. All during this time period I virtually ceased salting my food and the edema went away. But over time I became careless and resumed salting every bite of food. Pitting edema of my ankles is transient and depends upon how heavily I salt my food. I made the mistake of buying spicy salt which I drown my food in and one night last week it appeared as if I had large navel oranges in my socks where my ankles are; the swelling formed above the shoe line and obscured my ankle bones. Squeezing the swelling was like squeezing soft clay, leaving deep pits. I corrected my behavior and the swelling went away. Yesterday morning I asked my new doctor about this and he dismissed it casually as nothing more than water retention caused by too much salt. I would appreciate knowing whether I'm playing with fire when I salt a lot. If it's no big deal, like my current doctor seems to imply, then why should I stop doing what I like? Thank you.
    Anonymous 42789 Replies Flag this Response
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