Suggest Treatment For Severe Swelling In The Ankles

Posted on Sat, 24 Sep 2016

Question: I took a flight from xxxxxxx to XXXXXXX My ankles usually swell terribly any time I fly but last night something strange happened. I touched my tongue to the back of my upper teeth and blood literally started pouring out of my mouth. Not a scant amount but pouring out for a good 10 minutes. The next morning, there was nothing. It's completely fine. This has never happened before. My teeth and gums are healthy. I am a post surgically menopausal 49 year old in excellent health. Mildly obese. I do not smoke, drink or do any drugs. I take lamictal for seizures due to head trauma 20+ years ago, no changes in meds.

Should I be concerned?

Answered by Dr. Shailja Puri (19 minutes later)

Brief Answer:
Disorder of platelets, clotting factors or vessel wall suspected.

Detailed Answer:
Hello,
Thanks for posting your query on Health Care Magic.

Bleeding from back of teeth (gums most probably) without any history of trauma is suggestive of some disorder of platelets, clotting factors or vessel wall.

I suggest you to take up some preliminary investigations- platelet count, bleeding time, clotting time, prothrombin time and activated partial thromboplastin time.

These investigations are done to assess the status of platelets and clotting pathway.

A fall in platelets can occur following use of lamcital, however, the above mentioned investigations need to be taken up before concluding anything.

In addition, I would like to know whether you are hypertensive because swelling of feet is common in hypertensive individuals.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Shailja Puri (42 minutes later)

No history of HTN. My BP is normally around 126/ 76, pulse always wnl. Generally around 80. I have been taking Lamictal on and off for nearly 20 years. I am currently at 200 mgs qd, much lower than the 300 mgs bid I was once on a decade ago, so I'm not sure about that being a factor...although I am nearly 50 now, if that matters. I am prone to iron deficient anemia now and then, but generally one or two iron supplements a week get me back on track. I give blood every 60 days and have never had bleeding issues. I will go to a hematologist for a PT/PTT follow up as recommended.

Could this be caused by any underlying disease factor I should be immediately concerned with?

sidenote: I currently have a double middle ear infection. I do have Epstein Barr but it's never really interfered with my health, and I have interstitial cystitis, chronic since I'm 14 years old. I am allergic to aspirin, Dilantin and all nuts. I have not taken any naproxen or ibuprofen type medications in weeks.

Answered by Dr. Shailja Puri (2 hours later)

Brief Answer:
None of the co-morbid conditions are responsible,take tests mentioned above

Detailed Answer:
Hello and welcome again,
I understand your concern.
However, none of your co-morbid conditions are responsible for the symptom of bleeding.
I only suggest you to take up the preliminary tests mentioned above.
If the tests are normal and similar episode does not recur there is nothing to worry about.

Thanks and take care
Dr Shailja Puri

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Raju A.T