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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Swelling In The Legs And Feet

Good evening. I take Bemetanide daily. 2 - 1 mg tablets in the morning and 2 in the afternoon. If I don t take them my feet and legs will swell. Along with these I have to take a total of 200 meq s of potassium tablets per day to keep my potassium within range. Although sometimes my legs and feet will still swell and my potassium drops to a critical level. Such as yesterday it dropped to 2.7 at the hospital. Nobody can even tell me why I need to take the diuretics to start with??
Wed, 1 Feb 2017
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General & Family Physician 's  Response
Hello! Thank you for your query. Edema (swelling) of the feet and legs may indicate an underlying problem. Have you been diagnosed with a heart, liver or kidney problem? As these 3 may cause salt retention leading to fluid accumulation as manifested in swelling of the feet and legs, you have been prescribed with a diuretic such as Bumetanide to decrease it. Bumetanide is not a potassium sparing diuretic so it induces excretion of water and electrolytes(including potassium), this may lead to decrease potassium levels in your body.

Furthermore, it is important that we look into the root cause of your edema. Primary causes of edema includes the following:
1.) Heart failure- this happens when the heart's pumping of blood becomes weakened, it exerts more effort and blood does not move efficiently through the circulatory system, increasing the pressure in the blood vessels and forcing fluid from the blood vessels into body tissues, the symptoms depend on which area of the body is most involved. When the right side of the heart fails, fluid/water usually accumulates in the feet and lower leg.

2.)kidney- Heart failure and kidney disease impairs kidney function, the ability to excrete salt in the urine is limited. In both conditions, the amount of salt in the body increases, which causes the patient to retain water and develop edema.

3.)Liver- severe liver disease such as cirrhosis may cause retention of fluid. Cirrhosis may lead to low levels of albumin and protein. Albumin and other proteins in the blood keep fluid in your blood vessels.

For further work up, your doctor may suggest you to have your Glomerular Filtration rate, Blood Urea Nitrogen and Creatinine levels to check for functioning of kidneys, an Electrocardiogram or 2d echocardiogram for the heart and Liver function test SGOT, SGPT, Albumin levels to check for functioning of liver. If the main cause is identified and treated then your edema(swelling) will also subside. Please visit your medical doctor for further evaluation.


For the meantime, avoid intake of food high in salt content. Also limit your water intake.



I hope this helps, your feedback is greatly appreciated.
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Suggest Treatment For Swelling In The Legs And Feet

Hello! Thank you for your query. Edema (swelling) of the feet and legs may indicate an underlying problem. Have you been diagnosed with a heart, liver or kidney problem? As these 3 may cause salt retention leading to fluid accumulation as manifested in swelling of the feet and legs, you have been prescribed with a diuretic such as Bumetanide to decrease it. Bumetanide is not a potassium sparing diuretic so it induces excretion of water and electrolytes(including potassium), this may lead to decrease potassium levels in your body. Furthermore, it is important that we look into the root cause of your edema. Primary causes of edema includes the following: 1.) Heart failure- this happens when the heart s pumping of blood becomes weakened, it exerts more effort and blood does not move efficiently through the circulatory system, increasing the pressure in the blood vessels and forcing fluid from the blood vessels into body tissues, the symptoms depend on which area of the body is most involved. When the right side of the heart fails, fluid/water usually accumulates in the feet and lower leg. 2.)kidney- Heart failure and kidney disease impairs kidney function, the ability to excrete salt in the urine is limited. In both conditions, the amount of salt in the body increases, which causes the patient to retain water and develop edema. 3.)Liver- severe liver disease such as cirrhosis may cause retention of fluid. Cirrhosis may lead to low levels of albumin and protein. Albumin and other proteins in the blood keep fluid in your blood vessels. For further work up, your doctor may suggest you to have your Glomerular Filtration rate, Blood Urea Nitrogen and Creatinine levels to check for functioning of kidneys, an Electrocardiogram or 2d echocardiogram for the heart and Liver function test SGOT, SGPT, Albumin levels to check for functioning of liver. If the main cause is identified and treated then your edema(swelling) will also subside. Please visit your medical doctor for further evaluation. For the meantime, avoid intake of food high in salt content. Also limit your water intake. I hope this helps, your feedback is greatly appreciated. Thank you!