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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Swelling In The Ankles And Sleeplessness While On A CPAP Machine?

I have recently developed swollen ankles. I had open heart surgery about 10 years ago with great results, quad bypass. Also a cardiac stress test with (medicated) heart ultrasound about two months ago. Results were also good. Restarted compression stockings yesterday, didn t help much. Last night removed stockings, overnight most of swelling receeded. Wearing the stockings again today, and for the most part, swelling has returned. Very busy person, but in the evening when i have time, watching TV with feet elevated above heart. Will try sleeping again with stockings removed. I am also on a CPAP maching. Have not been gettinc adequate sleep lately. Going for sleep therapy session(s)starting this Friday at Henry Ford Hospital in West Bloomfield Michigan. Should I be concerned? Are there are other possible problems which may have excasperated the problem? Thank you. PS, my BP is averaging about 140/75, pulse stable at about 55bpm.. HDL AND LDL are under control with meds.
Mon, 26 Nov 2018
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General & Family Physician,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

One of the reasons for swelling in the legs may be due to your hypertension medications especially if you are taking calcium channel blockers like Amlodipine or Nifedipine. Talk to your doctor and see if the medications have to be changed. Consult your cardiologist and get your heart checked with ECG, ECHO, TMT etc. Get blood tests done. See if your kidney is working well with renal function tests like- urea, creatinine.
Seek emergency medical care if you have leg swelling and any of the following signs or symptoms, which may indicate a blood clot in your lungs or a serious heart condition:
i. Chest pain
ii. Difficulty breathing
iii. Shortness of breath with exertion or lying flat in bed
iv. Fainting or dizziness
v. Coughing blood

Certain medical conditions can also result in a swollen ankle or leg. These include:
i. being overweight
ii. venous insufficiency, in which problems with valves of the veins prevents blood from flowing back to the heart
iii. rheumatoid arthritis
iv. blood clots in the leg
v. heart failure
vi. kidney failure
vii. leg infection
viii. liver failure
ix. lymphedema, or swelling caused by a blockage in the lymphatic system
x. previous surgery, such as pelvic, hip, knee, ankle, or foot surgery

To treat a swollen ankle or leg at home, remember the acronym RICE:
i. Rest. Stay off your ankle or leg until you can get to the doctor or until the swelling goes away.
ii. Ice. Put ice on the swollen area as soon as you can for 15 to 20 minutes. Then repeat every three to four hours.
iii. Compression. Wrap your ankle or leg snugly, but be sure not to cut off circulation. Support stockings may be an option.
iv. Elevation. Raise your ankle or leg above your heart (or as far above your heart as possible). Two pillows will usually give you the correct elevation.

This encourages fluid to move away from your leg.
Regards
Dr Sanjay Kini
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What Causes Swelling In The Ankles And Sleeplessness While On A CPAP Machine?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. One of the reasons for swelling in the legs may be due to your hypertension medications especially if you are taking calcium channel blockers like Amlodipine or Nifedipine. Talk to your doctor and see if the medications have to be changed. Consult your cardiologist and get your heart checked with ECG, ECHO, TMT etc. Get blood tests done. See if your kidney is working well with renal function tests like- urea, creatinine. Seek emergency medical care if you have leg swelling and any of the following signs or symptoms, which may indicate a blood clot in your lungs or a serious heart condition: i. Chest pain ii. Difficulty breathing iii. Shortness of breath with exertion or lying flat in bed iv. Fainting or dizziness v. Coughing blood Certain medical conditions can also result in a swollen ankle or leg. These include: i. being overweight ii. venous insufficiency, in which problems with valves of the veins prevents blood from flowing back to the heart iii. rheumatoid arthritis iv. blood clots in the leg v. heart failure vi. kidney failure vii. leg infection viii. liver failure ix. lymphedema, or swelling caused by a blockage in the lymphatic system x. previous surgery, such as pelvic, hip, knee, ankle, or foot surgery To treat a swollen ankle or leg at home, remember the acronym RICE: i. Rest. Stay off your ankle or leg until you can get to the doctor or until the swelling goes away. ii. Ice. Put ice on the swollen area as soon as you can for 15 to 20 minutes. Then repeat every three to four hours. iii. Compression. Wrap your ankle or leg snugly, but be sure not to cut off circulation. Support stockings may be an option. iv. Elevation. Raise your ankle or leg above your heart (or as far above your heart as possible). Two pillows will usually give you the correct elevation. This encourages fluid to move away from your leg. Regards Dr Sanjay Kini