any help

[bobabensa]

hi all
iam 25 years old female suffering from rt ear pulsatile tiinitus of 12 months duration its machinary in nature and disappears when i press on my carotid and so irritable.6 months a go i had a continuous both lower limb edema which sometimes is so tense and painfull.a week ago i experienced a severe calf muscle pain which awakens me from sleep and made me limbing a whole day. i had this calf pain 3 times this week and it is so painful .my echocaridography and venous duplex on lower limbs both r normal ... so what is this pain caused by?
thanks

[DrNavneetMD]

Hello Dear,
The calf pain is due to over stretching or exertion of muscles or dehydration..You should take rest,keep your legs elevated and can massage the legs with NSAID  gel.If the cramps persist you can take Vitamin E on consulting a neurologist.

Oedema has many possible causes. Here are some of the more common ones:
• Prolonged standing or sitting, especially in a very warm environment, can cause excess fluid to accumulate in the feet, ankles and lower legs.
• Swelling of the feet is quite a common experience for people on long-haul flights
• If the valves in leg veins become inefficient, the return of blood to the heart becomes less effective and blood and fluid accumulate in the feet and legs
• Severe chronic lung diseases such as emphysema and bronchitis increase the pressure in the pulmonary blood vessels that lead from the heart to the lungs. This pressure acts back on the right side of the heart and the veins returning blood to it, causing swelling in the legs and feet
• If the heart is no longer pumping efficiently, fluid builds up in the lungs and other parts of the body, particularly the feet and ankles. This is called congestive heart failure
• If protein levels in the blood become low, perhaps because of a poor diet, liver disease or kidney disease, oedema can develop. The proteins in the blood, for example albumen, help to draw fluid back from the tissues into the blood
Increase the excretion of sodium and water by the use of a diuretic. Diuretics help to improve the situation in the short term but are not a cure, and should be used with care. Several types of diuretics are available and they have different sites of action, potencies, and side effects. In view of your age, begin with a low dose to minimise unwanted side effects. Some diuretics lower the amount of potassium in the body, and that is why supplementary potassium may be required while the diuretic is being taken.
Here are some of the things you can try for yourself to see if they help to reduce the swelling:
• Reduce the amount of salt that you take with your food, and avoid processed foods which are often high in salt
• While sitting for prolonged periods at your desk, try contracting and relaxing the muscles of your legs, for example by rocking your feet onto your toes and heels every few minutes. Every hour or so get up and walk around for a while. These activities will improve the circulation in your legs and help fluid return
• Reduce your weight if you feel it is appropriate
• Gradually reduce your fluid intake
• When the swelling is worse than usual, try resting on a bed with your head and legs slightly elevated, perhaps using elasticated stockings designed to reduce swelling of the legs
• Gradually increase your physical activity - a walk followed by elevation of the legs will help to disperse fluid that has accumulated in the feet and ankles
• Ensure good skincare over swollen regions to prevent skin breakdown and infection
• Avoid prolonged hot baths that may aggravate the condition


Best

[PaulMD]

Hi there.

I'm sorry to learn that you are experiencing all these pain.  From what you have described, you can really have some problems with the arteries or blood supply to your different organs.  The venous duplex scan only assesses one component of the circulation which is the venous drainage, however it cannot assess the arterial supply.  The pain can mean that the muscles are not getting enough oxygen.  This can be due to poor arterial supply especially seen in patients who have high cholesterol, patients with blood pressure problems, or primary vascular diseases such as berger's disease.  I suggest that you discuss these possibilities with your doctors to be worked up for such.

For now, be sure your legs get adequate rest.  Gentle massage may also help.
Regards and God bless.