Swelling of my left ankle... Any help?

[Anzel08]

I have a problem in my left ankle and calve since I was a teenager. I've been to many medical doctors and specialists, and no one can seem to find the problem. My ankle would swell very bad during certain days, like mid summer, when I was on my feet for some time etc. During winter there are no swelling at all. I went to my GP, and he thought initially it was a flat feet that resulted in the swelling and directed me to a foot specialist. Then the specialist discovered that both my feet were flat, so that couldn't be the reason for the swelling. Then my GP put me on water medication, which made the problem worse. I went to see another specialist, who did a ultrasound, and discovered that I have a shortage of lymph nodes in my ankle and that the water medication made it worse. Together with poor blood circulation in the left leg and this lack of lymph nodes, the swelling happens from time to time. The specialist then told me to lose weight, which I did. I lost almost 15kg and my ankle still swells. I didn't break my leg/ankle and the x-rays showed nothing as well. My other leg and ankle is perfectly normal. Now, I would like to know if there are some way to treat/correct the blood circulation and flow of fluids down to my food to prevent the swelling? It doesn't hurt, but it can get quite uncomfortable at times as I cant were my shoes. Sometimes, if I poke at the swelling, the hole of my finger will stay in the foot for a few seconds, which is a sign of water buildup. If my ankle swells, the whole foot swells as well. Any ideas? I'm tired of doctors playing guessing games.

[crackerjack4u2]

Hello
My thoughts on this are: because you have a shortage of lymph nodes and poor blood circulation in that area the amount of interstitial fluid- (fluid that comes from the lymph nodes) and blood return to the heart is lowered resulting in the swelling.  

The reason it is worse in the summer and doesn't happen in the winter has to do with the heat and your bodies sodium levels.  When the sodium levels are high it causes your body to retain fluid, resulting in swelling.  Sodium causes fluid to be retained because the body loses fluid by sweating which of course is worse in the summer.

Things that should help:  reduce salt intake, and avoid processed food and drinks with high sodium. elevate leg on pillow while sitting or lying down- the higher the leg is raised the better the return to the heart is.  At night while lying down flat,  if you can prop it up on 2-3 pillows, getting the leg well above the heart level, you will see a significant difference.    Drink plenty of water especially in the summer- this allows for the fluids to be readily available to nourish the body, and prevents the body from having to retain it in order to replenish what is being lost through sweating etc.  

I hope this helps.  Have a Wonderful Night!

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
A single ankle can swell in gout, rheumatoid arthritis, deep vein thrombosis, trauma, fracture, ligament tear, tendonitis, bursitis or ankle strain. It can also be due to localized infection of the skin above and not be related to the joint. Hence all other causes need to be eliminated too.  In your case a dopplar study of the veins, arteries and lymphatics should be done. Wearing compression stockings may help. Otherwise it will help to consult a vascular specialist and at times stripping and sclerosing treatments help. A comprehensive investigation is required keeping all the points in mind. Take care!