Idiopathic Edema

meownsmile, BSN, RN · Nov 10, 2005

Just becasue her blood sugar was OK last week doesnt mean she hasnt been trending high. It could be that she just hasnt been detected yet, she could have some normal decrease in vascular elasticity that can cause some mild edema as we get older and if she is on her feet or sits dependant for lengthy periods.

She just needs to keep at it with the doctors until they can find the issue. Maybe something that is easily handled,, may b something she might have to deal with.

Either way,, good luck hope she finds out what the problem is.

PhoenixGirl · Nov 10, 2005

Thank you for your response. Your right, it is good to retake the blood sugar. Just for piece of mind, if anything.

Rebecca

Curious1alwys, BSN, RN · Nov 10, 2005

My brother had something similar, but he did have an ingrown infected toenail on one foot. What was weird was the 2+ pitting edema on BOTH feet and lower legs. Then he got, like, spider veins appearing, which is maybe broken capillaries????? I should know that, but I don't. He was messing with IV drugs (illegal) at the time:uhoh3: , so I don't know if this is really similar, you know what I mean. Lord knows what was going on with his veins. :rolleyes: It did pass in a few days with antibiotic therapy for the toe, so who knows??

My dad currenty is having some issues all of a sudden with overwhelming fatigue in his legs. All of a sudden it is hard for him to even walk down the driveway..he says his legs all of a sudden have "30% of the strength they used to". No edema though. He has had lab tests too......all good. I think though I have heard that when you go into kidney failure it does not show up on labs until, like only 25% of your kidney function is left. Don't know about the accuracy of that though.

Anyway, no real helpful advice for you, sorry. I know how perplexing these weird medical things can be! Good luck to your mom, I hope the issue resolves soon!:)

redshiloh · Nov 10, 2005

Intermittent claudication? Have they looked (doppler) at how her blood is circulating to her lower extremities?

tridil2000, MSN, RN · Nov 10, 2005

Have any of you ever heard of this? For the past month my mother has experienced pain and swelling in her legs. This is unusual for her because she has no health problem, no weight problem, doesn't drink/smoke, exercizes everyday and eats really well. She is full Korean so doesn't even eat the normal american junk foods full of salt and fat. She is 51 years old and we have no family history of anything like this.
It has me so worried because this is a woman who wakes at 5am to go to work, comes home and walks a mile just to "relax." And now she is complaining of leg pain, tiredness, and this swelling. So I did a search on the net for "idiopathic edema" and I did find some stuff. Basically that this can be common in women. It mentioned kidney problems, diabetes, etc. But she recently had some blood work, kidney function looked fine, blood sugar was fine. The doctors are just brushing her off, sending her home with vicodin and hydrochlorothiazide. She hasn't taken any of it, and when I read about the idiopathic edema on the net it even said water pills are not going to work anyway because aldosterone is usually high in these patients.
My mother is not knowledgable about medical stuff. She keeps calling me up and asking me what should she ask the doctor. I have no idea! I'm only a nursing student, I don't have too much experience with seeing a lot of stuff. The doctors are sending her back for glucose testing today (so frustrating, since her blood sugar was fine last week!) and I told her to sit there and insist they do tests, do something! not just send her home with vicodin.
Have any of you ever seen this? heard of it? Experienced something?
Input is greatly appreciated.
Rebecca

are her pulses good in her feet?

if so, i'd recommend bilateral venous dopplers to rule out dvts.

what kind of work does she do??

PhoenixGirl · Nov 10, 2005

are her pulses good in her feet?
if so, i'd recommend bilateral venous dopplers to rule out dvts.
what kind of work does she do??

She's a secretary, so she does a lot of sitting. Would that have anything to do with it? But she's also very active and healthy. They do hiking on the weekends, she walks most nights as exercize. That's why it's just puzzling to me that all of the sudden, about a month ago, she wakes up like this. And the pain/swelling begin.

I will tell her about the dopplars and to have the doc check her pulses. Problem is she goes to this military hospital where you see a different doc everytime and it seems like they just push people out with a standard antibiotic or pain pill for symptoms. It's very frustrating.

palesarah · Nov 11, 2005

interesting... I've had really horrible pitting edema off & on for maybe 2 months now? I brushed it off as related to being on my feet for 12 hours straight some nights, but after I left my job last month it continued. I finally went to the dr's and have had a battery of tests since, and nothing is turning up. I did a 24-hour urine for creatinine clearance/tital protein, UA, kidney functions, liver functions, CBC, sed rate, glomerular filtration rate, all fine. Kidney ultrasound fine, chest Xray negative, even though I had at that point started having some SOB- lungs were clear, heart not enlarged. Started on lasix, had more labs drawn, BNP fine, Lyme titer fine. I'm having a cardiac echo & venous doppler studies next week.

I'm only 28!

Anyway, I feel for your mom. I never knew how much edema HURT until this started. It wasn't unusual for me to come home with slightly swollen feet after a long shift before, but that's nothing compared to the pain I have when I get all puffy. It's only pitting over my lower legs, but on my worst days (when it's pitting almost down to my first knuckle if I press straight down over my tibia) I feel puffy and uncomfortable all over - my hands, my shoulders, all over.

PhoenixGirl · Nov 11, 2005

This is like my mom, battery of tests, and no answers.

I talked to her tonight and they are sending her for a PET scan. Isn't that to test for cancer. What else can they find? OBviously cancer is scary, but I'm also thinking if they don't find anything there are STILL no answers.

I was reading that ACE inhibitors can work for idiopathic edema. Has anyone ever heard of this.

And finally... I asked her to ask her doc about idiopathic edema. And she told me he said "this is not idiopathic edema." Uhhh...okay the exact definition of idiopathic edema is swelling with no known cause. That is *exactly* what this is. So why would the doc say this is not idiopathic edema? He said to stay on the diurectic. Which she says does not help at all, and gets worse.

i'm going to the next dr. appt with her. But i am afraid I do not know what to ask. So again, more advice is only helpful.

Thanks to everyone,

Rebecca

interesting... I've had really horrible pitting edema off & on for maybe 2 months now? I brushed it off as related to being on my feet for 12 hours straight some nights, but after I left my job last month it continued. I finally went to the dr's and have had a battery of tests since, and nothing is turning up. I did a 24-hour urine for creatinine clearance/tital protein, UA, kidney functions, liver functions, CBC, sed rate, glomerular filtration rate, all fine. Kidney ultrasound fine, chest Xray negative, even though I had at that point started having some SOB- lungs were clear, heart not enlarged. Started on lasix, had more labs drawn, BNP fine, Lyme titer fine. I'm having a cardiac echo & venous doppler studies next week.
I'm only 28!
Anyway, I feel for your mom. I never knew how much edema HURT until this started. It wasn't unusual for me to come home with slightly swollen feet after a long shift before, but that's nothing compared to the pain I have when I get all puffy. It's only pitting over my lower legs, but on my worst days (when it's pitting almost down to my first knuckle if I press straight down over my tibia) I feel puffy and uncomfortable all over - my hands, my shoulders, all over.

HappyJaxRN · Nov 11, 2005

Have any of you ever heard of this? For the past month my mother has experienced pain and swelling in her legs. This is unusual for her because she has no health problem, no weight problem, doesn't drink/smoke, exercizes everyday and eats really well. She is full Korean so doesn't even eat the normal american junk foods full of salt and fat. She is 51 years old and we have no family history of anything like this.
It has me so worried because this is a woman who wakes at 5am to go to work, comes home and walks a mile just to "relax." And now she is complaining of leg pain, tiredness, and this swelling. So I did a search on the net for "idiopathic edema" and I did find some stuff. Basically that this can be common in women. It mentioned kidney problems, diabetes, etc. But she recently had some blood work, kidney function looked fine, blood sugar was fine. The doctors are just brushing her off, sending her home with vicodin and hydrochlorothiazide. She hasn't taken any of it, and when I read about the idiopathic edema on the net it even said water pills are not going to work anyway because aldosterone is usually high in these patients.
My mother is not knowledgable about medical stuff. She keeps calling me up and asking me what should she ask the doctor. I have no idea! I'm only a nursing student, I don't have too much experience with seeing a lot of stuff. The doctors are sending her back for glucose testing today (so frustrating, since her blood sugar was fine last week!) and I told her to sit there and insist they do tests, do something! not just send her home with vicodin.
Have any of you ever seen this? heard of it? Experienced something?
Input is greatly appreciated.
Rebecca

Has anyone taken her blood pressure lately? If she has lower extremity edema, her heart isn't able to pump this extra fluid out. Undiagnosed hypertention tends to lead to kidney problems. When the heart beats faster, the pumping action isn't as quality and less fluid moves to where it needs to be. Organs are not getting the blood that they need. The kidneys are very very sensitive to fluid shifts. If I were you, I would invest in one of those self-taking blood pressure machines and tell her to take her blood pressure several times a day. When she wakes up, before she gets started for the day. At work and when she's home at night. Tell her to document the rates and what she was doing at the time of the rates. Mild hypertension is as low as 130/mid 80's. Have her check with her MD as well.

I have hypertension and work on a Liver/KIDNEY/Pancreas Transplant Unit. A lot of people have hypertension and don't even know it.

HappyJaxRN · Nov 11, 2005

I know you said that she had labs done. In my experience, for myself as well as my patients with hypertention and edema in the lower extremities, with a fluid shift comes electrolyte imbalances. Specifically sodium and potassium. Both of which when out of whack, can cause leg pain.

Someone else mentioned DVT's. I thought of that when I was responding with the hypertention. DVT's can be a direct result of cardiovascular problems, specifically CAD.

Be aggressive. And be your mom's advocate. Good luck.

PhoenixGirl · Nov 11, 2005

Has anyone taken her blood pressure lately? If she has lower extremity edema, her heart isn't able to pump this extra fluid out. Undiagnosed hypertention tends to lead to kidney problems. When the heart beats faster, the pumping action isn't as quality and less fluid moves to where it needs to be. Organs are not getting the blood that they need. The kidneys are very very sensitive to fluid shifts. If I were you, I would invest in one of those self-taking blood pressure machines and tell her to take her blood pressure several times a day. When she wakes up, before she gets started for the day. At work and when she's home at night. Tell her to document the rates and what she was doing at the time of the rates. Mild hypertension is as low as 130/mid 80's. Have her check with her MD as well.
I have hypertension and work on a Liver/KIDNEY/Pancreas Transplant Unit. A lot of people have hypertension and don't even know it.

Thanks for the suggestion. And this is another odd thing, because they've checked her bp multiple times in the last few weeks and it's not high, not even mildly. Even when she's swollen.

You mentioned the heart but being able to pump the fluid back to the blood. How would they test for heart activity disfunction?

Rebecca