DEAR DR. DONOHUE: I have a problem with my feet swelling. They get so big that they hurt when I walk. My doctor is puzzled. He thinks maybe it’s due to my heart pills, but he can’t change them — my heart doctor has to. I have had two heart attacks, bypass surgery and a defibrillator put in my chest. When I’m in bed, the swelling goes down to almost normal. When I am up, it returns, even if I am sitting. I’d appreciate any suggestions. — E.L.
ANSWER: I believe I’m safe in saying your problem is chronic congestive heart failure. Your heart is pumping so weakly that blood circulates sluggishly. When you’re up or when you’re sitting, gravity pulls fluid out of your leg’s vessels, and it is the cause of your swelling. In the horizontal position in bed, gravity doesn’t have this effect, and the fluid stays in blood vessels. The swelling is called edema (e-DEE-muh).
During the day, take frequent breaks to lie down with your legs propped up higher than your heart. When you sit, rest your legs on the seat of a chair put in front of you. Walk as much as you can during the day. The contracting leg muscles push fluid back into circulation.
Limit the salt you eat; salt makes the body retain fluid. Read food labels. Most of our salt intake comes from the foods we eat, not from adding salt at the table or in cooking. But don’t do either. Your total daily salt intake should be less than 5,700 mg, preferably 3,800 mg. If salt is on the label as “sodium,” your total daily intake should be 2,300 mg or less. A better goal is 1,500 mg.
Tell your heart doctor about your swelling. He might make changes in your medicines either by increasing the dose or switching to other medicines that make the heart pump with more force.
There are other causes of edema, but this is the one that seems to fit you best.
The booklet on edema explains its causes and treatments. Readers can order a copy by writing: Dr. Donohue — No. 106W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Several bouts of stomach pain brought me to the doctor. The pain is located in my upper right side. The doctor was certain I was having gallbladder attacks due to stones. She sent me for an ultrasound test of my gallbladder.
I don’t have stones. I have something called a liver hemangioma. My doctor says I don’t need any treatment. I never heard of this and wonder what your thoughts are. — P.K.
ANSWER: A hemangioma is a small, ball-shaped mass of blood vessels. If 100 people had a liver scan, seven would be found to have a hemangioma. Women develop them more often than men do. They do not become cancers. They’re rarely a source of constant pain, unless they grow quite large and press on adjacent tissue. They don’t cause attacks of pain. Have you found out what causes your pain?
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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