DEAR DR. GOTT: My mother is 80 years old and
was diagnosed with congestive heart failure about two years
ago.
In November, her left leg started to swell and is still swollen
after 14 trips to the doctor. It is so bad that the lymph fluid is
oozing through her pores into her socks. Her shoes don't fit. She
does not have diabetes. Her main doctor, an internal-medicine
specialist, has referred us to a dermatologist with no results. She
has had a deep-vein-and-artery scan. Now we have been referred to a
vein-and-artery surgeon who wants her to have an angiogram. I am so
sick of the trips all over the area with no results, diagnosis or
treatment except antibiotics, cortisone creams and wraps. Her leg
is gruesome, and I don't see the light at the end of the tunnel.
Could this lymphatic swelling have to do with her congestive heart
failure? We haven't been to a cardiologist. Please help.
DEAR READER: Leg edema (swelling due to
inappropriate fluid retention in the lower extremities) is often
the hallmark of inadequately treated congestive heart failure, when
the weak heart action fails to circulate enough blood through the
kidneys. As a result, instead of being excreted, the excess fluid
pools in the legs.
I strongly urge your mother to see a cardiologist. I am
disappointed that your mother's internist hasn't urged her to see
such a specialist. She should have begun seeing a cardiologist on a
regular basis (one or two times a year) as soon as the diagnosis
was made. A cardiologist is the best choice for treatment options,
monitoring and controlling CHF.
A vascular surgeon will be of little help in the treatment and
management of your mother's ailment because it may be cardiac, not
vascular.
If I am correct that CHF is the basis of her problem, the
disorder is treated easily with drugs that strengthen the heartbeat
and drive the fluid out of her legs by way of the kidneys.
