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gailg
@baxtersmom

Posts: 36
Joined: Feb 03, 2016

Swelling and pain in my left ankle and lower leg - venous insufficiency?

Posted by @baxtersmom, Feb 3, 2016

I have had swelling and pain in my left ankle and lower leg for many years. I was a dancer for 25 years and had some ankle surgery in 2011 and 2012 which involved ankle fusion and tendon repair. As time has gone on I am getting swelling in both ankles and now it goes up my legs and into my knees; sometimes even higher by the end of the day. I am a college professor and on the days I teach by the end of the day I almost cannot walk. I was told by one cardiologist I had venous insufficiency and he recommended a venous ablation. I sought a second opinion and he said this was not venous insufficiency but he offered no other explanation that I have not already ruled out. He said venous ablation could make the pain and swelling worse. Has anyone ever had this procedure and where can I go to get a trustworthy answer as to whether this is the problem or not? I have suffered with this for 10 years and it is getting increasingly worse such that I fear I am going to no longer be able to work. I am 62 and otherwise in good health.

REPLY

Hi @Gailg and welcome to Connect.
How confusing when you get opposing advice. @spence had a venous ablation a while and may be able to share some insight. However he has livedoid vasculopathy, which you’re not talking about here I don’t think. You can see the message in this thread
https://connect.mayoclinic.org/discussion/livedoid-vasculopathy/?pg=1#post-15800

@mlemieux do you have any thoughts?

How have you been managing the swelling and pain thus far? Medication? Compression stockings?

Colleen
Connect Community Director

@colleenyoung

Hi @Gailg and welcome to Connect.
How confusing when you get opposing advice. @spence had a venous ablation a while and may be able to share some insight. However he has livedoid vasculopathy, which you’re not talking about here I don’t think. You can see the message in this thread
https://connect.mayoclinic.org/discussion/livedoid-vasculopathy/?pg=1#post-15800

@mlemieux do you have any thoughts?

How have you been managing the swelling and pain thus far? Medication? Compression stockings?

Colleen
Connect Community Director

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Thank you for your email/post. I take Norco 10-325 three times a day. I
tolerate it really well. I will say that I always still have at least some
pain and at the end of the day (I usually take the last one around 4 PM) I
am in a lot of pain. The LV sounds terrible. I am so skeptical of the
Venous Ablation. I have an appointment with a third doctor next week since
I have gotten conflicting advice. If I don’t feel satisfied with him, I
may try to seek out someone at a teaching hospital closer to me such as
Baylor Medical Center or I think they also have a group that studies this
down at MD Anderson. I took leave this semester to try to deal with so I
am not going to have any procedures unless I know I need them. Sometimes
it is so painful that you are tempted to try just about anything but I am
trying to ​think this through carefully even though the pain is
increasing. I used compression in the past after my first ankle surgery
but have not used them recently. Went to my primary care doc yesterday and
she suggested that I try them again so am going to. I still have an
appointment for the venous ablation later this month with the first doctor
I went to. But he is called an Interventional Cardiologist (I think this
means they do a lot of catheters–does anyone know what this means?). I
would rather have a Vascular Surgeon do it but the vascular surgeon I
visited is one that said he would not do it on me. Does anyone have any
idea who would be better to evaluate whether venous ablation is necessary.
Appointment next week is with another Vascular Surgeon. I am so glad I
found this Group. It sure helps to know that I am not alone with this.
Thank you again.

Hello @gailg ,

Thank you for sharing that with us, it means a lot.

Have you had an ultrasound done on your legs? If not, I would recommend having that done 1st and foremost. Blood tests can’t always “show” you problems you might have. I recommend this because anytime you have had a surgery, especially one repairing tendon’s and ankle surgery, the connective tissue in the area is affected. Sometimes arteries can be bruised and possibly damaged.

Here in Canada, after any surgery, our first order of business is to send a patient to see a “Thrombo” specialist (Outpatient Care) who will review ultrasounds, give blood thinners as a prescription to prevent clotting from surgery complications.

Venous Ablation:
Did your cardiologist give you a good reason to have the venous ablation procedure? varicose leg veins is usually a sign and symptom of something else. Swelling of the arteries usually doesn’t just happen, it normally is due to: surgery, blood type conditions, inflammation, etc.

I too have varicose veins, but it’s never been an issue, nor has any specialist been concerned with them since they are very common.

Pain & Inflammation:
Inflammation is something I constantly deal with from my lower legs. I HIGHLY recommend getting “Compression Stockings” right away and wear them anytime you work. Being on your feet is the worst thing you can do to increase the swelling and pain. Compression stockings can help to regulate blood flow and keep the swelling to a minimum. At the same time, I would recommend taking Baby Aspirin (talk to someone prior) once a day. Baby Aspirin is highly recommend to prevent inflammation and to help with blood flow.

I’m not sure if you have a dress code at work, but the type of shoes you wear daily is also key to preventing pain and swelling. Having a proper fitting shoe that doesn’t squeeze your feet and ankles can make a huge difference in your daily life.

Describe the pain:
Can you describe the pain? Do you feel burning sensations? Do you get spikes of pain all of a sudden? Is it concentrated behind the calf? ankles? or is it mainly in your upper thighs? Do your legs feel heavy after standing too long? Behind your knee, does it feel like an elastic band pulling your leg (wanting to bend the knee)?

I only ask because knowing your pain and the exact sensations can help a medical specialist to narrow down the type of pain-management you should have.

Here are the questions I would have for my specialists:
– Can we ultrasound my legs to ensure my arteries aren’t damaged?
– It there any possibility that I have a DVT (Deep vein thrombosis)?
– Do you recommend a certain compression stocking?
– What makes you believe that the venous ablation is the key?
– What type of diet will help my inflammation?
– Am I able to take baby aspirin daily to help?
– Should I take something for inflammation (ie Naproxen)?

I hope this helps! Also, remember to elevate your legs daily above your heart when you get home. This will drastically reduce the discomfort and swelling.

Please keep us posted!

Martin Lemieux
@Martin_Lemieux – Tweet

I have CAD with LAD-stent for nearly 20 years. I have swelling of both feet, but, no pain. Diuretic therapy is not working. I do not know if any elastic stockings
will be of help. I had this stasis problem, with dependent oedema for several months, off and on. There are no signs of any venous problem. I am 72 y/o and have no other problems.

My left ankle has been swelling for 30 years or so. I am 70 and the swelling has been in both feet, ankles and legs for four years or so. I was diagnosed with venous insufficiency. I wore compression stockings for a few years but I couldn't withstand the pressure when I developed fibromyalgia. Over the years I was tested for DVT, various injuries, lymphedema, etc – to no avail. I have just recently been diagnosed by a pulmonologist with Diastolic Heart Failure (stiff heart syndrome). The swelling is now up to my abdomen. I suspect the swelling has been a symptom of my progressing heart disease. I will know more in a few days when I see a cardiologist. Has anyone else been able to connect their swelling to a failing heart?

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