Does ankle/leg swelling o away quickly?

[WhatMeSnore]

As I may have said above, the edema started at the same time as all the other symptoms of OSA. I went from no health problems other than some lower back pain, to my wife telling me I was snoring a lot (new), feeling sleepy during the daytime (new), having night-long, bizarre dreams that I would return to after waking up (new), and using the bathroom a lot during the night (new). It's pretty startling how it all started at the same time. I think my doctors are anxious for me to start the CPAP therapy so they can see if anything DOESN'T go away and remains to be treated. Just a few more days probably until I have the unit.

[kteague]

Your doctor is right. When there are multiple symptoms without a defined cause, treating the known factors can clear the field enough to see a pattern in the remaining symptoms. Just be sure you get a machine that captures treatment data (not just usage hours). It's the only way to know for sure that your OSA treatment is therapeutic and that the remaining symptoms aren't still coming from only partially effective treatment. I'd be interested in hearing back from you after you've settled in to treatment for a few weeks to hear how your edema is doing.

[WhatMeSnore]

Your doctor is right. When there are multiple symptoms without a defined cause, treating the known factors can clear the field enough to see a pattern in the remaining symptoms. Just be sure you get a machine that captures treatment data (not just usage hours). It's the only way to know for sure that your OSA treatment is therapeutic and that the remaining symptoms aren't still coming from only partially effective treatment. I'd be interested in hearing back from you after you've settled in to treatment for a few weeks to hear how your edema is doing.

Thanks, I'll try to post an update. The DME called today to schedule the delivery/set up. The unit I'm getting is the Respironics AutoSystem One BiPAP w/ heated humidifier. I think this one gets mentioned around here pretty often - I'll have to see the exact model number to read up on it. Should be delivered Wednesday.

[Pugsy]

The unit I'm getting is the Respironics AutoSystem One BiPAP w/ heated humidifier. I think this one gets mentioned around here pretty often - I'll have to see the exact model number to read up on it. Should be delivered Wednesday.

That most likely would be the model 760.
https://www.cpap.com/productpage/pr-sys ... chine.html
There is the older 750 model which doesn't have the heated hose option but most likely unless one has been sitting on the self for a while or they try to give you a used one...they should be dispensing the 60 series.

It's a full efficacy data machine and software is easy to obtain and use. Check out my signature line.

[avi123]

see below

[avi123]

Chronic Venous Insufficiency

Treatment

{It's straight forward}

How is CVI treated?

CVI is usually not considered a serious health risk. Your physician will focus his or her treatment on decreasing your pain and disability.

Compression stockings:

For mild cases of CVI, your physician may recommend compression stockings. Compression stockings are elastic stockings that squeeze your veins and stop excess blood from flowing backward. In this way, compression stockings can often also help heal skin sores and prevent them from returning. You may need to wear compression stockings daily for the rest of your life.

You can help avoid leg swelling and other symptoms by occasionally raising your legs and avoiding standing for long periods of time to decrease the pressure in the veins. When you do need to stand for a long period, you can flex your leg muscles occasionally to keep the blood flowing. You can also help lessen the symptoms of CVI by maintaining your ideal body weight or losing weight if you are overweight.

More serious cases of CVI may be treated with injections, called sclerotherapy, or with surgical procedures. Fewer than 10 percent of people with CVI require surgery to correct the problem. Surgical treatments include ablation, vein stripping, bypass surgery, valve repair, and angioplasty or stenting of a vein.

Sclerotherapy:{this would be my choice}

In sclerotherapy, your physician injects a chemical into your affected veins. The chemical scars your veins from the inside out so your abnormal veins can then no longer fill with blood. Blood that would normally return to the heart through these veins returns to the heart through other veins. Your body will eventually absorb the veins that received the injection.

Ablation:

Ablation uses a thin, flexible tube called a catheter inserted into a varicose vein. Tiny electrodes at the tip of the catheter heat the walls of your varicose vein and destroy the vein tissue. As with chemical sclerotherapy, your varicose vein is then no longer able to carry blood, and it is eventually absorbed by your body.

Vein stripping:

To perform vein stripping, your physician first makes a small incision in the groin area and usually another incision in your calf below the knee. Then your physician disconnects and ties off all veins associated with the saphenous vein, the main superficial vein in your leg. Your physician then removes this vein from your leg. A procedure called ambulatory phlebectomy, or small incision avulsion, can be done either alone or together with vein stripping. Small incision avulsion allows your physician to remove individual varicose vein clusters from the leg through tiny incisions.

Bypass:

For more extensive problems, your surgeon may recommend bypass surgery to treat CVI that occurs in the upper thigh or pelvis. For example, your surgeon can connect an artificial vein, called a graft, or a transplanted vein to a vein not affected by CVI to help blood flow from your affected leg around the blocked vein. Most vein surgery can be performed through small incisions. Usually bypass surgery is safe, although there is a small risk of DVT and infection at incision points. Your physician will only recommend this procedure in the most serious instances.

Valve repair:

In valve repair, your surgeon shortens the valves inside your vein to improve valve function. After making a small incision into your skin, your surgeon cuts into the affected vein. Your surgeon then folds or tucks the valve flaps. He or she may place a fabric sleeve around the outside of your affected vein to help press the walls of the vein together to maintain valve function.

Angioplasty and Stenting:

In more severe cases of CVI, your surgeon may recommend angioplasty or stenting. An angioplasty is the use of a balloon to push open a narrowed or blocked portion of the vein. A stent is a metal-scaffold tube that helps to keep the narrowed areas open. In some instances, depending on where the vein blockage is, this may be used to open up the blockage. The procedure is performed through small needle punctures in the veins, either behind the knee or in the groin. Typically angioplasty and stenting are safe procedures.

Your vascular surgeon will help you decide the best treatment option for your particular situation.

[saycheese]

by palerider on Mon Jun 23, 2014 11:48 am



saycheese wrote: CPAP and BiPap is miraculous.


thank you for that word from our sponsor, philips respironics... and, now over to you, kathi, what's new on the world cup today?

Palerider, I don't think that comment was funny one bit. What I said about CPAP and BiPap being miraculous was based on personal experience and a well-known scientific study. Whether you call it bilevel or BiPap is not the issue. The fact that bilateral leg edema can have a correlation with sleep apnea is rooted in fact in a study by the Journal of Family Practice.
Here is an excerpt from the study.

Swollen Legs
Leg swelling is a symptom of severe sleep apnea. In 2002, researchers from Case Western Reserve University School of Medicine reported that leg swelling may be a reliable marker for sleep apnea when correlated with obesity.
Again, the desperate need for oxygen is the cause. When the body is starved for oxygen, blood flow concentrates in the central regions to protect the vital organs. In the extremities, meanwhile, fluids pool, causing a deep and painful ache. This is a dangerous symptom, as swollen legs can also indicate heart or respiratory failure. Call your medical provider immediately if experiencing swollen legs after awakening.
Bilateral leg edema, pulmonary hypertension, and obstructive sleep apnea: a cross-sectional study.
Blankfield RP, Zyzanski SJ.
Source
Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA. rblankmd@aol.com

[Bibliophile]

Say Cheese is absolutely correct. Lower leg edema has long been linked with sleep apnea. A cursory search of PubMed will turn up several research articles.

I've had a problem with lower leg swelling and horrible pitting edema for about seven years. I've had the hose, cardiac and leg ultrasounds and even an abdominal CT - all negative. I just started my CPAP in early July. Even though it's been a rough start (as in mask problems, haven't used it every night, etc) the difference in my leg edema is miraculous.

saycheese wrote: CPAP and BiPap is miraculous.

Palerider, I don't think that comment was funny one bit. What I said about CPAP and BiPap being miraculous was based on personal experience and a well-known scientific study. Whether you call it bilevel or BiPap is not the issue. The fact that bilateral leg edema can have a correlation with sleep apnea is rooted in fact in a study by the Journal of Family Practice.
Here is an excerpt from the study.

Swollen Legs
Leg swelling is a symptom of severe sleep apnea. In 2002, researchers from Case Western Reserve University School of Medicine reported that leg swelling may be a reliable marker for sleep apnea when correlated with obesity.
Again, the desperate need for oxygen is the cause. When the body is starved for oxygen, blood flow concentrates in the central regions to protect the vital organs. In the extremities, meanwhile, fluids pool, causing a deep and painful ache. This is a dangerous symptom, as swollen legs can also indicate heart or respiratory failure. Call your medical provider immediately if experiencing swollen legs after awakening.
Bilateral leg edema, pulmonary hypertension, and obstructive sleep apnea: a cross-sectional study.
Blankfield RP, Zyzanski SJ.
Source
Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA. rblankmd@aol.com[/quote]

[Sludge]

What did your diagnostic NPSG show? If you had wicked desats and/or overall significantly low oxygen baseline, and now you've got some right heart failure (that's why your ankles get fat), then fixing that in conjunction with a few other things may bring that swelling down.

Did you get some heart testing?

[SleepyEyes21]

I'm going to add my 'two cents' here... in January 2013, I went to the ER due to pain under my right rib cage that was not going away. I thought it was a muscle cramp of some sort as the pain wasn't excruciating, but it was significant enough to continue even while laying down. After a very long night in the ER with pain getting worse, I was diagnosed with a pulmonary embolism. After all hospital tests and genetic testing for blood disorders, nothing was found, and docs still cannot conclusively tell me why I had the PE.

I began to notice swelling in my right ankle/ foot mostly, and periodically in my left foot, post PE treatment. This occurs 2-3 times per week. From my research, I most likely have what is referred to as postthrombolitic syndrome, where swelling is thought to be caused from the leg vein expansion caused by the PE. I do wear compression socks when swelling occurs.

Thinking back about apnea symptoms occurring, I believe I may have had significant symptoms going back 10+ months. After some preliminary research, I have found some medical studies where a high percentage of PE is found in people with sleep apnea. From what I understand, there have not been enough studies done to date to indicate whether apnea causes PE, but it isn't out of the question.

My suggestion for anyone having swelling symptoms in legs or feet, is to seek medical advice and/ or treatment ASAP!! From what I understand, 50% of those who have a PE will not have ANY symptoms, and the mortality rate for this is 30%. I had ZERO pain or swelling in my legs/ feet; the only symptom I had was the pain under my rib cage. If I had not gone to the ER, I would have died.

I have no idea if apnea contributed to my PE, but it would not surprise me at all. As others have suggested and discussed, getting diagnosed and staying on effective treatment for apnea will help ALL of your body to function as it should. If your apnea treatment doesn't seem to be helping your edema, keep talking to your doctor about it, and ALWAYS advocate for yourself to get appropriate medical care. It could literally make a difference between life and death.

[Janknitz]

I had pretty severe, pitting lower extremity edema. CPAP therapy made little or no difference, I'm sorry to say. But my edema is now about 90% better. I still have very mild, nearly unnoticeable edema which flares up when the weather is very hot or when I sit for too long.

Here's what helped--some ideas to keep in your back pocket if the CPAP doesn't do it for you:

1. I went on a low carb diet. This made a HUGE difference. Why? Because we store excess glycogen when we eat a lot of carbs, and with every gram of glycogen comes 4 grams of water. So in the first two weeks that I cut my carbs, I lost 12 pounds, ALL of it water weight. If I eat too many carbs, I typically gain 3 to 5 lbs overnight, all of it fluid weight retained from the excess glycogen.

2. I drink a LOT of water, which flushes out the edema. It sounds counterintuitive, but it works. I'm horrible at drinking water, so this is my strategy: 1 8 oz glass of water in the morning before I take my pills and supplements, 1 glass of water with my pills and supplements, 1 glass of water after my pills and supplements. Morning coffee in a mug that holds about 2 cups. Then I just drink normally throughout the day with at least 1 cup of water mid-afternoon, and I hit my water goals without a fight.

3. I switched my diet to whole foods, organic, and natural. And most importantly that means natural fats. NO processed oils like canola, soy, vegetable, peanut oil. etc. My fats are butter, ghee, coconut oil, dairy fats, nuts and fatty cuts of meat. I take fish oil (Omega 3 supplements). Processed oils and margarines are highly inflammatory and cause fluid retention. Medium chain triglycerides like coconut oil (and pure MCT oil which you can buy) are especially therapuetic, they are not processed in the liver and don't generate excess fluids as your body absorbs them. (BTW, this diet has vastly IMPROVED my cholesterol ratios, in case you were wondering).

Also, FYI, I did NOT cut salt one bit, but I stopped eating processed foods (which are loaded with sodium). I enjoy salting my food liberally and don't worry about it at all.

As I mentioned, I still have some mild edema which is considered "primary edema" due to a genetic disorder. But the fact that I have had this much resolution, DESPITE the genetic issues is testament to how much my diet is helping.

[ShelaghDB]

That has nothing to do with Cpap, though it may be related to OSA in that you have some cardiac involvement and should see your doctor. Cpap may help to get rid of it, but it's not something you want to just wait around and see about... please let your MD know.

Love the edit.
Thats not what your original post said.

Even the poster looked annoyed by your answer before you changed the edit.
You simply said it was not related to CPAP and to see the doctor.

Being told it was related to CPAP you changed the post so as to look as if your original answer had any merit when it didn't.

I find so many of your answers to be absolutely useless and misinformed.
Ive seen on many an occasion that one of our top posters whose answers are always perfect, has had to give answers after your post to correct the misinformation you have given out.

If you just need some friends to talk to, why not take up Facebook?

[Bibliophile]

Here are a couple of more studies from peer-reviewed, scientific journals which clearly show the relationship between leg edema and sleep apnea. Remember - when looking for info about your health, the quality of the source is EVERYTHING.

“Conclusions Bilateral leg edema in obese primary care patients is associated with both OSA and modest pulmonary hypertension. If these findings are generalizable, then bilateral leg edema may be an important clinical marker for underlying OSA.”
Blankfield, Robert P., et al. "Bilateral leg edema, obesity, pulmonary hypertension, and obstructive sleep apnea." Archives of internal medicine 160.15 (2000): 2357-2362.

“This study was undertaken to clarify whether pulmonary hypertension is a useful marker for underlying obstructive sleep apnea in patients with edema. Twenty-eight ambulatory adults with bilateral leg edema and a normal echocardiogram were enrolled. Sixteen subjects had pulmonary hypertension, and 12 subjects had normal pulmonary artery pressures. Spirometry, pulse oximetry on room air, and polysomnography were obtained for each subject. Ten of 16 (63%) pulmonary hypertension subjects and 9 of 12 (75%) nonpulmonary hypertension subjects had obstructive sleep apnea (P =.48). Eleven of 16 (69%) pulmonary hypertension subjects and 11 of 12 (92%) nonpulmonary hypertension subjects were obese (P =.20). If these results are generalizable, obstructive sleep apnea is frequently associated with bilateral leg edema and obesity, regardless of the presence of pulmonary hypertension. Thus, especially in obese patients, bilateral leg edema may be a useful clinical marker for underlying obstructive sleep apnea.”
Blankfield RP1, Zyzanski SJ. Bilateral leg edema, pulmonary hypertension, and obstructive sleep apnea: a cross-sectional study. J Fam Pract. 2002 Jun;51(6):561-4

“Thirty-five percent (133/378) of the subjects with OSA had bilateral leg edema. Eighty-one percent (108/133) of the edematous subjects had mild pitting that was 1+ … Approximately one-third of OSA patients have edema. Edematous OSA patients are older, more obese, more likely to have diabetes mellitus and hypertension, and have more severe OSA than OSA patients who lack edema." Comparison of obstructive sleep apnea patients with and without leg edema. Iman Iftikhar, Mansoor Ahmed, Shannon Tarr, Stephen J. Zyzanski, Robert P. Blankfield Sleep Medicine - December 2008 (Vol. 9, Issue 8, Pages 890-893, DOI: 10.1016/j.sleep.2007.10.019)

[Phil587]

I'm a new member who was diagnosed with Sleep Apnea recently, and I'm expecting to receive my CPAP unit and training soon.

While the sleepiness has been really bad, I almost find the lower leg and ankle swelling to be even more annoying. Does this typically go away quickly once you begin using a CPAP unit? For the second sleep study, I was able to get a few hours of real sleep, which was exciting. Almost as exciting though was that I didn't have to use the bathroom at all during that!. So seeing some of these other symptoms relieved is very cool too.

As soon as I get the CPAP I'll set up a proper SIG with the make, model number, etc.

Congrats on your good start.

It's somewhat amusing watching these very helpful people fight like little children, huh! My story, very briefly -- I ended up on a sleep study precisely due to swollen lower legs. My MD did or had done all the standard tests -- congestive heart failure, etc -- and the last resort was sleep apnea being the culprit causing the edema. Bingo! Something close to two weeks of therapy caused *most* of the swelling to go away. The balance seems like it's going to be a slower go but I no longer feel my skin is going to split. The remaining swelling is so minor it is hard to see.

Now, that's just what happened to "me". Your trip may be totally different. Good luck!

Phil

[Paul_H]

I'm a new member who was diagnosed with Sleep Apnea recently, and I'm expecting to receive my CPAP unit and training soon.

While the sleepiness has been really bad, I almost find the lower leg and ankle swelling to be even more annoying. Does this typically go away quickly once you begin using a CPAP unit? For the second sleep study, I was able to get a few hours of real sleep, which was exciting. Almost as exciting though was that I didn't have to use the bathroom at all during that!. So seeing some of these other symptoms relieved is very cool too.

As soon as I get the CPAP I'll set up a proper SIG with the make, model number, etc.

The swelling (edema) could be due to medications or other causes. It would be good to discuss this with your doctor. I was experiencing edema, and my doctor made some changes in my HBP medications. I also started working out again on an exercise bicycle. The edema has totally disappeared now, but I can't say which or both of these things was the effective cause of that. What I do know is that the extra energy I experienced after starting CPAP therapy in April of this year was key to my resuming aerobic workouts again, and this has changed my life in numerous positive ways. Losing weight, running up stairs again, cycling on the road again, and also reducing and eliminating some other HBP medications.