Question: I don’t know who to turn to. I take Furosemide and it doesn’t seem to be helping as fast as it should be. Do I need to see a podiatrist or do I need to get a referral to go see a specialist? I’ve been off work for 2 and 1/2 months from total knee replacement and the swelling in my feet has not gone down the entire time. I’m a big guy, obese, 325 lb and that doesn’t help.
Answer: There can be several factors contributing to swelling in a larger individual. The primary cause is typically due to size, and a congestion in what is called the lymphatic system. Additionally, superficial vein insufficiency can be causing additional swelling in the legs. The lymphatic system is typically improved with weight loss as this system is responsible for carrying cellular waste to the liver to be excreted. When this system is overwhelmed by excess adipose tissue, the “swelling” typically affects the legs, testicles, and lower abdomen.
An ultrasound can identify whether the vein system is part of the problem. In the short term, there is a homeopathic agent that is derived from citrus that can improve lymphatic and venous circulation called diosomin. It can be picked up at a health food store or online. Ideally one should take about 635mg twice a day. A local vascular specialist can usually evaluate both conditions to identify whether there are treatment options aside from weight loss and increased activity.