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Ask Dr. Gott 10/26

Congestive heart failure causes leg swelling

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.
    To give you related information, I am sending you a copy of my Health Report "Coronary Artery Disease."

    DEAR DR. GOTT: With new types of water beverages "springing" up everywhere, I was wondering especially about the new sugar-free, sodium-free, zero-calorie, zero-carb, zero-caffeine, carbonated, fruit-flavored water. Does this carbonated water carry the same benefits as regular tap (or bottled) water?
    DEAR READER: I cannot answer your question because although I assume the product has been spiked with carbonation (harmless) and fruit flavor, I am not aware of any secondary health consequences. As you know, water is a natural source of hydration and is a necessary component of human nutrition. Some additives are dangerous, some are harmless. But the fact that your water is free of sugar, sodium, calories, carbohydrates and caffeine makes it just that: water.
    My advice? Drink plain water if you're thirsty, reserving the sparkly fruit-flavored drink for a treat.

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