Caring for Lower Leg Edema handbook - Providence Care

Lower Leg Edema

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in the feet, compression socks can sometimes help reduce the dizziness some people feel when getting up from bed lying. Keeping fluids from pooling in the feet during the day can also reduce the number of times you need to get up in the night to urinate.

Note: Few people can put on their own compression socks. Help will likely be required.

It is important that your helper learns the technique for putting them on properly or there are services in the community that may be able to help with this!

Caring for Lower Leg Edema Edema

means ‘swelling’ caused by a build up of fluids in your body. It commonly occurs in feet, ankles and legs but can appear in other parts of the body as well.

Keep an eye on your skin health!

Contact your doctor if any sign of skin injury, bleeding or weeping.

This material is available in accessible formats upon request to the Communications Department.

Specialized Geriatric Services November 2012

www.providencecare.ca

This handbook will only address swelling that occurs in the legs.

St. Mary’s of the Lake Hospital

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Lower Leg Edema

Lower Leg Edema In its earlier stages, swelling usually goes away when legs are raised higher than the level of your heart. That is the reason why there is less swelling in the morning after you’ve been lying down all night. (It is also why some people have to urinate in the nighttime, because the body is able to get rid of the extra fluid). If not treated, swelling eventually becomes chronic and is more difficult to manage.

Why are my legs swollen? (What are the causes of edema?)

Blood travels from the heart down to your feet through arteries; blood returns to your heart by veins. The veins have little valves directing the blood to flow one direction only, towards the heart.

When you are walking, muscles in your legs help pump the blood up through your veins against gravity. The valves keep the blood from falling back down. When the valves are not working well, or when people are not active on their feet, swelling can occur.

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What are compression socks?

Compression socks, or medical support socks, have some elasticity in them and provide an even amount of pressure on the leg. Their snug fit helps circulation by preventing blood fluids from pooling in the legs. They come in knee high and thigh high lengths depending on how high up the leg the swelling is.

Compression socks should be put on first thing in the morning, ideally before getting out of bed, when swelling is at its lowest amount and the legs are at their thinnest.

However, compression socks are NOT worn at night to give the skin a break. When lying down, legs are elevated so gravity’s pull is not a problem.

Compression socks are good for people who are walking or are up out of bed. They help fight the pull of gravity and prevent the pooling of blood fluids in the feet. By not allowing fluids to pool

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Lower Leg Edema

How do I keep my swollen feet healthy?

With all the extra fluid in your tissues, your skin is very fragile. Best care includes the following: • Wear proper footwear that is protective and well fitting • Wash your feet daily and dry well between toes.

• Cut nails straight across, never shorter than the end of your toe. Do not cut your corns and calluses.

• Do not walk in bare feet.

• Avoid extreme hot or cold temperatures (e.g. hot foot soaks, hot tubs, wearing light footwear in the snow) • Wear clean socks every day that do not cut in at the top. Compression socks may be prescribed.

Note: If you cannot reach down to your feet easily you may need help with your footcare.

Toenails should be cut by a trained professional to make sure the skin is not nicked.

Lower Leg Edema

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When blood isn’t returned to the heart, veins become stretched and fluids seep out into the tissues.

As fluid pools, fresh nutrients and oxygen cannot get to the flooded tissues.

This is why healing is so slow when there is an injury to the skin. For this reason, ulcers just above the ankles are common when people have significant vein problems.

Note: There are many medical conditions that affect circulation and can cause swelling in the legs. The actual cause of your swelling should first be identified by your Physician to get the appropriate treatment.

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Lower Leg Edema

Why does leg swelling need to be controlled?

It is important to treat leg swelling quickly for several reasons: 1.

Swelling tends to start in the feet but will spread up the leg if not treated.

2. Footwear doesn’t fit and clothing can be tight.

3.

Swelling stretches and weakens the skin.

Skin may blister or weep.

4. Veins weaken and can cause varicose veins.

5.

6.

Ulcers appear and skin is easily torn if bumped. Healing is slow because of the extra fluid in the tissues and some ulcers can take more than a year to heal!

Swollen legs are heavy and more difficult to move; it is harder to walk, and you may need help to lift your legs onto the bed.

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• Lace-up or Velcro to allow loosening/tightening Good slippers need to have the same features as a good shoe. Slipon slippers lack support and can create a fall risk. Follow the checklist for good shoes when buying slippers!

Sandals with wide, adjustable straps are sometimes used but you may find the skin puffs out between the straps. Skin health needs to be checked more often. If skin is red, or there are significant marks from the straps, sandals should not be worn.

Watch your skin. If footwear rubs the skin don’t wear them!

Note: It is important not to purchase new shoes until the swelling is improved or is no longer changing.

Also, it is best to shop for shoes in the afternoon when you have been on your feet for a while.

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Lower Leg Edema

What type of shoes should I wear?

Lower Leg Edema

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Eventually the colour of the skin will darken.

Skin becomes hard and abnormally dry.

Swollen feet don’t get longer in size however people often purchase a larger size shoe to get the extra width. Longer footwear can actually be a tripping hazard. They can become loose as swelling goes down and also the rubbing of loose shoes can cause blisters.

There is footwear available that is soft and roomy to protect the skin. Some have Velcro straps to make room for changes in swelling.

When purchasing shoes, select those that have: • Low heels • Non-slippery rubber soles • Good support (high sides and supportive arch) • Sufficient width (square toe box) and depth to prevent squeezing and rubbing of toes.

Note: Early detection and treatment of swelling is important. The longer it stays, the more difficult it is to treat!

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Lower Leg Edema

Lower Leg Edema

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What can be done about my leg swelling?

There are a number of things you can do to help reduce leg swelling especially if it is due to vein problems: 1.

BE ACTIVE! Avoid standing or sitting in one place too long. Walking works the muscles and helps pump fluids back to the heart.

2.

If you can’t move about, pumping your feet up and down at the ankle to move your calf muscle as exercise helps.

3.

Elevate your legs higher than the level of the heart for 20-minute periods throughout the day.

Note: Sitting with your feet on a footstool restricts blood circulation at the hip level and is NOT effective.

4. Maintain a healthy body weight and diet

(high fiber; reduce salt intake). Obesity

increases pressure on the veins in the hip

area and prevents blood from leaving the legs.

5.

Stop smoking. Among other problems, nicotine causes the blood vessels to constrict and become smaller in size and less effective every time you smoke.

6.

Avoid very hot baths or sunbathing that can dilate the blood vessels.

7.

Do not cross your legs while sitting as it cuts off the circulation.

8.

Take diuretic medications or “fluid pills” as prescribed by your doctor.

9.

Wear compression socks only if prescribed.