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Peripheral Neuropathy secondary to type 2 diabetes mellitus.

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I am a 70 year old woman. A couple years ago my left leg, foot, and ankle began to swell.
I had a blood clot in my left leg 14-15 years ago. Twenty years ago I fell down steps and hurt my knee and I have a history of falling. I always land on my left leg. The problem now is that my foot, ankle, and leg (all the way up, including my left hip) is swollen in spite of the fact that I'm seeing a dr., a primary nurse comes to my home, as well as a physical therapist.In the last couple months, I have visited two specialists; one checked me out and recommended another specialist to have an ultra sound of both legs. It was very thorough. Then a few weeks later, a person came to my home and took x-rays of my left leg and both hips. That woman told me all she saw was moderate arthritis in my knee.
IS CHRONIC SWELLING CAUSED BY ARTHRITIS? The other docs I saw didn't seem to know what was wrong with me and said things like, "it could be.....", I think maybe
it's......" and when I told one doctor about the left side of my body being A DIFFERENT size than the right side, he said he had never heard of such a thing. I wear different size shoe at the same time and when I wear snug jeans or slacks anyone can look and see that one leg is larger than the other.
I am diabetic and have chronic kidney disease but I've finally got the sugar under control, I exercise 5 days out of the week and have been on a very strict diet. Over the years I managed to lose over 80 lbs. with about 40 or so to go. Regardless of what I do, nothing changes re: the swelling. HAVE YOU EVER HEARD OF ANYONE WITH THESE SYMPTOMS? Any suggestions?
If you don't think I need a specialist please let me know because I don't have
a lot of money. Thank you very much.
Most Sincerely,
Karyn Davis
Columbus,OH


Category: Rheumatologist

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Category: Internal Medicine Specialist
Dr. Bimlesh Dhar Pandey is online now

Expert:  Dr. Bimlesh Dhar Pandey replied 4 Days.

Hello Karyn,

Thank you for choosing DoctorSpring,

Although I not unable to examine your Physically from the history you provided I have some differential diagnosis.

One can have different size on right and left side and it is a known medical fact. The frequent fall and injuries on left side can be because of LLD (limb length difference). Your diabetes can cause peripheral neuropathy leading to poor peripheral sensation, which contributes to fall.

The knee swelling is because of effusive osteoarthritis. ankle swelling can also be because of osteoarthritis. Since there was excess stress in the left limb secondary osteoarthritis is highly likely. Moderate arthritis can cause swelling. But your leg swelling is more diffuse (not limited to the joints alone). So we need to consider other possibilities here. The most important concern here is a DVT (or Deep Vein Thrombosis ). Your Doctor would have already ruled it out. The ultrasound like machine is actually a Doppler machine to assess the blood vessels.

Other possibilities are a postphlebitic syndrome and a Lymphedema. Unfortunately without further evaluation I will not be able to give a single diagnosis at this stage. I recommend this approach - Discuss with your Doctor whether DVT (or any blood vessle problem has been ruled out). If yes, then you can judiciously have a wait and watch approach for a week or two. You can take a NSAID anti inflammatory medication in the guidance of your Doctor. There is good chance the swelling will reduce with medication and rest.


Hope this helps
Feel free to ask followups / clarifications


regards


Dr. Bimlesh Dhar Pandey
Category: Internal Medicine Specialist
Experience: 
Senior Residency: Rhematology, All India Institute of Medical Schiences, New Delhi, 2009
Post Graduate, Junior Residency: MD (Internal Medicine), Rajendra Institute of Medical Sciences, Jharkhand, 2006
Residency: Physiology, Institute of Medical Science, Banaras Hindu University, Varanasi, 2003
Internship: Government Medical College, Trichur, 2001
Medical School: MBBS, Calicut University, 2001
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