Another question from a client -swollen legs

[AmandaB]

So I had my last prenatal with my Apr 16th clients last night. She showed me her legs, they are so swollen. Her toes look like they are going to pop off! The skin is so tight, that at times it is hard to stand on them. She saw her Doc on Monday (they were that bad then) and he didn't even look at them! He took her BP and it was normal. She is not worried, so much as she is uncomfortable and would like some ideas for relief.

So to recap:
Very Swollen legs to below the knee
Normal BP
Hydrating with over a liter of fluid a day
Peeing normally
No other symptoms of Pre-eclampsia or other issues
Would like suggestions for relief

[DoulaKaren]

I think her doctor should actually LOOK at them and see how bad they are. Isn't how severe the pitting is an indicator? In the meantime, elevating her feet, maybe?

[doula Michele]

Yes, I was going to say elevating her feet. Definatly stay off them as much as possible. maybe some cool foot baths, in some nice aromatherapy water?
I dunno, I just imagine that would feel good if nothing else.

But I would want my Dr to see it and at least look! I would demand it...but i'm cranky and not real tolerant of drs who are getting paid to look at me, and they don't even bother.

[RAnderson]

Maybe try laying in the bath for a long time or floating in a pool. I've heard being in water can help quite a bit. Good luck to her! I hope all goes well.

[sldsheppard]

Try some swimming pool time to force fluid back into the vascular system so kidneys can put it out. Possibly eat some cucumbers natural diuretic abilities which may help some

[DouLaura]

Quote:

Originally Posted by sldsheppard Try some swimming pool time to force fluid back into the vascular system so kidneys can put it out. Possibly eat some cucumbers natural diuretic abilities which may help some

She definitely needs to do some swimming. Also asparagus is a natural diuretic.

[tlcdoula]

I would definitely send her back to her doctor especially if he didn't look at them!!!

[AmandaB]

I will call her tonight and suggest that she see her doctor again, although see will see him Monday.

He sounds like a JackA@#! He told her that he will not be at the birth (not a surprize but most at least say they may), and that he is absolutly against Birth Plans as healthy babies is the only goal. "if I have to give you an Episiotomy to get you baby out, I will". Although when my client mentioned she hired a Doula, he said; "Oh, we like Doulas!". He seems to be an interesting duck.

[AussieDoula]

Quote:

Originally Posted by Amandoula1980 Hydrating with over a liter of fluid a day

My first thought is that a litre isn't nearly enough. I would steer clear of the diuretics and encourage her to atleast double her water intake to 2 litres a day instead. What types of fluids is she drinking? Obviously things like Gatorade etc are going to be counterproductive (as well as salty foods).

Is it only in her ankles and feet or does she have swelling in her hands and face too (in which case I would suggest she definitely see her doctor before Monday)?

Some things she can do for immediate relief would include elevating her feet (don't cross the legs or ankles) atleast three or four times a day. Don't sit too much and allow the blood to pool in the feet, try to rotate the ankles and flex the feet a few times a day. She can try maternity support stockings/hose by putting them on first thing in the morning so the blood doesn't have a chance to pool, and definitely try swimming to see if it will help any.

If she is having swelling anywhere else, one leg is much more swollen than the other, it becomes painful, or if the swelling came on suddenly, I would have her call her CP immediately.

*Disclaimer: This obviously isn't a substitute for professional or medical advice, she should see her doctor for a more accurate assessment.

[AmandaB]

No swelling in the face or arms. Both legs are equally swollen.

[Jilian]

Foot massages can help a little with circulation too. My sister had some serious swelling in her feet at the end of her pregnancy - her feet looked like two balloons at one point! It was really painful for her. The only thing that worked was laying down for a while. She had a little luck with soaking them in cool water and massage, but the swelling usually didn't go down until the morning after she slept for the night.

[LauraCochran]

I know they are ugly, and it is starting to get warm out... but compression stockings when she is not able to swim would be helpful. If she's not able to get to the pool, even long baths are helpful. Also, putting her feet up (if possible, above heart-level) and having lots of hydration are key.
I agree, she should definately go back to the doctor just to make sure everything is okay. Hope she finds some relief!
Laura

[Lindsay]

Quote:

Originally Posted by AussieDoula My first thought is that a litre isn't nearly enough. I would steer clear of the diuretics and encourage her to atleast double her water intake to 2 litres a day instead.

That was my first thought, too. That converts to about 33oz US, which isn't anywhere near enough. The guideline I follow for water in pregnancy is half my weight in ounces. So I'm up to about 100oz a day. The easiest way for me to get that much is to take 27 cents and head down to Sonic to order a Route 44 water, and try and go through three of those a day (I refill the cup). That alone should start showing a difference.

I tend to swell quite a bit end of my pregnancies (big babies + little torso'd me = puffy me in general), and some swelling below the knee is normal, especially at her gestation. I've never had edema of any kind other than pitting, and none of my care providers have been concerned at that particular bit of info.

The thing that has made the biggest difference in this pregnancy has been making absolutely sure I'm taking a calcium/magnesium citrate supplement. If I happen to forget it, it's Puff the Magic Mommy, and not pretty.