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Oh! That's swell!
by Lisa J. Binkley
The practice of medicine is fraught with major mysteries. Why did Baycol, which showed such remarkable results in some patients, cause kidney or heart damage in others? Why did Mr. Johnson exhibit all the traditional symptoms during his heart attack while Mrs. Smith, who suffered greater damage, experienced none? Why will a particular course of treatment cure leukemia in a child but not an adult? As science uncovers the answer to each question, three new ones are kindled.
Women's health issues, once thought of as psychosomatic hysteria and blamed on feminine weaknesses, are in the forefront of new research. Amazing advancements are expected in aspects of the gynecological, obstetrical, and overall health of women.
Test are being devised that can differentiate one type of breast cancer from another and specialize therapy based on the results. More sensitive PAP exams, despite being hampered by the lack of qualified cytotechnologists, are detecting cervical cancer earlier, which allows less drastic measures to be used to remove the malignancy.
In vitro interventions correct tiny hearts, close microscopic spinal cords, and repair fetal palates while the neonatal tissue is at its most elastic and forgiving.
Yet with all the important developments, the little things are still obstacles in the path of human health and comfort.
Interspersed among these bigger problems are the smaller puzzlers that litter every practitioner's day. Of these, none is as frustrating to diagnose as the seemingly causeless intermittent symptoms that plague otherwise healthy individuals.
Most women experience bloating or edema as part of the monthly menstrual cycle. Usually the discomfort is limited to a few days and the symptom is borne with a combination of good grace, resignation, 'fat clothes', and gallows humor. For a percentage, the minor burden becomes something more.
Idiopathic edema primarily strikes young women. The condition ranges from swollen ankles and facial puffiness to full leg pitting edema and shortness of breath. While the leg edema is cosmetically distressing, the dyspnea caused by fluid accumulation in the tissues surrounding the lungs can limit normal activity.
Traditionally in Western medicine, after being evaluated for kidney disease, hypothyroidism, inadequate heart function, or allergies and having ruled out pregnancy, doctors will prescribe a mild diuretic to expel the excess fluid. While successful in the short term, often the dosage needs to be steadily increased to limit future swelling.
Several studies suggest that in many cases of young women with sporadic edema diuretics are contraindicated because the cause may be a cyclic over-release of a kidney hormone called aldosterone. Chronic use of diuretics stimulates the release of more aldosterone and will aggravate the condition.
In lieu of 'water pills' for mild to moderate cases and once underlying disease has been ruled out, specialists often advise a trial and error holistic approach.
Start a workout regime. Regular exercise forces increased blood flow through the affected tissues. This pressure will drive the fluid from the interstitial spaces back into the blood, which will carry it to the kidneys and bowels to be eliminated. If standing or sitting for long periods of time is part of one's normal day, use rest breaks and lunch periods to walk briskly. This activity prevents sluggish circulation and the pooling of fluids in the legs. Prop up your feet when feasible.
Alter salt intake. Eliminate processed foods, which invariably contain large amounts of salt, and audition salt-free versions of your favorite chips, crackers, and pretzels to find the alternatives that have enough taste for your enjoyment at the lowest possible salt content. Aim to reduce intake to less than 2100 mg/day. Various studies found that such restrictions prevented water retention in women suffering regular bouts of unexplained edema.
Try new herbs, spices and vitamins. In addition to adding zing to your salt-free snacking, some herbs and spices can aid in reducing swelling. Cinnamon, garlic, ginger, ginko, ginseng, nettle, and saw palmetto are a partial list. Flavonoids, a chemical found in some herbs, coenzyme Q10, and Vitamins B6, C and E have also proven effective in some cases. Magnesium and calcium supplements help regulate fluid exchange.
Keep a food diary. Aside from salt intake, examine your nutritional habits over the course of a few months. Note when your edema appears. After a time, patterns may emerge and reveal other culprits such as food allergies, periodic protein deficiencies, and sugar bingeing. Some common foods contain naturally occurring mild diuretics; asparagus, parsley, beets, grapes, green beans, leafy greens, pineapple, pumpkin, onion, and leeks. Strive for a more moderate diet and sound nutritional consumption.
Buy a scale. Record your weight daily in the food diary. Fluid retention often causes fluctuations of up to five or more pounds. Also, excess body fat can contribute to the severity in bouts of edema.
Take an inventory of your medicine cabinet. Many types of medicine, either prescribed or over the counter, can trigger edema. When in doubt, ask your pharmacist about side effects. Contraceptives, blood pressure drugs called calcium channel blockers, some anti-depressants, corticosteroids, and others are possible causative substances. Rely on your family doctor for advice on these drugs and the possibility of switching to other types of medicines.
Consider alternative therapies. The World Health Organization and the NIH have approved acupuncture or acupressure for treatment of edema. Traditional Chinese medicine, gaining recognition for management of chronic disorders, may be successful in some cases of edema.
Reduce stress. Yoga, meditation, prayer, and family quiet times have impressive track records for lowering blood pressure. Intermittent and situational periods of elevated blood pressure may constrict capillaries and encourage fluid retention.
The list of possibilities may seem overwhelming to a young woman busy with the other matters of her life but, as physicians rediscover every day, that which works in one patient will fail in another. More importantly, the opposite is also true. What may fail in one woman will succeed in another.
In all the recorded history of medicine and herbal lore, there are two ingredients for successful treatment that every patient needs and every clinician strives to instill.
The first is curiosity. An interested patient actively participates in her care.
The second is the most powerful drug ever discovered and is one no doctor would abandon even for a moment.
That deepest of wells from which good things shall spring...
Hope.
References:
Peripheral Edema
reviewed by Jeffrey Heit MD. University of Maryland
John G. Hipps, M.D, Edema and
Water Retention, The Country Doctor
Edema, edited by
Robert I. Hamby, MD, The Heart Center Online
Scientific
studies about Herbal medicines, NaturalHealthVillage.com
Conditions
Recognized as Treatable with Acupuncture, 14ushop.com
Edema, Health Quality Partners
Edema Home
Care,
National Institutes of Health
Foot swelling when
traveling, MayoClinic.com
Homeopathic
Remedies for Edema (Water Retention), Healthwell.com
Frederick R. Jelovsek, MD, Idiopathic Cyclic Edema, Women's DX Cyber
Foot and Ankle Swelling,
Foot Care by ISHIZAWA Laboratories 2000
Herbal Medicine
Menu Overview, Y-Stress.com
Edema, Acupunture.com
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