Swollen Ankles

Q:  In April '97, I went on a 12-day bus tour. I experienced severe swollen ankles. I am looking forward to another trip this year in April. I am wondering if you have any suggestions to help avoid the same problem this time.

A nurse friend has suggested limiting salt intake. However, on a tour we are limited to eating restaurant food. I never add salt to my food when eating out. I am a senior citizen, but take no medications except a baby aspirin once a day as directed by my doctor.

A:  Sitting for long periods with your feet down causes pooling of the blood because of gravity. If the bus seats have foot rests, try to elevate your feet as much as possible and do ankle rolls or leg lifts to increase the circulation. Whenever the bus stops, be sure to walk around. Support stockings will help decrease the swelling.

Salt will certainly increase fluid retention. You could try to "special-order" your food without added salt and avoid foods with lots of hidden salt, like soups, luncheon meats, olives, pickles, crackers. Even fast food restaurants often have a few "healthy" items on the menu. Drink lots of water too.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.