Endometrial Biopsy for Pelvic Pain but No Bleeding?
A gynecologist provides information about pelvic pain and the endometrial biopsy.
Have you been experiencing unexplained pelvic pain and worrying that it might be uterine cancer?
“Pain is not a presenting symptom in most cases of uterine cancer; abnormal bleeding is,” says Alyssa Dweck, MD, a practicing gynecologist in Westchester County, NY, and co-author of the book, “V is for Vagina.”
An endometrial biopsy can reveal the presence of cancer in the uterus.
A woman with pelvic pain (and no other symptoms), who’s fearing uterine cancer, might reason that she should undergo a an endometrial biopsy.
Then, as she figures, if it’s negative, she could breathe easily and her doctor could focus on other causes of her symptom.
But it doesn’t work that way. It’s a fair question to ask why, since if a woman DOES have uterine (endometrial) cancer, it would make sense to find out as soon as possible, rather than spending time on other tests (e.g., ultrasound) that aren’t proficient at cancer detection—and meanwhile the uterine cancer grows.
“It is always a risk benefit game when considering an invasive procedure,” begins Dr. Dweck.
“Endometrial biopsy is typically quick and easy [for the physician, but many patients report it’s painful], but still carries with it risk of infection, bleeding and perforation of the uterus. In fact, I have seen bowel injury from this in a rare instance.”
Pelvic Pain Has Many Causes
Dr. Dweck says that the appropriate indication for an endo biopsy is paramount. “Most physicians will look for the obvious causes of pathology first and go with statistical likelihood.”
A young premenopausal woman complaining of pelvic pain vs. a 60-year-old postmenopausal woman reporting this same symptom will not generate the same ideas in a gynecologist as far as how to approach the situation.
“The vast majority of those with uterine cancer are older and have postmenopausal bleeding and/or ultrasound findings,” says Dr. Dweck. The key ultrasound finding would be a thickened uterine lining.
“The vast majority of those with pelvic pain in the absence of bleeding or uterine irregularity on ultrasound will have a normal endometrial biopsy.”
A woman with only pelvic pain may still want that endometrial biopsy for peace of mind, but her doctor likely will not offer this as a first-line test, says Dr. Dweck.
Pelvic pain not only has many possible causes, but can present with varying sensations.
For example, the pelvic “pain” of uterine cancer (which remember, is not a typical symptom of this disease) would feel different than the pelvic distress of the following, which would also all differ from each other:
Colitis, gas, strained low ab muscles, diverticulitis, food poisoning, celiac disease.
Dr. Dweck
practices general gynecology and is proficient in laparoscopic and robotic gynecologic surgery. Her special interests are female sexual health and dysfunction.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Rocketclips, Inc.
White-Yellow Discharge Soon After Menopause: Causes
A gynecologist gives some reasons why a postmenopausal woman might suddenly start seeing white-yellow vaginal discharge.
The seemingly unexplained appearance of a white-yellow vaginal discharge in a postmenopausal women may be due to:
“The use of products that may be irritants or result in allergic reactions (e.g., perfumes, douches, feminine washes or wipes, powders, panty liners or incontinence pads, soaps, deodorants, spermicides, lubricants, tight clothing) or a history of pelvic radiation, all of which can cause a vaginal discharge,” says Alyssa Dweck, MD, a practicing gynecologist in Westchester County, NY, and co-author of the book, “V is for Vagina.”
But what if there’s been no change in body products and no history of pelvic radiation?
Dr. Dweck explains, “With these caveats the only discharge that comes to mind is altered vaginal pH — and drainage as a result of that; a fistula, an abnormal connection from the bladder or rectum to the vagina which can cause drainage.
“In fact, I truly think vaginal atrophy due to menopause and lack of estrogen is the main cause.”
Vaginal Atrophy
After menopause the vagina can shrink and become less elastic and dry.
However, despite the dryness, a yellow-white discharge can indeed be a symptom of this atrophic vaginitis.
“A pertinent sexual history should be taken to evaluate whether the symptoms are associated with sexual activity,” says Dr. Dweck.
“Antihistamines can cause dryness even in the genitals, so discontinuation may cause increased secretions. Elicit a full medication history.”
Dr. Dweck practices general gynecology and is proficient in laparoscopic and robotic gynecologic surgery. Her special interests are female sexual health and dysfunction.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Natalie Board
Does Running up and Down Stairs Mean You Have ADHD?
Running up and down a staircase is believed to be a sign of ADHD by many people.
And we’re not talking about dashing up and down for exercise, either.
I was perusing an ADHD forum and noticed a a thread question:
Does running up and down the stairs mean you have ADHD?
The thread had a variety of feedback from people diagnosed with attention deficit hyperactivity disorder.
For this article I interviewed Dr. Robert Myers, creator of the Total Focus program at Legacy Publishing.
Dr. Myers is a clinical psychologist with 30+ years of experience working with children, adolescents, families and parents, specializing in children and adolescents with attention deficit hyperactivity disorder.
Dr. Myers explains: “Running up and down stairs certainly can be a sign of hyperactivity, which is one symptom of ADHD.
“However, if the child is fairly young it could simply be the sign of a very energetic child.”
It’s not uncommon for kids to bound up a staircase when using it to access an upper level of a house.
I did this all the time as a child. However, there was always a reason to get up the staircase: to go to my bedroom.
This isn’t the same as dashing up and down, up and down, up and down, consecutively, in the absence of training for sport.
Do you know any young kids who don’t run up and down the staircase?
Yes, this seems to be common behavior among children and even adolescents and teens.
This type of behavior can also be a natural byproduct of athleticism.
If a child is involved in sports, doesn’t it stand to reason that they would habitually run up and down their house’s staircase instead of merely walking up like their parents do?
This doesn’t mean they probably have ADHD.
All of this reasoning also applies to adults. My own habitual dashing up and down my home’s stairs had nothing to do with my attention span or how “hyper” I may have been in various situations.
I’m athletic and into physical fitness, and I never want to develop a slow body.
It’s only natural, then, that I’d have a habit of dashing up and down my staircase simply to get from one level to the next.
As a fitness enthusiast and former personal trainer, I encourage kids and adults to run up and down their home’s staircase!
Over time, the extra calorie burn can mean a few pounds of fat lost. But it will also mean an improvement in fitness.
Dr. Myers has 30+ years’ experience working with children, adolescents and parents, specializing in children and adolescents with ADHD. Total Focus is a comprehensive program to improve attention, concentration and self-control in children.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik.com
Microscopic Colitis Low Ab Cramp & Lifting Weights: Guidelines
Yes, you can lift weights if your microscopic colitis is causing a low abdominal cramp.
There are two kinds of “lower abdominal cramps” that you may experience with microscopic colitis.
This assertion is based on the fact that I myself have experienced two distinct types of low ab cramping as a result of lymphocytic colitis, which I was diagnosed with in 2010 May.
I’m also an avid bodybuilder and powerlifter. At the time of this article writing, I’ve had two flare-ups of microscopic colitis.
The first resulted in a little cramping in the lower abdominal area that felt slightly gassy and had some mild rumbling, as though things were, as I’d think, “going on in there.”
With the second flare-up, I had this same kind of mild dissonance that felt like there was a little gas, like gas bubbles brewing, but also with a little cramping; very mild.]
In both cases, I lifted weights as though it weren’t there. This included heavy bench pressing and deadlifting.
The weightlifting did NOT make the cramping worse.
The low ab cramp was just something in the background that I was aware of while I was passively resting in between weight lifting sets.
I’ve done exhaustive research on microscopic colitis, and I have NOT located any medical literature stating that weight lifting should be avoided by those with a low ab cramp from this benign condition.
The second kind of low abdominal cramping from microscopic colitis is the type that, if severe enough, would keep me home.
However, it’s also very responsive to Naprosyn. This second kind of pelvic discomfort is NOT related to the “gassy” kind described just a moment ago.
This second kind is quite uncomfortable, and even when mild, is very annoying. It feels JUST LIKE a PMS uterine cramp!
Research is ongoing as to the exact mechanism that microscopic colitis causes “pain” or aching beyond the abdominal cavity.
My belief is that this inflammatory bowel disease incites production of hormones called prostaglandins. See the source citations at the end of this article.
Prostaglandins are located throughout the body, and when activated, cause inflammation and discomfort at those regions.
They are part of PMS for many women, which is why joint pain or aches, along with low back ache and low ab cramps, are common PMS symptoms.
It’s believed that prostaglandins are in full force, which is why anti-prostaglandin drugs like Naprosyn and ibuprofen knock the aches out cold. Prostaglandins cause uterine spasms, leading to the sometimes disabling “low ab” pain of PMS.
Enteropathic arthralgia is the term for joint pain caused by a gastrointestinal problem. Enteropathic arthralgia is part of inflammatory bowel disease, and microscopic colitis is an IBD.
It would be no surprise that the joint aches and low ab (pelvic) pain of my MC involve the same mechanism as the PMS pain I used to get.
If I want to lift weights but have this second kind of low ab ache from microscopic colitis (it’s not PMS because I’m postmenopausal), I’ll simply take Naprosyn, which suppresses the enzyme that leads to prostaglandin production. I’ll then have a great workout.
However, those with MC should avoid NSAIDs! Fortunately, my “enteropathic arthralgia” hasn’t been frequent enough to interfere with scheduled weight lifting workouts.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Lestertair
Sources:
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04686.x/full (prostaglandins and MC)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629156/ (prostaglandins and MC)
http://www.ncbi.nlm.nih.gov/pubmed/6350580 (prostaglandins and PMS)
http://www.ncbi.nlm.nih.gov/pubmed/19594490 (prostaglandins and IBD)
http://www.ccfc.ca/site/pp.asp?c=ajIRK4NLLhJ0E&b=6349433&printmode=1 (flare-up of joint aches can occur separate from gut problem flare-ups)
What Low Backache from Microscopic Colitis Feels Like
If you think your low backache might be from microscopic colitis, I will describe what this feels like.
Not all “low backache” is the same, and that applies to microscopic colitis, which I was diagnosed with (colonoscopy) in May of 2010.
I have a very mild form; only two flare-ups at the time of this writing, the first flare-up taking about two months to run its course.
I’ll get to the point fast: The low backache associated with microscopic colitis feels IDENTICAL to the low backache of premenstrual syndrome (PMS).
It’s somewhat stiff, making me want to try to induce cracking (like a chiropractor would), but the overwhelming feature is an uncomfortable aching—and this aching, too, makes me want to get a good crack in.
If you’re a man, hold tight, as I will go into more detail.
The best way to describe the low backache of microscopic colitis is a nagging or persistent feeling in your low back that makes you want to repeatedly twist left and right forcefully to generate some vertebral cracking.
The feeling is an ache, for sure, but at the same time, it makes me want to stretch and crack the bones.
The low backache of microscopic colitis (or PMS) always makes me imagine that I’m at a chiropractor’s office and getting an adjustment; all the bones are getting cracked.
As an athlete, I’ve had low back strain more than once. A microscopic colitis flare-up (or PMS) feels NOTHING like a strained or pulled muscle that you might get from exercise or bending over while picking up something heavy.
In the body are a group of chemicals called prostaglandins. Research implicates them as being part of the cause of PMS.
Compelling evidence of this is that drugs that inhibit prostaglandin production work marvelously at squashing the joint aches of PMS.
Prostaglandin overproduction is also implicated in inflammatory bowel disease. Microscopic colitis is an IBD, and research specifically on MC also implicates prostaglandins.
This would explain why the low backache of PMS (at least for me) feels absolutely identical to that from microscopic colitis.
It’s the type of discomfort that would not prevent you from doing heavy lifting, if you’re trained, anyways.
It’s not the type of discomfort that would make you nervous about the prospect of moving furniture or shoveling snow.
But it’s really annoying and can be aggravating, because it makes me want to keep twisting to induce bone cracking and soft-tissue popping — which, when it happens, feels SO GOOD.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik.com
Sources:
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04686.x/full (prostaglandins and MC)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629156/ (prostaglandins and MC)
http://www.ncbi.nlm.nih.gov/pubmed/6350580 (prostaglandins and PMS)
http://www.ncbi.nlm.nih.gov/pubmed/19594490 (prostaglandins and IBD)
http://www.ccfc.ca/site/pp.asp?c=ajIRK4NLLhJ0E&b=6349433&printmode=1 (flare-up of joint aches can occur separate from gut problem flare-ups)
Can Back & Ab Aches of Microscopic Colitis Feel Like PMS?
Here’s the only article you’ll find comparing joint aches of microscopic colitis to those of PMS.
Having been diagnosed (colonic biopsy) with microscopic (lymphocytic) colitis, and being a woman who knows all too well what the joint aches of PMS (premenstrual syndrome) feel like…I am here to confirm this:
Joint aches of microscopic colitis and those of PMS feel identical in every way, shape and form.
At least for me they do. But I’m sure I’m not unique.
Researchers cannot solidly define the mechanism that causes joint aches that precede the menstrual cycle (“PMS”) nor the joint aches of microscopic colitis (enteropathic arthralgia).
But suspect in both cases are chemical messengers called prostaglandins. NSAIDS such as Naprosyn and Alleve suppress production of prostaglandins. This is why these drugs work so well on the joint aches of PMS.
However, when I had my second flare-up of microscopic colitis, Naprosyn kicked butt with the joint aches.
This tells me that the MC arthralgia was caused by a flood of those nasty prostaglandins (not to mention that the feeling is identical to premenstrual syndrome).
“Aching joints can be a symptom of microscopic colitis, but not necessarily. Many patients with aching joints don’t have microscopic colitis, but aching joints and gut problems often go hand-in-hand.
They’re both associated with inflammation, and many doctors speculate that cyclo-oxygenase (COX 2) or prostaglandins are involved because of the function they provide. Prostaglandins are chemicals that generally cause inflammation of our joints.”
– Dr. Jeffrey Fine, MD, the chief of gastroenterology at the Medical Surgical Clinic of Irving, from an interview for another post of mine, Why Does Microscopic Colitis Cause Joint Pain?
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/George Rudy
Sources:
onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04686.x/full (prostaglandins and MC)
ncbi.nlm.nih.gov/pmc/articles/PMC3629156/ (prostaglandins and MC)
ncbi.nlm.nih.gov/pubmed/6350580 (prostaglandins and PMS)
ncbi.nlm.nih.gov/pubmed/19594490 (prostaglandins and IBD)
ccfc.ca/site/pp.asp?c=ajIRK4NLLhJ0E&b=6349433&printmode=1 (flare-up of joint aches can occur separate from gut problem flare-ups)
Aching Joints: PMS vs. Microscopic Colitis
Is there a way to tell if your joint aches are related to PMS, your monthly cycle, as opposed to microscopic colitis?
Microscopic colitis, as well as PMS, are strongly associated with joint aches. However, not all people with microscopic colitis develop aching joints, and not all PMS symptoms consist of this, either.
As a woman, I know what both feel like. Is there a way to tell the difference, however, between the joint aches of microscopic colitis and those of PMS?
Yes. You do it by timeline.
My first flare-up of microscopic colitis came when I was expecting my period.
My periods were irregular, so the anticipated date of my first day of flowing was not pinpointed.
But I was approaching that day—it was anywhere from a day to a week or so out.
I began experiencing joint aches. I also developed strange diarrhea that I was having several times a day, and at times, overnight.
I do not recall which came first: the diarrhea or the arthralgia. But I definitely recall they came within pretty close approximation of each other. I blamed both on PMS.
Then I began flowing. Now, historically, joint pain from PMS always disappeared the first day I began flowing (not spotting, but FLOWING). Rarely, the joint pain persisted into the second day of my period.
In general, for women who experience premenstrual syndrome, the symptoms disappear when the period begins.
MedlinePlus states:
Premenstrual syndrome refers to a wide range of symptoms that:
Go away 1 – 2 days after the menstrual period starts.
Gooddaypharmacy.com states that the symptoms usually go away after the first day or two of flow.
The Premenstrual Syndrome In-Depth Report from nytimes.com states: The symptoms typically go away within 4 days after bleeding starts.
This is why it’s called premenstrual syndrome.
Oddly, though, my joint aches in this particular case not only persisted throughout the entire duration of my period, but they were about the worst I had ever had—really distracting me while I tried to work at my computer (ankles, low back, wrists, even neck). I didn’t take NSAIDS because they could damage the liver.
When my period ended, the “PMS” joint aches continued!
They just persisted for days after I stopped flowing.
Nevertheless, I attributed this to hormone fluctuations related to my monthly cycle, even after I was diagnosed with microscopic colitis.
I never connected the dots—until quite a while later when I learned that MC and arthralgia often go hand in hand.
So, the big tip-off that your joint aches are related to an inflammatory bowel disease such as microscopic colitis is that their timing does not correlate with your period.
Another tip-off that the symptoms aren’t PMS is that you’re postmenopausal, as I was at the time I had my second flare-up of microscopic colitis.
It began with joint aches that felt very “PMS-ey” or hormonal, but I had completed menopause four months prior.
The diarrhea came 27 days later (ranging from porridge-like to explosive pale yellow), and most of the arthralgia went away a few days after that.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Stasique
Sources:
onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04686.x/full (prostaglandins and MC)
ncbi.nlm.nih.gov/pmc/articles/PMC3629156/ (prostaglandins and MC)
ncbi.nlm.nih.gov/pubmed/6350580 (prostaglandins and PMS)
ncbi.nlm.nih.gov/pubmed/19594490 (prostaglandins and IBD)
ccfc.ca/site/pp.asp?c=ajIRK4NLLhJ0E&b=6349433&printmode=1 (flare-up of joint aches can occur separate from gut problem flare-ups)
nlm.nih.gov/medlineplus/ency/article/001505.htm
nytimes.com/health/guides/disease/premenstrual-syndrome/print.html
Ultrasound Tech Says Ovarian Cyst Is Complex?
Find out what it may REALLY mean when an ultrasound technician tells you that part of an ovarian “cyst” looks “complex.”
If you’ve been keeping yourself medically informed about the human body, then you know that when an ovarian cysts has “complex” qualities in a postmenopausal woman, this gets the attention of the radiologist fast.
So imagine my anxiety when I asked the ultrasound tech, when she completed the external exam, if the “cyst” she said was possibly on an ovary, had any complex portions – and she said yes.
If this happens to you, I strongly recommend that you ask the tech to repeat the ultrasound—after you let your bladder get more full, even if you feel you really need to relieve yourself.
She wanted to do a transvaginal ultrasound, but I declined because I knew this would be intolerable.
She said that if she sent the results to the radiologist, the impression would be “sub-optimal,” and the radiologist would want a transvaginal done.
So I’m lying there, weighing my options. I then asked if it’s possible that the transvaginal would show that the alleged ovarian cyst was not “complex,” and she said it was possible, and that the external image has limitations.
Only after a few minutes of this back and forth did she finally suggest a repeat ultrasound, because it appeared as though my bladder wasn’t maximally full.
In fact, from the get-go, I didn’t feel all that urgent and wondered if I was full enough, and I even asked when she began the procedure, if I was full enough, and she said yes.
Nevertheless, she changed her tune and said to drink more water and wait in the lobby, and when I felt extremely urgent, to have the clerk notify her.
She repeated the ultrasound, and it was uncomfortable due to my urgency (whereas the first one wasn’t).
She said the image was much better. As for the “cyst” on the ovary, she now said that based on her better view of it, she no longer felt I needed a transvaginal, and that the radiologist would probably just recommend a “follow-up in two or three months.”
The so-called cyst was average 1.5 cm, and the tech said this qualified it as a “follicle,” and that only when they’re at least 2 cm are they called a cyst.
With a much clearer image, she was able to see that it was “homogenous,” meaning same throughout, rather than more than one pattern or variegated. This was good news.
Another feature she was able to discern was that the “follicle” lacked “septations.”
Another good sign was that when she did a “flow” to see if there was a vascular network within the follicle, nothing “lit up.” This meant that the follicle did not have its own blood supply.
These are all features of a benign finding.
She had let me see the image and showed me the negative result when she did another “flow” test.
I might add that she told me she was NOT supposed to reveal such information to me (she told me this at least twice), but I guess there was something about my demeanor that encouraged her to break the rules.
But thank God I saw the image; it was very homogenous. However, it wasn’t black (which would indicate a very shallow object). It was a smooth gray. What WAS it? I’m postmenopausal, so it couldn’t have been a functional cyst.
Several days later I received a voicemail message from the doctor’s nurse with these exact words: “YOUR PELVIC ULTRASOUND WAS NORMAL.”
Hmmm. I sent an e-mail to the doctor asking to send me the report. No way would I mention what the ultrasound tech had told me, as this would get her in trouble.
The report stated:
FREE FLUID: Trace free fluid identified in the right adnexal region.
IMPRESSION:
Minimal free fluid in the right adnexal region.
I asked the doctor what this meant. Her response:
Your abdomen has fluid inside at all times bathing all your organs, and sometimes if they see some at the time of an ultrasound they will mention it because it may be associated with menstrual bleeding or an ovarian cyst etc. However, there was no comment of pathology and your right ovary as well as left was normal without cysts on the imaging.
So if the ultrasound tech tells you an ovarian cyst looks complex, ask yourself if your bladder could be MORE full, then ask for a repeat ultrasound in 30 or more minutes.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock
Ultrasound Can’t See Ovary Doesn’t Mean Anything’s Wrong
The ultrasound technician gave me a very normal reason why she could not “find” my left ovary.
If your ultrasound technician informs you that she can’t “see” or “find” one of your ovaries, do NOT panic or worry. If she says it’s “hidden,” do NOT worry.
The ultrasound technician told me that she was unable to see my left ovary.
She said the “bowels” were in the way of the ovary, and that the waves kept “bouncing off,” preventing her from getting an image.
If this happens to you, it does NOT indicate a medical problem. It’s an IMAGING issue.
In my case, the solution was to drink more water and wait for my bladder to get fuller.
That, I did, though it took a while, even though I had followed the water-intake instructions prior to the first imaging.
The technician took one or two patients while I waited for my bladder to get really uncomfortably full.
For the second attempt, she had absolutely NO problem getting a good image of the “hidden ovary.”
If you have an ultrasound scheduled, it will help you if you have this knowledge ahead of time.
Make sure your bladder feels ready to burst before you get the procedure done.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Cause of Mild Ankle Edema when All’s Been Ruled Out
Find out what my doctor said about my bilateral, mild ankle edema that doesn’t seem to have an identifiable cause.
The bilateral (both ankles) edema I first noticed several years ago was so vague that initially, my primary care physician didn’t even see it when I told her to look at my ankles.
Eventually she decided that I might have “trace” edema.
In fact, the “edema” was so mild that my veins and sinew were quite prominent, and I still had a thin ankle with bones jutting out.
But if a discerning eye looked closely, it appeared as though in certain areas, below the skin was more than just a thin layer of fat.
There was a fleshy, soft appearance, and I was able to grab at it with my fingers more than what I’d expect to for this location of my body.
The mild edema had not changed the shape of my lower leg or the diameter.
However, my cardiologist — during my annual routine heart health exam — immediately confirmed that my assessment was correct: that I had edema. He said it was “akin to a few grey hairs.”
Not long before this discovery I’d had extensive tests of heart function: all normal. Calcium score was zero. Stethoscope, EKG and blood lipids were all normal.
And, there were never any symptoms when I engaged in STRENUOUS exercise: high intensity interval training and intense and heavy weightlifting.
Blood tests for liver and kidney function were normal. Tests for celiac disease and low thyroid came back negative.
I wasn’t pregnant, and the mild bilateral ankle edema was not related to my menstrual cycle because I was newly postmenopausal at this time.
Menopause!
Could THAT be the cause of my vague edema in both ankles, I wondered.
The edema or whatever it was never went away overnight.
It was exactly the same at any time of the day. It had not changed in any way or degree since when I had first noticed it.
My OBGYN nurse denied I had edema, however. So did my dermatologist.
That’s three doctors (PCP, cardiologist and dermatologist) and one gyn nurse who had given their opinions.
But only two of these medical professionals believed it edema — one calling it “trace.” And two denied it. Very interesting!
Conclusion: I didn’t have edema in the ankles at all. It’s just that my ankle area isn’t going to look the same as it did 10 years ago or even five years ago.
I don’t excessively sit or stand.
I’m not on meds, and I have a low salt diet.
I have no symptoms that would suggest a kidney stone.
I don’t drink.
Lymphedema is a type of fluid retention characterized by marked swelling of the foot, which I don’t have.
I don’t have venous insuffiency and never had a blood clot.
I do have a small varicose vein in each calve, but I’ve had those for years. I don’t have ulceritis or Crohn’s. My colonoscopy was normal.
The “pseudo” bilateral ankle edema is non-pitting (no impression left when pressing a fingertip to the skin).
My advice if you seem to be in the same boat: Get doctor and nurse assessments, but consider the possibility that you actually do NOT have ankle swelling or fluid retention after all.
Instead, you’ve likely lost familiarity with what your ankles normally look like, and/or body fat stores can shift and settle closer to the ankle — something that wouldn’t necessarily be prevented with intense exercise.
