DEAR DR. DONOHUE: My daughter lives in another city, and I just learned she has a problem with swollen ankles. She was told to get plenty of rest and drink lots of water. No additional treatment was given. Can you give me any ideas to pass to her? – C.K.

DEAR DR. DONOHUE: For two years my mother has had swelling in one ankle that improves after a night’s rest. Her health is otherwise good. I hope you can give some suggestions. – A.Q.

ANSWER: Ankle swelling can be traced to a number of reasons, and treatment hinges on finding the exact one.

One-sided ankle swelling can be due to a clot in the main vein of that leg. After resolution of the clot, blood return through the vein can be impeded, and that leads to fluid leakage and swelling. Or it can be due to a previous infection of the lymph channels of that leg. Lymph channels are miniature hoses that suction tissue fluid and return it to the circulation. Blockage of those channels causes swelling, and leg lymphatics are those most commonly involved in this process. Elevating the leg, compression stockings and leg massage by an expert can often drain the fluid from the tissues around the ankle.

Both-sided ankle swelling can come from fluid and salt retention that occurs in heart and kidney failure. It also happens with liver cirrhosis. Medicines like ibuprofen, cortisone and verapamil can bring on ankle swelling. Simply letting the legs dangle downward while sitting in a chair for protracted periods of time can swell ankles. Treatment has to be tailored to the cause, but leg elevation, elastic stockings, curtailing dietary salt and the use of medicines can usually bring down swollen ankles regardless of the cause.

The advice given to C.K.’s daughter to drink lots of water puzzles me.

Edema – ankle swelling – is treated in depth in the pamphlet of that name. Readers can obtain a copy by writing: Dr. Donohue – No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Last week I went to a doctor to have my eyes checked. He said I have cataracts and that I should return to him in one year for another examination. Is there any medication or drops that will deter the formation of cataracts so they won’t have to be surgically excised? – B.C.

ANSWER: No medicine or drops deter the formation of cataracts. However, it is impossible to predict how quickly a cataract will progress. Most worsen quite slowly, and most people with developing cataracts never have to face the prospect of surgical removal.

A cataract is a clouded eye lens. The lens of the eye sits behind the pupil, and it focuses light onto the retina for clear vision. Aging, exposures to ultraviolet light and cigarette smoking figure into cataract progression. Wearing sunglasses that filter ultraviolet light can delay its worsening.

Lutein, a substance found in kale, spinach, broccoli, corn, peas, egg yolk, pumpkin, yellow squash, red grapes and zucchini (and many multivitamins), is believed to delay a cataract’s maturation.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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