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Diabetes

Mother`s swollen ankle

06/30/2008

Question:

Hello,

Thank you for getting back to me. I wrote to you about my mother`s swollen ankle and foot a few days ago. I just wanted to clarify the swelling was only in the left ankle not both ankles. She still has a depressed portion of reddness and induration on the right side of that redness. The red spot is not painful, the induration on the right side of the redness all the way to the foot is swollen and painful to touch. The swelling starts a little bit above the reddened area and continues down the ankle to the foot. After the recent blood test, the doctor has ruled out a heart and kidney problem as well deep vein thrombosis. Right now my mother has finished the antibiotics but the swelling and the pain continue.

I know it`s difficult for you to give me a definate diagnosis, but any more of your insight would be most appreciated.

Answer:

I think the important thing here is that your mother has a relationship with this doctor and that the doctor is clearly thinking about the key possibilities and doing the right thing to systematically work through and rule out treatable problems.  I would do the things that you mention your mother's doctor is doing.  There is very little way that I can better judge the situation over the internet for a problem like this than the doctor who is looking at the whole picture directly.  It is important to keep asking questions and either for your mother or somebody else there to be an assertive advocate for making sure that the possibilities are considered and looked into.  I think the worse thing that the doctor and your mother don't want to miss is the beginnings of some kind of infection that could become aggressive and lead to loss of part of the foot.  It may or may not be possible to get "the answer" but as long as everybody has their eyes on preventing that outcome and stay in touch, the situation should improve.  

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati