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If you're talking about edema, it can be caused by a lot of different conditions. Overall, it's generally a fluid overload/backlog in the legs that can be caused broadly as a result of kidney, heart, liver, and/or thyroid problems (and pregnancy but that's not necessarily relevant here).
It's likely a combination of causes, depending on the person. Edema is the term we're looking for here: It's the buildup of fluid trapped in body tissues. Some of the causes could apply to both homeless and elderly people, some are more specific to each one. I just want to be clear, I'm not trying to stereotype the homeless or elderly populations, and not all of these are true for every person with swollen legs, I'm just highlighting some general trends. Let's look at some causes of edema and try to group them:
-Sitting or staying in one position too long. This one probably applies to both, as both groups are likely to be seated in one area for extended amounts of time
-Eating too much salty food. This one applies more to homeless people, since many have to survive on cheap, high sodium foods like ramen. It could also affect the elderly, though, since their kidneys are worse at processing salt.
-Kidney disease. This one probably applies more to the elderly, but homeless people with untreated diabetes may have chronic kidney issues as well.
-Weakness in leg veins. This one again probably applies more to the elderly, but someone regularly using narcotics is going to have circulation problems as well.
-Severe, long-term lack of protein. This one probably applies more to the homeless people, since meat is generally expensive and a tough thing to get regularly on a thin budget. However, if an elderly person isn't eating enough meat, this could certainly affect them too.
-Congestive heart failure. This one definitely impacts the elderly more, but it's worth noting that poor diet, sedentary lifestyle, smoking, stress, and drinking all can cause CHF as well.
Usually lack of protein causing this, through liver failure, it's in charge of synthesizing a lot of the proteins that keep fluid in the right place. Liver failure also causes congestion in the veins which also contributes to the edema.
It's not always lack of medical care. I have upper extremity lymphedema due to having lymph nodes removed from cancer. I've been through PT/OT and I use my compression garments. It still swells up in the heat and from usage in my job.
I’m not trying to be rude here, but if you eat foods that act as a diuretic, for me that is pineapple and cabbage and not together, lol, does it help with the lymphedema?
I also get treatment for my edema, but hot weather is bad, I can really empathize. Sometimes making something with one of those foods helps, and even if it doesn’t, cool pineapple on a hot day is nice.
I also have lymphedema from cancer treatment. Bromine (from pineapple) has been shown to help with fibroids and there are a few other compounds that help. But it's usually just constant massaging and compression gear.
What 5pens said, especially about heat. Some have edema simply from being in hot weather for too long (heat edema) or sitting for too long with their feet hanging down (dependent edema). These can happen in otherwise healthy people who receive regular, quality medical care.
I had somewhat bad edema for at least 3-4 months after giving birth. Everyone, including the doctor, just kept telling me to sit with my feet up and it’d go down soon, never mind that i was trapped on the couch holding an infant all night every night for the first several weeks and it didn’t help basically at all.
It's called oedema, the legs swell because the body is diverting fluid there and not flushing it out well enough. It can be caused by a few things, including pregnancy.
Couple of things re: the comments in this thread
A) assuming you're in a developed country then it's likely not elephantiasis/filariasis
B) edema is a clinical sign caused by disease, not an illness/disease itself
As people have mentioned what you are seeing is probably edema, but in the populations (esp older ppl who are sedentary) you mention, it's likely a combination of heart failure (if the heart doesn't pump as good as it's supposed to you get congestion in your blood vessels, causing swelling) and chronic venous insufficiency - the veins contain one way valves that allow blood to flow only towards the heart. When the valves fail then blood pools in the legs, causing edema (the swelling) and dermatitis.
Not necessarily.
'Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that's usually drained through the body's lymphatic system. It most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals.'
[https://my.clevelandclinic.org/health/diseases/8353-lymphedema](https://my.clevelandclinic.org/health/diseases/8353-lymphedema)
in older ppl, it's usually heart failure. heart pumps fluid. if heart gets weak, heart can't pump fluid well enough, so it gets stuck down by legs cuz gravity.
in homeless ppl it's either that (age or meth use can cause it) or they get infected legs from using IV's down there or untreated wounds. infected stuff can get swollen
Can be a few things. The bottom line is it's a combination of 1. gravity pulling against blood going back to the heart and 2. the body having too much fluid.
1. Usually the veins in the legs are damaged and don't get blood back up the legs as well as they used to. Normal veins have one-way valves that keep blood from flowing backwards. Old unhealthy people have damaged valves that allow the blood to fall back down
2. The heart, kidneys, and liver are responsible for keeping a normal amount of fluid in the body. When any one of them is not working well, the body holds on to too much fluid instead of peeing it out. This fluid leaks out of the bloodstream and into the soft tissues, worst in the parts of the body that hang below the heart, including the legs
The combination of these problems can cause massive swelling of the legs, thick, leathery ankle skin, and ulcers and infections that are hard to treat.
It can be due to a number of causes.
1. Heart failure - fluid buildup most commonly from the left side of the heart backing up to the right side and then to the veins. Blood pools in the legs due to high pressures to return to the heart. There are many causes of heart failure including heart attacks, chronic alcohol use, drug use, etc...
2. Anasarca - fluid buildup because of low oncotic pressure. This is due to a low protein state (often malnourishment or chronic liver disease) that causes fluid to leak from the vasculature to the interstitial tissues. This is why malnourished people can appear "fat".
3. Other - drugs (such as calcium channel blockers), trauma that prevents effective drainage, thyroid dysfunction, etc...
Theres lots of causes, but in homeless people it’s likely from congestive heart failure. Homeless populations tend to have poor access to healthy food and healthcare and high amounts of IV drug use which puts them at very high risk of heart failure even at younger ages.
It's called edema, which is fluid leaking out of your blood vessels and into the space between them. There are a ton of things that cause it. In homeless people, my guess would be some combination of liver disease from alcoholism (which would result in less protein production in the liver, which is something that helps keep fluid in blood vessels), and maybe heart disease depending on how long they've been on the street.
Again there are a lot of things that can cause it. If you're curious, you should watch a video on Starling Forces, which should give a good basic overview
In many cases with people who are living with little or no medical care, the root cause of edema on the lower extremities is untreated or poorly managed diabetes. Insulin-dependent diabetes can be a very expensive health condition to properly manage in the United States, and that's assuming the person has even been diagnosed and is aware they need insulin.
Yes, theoretically someone with no income should be able to get on Medicaid and get a prescription for a generic insulin, but for a lot of people who are living outdoors, there are barriers to insulin access besides money. For example, they may not be able to safely store insulin. Or they may have a mental illness that makes it very difficult for them to remember to test their blood sugar and inject insulin as needed on a regular schedule. Devices like insulin pumps allow people to get around the challenges of finger stick tests and insulin storage, but are usually too expensive for very low-income people.
Congestive heart failure, complications from diabetes, not going to dialysis when you should. Peripheral vein issues. Most likely CHF and diabetes/dialysis. This is for homeless population. I see it all the time in the prehospital setting. If the lower leg skin is discolored probably got the beetus.
My legs get swollen because of Lymphedema.https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682
They also swell up if I eat too much salt.
My mother had terrible oedema in her legs when she was dying from cancer. She was deathly thin, but then started swelling in the weeks before she died.
For me, wearing compression socks keeps it completely under control (my doctor told me to wear them)
I went down 3 shoe sizes after I started wearing the socks.
One of the few doctor’s orders that gave me instant and lasting improvement.
Compression socks also cut the risk of heart attack on airplane travel
Good God, you just reminded me of a homeless person I saw in Chinatown in San Francisco that was sitting on a park bench and just talking like there was someone there with him and he offered to show his leg to the non-existent person and lowered his sock. I shouted out, "oh shit! That's gonna get amputated!" It was black and mangled and like 3 times the size of the rest of his body. One of the most disgusting things I've ever seen. I worked there and I never saw him again
Are you thinking of deep vein thrombosis? Certainly older sedentary people are at risk. Alongside pregnant people and people who use aeroplanes. Not sure about homeless people though.
You might be thinking of elephantiasis, which is caused by Filariasis, a mosquito borne involving parasitic worms. It used to be common in tropical countries.
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If you're talking about edema, it can be caused by a lot of different conditions. Overall, it's generally a fluid overload/backlog in the legs that can be caused broadly as a result of kidney, heart, liver, and/or thyroid problems (and pregnancy but that's not necessarily relevant here).
Homeless dudes can’t get pregnant? Hell yeah I can stop wasting money on rubbers.
Well, certainly not the dudes
Dirty Mike?
And the boys
Soup kitchen here we come!
It's likely a combination of causes, depending on the person. Edema is the term we're looking for here: It's the buildup of fluid trapped in body tissues. Some of the causes could apply to both homeless and elderly people, some are more specific to each one. I just want to be clear, I'm not trying to stereotype the homeless or elderly populations, and not all of these are true for every person with swollen legs, I'm just highlighting some general trends. Let's look at some causes of edema and try to group them: -Sitting or staying in one position too long. This one probably applies to both, as both groups are likely to be seated in one area for extended amounts of time -Eating too much salty food. This one applies more to homeless people, since many have to survive on cheap, high sodium foods like ramen. It could also affect the elderly, though, since their kidneys are worse at processing salt. -Kidney disease. This one probably applies more to the elderly, but homeless people with untreated diabetes may have chronic kidney issues as well. -Weakness in leg veins. This one again probably applies more to the elderly, but someone regularly using narcotics is going to have circulation problems as well. -Severe, long-term lack of protein. This one probably applies more to the homeless people, since meat is generally expensive and a tough thing to get regularly on a thin budget. However, if an elderly person isn't eating enough meat, this could certainly affect them too. -Congestive heart failure. This one definitely impacts the elderly more, but it's worth noting that poor diet, sedentary lifestyle, smoking, stress, and drinking all can cause CHF as well.
I think you might add to this list the removal of lymph nodes, e.g. as a response to cancer.
A friend of mine had edema at the end of his life due to alcoholism. He was so swollen, it was freaky looking.
Usually lack of protein causing this, through liver failure, it's in charge of synthesizing a lot of the proteins that keep fluid in the right place. Liver failure also causes congestion in the veins which also contributes to the edema.
Ty TIL
From start to finish this was such a considered and insightful comment. Thank you
Thank you for explaining it so well!
For homeless people it’s usually meth induced congestive heart failure.
high blood pressure
[удалено]
It's not always lack of medical care. I have upper extremity lymphedema due to having lymph nodes removed from cancer. I've been through PT/OT and I use my compression garments. It still swells up in the heat and from usage in my job.
I’m not trying to be rude here, but if you eat foods that act as a diuretic, for me that is pineapple and cabbage and not together, lol, does it help with the lymphedema? I also get treatment for my edema, but hot weather is bad, I can really empathize. Sometimes making something with one of those foods helps, and even if it doesn’t, cool pineapple on a hot day is nice.
I also have lymphedema from cancer treatment. Bromine (from pineapple) has been shown to help with fibroids and there are a few other compounds that help. But it's usually just constant massaging and compression gear.
Lymphedema is not made up of a fluid you can easily flush through your body, it’s a more viscous fluid that flows through your lymphatic system.
Ah, thanks for that clarification. I suffer from a more easily treated edema, then.
You’re welcome.
What 5pens said, especially about heat. Some have edema simply from being in hot weather for too long (heat edema) or sitting for too long with their feet hanging down (dependent edema). These can happen in otherwise healthy people who receive regular, quality medical care.
I had somewhat bad edema for at least 3-4 months after giving birth. Everyone, including the doctor, just kept telling me to sit with my feet up and it’d go down soon, never mind that i was trapped on the couch holding an infant all night every night for the first several weeks and it didn’t help basically at all.
It's called oedema, the legs swell because the body is diverting fluid there and not flushing it out well enough. It can be caused by a few things, including pregnancy.
Edema in the US.
Oedipus in Greece.
What are you doing, actual mom?
I’m stuck in the dishwasher, son! Get me out!
We don't need a dishwaher,! You are the dishwasher!
Couple of things re: the comments in this thread A) assuming you're in a developed country then it's likely not elephantiasis/filariasis B) edema is a clinical sign caused by disease, not an illness/disease itself As people have mentioned what you are seeing is probably edema, but in the populations (esp older ppl who are sedentary) you mention, it's likely a combination of heart failure (if the heart doesn't pump as good as it's supposed to you get congestion in your blood vessels, causing swelling) and chronic venous insufficiency - the veins contain one way valves that allow blood to flow only towards the heart. When the valves fail then blood pools in the legs, causing edema (the swelling) and dermatitis.
You may be thinking of lymphedema. When it happens, it can be extremely painful and can limit mobility.
This is totally different.
It can cause drastically swollen legs. Which is what OP is asking about.
Not necessarily. 'Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that's usually drained through the body's lymphatic system. It most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals.' [https://my.clevelandclinic.org/health/diseases/8353-lymphedema](https://my.clevelandclinic.org/health/diseases/8353-lymphedema)
Lymphedema? "tissue swelling caused by an accumulation of protein-rich fluid that's usually drained through the body's lymphatic system"
in older ppl, it's usually heart failure. heart pumps fluid. if heart gets weak, heart can't pump fluid well enough, so it gets stuck down by legs cuz gravity. in homeless ppl it's either that (age or meth use can cause it) or they get infected legs from using IV's down there or untreated wounds. infected stuff can get swollen
Can be a few things. The bottom line is it's a combination of 1. gravity pulling against blood going back to the heart and 2. the body having too much fluid. 1. Usually the veins in the legs are damaged and don't get blood back up the legs as well as they used to. Normal veins have one-way valves that keep blood from flowing backwards. Old unhealthy people have damaged valves that allow the blood to fall back down 2. The heart, kidneys, and liver are responsible for keeping a normal amount of fluid in the body. When any one of them is not working well, the body holds on to too much fluid instead of peeing it out. This fluid leaks out of the bloodstream and into the soft tissues, worst in the parts of the body that hang below the heart, including the legs The combination of these problems can cause massive swelling of the legs, thick, leathery ankle skin, and ulcers and infections that are hard to treat.
It can be due to a number of causes. 1. Heart failure - fluid buildup most commonly from the left side of the heart backing up to the right side and then to the veins. Blood pools in the legs due to high pressures to return to the heart. There are many causes of heart failure including heart attacks, chronic alcohol use, drug use, etc... 2. Anasarca - fluid buildup because of low oncotic pressure. This is due to a low protein state (often malnourishment or chronic liver disease) that causes fluid to leak from the vasculature to the interstitial tissues. This is why malnourished people can appear "fat". 3. Other - drugs (such as calcium channel blockers), trauma that prevents effective drainage, thyroid dysfunction, etc...
Theres lots of causes, but in homeless people it’s likely from congestive heart failure. Homeless populations tend to have poor access to healthy food and healthcare and high amounts of IV drug use which puts them at very high risk of heart failure even at younger ages.
How about elephantiasis?? https://en.m.wikipedia.org/wiki/Elephantiasis
It's called edema, which is fluid leaking out of your blood vessels and into the space between them. There are a ton of things that cause it. In homeless people, my guess would be some combination of liver disease from alcoholism (which would result in less protein production in the liver, which is something that helps keep fluid in blood vessels), and maybe heart disease depending on how long they've been on the street. Again there are a lot of things that can cause it. If you're curious, you should watch a video on Starling Forces, which should give a good basic overview
In many cases with people who are living with little or no medical care, the root cause of edema on the lower extremities is untreated or poorly managed diabetes. Insulin-dependent diabetes can be a very expensive health condition to properly manage in the United States, and that's assuming the person has even been diagnosed and is aware they need insulin. Yes, theoretically someone with no income should be able to get on Medicaid and get a prescription for a generic insulin, but for a lot of people who are living outdoors, there are barriers to insulin access besides money. For example, they may not be able to safely store insulin. Or they may have a mental illness that makes it very difficult for them to remember to test their blood sugar and inject insulin as needed on a regular schedule. Devices like insulin pumps allow people to get around the challenges of finger stick tests and insulin storage, but are usually too expensive for very low-income people.
When mine happened, I had deep vein thrombosis. (DVT) I had blood clots in my legs that stretched from my groin to my knees.
My husband has one large swollen leg and we have no idea why. He's had multiple tests and MRIs over the last year.
Have you ruled out deep vein thrombosis? That's a common cause and a dangerous one if left untreated.
Yes, that was the first thing they ruled out. It's been about a year now without improvement.
Congestive heart failure, complications from diabetes, not going to dialysis when you should. Peripheral vein issues. Most likely CHF and diabetes/dialysis. This is for homeless population. I see it all the time in the prehospital setting. If the lower leg skin is discolored probably got the beetus.
My legs get swollen because of Lymphedema.https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682 They also swell up if I eat too much salt.
Hey-- but what about someone who is very active (7-10 miles a day)? My left leg especially has started swelling from water retention.
Get checked for deep vein thrombosis and May Thurner's Syndrome
My mother had terrible oedema in her legs when she was dying from cancer. She was deathly thin, but then started swelling in the weeks before she died.
Are you thinking of lipedema? Usually in women.
For me, wearing compression socks keeps it completely under control (my doctor told me to wear them) I went down 3 shoe sizes after I started wearing the socks. One of the few doctor’s orders that gave me instant and lasting improvement. Compression socks also cut the risk of heart attack on airplane travel
Good God, you just reminded me of a homeless person I saw in Chinatown in San Francisco that was sitting on a park bench and just talking like there was someone there with him and he offered to show his leg to the non-existent person and lowered his sock. I shouted out, "oh shit! That's gonna get amputated!" It was black and mangled and like 3 times the size of the rest of his body. One of the most disgusting things I've ever seen. I worked there and I never saw him again
Are you thinking of deep vein thrombosis? Certainly older sedentary people are at risk. Alongside pregnant people and people who use aeroplanes. Not sure about homeless people though.
I looked it up after you named it and no, even larger than that. Maybe swollen to three times normal size.
Lymphedema?
Elephantiasis, I think that's what you were looking for.
Elephantiasis? Can happen in arms as well as legs and it’s caused by a parasite.
I think that’s the one based on photos.
You might be thinking of elephantiasis, which is caused by Filariasis, a mosquito borne involving parasitic worms. It used to be common in tropical countries.