Fluid In Legs

my mother has Pancreatic cancer, and she has fluid draining down her legs from her abdomin, she has trouble walking and is very uncomfortable, and were trying to decide if a medical stocking would help.any tips appreciated.

Dear Vickie,

fluid accumulating in the legs, called edema, can be the result of malnutrition, liver disease, heart failure, kidney disease, and/or a bunch of other things. here is a nice web site to learn more about edema:

Link:
http://www.healthatoz.com/healthatoz/Atoz/ency/edema.jsp

Using compression stockings puts pressure on the legs and returns some of the fluid to the circulation. If a person is unable to handle the extra fluid, such as a patient with heart failure, the extra fluid can tip them into congestive heart failure, landing them in the hospital and possibly killing them.

If the cause of the edema is malnutrition due to the pancreatic cancer, I wonder if anything can be done to improve her nutritional status, such as ppn, tpn, or perhaps a feeding tube. not only would that help the edema, but improved nutrition may give her some more time.

Link on tpn:
http://en.wikipedia.org/wiki/Total_parenteral_nutrition

Link on feeding tube:
http://en.wikipedia.org/wiki/Enteral_feeding

Perhaps read over the web sites linked above to get familiar with edema and nutritional supplementation and then bring a copy of the web pages when you go with you mother on her next visit to her oncologist. Tell the oncologist everyone is concerned about the edema and it interferes with walking; tell him/her you are wondering if the edema is due to malnutrition, show him/her the web pages. Ask the oncologist what was the Albumin level (a measure of malnutrition) on the bloodwork done during her last doctor's visit. The normal range for albumin for most labs is 3.4 to 5.4 g/dL. If it is below 3.4 she is malnourished.

Edema is an annoying problem. Correcting it, in your mother's case, may be tough.

Practical matters about compression stockings (my own opinions): Most people wind up not wearing their compression stockings because they feel so tight (if they are not tight, they are not going to do any good). Before buying a pair or two, clear it with her doctor. They come in different strengths of compression and they come in different lengths (knee high won't work, they will squeeze the fluid from the feet into the thighs, don't get knee high ones). The best thing to do is to get her doctor to write out exactly what compression stockings (strength, length) he wants, and how many pairs (2 pair is good) on a prescription pad. Insurance may pay for them depending on the insurance (at least they used to). Don't attempt to put them on in the afternoon. Put them on before she gets out of bed first thing in the morning or after a quick washup in the morning. The longer she is standing up in the morning, the more edema there will be (gravity pulls the fluid into the lowest parts of the body so that is why the legs are affected more than the arms). If she stands up too long there will be too much fluid in the legs to get the compression stockings on. Having two pairs, one for the dirty laundry, and one to wear, is a good idea.

Compression stockings are not the same as support stockings. Compression stockings have a compression level of 20mmHg or higher. Compression stockings are used for things like prevention of blood clots after surgery or for serious edema in patients who do not have heart failure. Support stockings are for relief of tired legs, mild swelling, spider veins, etc. Here is a web site that talks about the care of the stockings:

Link:
http://www.elitemedical.com/surstoc.html

OK, I will stop writing, before I put everyone reading this to sleep. :)

Best wishes for both you and your mom. She is lucky to have such a caring daughter.
-Amnia

Thank you so very much for your very informational message about the fluid in my mom's legs, you've givin' us many other avenues to explore and it's greatly appreciated, it's nice to know that there are other careing people out there willing to lend out their advice or opinions, we feel so lost right know just not knowing where to turn to next. Thank you,Sincerly Vickie

Vicki C,

I am new at this cancer board. My husband has had pancreatic cancer since Sept 2003. We have fought a lot of battles and WON so far. The edema build up was one we ended up in the emergency room and spent a month in the hospital over. We found that lasix and the compression stockings worked well to handle the problem. He has congestive heart failure, but with the lasix and using the compression stockings we were able to keep the swelling at bay. As the other member suggested get a prescription for the stockings, our insurance didn't pay for them. We used Jobst brand, recommended by the heart doctor. I ordered them from the internet after we found the correct compression. I thought the white ones they gave us at the hospital were strong. Hah - they were a breeze. We put the stockings on first thing in the morning and took them off last thing at night. Yes, they are tight, but fluid build up is worse than the discomfort. With water pills and watching the weight, we were able to stop using the socks after about 6 months when his legs quit swelling. We stopped because we ran into a side effect that caused soreness in the sole of the foot.

Hang in there it is a hard battle to fight. Here is a hug to you and your Mom.

Bonnie C.

Thank you so much for your message, we weren't so sure if the stockings would be a good option, but now hearing your expierence with them i think my mom should give it a try, we haden't heard of anyone else with this condition who could say either way if the stockings might help or not. I haven't heard of a case of a pancreatic cancer patient saying that their doing well or "won so far" like your saying, i think it's amazing, you just don't hear it with this illness, my mom is a stage 4 and now her third option shes trying is oral chemo, and the doctor says he had a couple of patients who've done well with it, it's $100 a day, but anythings worth trying. Good luck to you and your family, and God Bless

We are on Xeloda which has been doing a good job. The last Cat scans showed no growth, even though the CA 19-9 scores are begining to rise steadily. We started on Gemzar and used it as long as it would work, then went to Tarceva, Danny started filling up with fluid - all over not just the legs, he developed congestive heart failure due to the fluid build up, we used the stockings and Xeloda. He is very tired, does not have a lot of energy.
We both have a firm belief in God and know this journey is part of His plan. We don't know why and I haven't asked.(that is our our belief and I won't push it off on you)
This path is not easy, but the doctors have made great advances and they are still working for a cure.
www.pancan.com is a website that is dedicated to pancreatic cancer. They have lots of interesting articles and a support for caregivers that you might be interested in.

One note on the stockings - I think they are around 100 a pair. I machine washed (inside mesh sweater bags or delicates bags) and hung them up to dry to preserve the elasticity. Takes two or three days for a pair to dry.
When anyone asks what they can do, respond "Pray"

May God Bless you, good luck to you and your family on your journey. "

Bonnie,
Thank you for the advice, it is very helpful, my mom is or was also on tarceva, i have a hard time keeping track of the names, she does have fluid all through her body also, and low energy, you've given me some tips as far as the stockings and other medication names that i can discuss with my mom. I just found out about pancan through a social worker, i have a number they gave me to call, but i'm going to check out the web site as well. My mom has been getting some support through her church, but my parents both haven't gotten to the place where they will accept that they need emotional support, i did mention it to them and left the door open for them that there is more help out there. Thank you again
keep fighting and winning
Vickie

Bonnie,
I just wanted to thank you again for your kind and helpful replys, we did get and use the medical stockings, and they did help a little, unfortunatly my mother lost her battle with pc this past Thursday October 5th, on my birthday, i am still having a hard time excepting it on that day but i have a great support group, and i will always remember that was the day she was at peace, no more pain and struggling, and now she is reunited with her sister and her mother who she lost about 20 years ago, and for her to have that i am happy. I just wanted you to know you did touch our lives and for that i am greatful. I hope everythings is well with you and your family. God Bless.
Vickie.