Patient wasn’t swollen with pride at this unwelcome sign of ageing

MY patient was worried it was a sign of ageing – but it wasn’t greying hair or wrinkles.

She’d come in to ask me about her ankles, which had started to swell.

It’s a problem tending to affect older people and my patient didn’t seem happy about it.

Blood flows round the body as it should, and your moving calves act as a sort of pump when it reaches the lower legs – to help get blood back to the heart against gravity.

If there’s a problem then fluid starts to accumulate in the legs, and we give this fluid retention a fancy name – oedema (pronounced ih-deem-a).

There are potentially lots of causes of swollen ankles, though.

Older people will often sit in the one position for long periods, meaning the lower extremities aren’t pumping blood.

The same goes for sitting on a plane in the one position for a long time. Being overweight doesn’t help either – constriction in the middle of the body means blood won’t flow back as freely.

Varicose veins can also lead to ankle oedema, as can medicines such as certain blood pressure tablets.

Most pregnant women will have some swelling, but pre-eclampsia will lead to more marked swelling with high blood pressure.

However, oedema in the ankles can also be caused by heart failure, where the heart isn’t strong enough to pump blood round the system. Heart failure will cause shortness of breath.

These are just some of the causes of swollen ankles and it’s worth getting your GP to have a look if you’re worried.

If it happens on one side, though, particularly if tender and inflamed, then it might be a sign of deep vein thrombosis – this should be checked out quickly.