Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
Here are the results of both blood test and urine culture. As for the question regarding gout, I drink a lot of water, urine is always light in color. I have had gout since I was 41 years old. Various doctors have tried to stop this, including with allopurinol. This has not worked.
No alcohol and walking for at least an hour a day, not eating some things and then, I keep it reasonably under control. You also usually feel an attack coming. I usually suppress this by taking Arthrotec with Colchicine for a few days. Furthermore, I always have some blood cells in the urine, I assume that this has nothing to do with the swollen feet of now?
Please find yourself.
Best regards
******
Dear T,
An excellent result, but that does not mean that you are not rid of your complaints.
The most common causes of swollen feet are:
– A circulation problem caused by poor venous return. This is usually due to broken or calcified valves in the large leg veins. This can cause CVI (Chronic Venous Insufficiency). It gets better when walking, because the muscle pump then works, which pushes the blood upwards. In that case, raising the foot of the bed and a footstool when you are sitting will help. Possibly support stockings, but that is no sinecure in the heat. The leg vessels can be viewed with an ultrasound doppler.
– Varicose veins, called Krampfadern in Germany. The word says it all. That can be treated well with microfoam, or LASER. This is usually done by a phlebologist or vascular surgeon, but there are also dermatologists who do this.
Sometimes surgical intervention by a vascular surgeon is necessary
– A heart problem. Less likely.
For now, focus on the first two points, which overlap
Yours faithfully,
Dr. Maarten