Doc: Clonazepam not the best treatment for anxiety, OCD
Dear Dr. Roach: I am a 76-year-old female in good health who eats a sensible diet and exercises regularly.
Despite many years of experimenting with different medication (including hydralazine, candesartan and atenolol) for high blood pressure, my pressure remains high (today’s reading is 183/107).
I also am suffering with water retention and swollen legs and ankles, despite taking a diuretic. Please tell me about the connection between high blood pressure and water retention.
Dear J.B.: The most likely cause of swollen legs and ankles in you is probably the hydralazine, which works by opening up blood vessels. Swelling, also called edema, is a common side effect of hydralazine and other blood pressure medicines that work this way, especially the calcium channel blockers, like amlodipine.
However, there other potential causes.
The first is that many people, especially older women, develop leaky veins due to the valves in the veins wearing out over time.
Many, if not most, older women will notice a little fluid in the ankles and feet at the end of the day, especially if sitting or standing for much of the day. This normally is a benign condition.
The blood pressure you noted today is very poorly controlled, and continued high numbers may damage the kidneys and heart.
Leg edema can be a sign of damage to these organs, and in addition to getting the blood pressure under better control promptly, your doctor may wish to consider looking for damage to the kidney (especially protein in the urine) or heart (with an echocardiogram).
Dear Dr. Roach: Can lymphoma be cured?
Dear D.E.B.: There are many (over 10 different groups) lymphomas, and many are curable. Hodgkin’s lymphoma is a common type of lymphoma, and is curable most of the time, though unfortunately not always.
Non-Hodgkin’s lymphomas are a mixed group of diseases, and in general, the aggressive types often are curable, while the slower-growing ones can be treated but not cured.
However, more and more, these cancers are being treated based not on how they look under a microscope, but instead on the examination of the DNA of the tumor cells. The prognosis depends on the exact type, and on how far advanced it is.
Email questions to ToYourGoodHealth@med.cornell.edu.