Dr Dulcy Rakumakoe
2 minute read
25 Mar 2019
11:25 am

Ask the doctor: Ankle swelling and liver damage

Dr Dulcy Rakumakoe

Dr Dulcy Rakumakoe shares advice on reader questions.

Picture: iStock

Dear doctor, in this modern day and age isn’t there a substitute for Warfarin, please? I am so sick (pardon the pun!) and tired of having to go and get myself “needled” each month in order to check my INR (International Normalised Ratio) levels.

This has been on-going for almost two decades already! I’m approaching 76 years of age.

In the last few years there has been approval of new anticoagulants as alternatives to using Warfarin. These are the likes of dabigatran (Pradaxa), a direct thrombin inhibitor; rivaroxaban (Xarelto), a factor Xa inhibitor; and apixaban (Eliquis), also a factor Xa inhibitor.

You will have to see a physician to discuss these alternatives and run some tests to show which would be most appropriate for you.

Dear doctor, how do you treat reoccurring swelling in an ankle?

Swelling of an ankle can be from an injury related to twisting, falling or even direct trauma. Swelling and how long it lasts is related to what structures are damaged, ie. vessels, nerves, ligaments, tendons, muscle or even bone. An X-ray and/ or MRI will confirm this.

If there is no injury, the swelling can be due to more serious causes like vascular diseases or chronic diseases affecting liver, heart or kidneys. You will need to see a doctor to be fully examined and diagnosed.

Dear doctor, what are the signs of permanent liver damage?

The signs can include abdominal swelling, bleeding and bruising easily, jaundice or yellow discolouration of eyes and skin, skin itchiness, being permanently tired and sleepy, and it can lead to coma and death.

It is important that you take care of your liver so that things don’t get to go this far. Eat healthy, exercise and limit your alcohol intake.

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