Richard Holm

For years I cared for a young gentleman with recurrent leg swelling associated with redness, fever, pain and open sores between his toes and lower legs and the rash of athlete’s foot. Once again, the emergency room doctor admitted the patient, and started him on intravenous antibiotics while the nurses put on support hose and encouraged him to elevate his legs.

There are two types of blood vessels making up “the vascular system.” Going away from the heart, blood is pumped through arteries providing oxygen and nutrients to almost every cell in the body. Coming back to the heart, blood travels through veins, oxygen depleted and loaded with waste. When venous blood passes through the kidneys, liver and lungs, waste is removed.

When arterial flow is blocked, pain, loss of muscle strength and open sores develop. In contrast, when venous flow is blocked, swelling and congestion occur which can also reduce arterial flow. Most dangerous, poor venous flow can result in blood clots.

Reversible causes for arterial blockage include regularly eating too many calories, not getting enough exercise, smoking and failing to connect enough with people and nature (which is entirely under-rated). Others may talk about pills and supplements, but the plain truth is that nothing comes close to these healthy lifestyle habits in preventing premature obstruction of arteries.

A list of preventable or treatable causes for vein and venous obstruction with swelling in the legs is long. It includes congestive heart failure, inherited varicose veins, jobs that require prolonged sitting or standing in one place and leg trauma, all of which injure vein valves, make edema worse and increase the risk for clots. Clots developing in veins are dangerous. They can move to the lungs, threaten life and worsen swelling.

My young patient had a combination of foot fungus (athlete’s foot) and bacterial infection growing in toe cracks and leg sores. He also had venous insufficiency (the valves in the veins were destroyed) and new blood clots, possibly triggered by the fungal and bacterial infections. His condition was complicated, indeed! We elevated his feet even higher, increased the pressure of his support hose and added medicines including a low dose diuretic, an anti-fungus medication and an anticoagulant. His leg swelling resolved and stayed that way, especially because he wore 20 pound below-the-knee compression hose.

Bottom line: The vascular system makes up an incredibly complex organ system. Please take measures to protect blood vessels by understanding the values of a healthy lifestyle and, when needed, wearing firm below-the-knee support hose.

Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central.


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