My 54 year old mother has had diabetes for about 20 years (type 1, I think), and she has had one below-the-knee amputation. For about a month, she has been having swelling on her left side that runs all the way up to her breast and is very sore and tender. She has not been able to urinate or have bowel movements on a regular basis and is taking Lasix which does help her to urinate.

Although my mother was hospitalized for a week, there are still no real answers. The doctor says since she lies on her left side that the fluid is accumulating because of gravity. Does this sound logical? Do you know of something else we should ask her doctor about?

When people have diabetes, and they have elevated blood sugars over time, there is increased risk to small vessels in the feet and to large vessels, especially if they smoke. Once infection sets in, people with poorly controlled diabetes have difficulty getting rid of the infection. If the soft tissue swelling extends from her feet to her chest, this is an indicator that the infection may have travelled. If this is the case, antibiotics are necessary. In addition, any localized removal of diseased tissue may be necessary. Blood sugars need to be kept under good control to allow healing and let the white blood cells do their job at containing the infection.

Her inability to urinate may be related to diabetes or it may not. After long periods of time with poor control, the kidneys become damaged. Since the kidney is responsible for controlling the internal fluid balance and eliminate toxins, this may add to fluid retention. If the doctors are using pain medications, these often have the ability to cause constipation.

However, a number of other causes can do this and I am afraid I can’t tell you why. I wish you and your mom the best.

JTL