DH's ankles are swollen. Is this more than just a weight issue?

[StubbornHusband]

DH is overweight. It's not new, he has been for some time. He has tentatively addressed it. I have supported him, tried not to make a big deal about it as I don't want him to think it's an issue for us as a couple. It's not, but he is sensitive about it.

However, I am worried about it from a health perspective. I have tried being gentle, tried being a little more forceful over the years, reminding him we have young children, and I don't want him to become very poorly and the children certainly don't either.

He is starting to take better care of himself, he has quit smoking, he has joined the gym (ok, last year, used sporadically, but renewed last week to address his health properly now he has stopped smoking). He doesn't eat enough fruit, or drink enough water, although he is not a big drinker. He does have a couple of pints here and there, or a whisky in the evening, but nothing major and within the safe drinking guidelines for a man, sometimes almost none at all, sometimes higher toward the top of the guidelines, like many people.

He has had issues with apnoea for some time. Largely when he sleeps on his back, but more recently it has crept into more general sleeping, on his side (and he finds himself turning onto his back more and more). He simply refuses to listen to me and do anything about it now (of course losing weight is something he is working on slowly, but he needs to address the apnoea now).

Anyway, I noticed a few months ago that his ankles were swollen, like he had put on weight on his ankles, but thought it was odd as it's not somewhere he has weight gain normally (belly is the biggest culprit really, little around his face). I pointed it out, asked if he realised and if he knew what was causing it, he was a bit embarrassed and just said it was nothing, just on his feet too long (we were sitting out having a picnic at the time). They were not hot and swollen like they can be when standing on them too long, and his feet were not swollen, nor his legs just around the ankles, on both feet. He knows it's weight related but thinks it's not serious.

I noticed again they are swollen. Quite a lot. I did not mention it today as we have argued a bit about some other stuff and I don't want him thinking I am nagging him or not finding him attractive as I think he is going to take it that way.

So.

1. Is this a problem bigger than simply a bit of weight - i.e. could it be a problem with his heart, or cholesterol or put him at risk of a stroke i.e. more of a risk than before - i.e., is it potentially a symptom of something being seriously wrong right now? Does he need to see a GP, or does he just need to lose weight (ok, 'just' is flippant, I know it's not that easy).
2. How do I get him to address his health issues with a greater sense of urgency, get across to him that he is going to become unwell and put his life at risk?
3. How do I support him and encourage him to address the overall issue of his weight in the immediate and longer term without him taking it the wrong way (which he will) and think it's about aesthetics. He will take it, store it, and when we argue about something else (low sex life for example due to pain meds issues with me) he will say it's because he is fat and I don't fancy him. I need him to get this sorted, and I could not give a toss about his weight in terms of how he looks. I still fancy him, find him handsome, he has not suddenly become a different looking man, just carrying more weight (he was never skinny in the first place).

I have said he is going to the gym, but I don't think it's enough, especially as he still has the 'i'll do it tomorrow' attitude, the 'there's too much going on with DS doing half days' 'got stuff to do that can't wait'. But it doesn't stop him from eating more fruit, more water, less fat, less sugar, less crap right this second.

Hi I think your DH needs to get a checkup swollen ankles could be something to do with blood pressure or gout ? I had experience of this when I had hypertension when pg & DH got them from BP meds which he then changed.

Could be blood pressure. I also tend to get it if I have a combination of very hot weather, not drinking enough and being premenstrual (doesn't happen if not all three are there, I find, and I'm better at drinking more these days.)

I would definitely get it checked though, especially as he won't be having premenstrual water retention. He probably needs to have blood pressure and cholesterol and blood sugars checked if he hasn't had them done for a while.

It's not gout, as that's arthritis in the big toe due to build up of some crystals the name of which I can remember! But, I would not at all be surprised if he has high blood pressure. And, I also know he is absolutely never going to go get it checked and it worries me about how to get him to do it.

At our gym, they do a health MOT, look at blood pressure, cholesterol, BMI, sugar levels. They also then help work out an initial plan of exercise to ease into. I have also said that I would be happy to pay for a few sessions of personal trainer from that, to look at what he needs to be working on and working out a proper plan that he can build on to improve those areas. But, he absolutely won't get any of it checked - 'not until I have lost some weight'. So, he knows it's not going to be good. But he needs to know a) what he needs to work on and b) and plan with experts who can help him properly. AND if he makes the biggest change in a month at the gym, he gets a month's gym membership free what more incentive is there than that?!

seriously though, I am starting to get worried about the nearer future more than slightly aware and concerned for the longer term future.

EB he has never had them checked. He won't do it. He is afraid to get them checked, but is also, by not knowing, pretending it's ok. I don't want him to wait until he gets a really bad health scare, or worse, to understand he needs it checked. And, swollen ankles don't seem to bother him enough to go check. Or, they frighten him.

And, re hot weather, the first time it was not hot. I remember as I was surprised as how they had swollen, if I had seen one ankle only I would have thought he had sprained it or something by looking at it. Last time it was quite hot, but not hotter than other days, and, I get swollen feet in the heat, and it's not the same kind of swelling. It doesn't look sore. Does look uncomfortable though.

He definitely needs the doctor esp if the swelling is recent. I usually get DH to the doctor by playing the guilt card. Then just make an appointment for him. He'll have to go !

Would it make a difference if you got a home monitoring BP kit for yourself - and left it around for him to check his own when no one was looking?

Thing is, BP can be treated but if it's not, it can kill. Ignoring the symptoms aren't going to make it go away, and you're right that experts should help him manage it.

(Gout is uric acid build up, I think? But I think it can in joints other than the toe, it's just toes are more common.)

I had gout in my knee, exquisitely painful. I needed crutches.

Swollen ankles can be a sign of heart disease, kidney disease or lung problems, as well as lots of non serious causes too. So he definitely needs to see dr. Good luck!

agree it could be a sign of a more serious issue than just weight. Kidneys, heart etc, all can cause swollen ankles. The other biggie is thyroid problems, has he ever been tested for an underactive thyroid?

swollen ankles are usually a sign of impaired heart function or impaired kidney function.

He ought to go to the drs pretty quickly.

It could also be DVT- deep vein thrombosis- but this usually is on one side only, not both.

sorry for the multiple posting- but he really should NOT go to the gym with these symptoms. Exercise could make the condition worse if it's not treated.

Seriously- swollen ankles are usually a sign of something chronic and potentially serious going on. You need to make him an appt and get him to go asap.

ok. So. He needs to get it checked. But how?

I mentioned it this evening, he ignored it, i got frustrated, he got angry, now he is not talking, he is just shouting if he is speaking at all. It's as it always is. He has now used me having 'no compassion' as a reason to, yet again, ignore it all.

btw, not sure if it's relevant. He has very flakey and sore skin on his feet. Which he is also ignoring. Not even putting cream on it.

Someone asked about thyroid. He has not had his thyroid checked. He simply won't go to the docs. He has been three times in 15 years. Once for a severe throat infection (it took him a week to go, it was really bad by that time), about 6 or 7 years ago, followed by a throat infection last year and problem with flakey skin on his hands. He only went that last time as he couldn't work due to handling food and needed a sick note!

He won't go if I make an appointment for him. I would talk to my GP but he is not DH's GP (different surgery). Maybe I will do that anyway, as maybe he could suggest how I could get him to go and talk to his GP, even if he can't talk specifics or diagnose.

I don't think it's dvt. no pain, redness or tenderness etc, and it's quite uniform in both ankles. It's definitely odema type swelling rather than say injury or weight gain.

He won't listen to me.

Ok if it is his thyroid, and he is hypothyroid, all he will have to do is take a tiny pill every day AND it could help him lose weight and feel like a new man. Honestly, i feel like i have got my life back. I know people who got oedema with thyroid problems and they are like completely different pwople now. Happier, active, sporty (and loving it).and slim.

He does need to get it fully checked out asap. I had oedema when pregnant with pre eclampsia and was no fun at all.

He's clearly worried stiff about what it is.

Can you try the emotional blackmail bit- 'If you drop dead with a heart attack, what about me and the DCs?'

Which is not tbh totally unlikely.

You can't force him but you can try to make him see the impact his ill health or disability through a stroke or heart attack would have on you and the family.

pink I can't figure out if he is scared, or avoiding it so he doesn't think about it, and avoid being scared. Not sure if that makes sense. See, I worry and think and consider and it would go around in my head and I would go nuts not knowing what was wrong, bad or not. But, he historically, just ignores things, he doesn't do worrying, he does burying his head in the sand and literally pretending it is not happening. He does it with everything.

yegods would thyroid problems make him irritable? Lilke, really fucking irritable? I know he has given up smoking and that makes him irritable, he is using nicotine replacement atm so it should not be particularly problematic for moods? And he has not been the calmest most rational person for a while.

Don't make allowances for him. Expect him to do the same as a person his age at the peak of his fitness, as he should be on top form with all he's doing. Let him realise that life would be so very much better if he were well, and he's done what he can to get well, now he needs a bit of help from a doctor to keep on track.

Do you know why he doesn't like going to the doctor? Is it because he feels like a fraud, or he's afraid it will lead to finding out he has something very serious wrong?

What if he has something relatively minor wrong, which if treated can transform his life and make him a much happier person (and nicer to live with)? If he can give up smoking, he can go show the doctor his ankles. he can request a male/female doctor if he wants to.

Sounds like he's got a number of issues that he needs to get sorted out by seeing his GP. There's no real other option.

If he's got sleep apoena then he's likely to be tired, irritable and will find it almost impossible to lose weight consistently. Plus if he drives he's got a pretty high risk of causing an accident and potentially killing someone else. If he does nothing else he needs to get that treated, as it's likely to kill him.

Yes he needs to see someone. Don't want to worry you but my dad had this and it was related to his heart. Best to get it checked.

My FIL had this too, and it was also heart related. He has a pacemaker now.

Hope you can persuade him to get it looked at.

strangely, despite him not sleeping well, he goes to bed late, gets up at a reasonable hour (prefers a lie-in and will stay in bed til 11am if I let him, but that's a rare occurrence, and he doesn't complain too much about getting up, as long as it's after 7am!), doesn't 'feel' tired, although he would never admit it, he is not ready to go to bed before midnight, never has been. Although, I absolutely do think he is more tired than he realises.

He does not wake up feeling exhausted, like I would expect him to be having not been breathing well in the night. I wake up lots, partly because he kicks his legs out before waking himself briefly when he stops breathing. And sometimes he stops again and I nudge him while I am still awake. Sometimes I notice it because I am already awake as I am a shite sleeper for other reasons. He does it a good 3-4 times that I am aware of, so who knows how often when I am asleep not so severe as when I wake?

I guess, that the apnoea has been on my mind in that it can increase the risk of heart problems and stroke as it puts pressure on the heart by starving of oxygen so often, along with the additional issues of fatigue and weight gain/lack of weight loss, so these swollen ankles made me a little concerned. Hence my tentative fishing - wanting go gauge if I was just being dramatic, but actually suspected not.

yegods he doesn't normally go to the docs as surprisingly, he is rarely sick. He gets the odd minor cold which he can shake off easily with little more than an early night and some paracetamol for a day or two, other than those two throat infections in the last 15 years, that's been the extent of his sickness. Other than his sleep apnea, which has gone on for years. I guess it's not a problem for him as he doesn't see the impact of it instantly, he doesn't really remember waking in the night, doesn't 'feel' sick as a result of it.

I think, with all this, that, having considered it more, perhaps, he is afraid of being told what he knows - that he needs to lose weight (he hurt his knee a while ago, twisted it, unable to walk on it for a few days, but was very conscious that it would be linked with his weight). But, it's more than that at the moment. And as people have said, it might be relatively simple to fix that will sort out the immediate issues so he can start to lose weight, and if it a heart or kidney issue, he can address it now. So, I think he is embarrassed about having not lost weight like he has wanted.

He is in his very early 40s.

sleep apnoea is linked to being overweight.
It also puts strain on the heart.
People can die from it in their sleep.

It's not good :(

How overweight is he?

As several of us have said he really does need help - for his sake but he is a liability to others with these health problems. what if he had a heart attack at the wheel?

Have you been really blunt with him about the possible causes of his swollen ankles?