Expert: Jacqui - 11/6/2008

Question
Hi, I have been taking Vicodin long term (between 1 and 2 years and am now at the highest levels I have ever taken (20mg/day. Recently, my ankles and feet began to swell. Fearing kidney or liver disease from the long term use of they Tylenol in the Vicodin, I had bloodwork done (about 4 months ago I guess) and everything came out fine. I ma now thinking is is hormone related since I think I am hitting THAT stage as I am 45. Can long term use of this drug make my feet and ankles swell, aside for that being an effect of liver or kidney problems? Oh, the doc listened to me heart as well at the time.
My other question is, sometimes I get breathless (doc says lungs are fine though and heart sounds good) and it is immediately gone when I take my Ativan...is this just nerves from the Vicodin? Thanks for your help, its just htat I have no insurance and my husband and I have been unemployed for 6 months now and mine is going to run out soon so I really cannot pay a doc if I dont have to.!  Diana

Answer
Hi Diana,

Firstly, it is so sad that you need to ask someone on an internet site for medical advice because you don't have health insurance.  I hope that things change with your new president!  (we have a system here in Australia where anyone can get free health care, we just pay a little bit extra in our tax - god forbid!)

Now to get to your question (sorry for the political tirade).  There are two issues - the breathing and the swelling in your ankles.  Firstly, the caveat.  I am not a medical practitioner, so what I tell you does not constitute medical advice.  I have looked up hydrocodone and lower limb oedema (which is swelling in the lower limbs) and can't find any specific information, suggesting it is not a common side effect.  One reason for swelling can be problems with your circulation, meaning basically the blood doesn't get back from your lower limbs very well ... I am not sure if you have ever had vein problems.  A serious possibility is deep venous thrombosis, but if your doctor has checked you out he would've checked for this (I am assuming, as if I know about it, then a doctor should too!).  

As far as the breathlessness goes, chronic opiate use has been linked with things like sleep apnoea (problems breathing while you sleep) but it seems that your problem is the opposite.  Opiates CAN work as a cough suppressant, but I am not sure this would cure breathing problems.

My main concern is that in rare cases, people who have deep vein thrombosis (a blood clot in the veins) can have it 'break off' and end up in the lungs.  Again this could've been checked by your doctor (I hope).  

Diana I am sorry that I can't provide you with definitive information and I am more sorry that you can't really afford a doctor.  I can only say that if you really need medical assistance it is important that you get it.  Is there a free clinic of some kind in the area?  The other possibility is that there is nothing wrong, but in the case of breathing it is always better to err on the side of caution.

Hope things get better and congrats on your new pres!

Stay safe,

Jacqui