I lucked out and got into dr office.

Apparently there are two separate issues.

First issue easy to handle.
She feels swelling is caused by a sprain that was aggravated by 70km. Suggested that I not stop riding fully, just dial back for a few weeks then build back up.

Second issue is more complex.
Apparently my left foot is pushed outwards as I walk (or bike). This causes me to lean onto the outside of my ankle and as I age this will get worse. She said I need to move my left foot closer into bike which will spread pressure more evenly. She said even a few mm would be very helpful.

Spoke of this to local framebuilder who suggests I move to cartridge BB and adjust d/side in an extra mm or 2.

Can try the cartridge method.

Now wondering if anyone makes a shim for cleats to lift the edge of the foot inwards or could I install a shim under insole to cause same????