Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: Karen W. on 23/06/2007 10:08:12
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WELL IF IT CAN.. COULD ANYONE EXPLAIN THAT TO ME?
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Hi Karen
take a look at Stephanie Modi's article about how the lymphatic system works, which might give you some clues:
http://www.thenakedscientists.com/HTML/articles/article/thelymphaticsystem-1/
Put simply, excess lymphatic fluid (i.e. lymphoedema) is more often a sign rather than a cause of heart failure.
Chris
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Thanks Chris I will go look now!
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Hi Chris.. WOW!!!!! That is scary!! So Right now I am wearing tight uncomfortable compression stockings and am on a diuretic to get the swelling down.. seems the diuretic was not working and rather then put me on more she wants to try the stalkings.. I understand from that article this is only treating the symptom which is the swelling, so she said I have Hashimotos disease , but still have Aorta Sclerosis along with some kind of left ventricle problem..She said that all the valves have it. Carotid arteries look good. cholesterol is in upper normal range, not high, but said she started me on lipitor to be preventive..as she said I have too many cardiac markers so she wants to be safe.. I still have not seen the new Cardiac guy and she upped my thyroid by to 0.150 from 0.125 and I am assuming that will help the goiter they found.. My feet are up and I have been down on my back a lot the last 5 days trying to keep the swelling down.
Thanks for the link .. and answering my question..I think I am awful grateful that I have not got the degree of problems seen in those pictures.. but I must say I am concerned about the effectiveness of this treatment..
She does not seem to be addressing the problem underlying the swelling just throwing water at a fire and not finding the cause!
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Chris.. I have another question.. Is these stockings help reduce the swelling in the lower extremities and they have with having my feet up a lot also.. where is all the excess fluid going.. I know a certain amount goes back up into the heart area as she told me when she did the temporary wraps that is the heart was overwhelmed by the fluid upon return to the upper body and I began having heart palpitations again. that I was to remove the wraps immediately to stop it from causing more trouble with the heart.. so am I just transferring trouble from one end of my body to the other using these leg compression stockings.. They hurt like crazy on my legs... they feel bruised badly at night when I take them off and are still tender in the morning.., but my ankles are no longer swollen... they feel better aside from the pain during the day from the stockings.. and the huge dents in my legs where they cut in at the ankle..
I know it helps my legs, but what about actually treating what is causing the swelling.. She now says she doesn't think it is congestive heart failure.. But she cannot tell me why they are still swelling?? Do you think I should see another Doctor? Again This is about the fourth one..She said she was setting me up with one of two Cardiac specialists and as of yet has not followed through with that..My original and second cardiac surgeons have died.. The local fellows I have not got to see yet since this whole new mess. Should it take so long for them to do all this stuff!..it has been weeks now 4 or 5 since the TIA.. anyway..
where does this fluid go!! Is my body producing excess or just not getting rid of it sufficiently?
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Hashimotos thyroiditis, heart valve defects and TIA's are symptoms of lupus (SLE).
The TIA's in lupus can be due to AntiPhospolipid Syndrome (APS), the treatment for APS is anticoagulant such as Warfarin, (Coumadin). The autoimmune inflammation of the heart valves in lupus is called endocarditis, it can be treated with corticosteroids, or valve replacement in severe cases.
If you have other autoimmune diseases, (other than Hashimoto's), this would support a diagnosis of multi-system autoimmunity, such as Lupus (SLE),
e.g. Rheumatoid Arthritis, Sjogren's Syndrome, type-1 diabetes, etc.
Lupus is often photosensitive: sun exposure can exacerbate symptoms, (with or without a rash on sun-exposed skin).
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Thanks ! I just replied in PM!
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Thanks Chris I will go look now!
Did Chris help you in this crucial diagnostic path?
Me poor transfusion doc still waiting for two data:
ESR (erythrocyte sedimentation rate)
CRP (C reactive protein)
still think of your previously reported
"infection in the blood"...
iko [???]
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Yes me too. I am waiting for results I go back tomorrow! My records should be there also! I ordered them up.. LOL.. I want to see with my own eyes some of this stuff!
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Thanks Chris I will go look now!
Did Chris help you in this crucial diagnostic path?
Me poor transfusion doc still waiting for two data:
ESR (erythrocyte sedimentation rate)
CRP (C reactive protein)
still think of your previously reported
"infection in the blood"...
iko [???]
A high CRP level could also occur with autoimmune inflammatory disease such as lupus.
http://arthritis.about.com/cs/diagnostic/a/crp.htm
If the diagnosis of Hashimoto's Thyroiditis is correct then Karen has a "rare"
1:200 autoimmune disorder.
http://www.wrongdiagnosis.com/h/hashimotos_thyroiditis/prevalence.htm
So a diagnosis of "rare" autoimmune syndrome, like lupus, is worth considering.
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Here I am making copies of things..See if this is visible..
These were taken the Saturday of my TIA.. Other info on top are personal details I don't want public, so I am leaving them out, you know address billing all the personal stuff.
(https://www.thenakedscientists.com/forum/proxy.php?request=http%3A%2F%2Fi17.photobucket.com%2Falbums%2Fb73%2Fkarenw44%2FScan0021bloodworketc.jpg&hash=66fa80ba2bbbd208df0cd5578d5fb4c3)
(https://www.thenakedscientists.com/forum/proxy.php?request=http%3A%2F%2Fi17.photobucket.com%2Falbums%2Fb73%2Fkarenw44%2FScan0019EKGatHospital.jpg&hash=1030c33603bdb940d48d1d171849a6db)
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They still did not have my records ready for the other tests.. I asked, she said she would see what is holding them up!
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I am waiting on tests.. new lupis tests...
HEY WHY IS LUPIS OFTEN MISDIAGNOSED THE FIRST TIME...? I WAS TOLD THERE ARE A COUPLE MORE DIFINITIVE TESTS. WOULDN'T THEY HAVE USED THOSE TESTS AT STANFORD THE FIRST TIME THROUGH?
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HEY WHY IS LUPIS OFTEN MISDIAGNOSED THE FIRST TIME...?
SLE (http://en.wikipedia.org/wiki/Systemic_lupus_erythematosus) (Lupus) activity is intermittent: relapsing remitting.
If a person with SLE is tested during a remission blood tests could be negative.
As the disease becomes more extensive and the duration relapses (flares) become longer the odds of a positive blood test (and diagnosis) increase.
SLE is also diagnosed late (http://news.bbc.co.uk/1/hi/health/6216468.stm) (typically a decade late) because symptoms are intermittent, diverse,
and it is a rare condition which can be mistaken for more common conditions (e.g. hypochondria, fibromyalgia).
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Thank you RD...So Two weeks ago I had a real bad flare of the arthritis in my fingers and wrist joints..hip and knees and shoulders all became super inflamed sore and red kinda shiny..like my kin in those areas at least on the hands were pulled tight from inflammation and what I could feel the hard nodules on the first joints of my three fingers thumb index and middle on both hands right more severely then the left of course I am right handed.. they hurt so bad and were white and red around the knuckles..extreme stiffness almost impossible to close my hands particularly that pincer like motion that you use to pick up small items! It was miserable.. so would that have been the best time to be tested was during flare ups like that!
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... like my {s}kin in those areas at least on the hands were pulled tight
Sclerodactyly ? (http://www.nytimes.com/imagepages/2007/08/01/health/adam/19508Sclerodactyly.html)
Sclerodactyly is a symptom of lupus-like conditions MCTD (http://en.wikipedia.org/wiki/Mixed_connective_tissue_disease) and systemic sclerosis.
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Thanks RD, Yes I am aware of these already as I have the Systemic Sclerosis (Scleroderma). The arthritis and the Raynaud's, heart, liver, and kidney are all involved.. or at least that is the Doctors belief thus far.
I also have the hardened patched of darkened sunken in skin on my legs.. they have faded and treatment has helped... so they are mild compared to what I have seen in photos so I am fortunate...
Was told that treatment will not stop the progression but will help ease the discomfort and such.. at least that is my understanding anyway. I think having them recheck at Stanford is the best.. as I really want to see what they say and the Doctors here have been wrong in the past so I assume double checking is good...She said that that is why the prognosis is not good. but we will see.. I intend to keep on going regardless of the final outlook!
Sorry I meant to get back to you on this but have had my hands full.
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Thanks RD, Yes I am aware of these already as I have the Systemic Sclerosis (Scleroderma).
Sorry I didn't know you had been diagnosed with Systemic Sclerosis.
Systemic lupus and systemic sclerosis are essentially the same (they can even overlap (http://rheumatology.oxfordjournals.org/cgi/content/abstract/31/11/783)). If you are formally diagnosed with systemic sclerosis and are receiving treatment for it, then whether or not you also fullfill the diagnostic criteria for SLE is an academic point: it would not change the treatment you are receiving.
For the benefit of other readers those with scleroderma will not necessarily go on to have, systemic disease (affecting internal organs), i.e. it can be limited to the skin ... http://en.wikipedia.org/wiki/Morphea
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Thanks RD, Yes I am aware of these already as I have the Systemic Sclerosis (Scleroderma).
Sorry I didn't know you had been diagnosed with Systemic Sclerosis.
Systemic lupus and systemic sclerosis are essentially the same (they can even overlap (http://rheumatology.oxfordjournals.org/cgi/content/abstract/31/11/783)). If you are formally diagnosed with systemic sclerosis and are receiving treatment for it, then whether or not you also fulfill the diagnostic criteria for SLE is an academic point: it would not change the treatment you are receiving.
For the benefit of other readers those with scleroderma will not necessarily go on to have, systemic disease (affecting internal organs), i.e. it can be limited to the skin ... http://en.wikipedia.org/wiki/Morphea
RD, Why do you suppose I was not told they were essentially the same.. Do you think they are waiting for the last tests and Stanford.. ?
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Scleroderma is not the same as Lupus, as I mentioned above scleroderma can be confined to the skin (Morphea (http://en.wikipedia.org/wiki/Morphea)) without systemic involvement. Scleroderma can occur by itself or part of Lupus or Systemic Sclerosis or other connective tissue disease...
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http://www.scleroderma.org/pdf/nationalconference/2006/presos/overlaps_in_scleroderma.pdf
The treatments for autoimmune connective tissue diseases are anti-inflammatory and immune-suppressive.
Anti-malarial drugs, (e.g. Chloroquine (http://en.wikipedia.org/wiki/Chloroquine#Uses)), are also used as is the antibiotic Dapsone (http://dermatology.cdlib.org/DOJvol8num1/reviews/dapsone/wolf.html).
Here is is a link to more info on treatment of rheumatic “overlap syndromes” …
The etiologies of all autoimmune connective tissue diseases are unknown and diagnosis has had to depend on patterns of symptoms and signs. The problem is heightened by the tendency for one disease type to merge with another, resulting in a continuous spectrum of clinical features among the rheumatic diseases, with the traditionally accepted entities such as systemic lupus erythematosus (SLE) or systemic sclerosis occupying only part of the continuum with the overlap syndromes lying between.
http://www.wsahs.nsw.gov.au/SERVICES/rheumatology/documents/OVERLAP.pdf
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Wow.. Thanks RD That is a lot of interesting information..my appointment is coming up in a few days so I will know the rest of the test results..I will let you know...
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Scratching head with my Doctor! My tests all come back fine in as much still negative lupu reading and kidneys havenot gottn any worse they are actually looking good she said. so what the heck does all this mean..She is sending me back down to Stanford to both the Cardiologist and surgeon there and to the Rheumatologist again!!! She said he is going to check up on the Scleradema again.. because of my negative results with the lupus...I have to go have new X-rays on my hips and I have to see a gastrointestinal specialist for my swallowing problems... She suspect Goiter is causing that but says there could be other reasons so wants a specialist to delve in there with a camera!!
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She said he is going to check up on the Scleradema again.. because of my negative results with the lupus...I have to go have new X-rays on my hips and I have to see a gastrointestinal specialist for my swallowing problems... She suspect Goiter is causing that but says there could be other reasons so wants a specialist to delve in there with a camera!!
(o)esophageal dysmotility (swallowing problem in gullet) is a common Systemic Sclerosis symptom.
People whose syndrome has some elements of Lupus, Systemic Sclerosis and other connective tissue diseases (e.g. dermatomyositis), but do not fulfil all the diagnostic criteria for any one are given sometimes the catch-all label of Mixed Connective Tissue Disease (MCTD) (http://en.wikipedia.org/wiki/Mixed_connective_tissue_disease).
BTW There is a recognised variant of systemic sclerosis called CREST syndrome (http://en.wikipedia.org/wiki/CREST_syndrome) which you may want to have a look at.
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Thanks RD...I do not know how Doc
tors do it... Diagnosing has to be incredibly tough when so many symptoms and problems are shared by so many different diseases and illnesses!
Hey Just how do they expect me to swallow a camera when I cannot hardly swallow water and my pills?
Iwonder how long it will be before they finish diagnosing all this crud!
Is it common to be taking this long to figure this all out.. Its sure wearing on me and I am totally tired of it all?