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Posted 6/8/2005 1:00 PM (GMT 0)
Hi all - I have had swelling in my ankles on & off (CHF), and last week I was at the clinic and asked for a diuretic. I'm completely off salt - no processed foods at all, do not eat out, etc. and all of a sudden my ankles have been swollen lately. The only thing that's changed that I can think of is the weather - much hotter now, but I'm not even outside that often.
What would cause this - and when would a Doc normally prescribe a diuretic? When I asked for a scrip at the clinic last week, the Doc said they do not prescribe it unless your legs are swollen from top to bottom. This doesn't seem right to me. Why would they want to wait until it got that bad? I have never had my entire legs swollen, just ankles. (using health clinic affil. w/teaching hosp - no ins)
What do you think? - and at what point was it prescribed for you?
Oona
Posted 6/8/2005 2:37 PM (GMT 0)
Oona

My friend and sister in Fla, how is your Blood Pressure when yur sweeling is up?

My Bp was high when I was sweling hence my first diuretic HZT then later on after i was diagonised with that dreaded CHF many of us suffer from I got on Aldactone 50 miligrams and I do see a teaching Hospital on the clinic card too. Maybe you have been doing to much like Teri told me once for i try to stay busy and feel guilty if I sit down and rest the way I was raised.

But first what about your fluid intake too, Caffine too Teri let me now the other day that caffine plays with ur heart with palpitations  and then fluid can affect our swelling too. but I wuld also ask to see another dr and when you renew your clinic card ask for the Doctor yu like you trust and want to see that is what I had to do when I changed my clinic card and still seeing her and him for my thyroid and doing some better. Hope this helps and maybe Teri,Kathlyn and others can also give their input too.

Heidi smurf

Posted 6/8/2005 3:24 PM (GMT 0)
Well, if it isn't my FL heartsister Heidi! cool Hi there!
Nope, I have verrrry low BP, due to leaking valves. 90/60 was my norm for many years - now it can be somewhat less alot of the time. And a really slow heart rate too ~55-70 usually.
I'm not Doing Too Much, either - mostly sitting here at my computer working - with my feet up. I have alot of fatigue lately, but after 3mo. off due to hyst., (Oct-Dec) I had worked my way back up to walking 2 mi/da thru about mid-Feb. Then - whammo! I completely hit the wall with that. I can't do it at all since then.
My total fluid intake is less than 2 liters - more like 1.5L. I have to admit, at least half of that is coffee lol! I am convinced I wouldn't have a BP or a HR at all without it.
But I know I'm retaining water - my weight is +10lb over normal and it's not due to fat. I've also lost my appetite lately - the timing of that sort of coincides with the swollen ankles....
BTW, I have no other health issues besides this. Thyroid is fine, etc. - all checked out OK last Jan.

(Teri, why is my mCode disabled? - least of my problems, lol!)
Posted 6/8/2005 4:48 PM (GMT 0)

Oona,

Gosh, I'm sure sorry to hear about all of this, but I can tell you that you are definitely not alone here!

First of all I have CHF as well, both left and right sided.  Once your Heart Failure (HF) is compensated then you usually do not show a lot of the symptoms of HF-the med.'s, the diet, the exercise, the heart are all in sync and things are working right.  When you go back 'into heart failure' you are no longer compensated, so adjustments need to be made (perhaps even med.'s tinkered with).  Usually, it's something like you had too much salt intake, or you've overdone with something.  I was doing fine as well till a couple of weeks ago when I did too much walking and just generally overdoing.  I had swollen legs/ankles even my abdomen.  They cannot put me on diuretics as they also act as BP med. to help lower your BP and my BP is low on it's own, with 90/60 being the norm.

So I am assuming your are in the same boat.  When you had your MI, what kind of damage was done?

Right now, I'm just slowly trying to get back to where I was...if you have left sided HF, perhaps your EF dropped temporarily down a notch or two?  That can make you feel that way, too.  You have to gradually make yourself go a bit further each day and continue to watch your salt intake.  Just a few suggestions...

Wishing you well, and big Hugs, Teri tongue

PS  If I knew what the mcode was I could help you, but...? lol

Posted 6/8/2005 6:58 PM (GMT 0)
Hi Teri - thanks for your reply - I suspected we had a few things in common tongue
I didn't realize that all diuretics lowered blood pressure! Is that from the drugs or reduced volume?
No meds to tinker with....I'm not on anything - just .81mg aspirin, and nitro.
At the moment, I have very few facts to try to figure out what is going on. (no cardio since '77), and my referral to a cardio at the teaching hosp got turned down because I 'passed' the thalium stress test.

In '77 I had a cath (& heart attack @ end of cath) which showed aortic stenosis, mitral & tricuspid regurg. I was told I would need 3 valve replacements within 5 years. (I did not do this) My history is rheumatic fever.

In late January this year, I went to ER with severe chest pain & was admitted for 3 days. Had echo, EKG's & thalium stress test. From the med records it now shows - mitral and tricuspid regurgitation with mild pulmonary hypertension (35), sclerotic aortic and mitral valve, borderline left atrial abnormality, probable left ventricular hypertrophy, right BBB. EF=50, and now they have a really hard time hearing the murmur - very faint.

So I don't know what's going on - or even if that was an MI in Jan. (sure feels like it tho) EKG also shows an 'old infarct'. My referral to the cardio at the teaching hosp was turned down because I passed the thalium stress test. I have not been officially diagnosed with HF by a cardio, but my PCP's opinion is CHF. (not in writing, lol!) Can you tell from any of this if it's left or right sided? (not sure what that means) I have alot of CP, and shortness of breath. Haven't been able to sleep lying all the way down for about 2 yrs now, but the thing I'm more worried about is that about 2-3 weeks ago I started having arrhythmia - at first only at night, within an hour of bedtime, but lately being woken up by it at night or in the early a.m., and once in awhile in the daytime too. That's a new thing. I am trying to light a fire under my PCP to somehow get the referral to a cardio, but so far no success. Any ideas? (other than the ER, if need be?)

hugs,
Oona
(mCode is being able to write posts in purple, etc.!!)
Posted 6/8/2005 7:27 PM (GMT 0)

Hi Oona, tongue

First re mcode...when you read the last post and you want to reply, do not go to the blank posting space and write-that will always be black and white. :)

Where it says "Post Reply"?  Click on that, and all the options will be made available then-just click on the color button for options and click on the smileys that interest you! yeah

I'm not a Dr. so I cannot diagnose any of your problem, all I can suggest is that you really need to see a cardiologist with your ongoing symptoms!!  I have mitral valve regurgitation and stenosis and it's heard as a heart murmur-it's between mild and moderate (has been for years!)-they don't do anything invasive until it's severe.

If you have to sleep with pillows elevating you, I can only speculate without knowing any of your diagnosis that you either have some lung problems, some fluid perhaps in your lungs, (any wheezing?), or GERD (acid reflux disease) that can actually cause a lot of problems!!

A stress test is not conclusive by any means as many people can attest to!  You sound like you need a cardio Dr. to evaluate you.  An EF of 55-75% is considered within normal range.  40 and below is suggestive of Heart Failure.  If you have right sided HF a normal EF could be anticipated.

What is BBB?  Right off hand it's not coming to mind.

I hope this helps a bit, Oona.  Big Hugs, Teri tongue

Posted 6/8/2005 9:43 PM (GMT 0)
Hi Teri - I still don't get the mCode options...must be because I'm on another platform, but thanks for the info.

I truly sympathize with anyone who has GERD - especially in conjunction with heart disease because it causes such confusion of symptoms. In fact someone's brother just had a full blown heart attack after being discharged from the ER with a GERD diagnosis.

OTOH, I do not have it, (I have never, ever had it) but it causes me endless grief to have been misdiagnosed with it, and have it in my medical records and have to waste time ever dealing with it - especially during any emergency.

BBB is bundle branch block. (a new thing to research!!! lol!)

Yes, I agree I need to see a cardio. Catch 22.

hugs,
Oona
Posted 6/9/2005 2:03 AM (GMT 0)
Oona, what happens when you hit the "Post Reply" button?  No emoticons or anything shows up?  Try Forum Help under the 'Community' section on the right side of the page...let me know what happens.  I want to make sure you get to use colors, too!! tongue

 

Having had an ECG I'm guessing with that they were able to see any heart damage and the other problems re the valves.  I wish I could offer you something more...

 

Yes, it's been years, but BBB just didn't even ring a bell...for you and others that would like to learn a bit more, I've added a link.

 

Hugs, Teri tongue

 

http://www.americanheart.org/presenter.jhtml?identifier=990

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