A bump in the road, miles down the highway

[happyheart]

After a remarkably smooth recovery from an aortic valve replacement (November 2004, ATS Mechanical), I've hit a little rough patch.

Until January of this year, I had my old life back: running, biking, hiking to moutain tops, weekly trips to the gym. I gradually resumed these fun things after pampering myself for the first six months after the surgery. When my body starting telling me: "You can do it", I did.

But for the past couple of months I haven't felt so hot. And it's slowly gotten worse.

Last year I hiked up 5,000 feet of mountain. Yesterday making the bed gave me shortness of breath. I wake in the morning to swollen ankles, feet and hands. I tire easily and sometimes feel a little dizzy. I've not been for a bike ride in weeks nor have I visited the gym.

This week I had an echocardiogram. Haven't gotten the cardiologist's report yet, but from what I could weezle out of the technician, my heart looked like it was functioning fine, pumping strong, no leaky valves, no longer enlarged.

Blood tests show that all of my organs are doing their job. I'm not suffering from any virus or anything exotic like Valley Fever or West Nile Disease.

What gives?

The doctors seem clueless and look at me as if I'm making all of this up. ("But doctor, last year I rode my bike five miles to come visit you. Today, I had trouble climbing the one floor of stairs to your office!".)

So, I thought I'd come home to the forum of folks who helped me so much when my ticker was needing an overhaul.

Any idea what I should be asking the white coats?

Thanks.

 

[Ross]

I think you need some more testing. This is all sure signs of congestive heart failure and warrants further investigation.

 

[savysmommy]

So sorry to hear about your recent health concerns. The swelling certainly doesnt sound good. The dizziness and shortness of breath could be an arrythmia. Have you been checked for that?

I hope you get answers.

 

[EireCara]

Sorry you are feeling so unwell. I hope you get to the bottom of it and get to feeling better soon. Best Wishes.

 

[Nancy]

Any medication changes lately?

 

[Christina L]

Oh my goodness, there

Oh my goodness, there

could be a lot of reasons for what is happening to you. WAIT until you talk with your cardiologist. Technicians are not supposed to tell you anything about what they see on the tests. I would not suspect heart failure - no, I think it is something very fixable, even though heart failure is "fixable" also. Keep your chin up. But maybe this is a sign that you might need to cut down just a tad on the physical activity. I think as we age, vigorous physical activity is not always the way to go - more moderate exercise and relaxation - especially in someone who has had heart surgery.

God bless!

Christina L

 

[happyheart]

Thanks for the comments

Thanks for the comments

Hopefully I'll know more after a cardiologist checks out my latest echo. (It is fun though to see how much you can get the technician to say. "Dumb" questions often work: "And what does that color on the monitor mean?".)

No medication changes. Still on coumadin and a small amount of a statin for slighly elevated cholesterol.

Perhaps I did get a little too much exercise. Hoping that's the reason and that there's a simple solution. I'll keep you posted.

 

[Sir Reel]

It sounds like you were doing everything right with the exercise and all. Let's hope they will have an easy fix and you can get back to the things you like to do.

 

[tobagotwo]

Well, this is a tough thing to think through. First thing is to get a list or two of what can cause edema.

Eating too much salt
Sunburn
Heart failure
Kidney disease
Liver problems from cirrhosis
Problems with lymph nodes, especially after mastectomy
Standing or walking a lot when the weather is warm
Prolonged standing
Long airplane flights or automobile rides
Being overweight
Increased age
Injury or trauma to your ankle or foot
Blood clot
Leg infection
Venous insufficiency (when the veins in your legs are unable to adequately pump blood back to the heart)
Varicose veins
Burns (including sunburn)
Insect bite or sting
Starvation or malnutrition
Surgery to your leg or foot
Pregnancy

Certain medications may also cause your legs to swell:

Hormones like testosterone or estrogen (hormone replacement)
A group of blood pressure lowering drugs called calcium channel blockers (such as nifedipine, amlodipine, diltiazem, felodipine, and verapamil)
Steroids
Antidepressants, including MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (such as nortriptyline, desipramine, and amitriptyline)

Okay, so we'll rule out pregnancy. We'll also prune out the major organ failures you've said are covered by blood tests, and diabetes. We'll also take away blood clots, leg infections, burns and sunburn, insect bite or sting, chemotherapy, and leg trauma/injuries, mastectomy, and varicose veins, under the assumption that you'd know if you had them, and they're too obvious.

Eating too much salt
Problems with lymph nodes
Standing or walking a lot when the weather is warm
Prolonged standing
Long airplane flights or automobile rides
Being overweight
Increased age
Venous insufficiency (when the veins in your legs are unable to adequately pump blood back to the heart)
Starvation or malnutrition
pulmonary hypertension

Hormones like testosterone or estrogen (hormone replacement)
A group of blood pressure lowering drugs called calcium channel blockers (such as nifedipine, amlodipine, diltiazem, felodipine, and verapamil)
Steroids
Antidepressants, including MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (such as nortriptyline, desipramine, and amitriptyline)

Plainly this combination of lists doesn't contain everything. One thing I have added is pulmonary hypertension. An echo won't show that unless you are displaying right ventricle enlargement. If you lived further north, the January start date for your issues would make sense, as your exercising would decrease in winter. Exercise decreases symptoms of PH. Might you have slowed down exercising for the "winter" in San Diego, maybe gained some weight, started eating out more (restaurant food is usually highly salted)? This is one of those few times when an exercise echo can help to detect an issue (the other alternative is a more definitive, but invasive right-heart cath).

It's frustrating that PH was not on the lists I found, because it means that other things must be missing as well.

Diet:
So, have you been on a restrictive diet, that may be causing you to miss a nutritional need? Have you been drinking too much water, which can flush B vitamins and can cause edema and other problems? Have you tried eliminating as much salt as possible from your diet, to see if it helps (be cautious of prepared foods which have high, hidden sodium)?

Medications:
Have you been moved to a calcium channel blocker, or had other medications added? Are you using topical medications, such as minoxidil, anti-itch creams, or muscle ache medications (particularly prescription)? Any new natural supplements in your life? Have antidepressants been added?

Conditions:
It's still possible that you may have venous difficulties in your legs (the veins actually have one-way "valves" built in, to help blood move back up), or are developing primary pulmonay hypertension. Alllergies are another overlooked suspect. Colds/flu can also cause these symptoms, although that would be a heckuva long case of the flu.

Physical hazards:
Does your job cause you to sit or stand for extended periods? Are you under severe stress from work or home issues? Have you been jogging on hard concrete and roadways for years, that may have harmed lower leg veins?

It's hard to know what could be causing these symptoms, as there are a myriad of reasons for edema and SOB. You've ruled out most major organs, except possibly lungs. This might give you some starting points. Do any of these things ring any bells?

Best wishes,

 

[Susan BAV]

Thorough list, Bob!

Jim, sorry to read this. Hope the cardio has some answers. Did they do a blood culture? Please post again and let us know what you find out.

 

[happyheart]

Bingo Tobagotwo

Bingo Tobagotwo

Bob H.,

14 hours ago you isolated the condition my doctor called about one hour ago: "PH"--pulmonary hypertension.

Apparently my heart is working great except that my right ventricle is putting in overtime trying to push blood into my lungs. While the problem still might be with my ticker, it appears I have more of a lung problem.

At any rate, I'm relieved to know what to be focusing on. Apparently PH is a relatively rare condition that can sometimes be caused by cogenital heart problems, although there's a list of culprits to consider.

From what I've read so far, I'd rather have a BAV than PH. But thanks to the Internet and forums like this one, no question is unanswerable. Especially when you wake up at 3 a.m. in the morning scratching your head over "what ifs".

Tobagotwo...you are a special gift. When I first joined this group in 2003, I followed your posts religiously.

Thanks for the help you and other loyal posters provide.

 

[Guest]

happyheart,

Glad that you are relieved to know what is going on ... but, sorry about the news.

Thoughts/prayers are coming your way.....



Cort:33swm."Mr Monte Carlo.Mr Road Trip".pig valve.pacemaker
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my radio show:CD SHOWCASE.7:30p central.Friday/April 20 = www.wrmn1410.com

 

[WayneGM]

Sorry to hear this.

I recently posted in the Heart Talk forum about a friend of ours whose 15 year old son was just diagnosed with PH. Harrybaby666 and Nancy were kind enough to post the link to this site http://www.phassociation.org It has lots of information and certainly provided more comfort to the family than their doctor did.

Best wishes.