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Red hot swelling in legs and its treatment, Endometriosis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1556 Questions
User :   good day
Doctor :   Hi
User :   I have a question for my father
Doctor :   Please post your query
User :   it started on saturday
Doctor :   ok please proceed
User :   he has a red hot
User :   very swollen legs
Doctor :   is he diabetic?
User :   no
Doctor :   I s he having fever?
Doctor :   was it following any wound?
User :   yes he had fever 2 days ago
User :   but was already well the following da
Doctor :   when did you notice the swollen leg?
User :   it looks like a little bit with scales
Doctor :   May i know his age?
User :   69
Doctor :   Since when he has this?
User :   just last saturday
Doctor :   ok
User :   it looks like its been bitten ny a giant bug
Doctor :   is it increasing?
Doctor :   ok
User :   yes
Doctor :   then it might be do to the allergy to its toxin
Doctor :   Is he having itching?
User :   but yesterday i let him dring celebrex 200mg and the redness decrease but the inflammation is desame
User :   no its not itchy
Doctor :   is it there on both legs?
Doctor :   celebrex is a pain killer
User :   no just the right
Doctor :   ok
User :   oh because when i have inflammation the doctors give me celebrex
User :   he said its not painful and he doesnot feel that its hot
Doctor :   so did you try applying caladryl or calamine lotion
Doctor :   ok
User :   its hot only when touching it
Doctor :   ok
User :   no we did not
Doctor :   did he try ice compresses
User :   no we did not
User :   can ice help?
Doctor :   yes ice compresses
Doctor :   can reduce the pain and swelling
Doctor :   even aloevera cream can be applied
User :   oh and what medicine can help lessen the inflammation?
Doctor :   Is he allergic to any food or medicines in the past?
Doctor :   first try topical medicines like calamine lotion over the swelling
User :   none
Doctor :   you can also use benadryl
Doctor :   ok
Doctor :   so this is easy to cure
User :   ok
User :   docotr i would like you to interpret for me my pathology report
Doctor :   irstly, you should clean out the area which has been bitten using an anti-bacterial soap
Doctor :   yes sure
User :   because i cant understant a word being said
Doctor :   It is very important to clean out the bitten area as you should avoid bacteria from the atmosphere and on your skin trying to gain entry into your body.
User :   Sections of the uterus reveal gravid uterine changes exemplified by decidualization of the endometrium and hypertrophy of the myometrium. Sections of the lower uterine segment as well as the three detached tissue fragments reveal presence of chronic villi, some with myxoid degeneration, on and within the upper layer of the myometrium without an apparent decidual plane.
Doctor :   In case you are allergic to insect venom, there is a good chance that you are going to get anaphylaxis
Doctor :   is it yours?
Doctor :   may i know your age ?
User :   yes that is mine
Doctor :   do you have any pain?
User :   that was done when i was only 22
Doctor :   ok
User :   yes a lot
Doctor :   were you pregnant then
User :   and so many complications
User :   im not sure
User :   what does it mean
Doctor :   was your periods regular?
User :   can you tell me in words on which i can understand
Doctor :   what was your symptoms then?
Doctor :   was it called by your doctor as endometriosis?
Doctor :   Most women who have endometriosis, in fact, do not have symptoms.
User :   it became irregular because of depo proveda
Doctor :   Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility.
Doctor :   Some women experience painful sexual intercourse (dyspareunia) or cramping during intercourse, and or/pain during bowel movements and/or urination.
Doctor :   ok
Doctor :   what i feel is it might be endometrioisis
Doctor :   Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus, but in a location outside of the uterus.
User :   oh
Doctor :   Laparoscopy is the most common surgical procedure for the diagnosis of endometriosis.
Doctor :   During laparoscopy, biopsies (removal of tiny tissue samples for examination under a microscope) can also be performed for a diagnosis
User :   what did you see in that report that suggested endometrios
Doctor :   it is the increased cells in the uterine tissues
Doctor :   were you pregnant then?
Doctor :   some times some lost pregnancy can also cause it
User :   because i got confused when i let it read by a family physician he said that it explains that i was pregnant at that time
Doctor :   what is called an hydatidiform mole
User :   is it possible?
Doctor :   yes sure
Doctor :   thats what i also felt
Doctor :   it is a missed pregnancy
Doctor :   called hydatidiform mole
User :   in that report what can tell that it was pregnant?
Doctor :   A hydatidiform mole is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic diseas
Doctor :   chorionic villi and myxoid degeneration
Doctor :   in the report
Doctor :   A hydatidiform mole, or molar pregnancy, results from over-production of the tissue that is supposed to develop into the placenta.
Doctor :   The placenta normally feeds a fetus during pregnancy. In this condition, the tissues develop into an abnormal growth, called a mass.
User :   but if i had endometrios can they see that cells also?
Doctor :   A partial molar pregnancy means there is an abnormal placenta and some fetal development.
Doctor :   but you will severe pain
Doctor :   and some will show only pure endometrial cells
Doctor :   but you have chorionic villi
User :   but in the report there is no fetus or ambilical cord seen
Doctor :   which is a placental tissue
Doctor :   yes i will explain
Doctor :   A partial hydatidiform mole pregnancy means there is an abnormal placenta and some fetal development.
Doctor :   In a complete hydatidiform mole pregnancy, there is an abnormal placenta but no fetus.
Doctor :   did you understand?
User :   is it called also placenta accreta?
Doctor :   Both forms are due to problems during fertilization. Potential causes may include defects in the egg, problems within the uterus, or a diet low in protein, animal fat, and vitamin A
Doctor :   no
User :   oh so its different
Doctor :   placenta accreta is poor and attachment of placenta to uterus in an abnormal manner
User :   in hydatidiform mole what are the treatments for that?
Doctor :   with out an intervening tissue in between
Doctor :   yes
Doctor :   If your doctor suspects a molar pregnancy, a suction curettagesuction curettage (D and C) may be performed.
Doctor :   A hysterectomyhysterectomy may be an option for older women who do not wish to become pregnant in the future.
Doctor :   After treatment, serum HCG levels will be followed.
User :   in the report i gave you can you say that it might have been possible for a placenta accretA?
Doctor :   More than 80% of hydatidiform moles are benignbenign (noncancerous).
Doctor :   Placenta accreta is very rarely recognised before birth, and is very difficult to diagnose.
Doctor :   A Doppler ultrasound can lead to the diagnosis of a suspected accreta and an MRI will give more detail leading to further suspicion of such an abnormal placenta.
Doctor :   ok thats good
User :   can i send you the final impression of the ultrasound
Doctor :   so taht was to rule out these
Doctor :   ye sure
User :   so you could tell me what you see?
Doctor :   how will you send
Doctor :   can you paste it here now
User :   asymmetrical slightkly enlarge anteverted uterus
User :   bulging lower segment
User :   rule out accreta
User :   right ovary not seen
User :   no adnexal pathology
Doctor :   that means there was an growth or pregnancy in uterus
User :   i donot understand
Doctor :   it means the uterus size is enlarged than normal
User :   because that is the 2nd month after i had my regular injection of depo proveda
Doctor :   ok
User :   the uterus size here seen is 5.3x7.4x5.2
Doctor :   ok
Doctor :   it is enalrged
Doctor :   depo proveda can cause
Doctor :   bleeding
User :   there is 2 first degree family who had also endometrios and 1 fribroid but i dont know if that is hereditary
Doctor :   yes it is possible
Doctor :   What you should be careful now is
Doctor :   In a few cases, a hydatidiform mole may develop into a choriocarcinoma, a fast-growing cancerous form of gestational trophoblastic disease
Doctor :   so you should be under regular followup
Doctor :   with your blood HCG levels monitored
User :   doctor may i know what are the symptoms if it becomes cancerous
User :   i have so many symptoms
Doctor :   so do discuss it with your dr
Doctor :   yes
Doctor :   then there will be increase
Doctor :   of your blood HCG levels
Doctor :   More than 80% of hydatidiform moles are benignbenign (noncancerous). The outcome after treatment is usually excellent.
User :   what is the test that could tell your HCG
Doctor :   Close follow-up is essential.
Doctor :   After treatment, you should use very effective contraception for at least 6 to 12 months to avoid pregnancy.
User :   i was already hysterctomized
Doctor :   A qualitative HCG blood test checks to see if there is a hormone called human chorionic gonadotropinhuman chorionic gonadotropin in your blood. HCG is a hormone normally produced during pregnancy.
Doctor :   ok
Doctor :   so you have removed your uterus
Doctor :   taht is the definite surgery
User :   yes
Doctor :   to prevent any cancer
Doctor :   but is only done in older
Doctor :   ladies
User :   and after 1 1/2 years my left ovary twisted and ruptured
Doctor :   who dont want a child anymore
User :   the histopath of the ovary is
Doctor :   it might be the cyst
User :   left ovary: serous cyst with hemorrhage
Doctor :   thats is usually assctd with hydatidiform mole
User :   and focal areas of infarction
Doctor :   yes it will be there
Doctor :   yes
User :   the fallopian tube: congestion
Doctor :   ok
User :   what does it mean?
Doctor :   its because of the bleding
Doctor :   bleeding
User :   so correct me doctor if im wrong
User :   the possible of what happened based on the reports that i send you
Doctor :   Theca lutein cysts: These are ovarian cysts greater than 6 cm in diameter and accompanying ovarian enlargement.
Doctor :   theya re the one that you just now mentioned
User :   is it was possible that i had hydatidiform mole and after total abdominal hysterectomy
Doctor :   they are assosciated with hydatidiform mole
User :   there is the connection of having a cysts in the ovary
Doctor :   hydatidiform mole will be in uterus
Doctor :   Theca leutin cysts develop in response to high levels of beta-hCG
User :   yes the ovary became very large 9.0x8.0x4.0 was its size
Doctor :   These cysts are not usually palpated on bimanual examination but are identified by ultrasonography.
Doctor :   ok
Doctor :   Theca leutin cysts spontaneously regress after the mole is evacuated, but it may take up to 12 weeks for complete regression.
Doctor :   Once a molar pregnancy is diagnosed, a baseline chest radiograph should be taken. The lungs are a primary site of metastasis for malignant trophoblastic tumors
User :   ok what might be my risk because of having all of this?
User :   oh my god
User :   after my TAH
Doctor :   since your
Doctor :   uterus is removed
User :   i have pain under my scapula
Doctor :   your cancer chances are very less
Doctor :   since when
Doctor :   do you have cough?
User :   we have a family history of breast cancer
User :   yes
User :   and we keep on asking why my cough sometimes stays like morethan 3 weeks
Doctor :   Lung problems may occur after a D and C if the woman's uterus is bigger than 16 weeks gestational size.
Doctor :   ok get an xray done
User :   i have now are kidney problems
User :   my right kidney is already moderately hydronephrosis
Doctor :   ok
Doctor :   are you on any medicines
Doctor :   is your urine out put good]
User :   they just put a ureteral stent
User :   but it was not cause by a stone the obstruction
User :   i urinate but the ultrasound says that since 2007 there is urine retain
User :   ill send you the most recent ultrasound report pls be so kind of explaining to me what it is
Doctor :   was it there in both kidneys
User :   The Liver measures 16 cm. at the midclavicular line. The organs appears hyperechoic. No focal lesions are seen. The gall bladder is not visualized. A bright echo, measuring about 7.6 mm., is persistently noted at the porta hepatis region, close to the common duct outline. No evidence of bowel dilatation is seen. The spleen and the pancreas are within normal in sizes, forms and echotextures. The abdominal aorta and the para-aortic regions are unremarkable. No evidence of bowel dilatation, mass lesion nor intra-peritoneal fluid collections in the visualized abdomen. The right Kidney measures about 11.3 x 5.7 cm. The cortical thickness are about 1.7 cm. The cortico-medullary junctions appear intact. A shadowing echo of about 2.4 cm. size is noted within the middle/lower pole central echo complex region, with mild calyceal dilatations noted at the superior pole. The Left kidney measures about 12.5 x 6.1 cm. The cortical thickness is at about 2.6 cm. The cortico-medullary junctions are intact. A tiny bright echo of about 2.7 mm. size is noted at the anterior superior pole cortico-medullary region of the kidney. No evidence of ureteral dilatations. The urinary bladder shows the distal end of the stent within its lumen. No intraluminalcalculus is seen. Post-voiding examination shows a residual urine volume of about 35.6 cc. during this occasion. TVS shows non-demonstration of the uterine fundus and corpus. A prominent mid pelvic structures of about 12, 7.1 and 7.3 mm. sizes. The right ovary is noted, measuring about 3.9 x 3.5 x 3.1 cm. Small anechoic foci are noted within its outline. The Left ovary is not identified. The rest of the pelvic areas are unremarkable.
User :   Impression: â?¢ Mild hepatomegaly, with fatty infiltration. â?¢ Non-demonstrated gall bladder, consistent with a post-cholecystectomy status of the patient. â?¢ Presence of a persistent â??brightâ?? echo of about 7.6 mm. size at the distal gall bladder fossa region. â?¢ The considerations should include: sa focus of duodenal gas, phlebolith, food particle, calcification, or a calculuswithin the cystic duct. â?¢ Close ultrasound monitoring suggested â?¢ No evidence of biliary dilatation â?¢ Mild hydronephrotic change the right kidney, from a calculus (nephrolithiasis) of about 2.4 cm. size within the mid lower medullary region of the kidney. â?¢ Tiny non-obstructing nephrolith, as described, left kidney. â?¢ Presence of a distal end of a stent within the urinary bladder, suggestively coming from the ureteral region. â?¢ Presence of significant urinary bladder retention of urine. Consider cystitis. Please correlate â?¢ Status post-hysterctomy, with prominent Nabothian Cysts within the residual cervix, as described. â?¢ Prominent right ovary, with developing follicles â?¢ Non-demonstrated left ovary â?¢ Negative for intra-pelvic fluid
User :   yes of course
Doctor :   Are you diabetic?
User :   no im not
User :   that is based on this months test
Doctor :   ok
Doctor :   so it has some mild retention of urine too
User :   i was that report on my liver since after my TAH
Doctor :   probably due to the distended uterus
User :   yes
User :   uterus?
Doctor :   but dont worry no tumors are seen in liver
Doctor :   that distension what you have is common
User :   im post-total abdominal hysterectomy & Left salpingo-oophorectomy
Doctor :   more common in diabetics
Doctor :   ok
Doctor :   are you on hormone replacement
User :   they just also removed my gallbladder last month
User :   no im not, they said that i dont need one yet because i still have 1 ovary remaining
Doctor :   did you have pain in the right side
Doctor :   of your abdomen
Doctor :   ok thats Very good
User :   yes since the very day after leaving the hospital on TAH procedure up this moment i have pain in the right
Doctor :   ok
Doctor :   when was the gall bladder removed?
Doctor :   was it before TAH?
User :   april 27,2010
User :   TAH 6/15/2005
User :   USO is 1/14/2007
Doctor :   ok
User :   ureteral stent was place 6/12/2010
Doctor :   WWW.WWWW.WW Doctor :   use this link to get expert opinion from our specialist
Doctor :   if you want
User :   why docotr is there something wrong
Doctor :   you can post your detailed query regarding any problems you still have
Doctor :   he will gwt back to you
Doctor :   no its for better gastro opinion
Doctor :   only if you need
User :   in the last report what does it say?
Doctor :   small stone in right kidney
User :   im I at risk of any kind of cancer in the future?
Doctor :   small cysts in cervix whicha re normal
Doctor :   no not at all
User :   thats good
Doctor :   but what you can do is do get regular checkups
Doctor :   for a good health
Doctor :   and stop worrying
Doctor :   unnecessarily
User :   ok thank you very much doctor
Doctor :   since all required prevention is done
User :   ok
Doctor :   you dont worry
Doctor :   be bold
Doctor :   since the best treatment si given to you
User :   ok i will
User :   thank you very much
Doctor :   Thanks for consulting........
Doctor :   THANKS FOR CONSULTING..........
Doctor :   BYE FOR NOW..............
User :   bye doctor
Doctor :   TAKE CARE...........
Doctor :   BYE......
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