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Suffering from Pulmonary Arterial Hypertension and Irregular menstruation - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2380 Questions
User :   i am suffering with severe pah and type2 diabetes.i am also suffering badly with frequent menstrual bleeding.pls sugest me how it can be controlled?
Doctor :   Hi
Doctor :   Let me read ur query
User :   HAI SIR
User :   OK
Doctor :   May i know your age ?
User :   I AM 24
Doctor :   and the cause of your PAH ?
Doctor :   do you have any other medical condition related to your heart ?
User :   DOCTORS TOLD ME THAT THERE MAY BE ANY REASON,AND ALSO I AM DIABETIC NA THATS WHY I THING SO
Doctor :   Diabetes by itself does not cause PAH
User :   YES,I UNDERWENT PDA OPERATION WHEN I AM UNDER THE AGE OF 9YEARS
Doctor :   ok
User :   BUT IN MY CT SCAN DOCTORS FIND OUT THAT PDA IS NOT THE REASON
Doctor :   PDA operation once done at a late stage cannot repair the earlier issue of PAH that was present earlier
Doctor :   May i know what are ur symptoms at the present
User :   ok sir,but i am not getting the reason why i am getting frequent periods
User :   i am etting nausea,vomiting,head ache and leg pains
Doctor :   may i know your LAST menstrual period?
User :   my l.m.p is on 1st dec
Doctor :   how many days do u have your period in ?
User :   i am getting the periods just within 10 days every time
User :   i am having periods upto 7 days
Doctor :   presence of irregular periods, pain etc could be due to thyroid issues, as well as fibroids, endometritis , etc
Doctor :   do ur periods begin every 28 days ?
User :   i approached gynaecologist and she said that this is just because of hormonal imbalance
Doctor :   i mean how often u get your periods ?
Doctor :   Has she done any Ultrasound pelvis, and ovary ?
User :   i am getting 2 to 3 times in a month
User :   abdominal scan has been done
Doctor :   You mean to say u get periods 2 -3 times in a day ?
User :   my thyroid levels and progestorone are also normal
Doctor :   what were the scan reports ?
User :   no i am getting periods for every 10 days
User :   scan reports are all normal
Doctor :   ok
Doctor :   In that case you may need medicines to regularise your cycles
User :   doctor gave me tranecid-mf to make the bleeding stop
Doctor :   these are similar to hormone pills as in contraceptive pills
User :   yes,but is it possible for me to use medicines in this severe pah condition?
Doctor :   TRANEcid , helps to reduce the bleeding and works well
Doctor :   yes
User :   but how to make my menstruation normal?
Doctor :   tranexa does not cause regularisation of your periods
User :   what i have to do now to regularise my cycle?
Doctor :   You need additional medicines prescribed by your gynae which will make your periods normal
User :   but they are telling that i cannot use any hormone related medicines
Doctor :   Medicines like mala D, etc, with proper dose titrated to your needs will help you
User :   can u pls help me to get rid of this problem sir?
Doctor :   Dose reduction will definitely help you in this case
User :   please suggest me what to do sir
User :   in severe pah condition is there any reason for my irregular periods?
Doctor :   You might consider consulting a experienced gynaecologist who will prescribe you proper medications after examining you, the exact dosage for normalisign your periods
Doctor :   Severe PAH., does not cause any irregular periods
User :   is mala D , a hormonal medicine?
Doctor :   Yes it contains low doses of hormones
User :   doctors said that my rvsp is 110
User :   it is a very high level na,thats why i thought
Doctor :   that is elevated pressure in the Rt ventricle
User :   my padp level is 45
Doctor :   and they think you may develop clots if you are given such medicines
Doctor :   I guess you have moved out of the chat session
Doctor :   please log in again, if u have any medical query
Doctor :   thank you for consulting me here
Doctor :   take care and bye for now
Doctor :   Are u back ?
User :   YES
Doctor :   your doctors think you may develop clots if you are given such medicines
User :   sir i want to know whether if my condition improves can i plan for a child in future?
Doctor :   But there is no need to be worried as such medicines will definitely help you
Doctor :   Pregnancy in PAH can cause more problems and worsen your condition
User :   i am suffering very much just because of this frequent bleeding
Doctor :   the frequent bleeding is curable
Doctor :   and easily treatble with medicines
User :   ok,but is it possible to lead happy marital life by taking proper medication?
Doctor :   yes
Doctor :   marital life is not going to be any problem
Doctor :   but pregnancy can cause worsening of your PAH, and can result in pregnancy loss as well as increase the chances of your death
User :   ok sir,then can u suggest any safe medicines for treating irregular bleeding?
Doctor :   Please consult your treating doctor, or gynae who will give you the needed medicines.
Doctor :   I am sorry as without examination or having your records , it will be illegal to prescribe medications over the internet
User :   ok and i also want to ask u that i am suffrng with mygraine headache and if i use any medicine like TOPOMAC iam getting the bleeding then
Doctor :   topomac , helps in preventing migraine attacks
Doctor :   it has nothing to do with your irregular periods
Doctor :   its not a hormone drug either
User :   but i am instantly getting my bleeding problem after taking that tablet
Doctor :   Topomac is a beta blocker
User :   and for ur info,i am also getting bleeding problem when i use paracetamol and domperidone tablets
User :   even if i take restyl tab for sleep then also i am getting the same bleeding problem sir
Doctor :   this means that this is just incidental and not associated with intake of pills
Doctor :   none of the tabs cause bleeding isses
User :   ok,can i use topomac undoubtedly?
Doctor :   definitely
User :   sir,what do u think as a reason to irregular periods in my case?
Doctor :   it could Be PCOD,
User :   if i get any cough and cold associated with fever which medicines i have to take then?
Doctor :   you can take some Crocin or sinarest which will help u
User :   but in my u/s scan , doc told that everything was ok?
User :   can i take MONOTAX-O OR TAXIM?
Doctor :   Yes
Doctor :   they would be perfect
User :   ANOTHER DOUBT I AM HAVING SIR
Doctor :   ok
User :   what tests i have to undergo every month?
Doctor :   no need for any tests every month
User :   i am using penegra25mg and fruselac tablets for pah
Doctor :   just see a good gynae , in a reputed hospital in your city
Doctor :   and she will help u out
User :   sir,what is the effect of BOSENTAS TABLET for pah patients?
Doctor :   a experienced gynae, will definitely correct your irregular bleeding isssues
Doctor :   Bostenton is a very good drug to help PAH and reduces symptoms by dilatting the blood vessels
User :   ok i have heard about that but my doc is not giving that drug?
Doctor :   did you discuss your concerns with your doctor ?
User :   sir,how long it will take to control my severe PAH?
User :   YES
Doctor :   discuss it with him, and he will tell you, if that drug is not suitable or not
Doctor :   With proper treatment , 60-90% of PAH patients can control their symptoms,
User :   BUT HE SAID THAT AFTER OBSERVING THE CHANGES HE WILL CHANGE THE MEDICATION
Doctor :   though it does progress gradually
Doctor :   the best treatment here is - heart lung transplant
Doctor :   ok,
Doctor :   do not try to change the medications
Doctor :   let the doctor decide
User :   I AM NOT ASKING ABOUT SYMPTOMS SIR,I WANT TO KNOW ABOUT HOW LONG IT WILL TAKE TO REACH NORMAL LEVELS?
Doctor :   as bostanton can be used at later stages
Doctor :   since your current medications will be effective for some time, he does not want to start medicines which can be used at a later date
User :   if they suggest lung transplant,then after that can i lead a normal life
Doctor :   yes , with a transplant,
Doctor :   the symptoms will definitely improve
User :   can i plan for pregnancy then?
Doctor :   yes, sure
Doctor :   But to find a complete set of heart and lung , may take a while
User :   pardon
Doctor :   just a lung transplant will not work in PAH
Doctor :   lung + heart transplant is needed as this is a circulatory problem
User :   but what is the alternative to cure my disease?
User :   can i cure this by just using costly medicine?
Doctor :   I am very sorry to inform you, that other than Heart lung transplant, PAH has no alternative treatment that can provide complete cure, it can only be controlled with medicines and surgical procedures, if needed
Doctor :   yes better medicines will help to control this issue
User :   do fluctuations in diabetes cause any irregular periods?
Doctor :   No
User :   i want to tell u an important thing sir
Doctor :   diabetes , has no issues that causes irregular bleeding
Doctor :   sure , please proceed
User :   when i have traced my diabetes problem,then the levels are high,my fasting is 285mmhg then,
User :   is it the main reason for my severe PAH problem?
Doctor :   Are u on any medications for controlling the diabetes
User :   sir,what is the normal range of RVSP,PADP?
Doctor :   HIGH bLOOD SUGAR, does not cause any issues with PAH
Doctor :   RVSP = A normal value is less than 35 mmHg
User :   SIR WHAT IS THE NORMAL RANGES OF ABF,PBF,TR JET VEL,TAPSV?
Doctor :   Do u have the Echo report with you ?
User :   SIR,WHAT IS THE EF IN THE REPORT MEANT FOR?
User :   YES
Doctor :   EF is the ejection fraction, and its normal value is above 65%
Doctor :   the ECHO will have the normal valuses mentioned
Doctor :   in it
Doctor :   i guess you have moved out of the chat session
Doctor :   please log back in if u have any medical query
Doctor :   bye for now
Doctor :   Hello and welcome back
User :   HAI SIR
Doctor :   the ECho report will also have the normal values in it
User :   CAN U ASK REG MY ECHO?
User :   MY EDD IS 3*6CMS,ESD IS 2*2CMS
User :   EF IS 65%
Doctor :   Your levels of EF is good
User :   RA,RV ARE NORMAL
Doctor :   Please read the last sentance of the report - interpretation
User :   IVS,IAS ARE INTACT,WHAT ABT DAT?
Doctor :   they are normal
Doctor :   it means - interventricular and interatrial septum are intact
User :   POST PDA CLOSURE,NO RESIDUAL PDA,DILATED RA/RV/MPA,MODERATE TR WITH SEVERE PAH,GOOD LV SYSTOLIC FUNCTION,MILD RV DYSFUNCTION,IVC MILDLY PLETHORIC
Doctor :   MODERATE TR WITH SEVERE PAH - it means that PAH had already occured at the time of closure of the PDA
User :   IVS,IAS ARE INTACT,WHAT ABT DAT? IS THIS A SERIOUS PROBLEM?
Doctor :   THIS SENTANCE - means that it is normal
Doctor :   there is nothing serious about that
User :   MY PADP IS 45MMHG
User :   CAN U TELL MY CONDITON IN BRIEF SIR?
Doctor :   Your condition is due to high pressue in the blood vessels in your lung
User :   SIR,THEN WHAT I HAVE TO PLAN FOR?
Doctor :   Presence of PDA at birth and inability for earlier correction, has lead to hypertrophy of the endotherlail cells and thickening of the blood vessels
User :   IS THIS A BIG RISKY CONDITION?
Doctor :   the method to tackle this is to dilate the blood vessels
User :   CAN IT BE CURABLE?
Doctor :   the risk depends on the severity
User :   PARDON
Doctor :   if the severity is high, it progresses over time, causing severe respiratory issues
Doctor :   if it is less severe, then there is no much symptoms and you lead a normal life
Doctor :   Here in your case, if u dont have chest discomfort, difficulty sleeping, difficulty breathing , etc, then you can relax
User :   IF IT CAN BE CONTROLLED BY MEDICATION AND HEALTHY LIFE STYLE CAN I PLAN FOR A CHILD?
Doctor :   Your current issues with bleeding during menses, can be corrected with medicines
Doctor :   please understand, pregnancy, will increase load on the lungs, and cause worsening of PAH
Doctor :   Medications just control the PAH
Doctor :   if PAH worsens, it will not be controlled
Doctor :   and post pregnancy, if complications occur, then it could lead to loss of pregnancy as well
User :   WHAT IS THE NORMAL VALUE OF PADP?
Doctor :   For having kids, you can consider the option of adoption as well as surrogate motherhood
User :   NOW-A-DAYS I AM GETTING RASHES ON MY SHOULDERS,LEGS
Doctor :   PADP values range from 15-35 mmHg
Doctor :   can u describe the rash
Doctor :   color, any itching , etc ?
User :   THE RASH IS IN RED COLOUR,SMALL RASHES R THERE
Doctor :   Hello and welcome back
User :   HAI SIR
User :   THE RASH IS IN RED COLOUR,SMALL RASHES R THERE
User :   RU A CARDIOLOGIST?
Doctor :   the red color rash, could be due to dermatitis, or it could be a blood related issue (low platelets )
Doctor :   It can be diagnosed by having a look at it
User :   MY PLATELET COUNT IS 2*27LAKHS
Doctor :   That is normal
Doctor :   May i know when your blood tests and Echo were done ?
User :   IT IS NOT REMINING STABLE I MEAN THE RASHES ARE APPEARING AND ALSO DISAPPEARING?
User :   THESE ARE THE REPORTS OF 1ST DEC
Doctor :   it could also be due to skin issues
Doctor :   ok
User :   MY FIRST ECHO WAS DONE ON 28JAN 2010
Doctor :   ok
User :   TILL NOW I UNDERWENT 3 ECHOS
Doctor :   that is fine
User :   SIR MY ECG REP HAS
User :   RATE 93
User :   PR 133
User :   QRSD 85
User :   QT 374
User :   QTC 465
User :   AND AXIS P IS 71
User :   QRS 104
Doctor :   ok,
User :   T IS 24
Doctor :   most of them, are within range,
Doctor :   Where do you reside ?
Doctor :   thats not an issue
Doctor :   i am happy to help
User :   CAN U GIVE ME UR CONTACT NUMBER?IF U DONT MIND?
User :   THANK U SIR
User :   OR IF U HAVE ANY MAIL ID?
Doctor :   I am a general physician, with experience in cardiology for over 6 years
User :   THATS GREAT SIR,THANK U SIR,GUD NI8,BYE.
Doctor :   THANK you for consulting me here
Doctor :   Take care and good night
Doctor :   bye for now

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