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What Causes Swelling In Body With Bow Leg And Bow Elbow?

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Posted on Thu, 4 Sep 2014
Question: I am a dangerously obsese (325lbs/5'3"), female with pulmonary hypertension, arthritis, type 2 diabetes,
thyroid problems and very limited mobility (wheel chair). I have noticed changes in my bone structure,
I had 'knock knees', now I'm bow-legged, my elbows are bowed and I have lumps & humps in my skull.
I am unable to exercise, I have tried diets popular to unknown, I have problems with swelling and I have experienced weight gain EVERY month for the past year. I take 40 mg of Lasix twice daily, along
with 2.5 mg. Metolazone PRN for increased swelling. Until 2000, I worked 1 full-time job and 1 part-time
job all year, adding teaching lifesaving and beginner swimming every summer. Until 2013, I smoked
one (1) full pack of cigarettes 6 days per week. I was given a name for a possible condition with my
bone changes, but I have forgotten the name. Can you help with names for this condition, I will
recognize it if I see it. Is there ANYTHING I can do to loose weight. No one wants to do surgery due
to my respiratory problems (I have sleep apnea too of course), my doctors have left it up to me to
'cure' my obesity. Physical therapists seem afraid of me when they observe my legs buckle or hear
my knees (no cartiledge) crack. I am in constant pain with constent swelling in my legs and thighs.
I am 66 years old and I want to live!!
doctor
Answered by Dr. Binu Parameswaran Pillai (8 hours later)
Brief Answer:
Hi

Detailed Answer:
Good dear,

Noted your concerns. Is the bone condition what you are mentioning Osteopetrosis or PAget's disease ?

I feel the bone condition has made you wheel chair bound and that has made you obese. If you consume the same amount of calorie which you were taking prior to becoming wheel chair bound, then you will gain weight. Since you do minimal activity, you need only around 1000 calories a day. If you confine to a 800 to 1000 calorie diet, then you will lose weight. I hope your Thyroid and cortisol tests were done to find cause of weight gain and they were normal,

I noted that you have sleep apnea and diabetes. With all these, you are a good candidate for bariatric surgery. I agree that any surgery under general anaesthesia is risky in you . But if you are prepared to face that risk and request an endocrinologist, they probably will consider bariatric surgery which can make you lose considerable amount of weight. And that may make your life better.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (9 hours later)
Thanks for your reply. I have been told I have Osteopetrosis but I think Paget's
disease is what my endocrinologist mentioned. I had a portion of my left kidney
removed (cancer) in 2009 and I have a gorter. I have counted and reduced calories and am currently at two meals per day with occassional fresh fruit snaks.
I have been told I need both knees replaced and possible back surgery due to
disc problems. I changed endocrinologists in 2011 (due to location) but the
current and past endocrinologists have not mentioned bariatric surgery. What is
bariatric surgery and how can it help? Weight gain increased in 2013 and has
risen rapidly to sometimes 5 to 8 pounds in one week.
I have noticed and discussed with my endocrinologist increased swelling in legs
and feet with regular use of metformin (prescribed at 500mg twice daily). I stopped taking it, but the doctor told me to resume with one daily for a while.
I have had to stop again this week. One doctor told me Metformin does not cause swelling while the nurse told me it does/can cause swelling. ALSO, I have not had a cortisol test, and thyroid blood work and an USG have
been the only thyroid tests. My colestrol level is high and zytec prescribed but
never used due to my fear of MORE leg pain.
doctor
Answered by Dr. Binu Parameswaran Pillai (3 hours later)
Brief Answer:
Hi

Detailed Answer:
Hello,
considering the reduced mobility and excess weight, it may be better to take a cholesterol lowering pill.
Cortisol test is not for thyroid. It is a blood test to detect high cortisol in body which can cause weight gain. You may eithe need a 24 hour urine test or a mid niight saliva test for that.
Metformin usually doesn cause swelling around legs and it is an excellent drug,. It may hel you to redce weight as well. Adding metformin may help you to reduce glipizide which cause weight gain.

Bariatric surgery is weight rediction surgery and there are different kinds of it. You may have to discuss it with your endocrinoologist next time so that he can assess if you are okay for it
Binu
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Swelling In Body With Bow Leg And Bow Elbow?

Brief Answer: Hi Detailed Answer: Good dear, Noted your concerns. Is the bone condition what you are mentioning Osteopetrosis or PAget's disease ? I feel the bone condition has made you wheel chair bound and that has made you obese. If you consume the same amount of calorie which you were taking prior to becoming wheel chair bound, then you will gain weight. Since you do minimal activity, you need only around 1000 calories a day. If you confine to a 800 to 1000 calorie diet, then you will lose weight. I hope your Thyroid and cortisol tests were done to find cause of weight gain and they were normal, I noted that you have sleep apnea and diabetes. With all these, you are a good candidate for bariatric surgery. I agree that any surgery under general anaesthesia is risky in you . But if you are prepared to face that risk and request an endocrinologist, they probably will consider bariatric surgery which can make you lose considerable amount of weight. And that may make your life better. Regards Binu