Question: I was in the ER last night to evaluate for a pulmonary embulus (I have bronchitis, pneumonia and pleurisy pain and started having palpitations and fluttering in my heart so doc sent me to ER). The d-Dimer test came back elevated so I had a CT Angio with contrast, which showed no PE. Thank goodness as for that. They asked questions about DVT and I think they examined my legs, although my recollection of the whole evening is fuzzy. Anyway, I've been thinking about it today and wondering if I do have DVT. For several months, I've been having a huge problem with my feet and ankles swelling. It got so bad about 2 months ago that I was getting blisters and clear fluid was seeping from the skin. This was happening in both legs however the right leg was always worse - larger, redder, more tight and sore and more oozing. No diagnostic work was done to find out why the swelling except for a chest tray to look for signs of congestive heart failure. My family doctor put me on Lasix and potassium which did nothing for me. Then she switched me to Aldactone. It took about 4 weeks for it to really start working but now it has been like a miracle drug - I've lost more than 30 pounds in water weight in about 2-3 weeks and still continuing to lose about a pound a day. Electrolyte levels are being checked (CMP every 2 weeks) and so far have been normal. My legs look better than they have in years and the horrible pain from the swelling is gone. Now, however, I'm wondering if I do have DVT. Is it possible to still have it, even if the swelling is controlled because of the diuretics? I was feeling around on my legs tonight and did find an extremely tender place on the inside of my calf, about halfway up. They either didn't actually touch that spot last night during the exam or it wasn't sore at the time. I have extremely painful nighttime muscle spasms which have been much worse in the past week, happening pretty much every night in my feet, ankles and calves, lasting 20-30 minutes and sometimes happening 2 -3 times each night. I didn't think about this last night and they didn't ask so this information was not included in the exam. So, is it possible that I still have a DVT? And if so, should I return to the ER or see my doctor tomorrow? Is it possible that I could still develop a PE? If I had known more about this last night, I probably would have answered some of their questions differently and would have told them about the muscle cramping/spasms. Thanks.

Thank you for you answer. We're you able to lock through my other recent inquiries as well? It sounds like perhaps you were. I just feel there is so much going on and I'm not getting answers. I see my doctor again on Thursday and I do believe she is going to order the echocardiogram. I had one done three years ago as well so that should help as a baseline. Thank you

Thank you. They did see enlarged heart on the CT in the ER. I SEE MY DOCTOR AGAIN TOMORROW and she already told me she was going to order another echo (the last one was three years ago). Do you think the neurological difficulties could be related to the heart or should just be viewed as 2 separate investigations? I really need someone to take a look at all the issues that can tell me if they are interrelated or not. What was it that made you zero in on the heart, other than being a cardiologist? Thank you

Oh and another question, one of the other doctors recommended getting an inpatient diagnosis to speed up the process and be able to deal with all the stuff going on.Do you feel this would be a better and faster way to find some definitive answers? Thank you.

Me again - another question I thought of - is it safe for me to be losing so much water weight so quickly? In less than 2 weeks I've lost 38 pounds, 6 pounds just in the last 2 days. Metabolic panel was normal in the ER MONDAY NIGHT.


Please answer my additional questions as soon as possible. Tonight the pain in my right back/lung was so intense that I could hardly breathe. I took my BP and it was 144/92 (it usually runs low, about 110/55). I almost went back to the ER BUT was able to calm down a bit and BP is now 120/70 although pulse is 98. I think it was just anxiety or do you think I'm in denial? I feel like something terrible is wrong and this pneumonia has exacerbated whatever it is. What do you think? Please be honest with me as your responses will guide me to know what to ask my doctor tomorrow. I am thinking of requesting that I be admitted for the cardiac workup so that we can get it done more quickly and move to treatment. Would that be a reasonable request? please let me know your responses to these additional questions. Thank you! I can tell you are a kind doctor.