Hi ma'am,
Thanks for your query.
I have gone through your detailed query very thoroughly.
I am of the strong conviction that you are indeed suffering from
MYOTONIC DYSTROPHY, since majority of your problems fit into this condition. I will try to solve most of your problems, if not all.
Firstly, the heaviness in the center of chest and upper abdomen with minimal exertions; swelling of the lower torso during the day, is STRONGLY suggestive of failing of the entire heart along with co-existing coronary artery disease. Investigations like 2-D Echo, stress TMT/Thallium test and coronary
angiography will confirm my views. Medicines like digoxin, diuretics, low-dose alpha-beta blockers (such as carvedilol), coronary vasodilators in adequate doses and ACE inhibitors in titrated doses will certainly help you.
Further, the tachycardia-
bradycardia syndrome (also called
Sick Sinus Syndrome, which is part of the manifestations of Myotonic dystrophy) can be kept under control on anti-arrhythmic drug, such as, amiodarone and, ideally a dual chamber pacemaker.
Difficulty in opening fingers after sustained squeezing of fingers, as well as, transient ptosis (drooping of the eyelids), is also part of the symptoms of Myotonic Dystrophy. Perhaps, serum Potassium estimation should be periodically.
Since the disease primarily affects the muscles, the intestinal smooth muscles too tend to get involved, leading to bloating,
constipation, poor digestion. Perhaps, pro-kinetic drugs, such as
metoclopramide + omeprazole will be of some help.
For
osteoporosis, adequate calcium + Vit D3 (1000mcg) daily intake will of significant benefit.
Lastly, may I inform you that it is a genetic disease and has NO TREATMENT. Only symptomatic treatment can be given to relieve different problems associated with the condition.
Consult your doctor and apprise him of my opinion/recommendations and treatment. I am certain that he will agree with my opinion and clinical acumen; order required tests, and- based on the reports- will prescribe suitable treatment as advised.
If you find my response helpful and informative, do not forget an “excellent” rating to my answer, to encourage all doctors- engaged in social service- to render sound advice to the FREE queries.
Fond regards and have a nice day,
Dr. Rakesh Karanwal