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Pitting edema in leg, swelling in abdomen and fatigue - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
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General & Family Physician
Practicing since : 2008
Answered : 3632 Questions
User :   I am having problems with bilateral pitting edema in my legs, worse in right leg. My abdomen will also swell. I will put on about 5-6 lbs of water weight which is a lot on me as I have a small frame. This problem has become worse over last several months. I have no shortness of breath, just edema and fatigue. I experienced edema for the first time in 2001 after lengthy surgery which put me in ICU with pulmonary edema and lots of fluid on my body. Lasix will eliminate the swelling but I want to know the underlying problem. I am 41 years old. My symptoms look like my grandmother who had CHF. I am a runner and have always felt like my heart was strong. The problem happens frequently throughtout the month at various times. Last week I went to the ER as I was feeling really bad and was swollen. An EKG and blood work were performed with no problems noted. I was given 40 mg of lasix to address the fluid. I need some answers on what is wrong.                                                                 
Doctor :   hi
Doctor :   Dr. XXXXXXXX here. let me read what u have typed.
Doctor :   was anytime an ECHO done?
Doctor :   was anytime liver function tests done?
Doctor :   when was your blood pressure checked? is it elevated?
User :   My blood pressure always runs low. For me normal is 98-105/60. Not sure about liver function test
User :   which test is echo?
Doctor :   ECHO test is similar to ultrasound scan which is done for your heart
Doctor :   get your liver function tests and kidney function tests done along with ECHO, to look for probable causes for your symptoms
User :   No echo done. kindney test look good.
Doctor :   ok
Doctor :   then proceed with liver function tests it will show if albumin globulin are low thereby causing the edema
User :   How is CHF diagnosed.
Doctor :   CHF is diagnosed by doing ECG, ECHO, Chest x-ray, blood tests and correlating findings with your symptoms
Doctor :   how are your eating habits? please provide your height and weight.
User :   I was advised to follow up with cardiologist who saw me in 2001 when I was put in ICU after problem with surgery. Will see him in 3 weeks as he is on vacation. If CHF were possible cause would I not have shortness of breath? My eating habits are good. I try to eat healthy and must do a low salt diet or I have big problems with pitting edema. I am 5'6" and weight 112 lbs.
Doctor :   ok. CHF will present with breathing trouble especially with exertion.
Doctor :   wait for your appointment with cardiologist
Doctor :   and request your regular doctor in the meantime to
Doctor :   get a liver function test done
Doctor :   to see if the protein levels are fine
User :   Okay I will check on liver. Sometimes if I drink large amounts of water, my swelling gets worse instead of better. Elevation of my legs help too. Days where I am up all day or sit with feet down problem is also worse.
Doctor :   yes, increased water consumption will increase the problem. limit your water intake to 1.5 to 2 liters
Doctor :   not more than that
User :   Is bilateral pitting edema in 41 yr old odd?
Doctor :   keep legs elevated most of the time
Doctor :   it is not normal, there is some pathology behind it, and investigations should be directed to find out the cause and treat it.
Doctor :   since your kidney functions and ECG were fine, you should consider checking the ECHO and Chest x-ray and liver function test.
User :   Which test shows ejection fraction?
Doctor :   ECHO shows ejection fraction. was it done for yo? if yes, what was your EF?
Doctor :   EF=ejection fraction
User :   I have not had it done. I just read that problems with right side of heart cause cause swelling in legs and abdomen. Although I am not short of breath is this a possible concern for me or not
Doctor :   since you are not having any shortness of breath, do not worry much on it, rather focus in determining the cause for it
User :   Every since the problem occured where I developed fluid around my heart and lungs and all over my body and I was put in ICU to address it in 2001, I have had trouble with pitting edema from time to time. Not sure what went wrong with that surgery but could it be related to now.
Doctor :   what surgery was done at that time? can you name the procedure done for you?
User :   It was done in for endometerosis. Long surgery about 4-5 hours as it was so severe. He used a special procedure to cut it out.
Doctor :   ok
User :   To make sure I understand you recommend looking at heart and liver. Any other cause. Hormones can't do this can they?
Doctor :   do you mean to say that you had endometriosis even in chest cavity?
Doctor :   hormones will not make you have edema to such extent
Doctor :   however getting a hormonal analysis done will help to make sure that the cause is not related to it
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