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Suggest Treatment For Angina And Diabetes-2 Fluid Retention Problems

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Posted on Wed, 25 Mar 2015
Question: I am having problems getting instant answers to my Angina and Diabetes-2 fluid retention problems, having had a heart attack in 2003 and a Crescendo Unstable Angina attack last September, my UK NHS GP's next appointment to see me being the 14th of April ! 3 UK Cardiologists also being of little help.
You can check my medical CV here:
XXXX
and what I have done about Fluid Retention using this nurse's advice: http://www.alsindependence.com/Leg_Swelling.htm
which is working.
doctor
Answered by Dr. Benard Shehu (1 hour later)
Brief Answer:
Not due to cardiac issues;other specialists to get consulted...

Detailed Answer:
Hi XXXX,

I have gone through your medical history and lab reports you provided carefully and understood your concerns.

Let me summarize your medical history:
- diabetic neuropathy
- angina
- chronic lymphoma
- high liver enzymes suggesting for liver problems
- lack of physical activity
- functional renal failure
- benign prostate adenoma

All of them are making your fluid retention worse. Your case should be followed up by internal medicine specialist and not from cardiologist. All your problems are nothing to do with heart, but with other issues as mentioned above.

If I was your caring doctor would advise to follow the advice as given by the nurse you are reporting together with scheduling cardiac physical activities like walking up to 15-30 min/day.

Try to keep your legs raised when laying down by putting 1-2 cushions underneath from your buttocks to your feet. Leg's stocking are also advised to improve lymph and blood circulation in your legs.

If all these measure doesn't help you should discuss with an internal specialist doctor to start water pill to deal with your problem.

Hope it was of help!
Dr.Benard
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (21 hours later)
Did not receive any email with your answer 20 hours ago !

My main concern is Angina chest pain, the prescribed medication not controlling my heart beat 24 hours and some chest pains occasionally start 8 hours after me having taken the second instalment at about 24:00 midnight

The advice you have given me is the general standard one I can read in dozens of posts searching in Google and is not worth a Cent / XXXXXXX to me.

My e-mail to my main UK Cardiologist Professor XXXXXXX Baumbach:
..................................................................................................

Professor XXXXXXX Baumbach
Consultant Cardiologist
Research Lead for Cardiology
Bristol Heart Institute
University Hospitals Bristol

From: XXXX [mailto: YYYY@YYYY ]
Sent: 02 January 2015 23:58
To: Baumbach, XXXXXXX
Subject: Swollen Legs

Dear XXXXXXX !

Now taking 2 x 2.5mg Bisoprolol, one at about 12:00 midnight with one Isosorbide
60mg and another one on its own at 12:00 noon, they are doing their job better
but still get the occasional mild chest pain when starting to do something physical, blood pressure going up, yet pulse not exceeding 60 beats per minute.

When resting, which is what my body is doing most of the time, like now as usual
sitting in front of my computers, BP is 117/58 and pulse is 52 and lower on average most of the time !

This rather low pulse rate is causing my legs to swell up more than before, making my Diabetes-2 Oedema problem worse.

Walking is not moving much fluid from my legs, returning to them as soon as I sit down again and only during the night when I am in bed with my legs level with my heart and kidneys is there a reduction.

Compression stockings are being suggested, but do not like the idea of using them, possibly having an adverse effect on the circulation of whatever in my legs.

Their sensitive skin also showing some small fluid blisters, a large 5 cm one bursting in September, fixed by the Spire specialist Dr. Simson having a nurse apply a bandaged Mepitel dressing to allow the damaged skin to be recreated which worked !

"A diuretic like Frusemide might be able to take the edge off this problem."

To flush out Potassium and Vitamin-C with the Urine, which is not reaching my kidneys, fluid being trapped in the lower legs when not in bed ?

Also increasing the need to go to the toilet more often when I am asleep, already having to visit it every 3 hours because of my enlarged, benign Prostate !

An Aldosterone Antagonist diuretic could be a better idea, also helping to stop my heart going into overdrive ?

I think I shall stick to doing what I am at the moment until my Dermatology specialist Dr. Clive Archer has seen me soon and gives me his Specialist advice an diabetes-2 related skin problems. (Was also useless and a waste of his high consultation fee !)
doctor
Answered by Dr. Benard Shehu (23 hours later)
Brief Answer:
Following answer to your query.

Detailed Answer:
Hi,

Based on the details you provided, further changes in your treatment are needed including to add Ranolazine.

Angiography is advised to evaluate the changes in heart blood vessels to determine if stent is needed. Coronary stenting is more effective in controlling chest pain.

Hope it was of help!
Dr.Benard
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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Suggest Treatment For Angina And Diabetes-2 Fluid Retention Problems

Brief Answer: Not due to cardiac issues;other specialists to get consulted... Detailed Answer: Hi XXXX, I have gone through your medical history and lab reports you provided carefully and understood your concerns. Let me summarize your medical history: - diabetic neuropathy - angina - chronic lymphoma - high liver enzymes suggesting for liver problems - lack of physical activity - functional renal failure - benign prostate adenoma All of them are making your fluid retention worse. Your case should be followed up by internal medicine specialist and not from cardiologist. All your problems are nothing to do with heart, but with other issues as mentioned above. If I was your caring doctor would advise to follow the advice as given by the nurse you are reporting together with scheduling cardiac physical activities like walking up to 15-30 min/day. Try to keep your legs raised when laying down by putting 1-2 cushions underneath from your buttocks to your feet. Leg's stocking are also advised to improve lymph and blood circulation in your legs. If all these measure doesn't help you should discuss with an internal specialist doctor to start water pill to deal with your problem. Hope it was of help! Dr.Benard