What Causes Leg Cramps When Diagnosed With Hypersensitivity Pneumonitis?
the bp, pulse and 02 fluctuating as much as it does such a short time, he needs to rest between bouts. when his bp drops below the normal mark and down to 80/40, his 02 sats drop into the upper 70th percentile! His pulse will drop into the 40bpm and when his bp sky rockets again, his 02 is now back in the 90th percentile on room air, however that's because his pulse will jump asp the way up to like 140bpm! Whenever his pulse gets super high (250+ bpm, my pulse ox machine doesn't go any higher), he becomes unresponsive, pale, cold, diaphoretic...all signs of a heart attack. The ER will give him like 4 doses of morphine to lower it then send him home without trying to figure out the cause! Yet they don't provide him with morphine to control this at home. this has been going on for over a year. his cardiologist says it's not her problem, we are in the middle of getting a second opinion referral done. Yet it scares me because he flips from being okay to full blown cardiac/pulmonary emergency. he does where 02 all the time. i do have to titrate him occasionally by bumping his 02 all the way up to 4L. I'm tired of the finger pointing going on between the doctors/specialists! i need a strong team that will work together. He's only 46! he shouldn't be having these sort of life issues! is there any place, besides the mayo clinic. that you know of who will be willing to make this a team effort since it obviously involves multiple organs? his dad passed away at the age of 52 due to heart valve failure. His mom passed away in her early 70s from complications of west Nile. it basically destroyed both kidneys. both parents were diabetic. when he has had the chest pain, I've checked his glucose levels using my dad's glucose meter and at fasting it's around 150ish. oh, one last symptom i forgot about. he has horrendous leg cramps at night that will wake him from a deep sleep and cause to have to get up and walk around or kick his legs around, bit nothing helps So i usually find him standing up and asleep while slumped over our livingroom chair. can these massive legs cramps have anything to do with anything listed here? thank you so much for your help so far. i respect a physician who doesn't get upset when either a patient or patient's family has medical knowledge. i may be retired now, however i did graduate with honors and as #1 in my class of over 500+ people. so i thank you for taking me seriously.
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that his symptoms seem to be related to Chronic obstructive pulmonary disease (copd) and acute exacerbation, like asthma.
That is why I would recommend consulting with a pulmonologist for a careful physical exam and some tests:
- a chest X ray study
- pulmonary function tests.
He may need to take bronchoodilators drugs with inhalation or steroids with inhalation in order to prevent or treat those episodes of cough (which are probably caused by the bronchial spasms).
Regarding his changes in the heart rate, they can be explained with the difficulty in breathing during those episodes.
But you should know that copd is often associated to changes in the heart function and structure. For this reason, I would like to directly review your cardiac ultrasound for a more professional opinion.
An ambulatory 24-48 hours ECG monitoring is necessary to examine his heart rhythm trends for a prolonged time and exclude possible cardiac arrhythmia.
Regarding his leg complaints, I would explain that his symptoms seem to be related to Restless Leg Syndrome.
For this reason, I would recommend consulting with a neurologist for a careful physical exam. Other tests are needed to investigate for the possible causes:
- a nerve conduction study to exclude possible polineuropathy
- complete blood count for anemia
- HbA1C for diabetes (especially considering the fact that his glucose is often borderline)
- blood electrolytes for possible electrolyte imbalance
- kidney and liver function tests.
You should discuss with his doctor on the above issues.
Hope to have been helpful!
Feel free to ask me again whenever you need!
Kind regards,
Dr. Iliri