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It Started With Swelling Ankles And Feet With Blisters On
Question: It started with swelling ankles and feet with blisters on my toes. blisters would go away and come back. now blisters are gone but swelling somewhat comes and goes but never completely goes away. Had weight gain about 1lb. per day for about 2 weeks. started getting out of breath easily with bloated abdomin. irregular bowel movements. had CBC all came back in the normal range except MONO which was 1.38 10*9/L. CMP details were normal but BUN value was 23mg/dl, Calcium 10.3 mg/dl, ANION GAP 13meq/L. TSH value 4.450 m(iu)/L. Lipid Panel Cholesterol 211mg/dl LDL 143mg,/dl. Non-HDL cholesterol 166mg/dl rheumatoid factor screen value negative. CT Heart calcium scoring over 600. GFR score of 95. currently I also have been sweating from the back of my neck while the rest of my body is chilly. approx. 15 years ago my tryglycerides were over 7400. yes 7400 they are normal now.
Brief Answer:
Please refer to the detailed answer below
Detailed Answer:
Hello
After reviewing the medical details provided by you I can understand your concern for your health and I would like to tell you that you have multiple health issues which require multidisciplinary approach of specific medical specialties.
High BUN levels means there is kidney injury which could be the result of high blood pressure or diabetes or both. Your TSH levels are towards the higher side which could be the cause of your weight gain as well as lack of adequate physical activity also promotes weight gain. Your lipid profile is still slightly on the higher side.
All these are the risk factors for cardiovascular disease and having a calcium score of 600 means probability of coronary artery disease will be high.
I would like to suggest you to kindly consult a cardiologist personally as some basic cardiac tests like ecg, BNP, and echocardiogram will be required. The cause of constant swelling in your feet could also be the result of weakened pumping capacity of your heart.
I hope this information will guide you properly.
Kind Regards
Please refer to the detailed answer below
Detailed Answer:
Hello
After reviewing the medical details provided by you I can understand your concern for your health and I would like to tell you that you have multiple health issues which require multidisciplinary approach of specific medical specialties.
High BUN levels means there is kidney injury which could be the result of high blood pressure or diabetes or both. Your TSH levels are towards the higher side which could be the cause of your weight gain as well as lack of adequate physical activity also promotes weight gain. Your lipid profile is still slightly on the higher side.
All these are the risk factors for cardiovascular disease and having a calcium score of 600 means probability of coronary artery disease will be high.
I would like to suggest you to kindly consult a cardiologist personally as some basic cardiac tests like ecg, BNP, and echocardiogram will be required. The cause of constant swelling in your feet could also be the result of weakened pumping capacity of your heart.
I hope this information will guide you properly.
Kind Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for your reply and suggestive diagnosis. Fact remains, every diagnostic impression received so far, all doctors point to cardiology,arteriosclerosis,pilkmonary fibrosis,coronary disease, RASCKD and so on. SO I read and I read to find which is the closest to these symptoms of mine for two months. Just like I was afreak of nature 15 yrs ago with a 7482 LDL try. level. Then with proper cholesterol meds from an Endo. internal specialist and Omega 3, 4000 t0 2000's to 800's and then ultimately normal where they shouldbe taking only Finofibrate.
So these new doctors last Nov witched my BPmeds from Losartan after Id changed from Lisoopril which caused the dry cough. Id asked for Losartan if it didn't cause thecough. They prescribed 3-4 different BPs all of which I no longer take feeling they contributed to my weird body changes since?
Again, I read into what meds cause the calcium build up. Id also been taking aleeve for years treating osteoarthritis in my fingers and carpul tunnel I my wrists, which could also affect it? More to come.
So these new doctors last Nov witched my BPmeds from Losartan after Id changed from Lisoopril which caused the dry cough. Id asked for Losartan if it didn't cause thecough. They prescribed 3-4 different BPs all of which I no longer take feeling they contributed to my weird body changes since?
Again, I read into what meds cause the calcium build up. Id also been taking aleeve for years treating osteoarthritis in my fingers and carpul tunnel I my wrists, which could also affect it? More to come.
Con'd..., so none of these diagnosis include the SWELLING of the ankles tops of feet and the blisters ontop each toe when it all started 2 months ago.
So, share with me your opinion. I don't have insurance, If I have to pay to see another specialist I think a pulmonolgist rather than cariologist as my next appointment. To review the diagnosis I find to be the closest to what I have and why it has been so hard to diagnose. Tell me what you think because I need to change tomorrows appointment online tonight if you agree.
Cardiac Sarcoidosis.
Thank you, Dorry XXXXXXX
So, share with me your opinion. I don't have insurance, If I have to pay to see another specialist I think a pulmonolgist rather than cariologist as my next appointment. To review the diagnosis I find to be the closest to what I have and why it has been so hard to diagnose. Tell me what you think because I need to change tomorrows appointment online tonight if you agree.
Cardiac Sarcoidosis.
Thank you, Dorry XXXXXXX
Brief Answer:
Hello again
Detailed Answer:
As I already said in your case you will be requiring the help of different specialists due to multiple abnormalities.
Heart failure is a very important cause of long standing ankle edema. Now as the skin over the legs are exposed intercellular fluid for a long time due to which it become fragile leading to blisters and also become highly susceptible to infections.
Long term use of pain killers also affects kidney function ultimately leading to fluid accumulation and swelling.
Also I would like to know about your blood sugar level status. Have you ever done your HBA1C in past, if yes kindly let me know the report.
You have to understand that it’s not a one man show any more. Better is to consult your primary physician first with all your records and let him decide what’s best for you.
Hopefully this will help.
Kind Regards
Hello again
Detailed Answer:
As I already said in your case you will be requiring the help of different specialists due to multiple abnormalities.
Heart failure is a very important cause of long standing ankle edema. Now as the skin over the legs are exposed intercellular fluid for a long time due to which it become fragile leading to blisters and also become highly susceptible to infections.
Long term use of pain killers also affects kidney function ultimately leading to fluid accumulation and swelling.
Also I would like to know about your blood sugar level status. Have you ever done your HBA1C in past, if yes kindly let me know the report.
You have to understand that it’s not a one man show any more. Better is to consult your primary physician first with all your records and let him decide what’s best for you.
Hopefully this will help.
Kind Regards
Above answer was peer-reviewed by :
Dr. Kampana
I will get back to you with the sugar levels. Diabetes and CKD or RAS has been ruled out. Guess you didn’t see my question on pulmonary edema or sarcoidosis?
I don’t wanna be rude but If I had money to spend on multi man/woman specialist docs would I be spending 35!bicks I don’t have to spare, trying to get a complete answer and diagnosis on your site? Guess you’re not allowed to commit and give an actual diagnosis. Not diagnosing That I need to have specialists diagnose. I went to you as a doctor to do exactly that. What do you medically provide! Advice? Well Thanks for that. I appreciate it very much .
I don’t wanna be rude but If I had money to spend on multi man/woman specialist docs would I be spending 35!bicks I don’t have to spare, trying to get a complete answer and diagnosis on your site? Guess you’re not allowed to commit and give an actual diagnosis. Not diagnosing That I need to have specialists diagnose. I went to you as a doctor to do exactly that. What do you medically provide! Advice? Well Thanks for that. I appreciate it very much .
Brief Answer:
Hello again
Detailed Answer:
With all due respect the doctors here are not here for the money, they are guiding the patients like you and spending their valuable time because they love their profession and like serving people like you.
But on the other hand you have you understand that treating patient is not like reading a novel and it involves physically examining the patients also which is an integral part of treatment. I understand you have financial issues that’s why is suggested you to go to a primary physician first.
And yes this portal is just for second opinions and guidance and not for primary or full fledged treatment.
PLEASE ask for your REFUND and spend it by taking an appointment of your doctor.
Best Regards
Hello again
Detailed Answer:
With all due respect the doctors here are not here for the money, they are guiding the patients like you and spending their valuable time because they love their profession and like serving people like you.
But on the other hand you have you understand that treating patient is not like reading a novel and it involves physically examining the patients also which is an integral part of treatment. I understand you have financial issues that’s why is suggested you to go to a primary physician first.
And yes this portal is just for second opinions and guidance and not for primary or full fledged treatment.
PLEASE ask for your REFUND and spend it by taking an appointment of your doctor.
Best Regards
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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