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Avatar universal

Hep Tx and heart failure?

Howdy happy heppers!
Wow, its been a while since I've checked in on you all to see what everyone's up to...I'm from the 2008 treatment "brat pack" and still SVR I might proudly add!!! How is everyone?!?
Hey, a question for the "long timers"...Has anyone here ever been diagnosed with heart failure after finishing treatment? My Dr is suspicious that the chest pains that I had from the anemia during treatment (finally leveled out at HGB of 8.5 and HCT of 24.5 -no rescue drugs) may have been a sign the anemia was causing heart damage, possibly causing the signs I have of mild heart failure now...I keep thinking there must be another explanation for the palpitations and swelling in my lower legs, but as yet, haven't come up with anything...
Anyone have any input on this? -My liver biopsy was 1/1, so liver damage probably isn't the cause either...~MM
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Avatar universal
Hiya!
They use the process of elimination (i.e. lab rat approach)...They look at the symptoms and then go,"Hmmm, let's try this...)"LOL (I think my name should have been LabRat #457 LOL) For me, being compliant with (and increasing slightly) my calcium and magnesium supplements is what has decreased most of the symptoms...As my naturopath pointed out (when I was preparing for treatment) everything in the body is connected and each process's compensation robs from another so, if all processes are working in unison and have what they need to work without taking away from another process, then you will remain healthy. A simple yet complicated approach, eh? ~MM
Helpful - 0
250084 tn?1303307435
.....so, the levels of elemental magnesium and calcium show normal ranges in blood tests, the body isn't using it like it's supposed to......

How do they test for that, come to that conclusion??

And had to laugh on googling.....don't we all with post tx issues, lol.  You do have to be a chemist to figure out how to keep EVERYTHING in sync!
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Avatar universal
LOL I learned that one a long time ago. -It's one good way to freak yourself out! I'm grateful I have a pretty good medical knowledge base, but I still have to pay a Dr the "big bucks" to figure the more complicated stuff out. I don't miss my parathyroid gland that gave me so much trouble, but I'm glad you didn't have an unnecessary surgery for your issue! It's good to se you are on the mend! (((((((((((((((HUGZ))))))))))))~MM
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717272 tn?1277590780
Just went through a similar experience with blood chemistry being out of whack, causing all kinds of crazy symptoms and feeling terrible (low D leads to high PTH leads to high calcium leads to frequent urination leads to no sleep leads to.....you get the picture).   I just barely escaped going under the knife to have a gland unnecessarily removed.  Blood chem imbalances are slow and anxiety-provoking to work out. Glad they figured yours out.  Whatever you do, don't google your symptoms together!  
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Avatar universal
Thanks lady!
I've finally got to the bottom of what's going on...For some reason I'm not absorbing magnesium like I should (sigh...one more thing to monitor) so, the levels of elemental magnesium and calcium show normal ranges in blood tests, the body isn't using it like it's supposed to. So, I've been told to drink more water to act as a better "carrier" to my tissues, and to take a additional cal-mag supplement each night. It seems to be working! Less palpitations, less leg swelling, and the leg spasms are gone...-I guess it was just a matter of figuring out what's going on, eh? (Much better than heart failure! Whew!) (((((((((((HUGZ)))))))))) ~Melinda
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250084 tn?1303307435
Hi medicmommy! Good to 'see' you!

Although your cardiac test came out good (happy for you in that!)....
Here's a link that touches on that, also has some interesting info on ribavirin.

http://en.wikipedia.org/wiki/Ribavirin

"Well, I gave up belly dancing a long time ago because I was frightening small children and dogs"....
lol! Cute :)


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Avatar universal
Hiya! -Yah, I'm glad the cardiac stuff turned out well too...As for the swelling and palpitations, -they're still there. I've increased my mineral and vitamin supplements (or rather, am taking them religiously now rather than "whenever") and am drinking more water to see if it that helps. The persisting tingling everywhere and the fatigue is the most perplexing. Two Drs are still "chasing zebras" on that. My GP keeps leaning towards a perimenopausal cause (which I categorize as a "blow off" diagnosis like "anxiety") but, if that was the case, then it would respond to the supportive stuff that I've been doing. If nothing else, going though the Hep C treatment does make one aware (and just a bit paranoid) of bad ju-ju! Well, I figure this will either get worse, and the Drs will figure out what it is, or it will get better and life will go on. Either way, I'm done fretting over it. I won the Hep C battle and get a second chance at good health -life doesn't get much better than that! :) ~Melinda
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Avatar universal
Wow, Melinda, what a difference a week makes. A big relief to hear your good news but wasn't that a scary suspicion your first doctor had. Good that he was so concerned but quite the trip to put you through until you cleared it up.

Good going and diuretics don't make you go as often as that! Glad you won't need them, though.

So how are your palpitations and swelling now?

Best regards,

Susan

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419309 tn?1326503291
Yay! So glad that it's nothing serious -- glad you kicked some treadmill butt!
Happy exercising! ~eureka
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179856 tn?1333547362
OH man Mommy that is just the perfect news.......I'm sorry about the  edema but wow it's just SO much better! :)

Amazing how we self diagnose all our problems now and blame it on HCV and usually it's not even related.  Why did this disease make us so obsessive I'll never know or understand but boy I'm sure glad we are wrong - a LOT.

YAY!
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548668 tn?1394187222
Nice work Melinda - I suppose it pays for us all to keep those mineral checkups tagged onto our normal bloods for sometime after tx...... so glad to hear you found an 'fixable' cause not related to long-term damage (or the changed lifestyle you mentioned further up the thread)....
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Avatar universal
That's great news, Melinda.  Phew!  Glad to hear it.

jd
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Avatar universal
Hiya Happy Heppers!
Well, all cardiac studies are in, and I lasted longer on the treadmill than the cardiologist! He gave me good news...No heart failure, just too much stress and not enough minerals (calcium, magnesium and potassium) or water which was causing the leg edema and heart palpitations. And I need to get off my flabby rear end and exercise more (like I didn't know that already?!?) Sigh. Well, I gave up belly dancing a long time ago because I was frightening small children and dogs...Maybe I'll take up jogging...Hmm...:) ~Melinda
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Avatar universal
Hiya Susan!
Well, you can run, but you can't hide! MWA! HA! HA!
I'm holding out hope that the Dr is wrong, and my issues are being caused by something else...One thing I've learned about specialists...They chase a lot of "zebras" with the thought of "Hey, it looks like this!"...Its like the blind men and the elephant story..One feels a leg and thinks it looks like a tree, another feels the trunk and thinks it looks like a snake...The bottom line, -its an elephant and neither is correct...Yannow? :)
I'm so glad I was able to offer you a bit of insight on your thyroid issue. -I am glad I was able to "pay it forward" for the times when I was a treatment "newbie" and scared spitless when the sides started to hit. I hope all is well now...Take care and its nice to see you again! (((((((((HUGZ))))))))~Melinda
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Avatar universal
Hi Melinda,

This news caught me off guard. I'm on the run, leaving town, but when I get back I hope to hear more from you and follow your situation and insights about this.

I'm so really sorry to hear about this development but know with your upbeat attitude, you'll get to the bottom of it, not just for yourself but for others who are facing this.

Thank you for all the info you've so generously shared about thyroid and cardiac issues. You were a tremendous help for me when my heart used to pound and fly out the window during tx. I have no idea what's going on with my ticker these days but when I was worried, you stepped in to help in a big way, so thanks always.

xoxo
Susan
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Avatar universal
Thanks everyone! My cardiologist called and moved up my cardiac ultrasound to tomorrow and the treadmill for Monday..so, if the tests don't kill me first...LOL...I've done a bit more research, and unfortunately, congestive heart failure is among the rarer of the listed side effects...Oddly, the thing I'm dreading most, is the possibility of taking diuretics while working...I can see it now...I'll have to strap on a "wee bag" for the long patient transports and wear the "invisible" Depends for when I lift the fatties so I don't have "squitter accidents"... (How I envy guys sometimes for their "outdoor plumbing" and the conveniences it offers! LOL) such a wonderful thing to look forward to...It still beats dying from hepatic failure though...:o ~Melinda
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419309 tn?1326503291
I wonder if your doc's suspicions might be valid.  I can't answer your question directly, but a case in point -- my husband had a pre-existing heart condition, and during tx his hgb dropped fairly steadily.  His tx team missed reading a few blood tests -- to make a long story short, when his PCP and cardiologist got my husband's CBC copies in the mail, I understand they got together found out neither had been called upon to consult on the low hgb, and contacted hubby's tx team and read them the riot act.  Nurse actually called us (sounding VERY stilted and abashed) that his cardiologist/pcp demanded that hubby's hgb be allowed no lower than 10, and to transfuse if hematocrit got below 30 -- because any lower would mean 'unnecessary' work and stress on the heart and potentially dangerous.

A hematocrit of 24 is pretty low, Melinda -- I sure hope it's a recover phase and you can get back to feeling 100%, but definitely keep in close touch with your cardiologist until this resolves for you.  Hugs and best wishes to you. ~eureka
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179856 tn?1333547362
I'm sorry Mommy - my own mommy just recently suffered several heart attacks (they presented as indigestion and leg pain so we didn't realize it) and has heart failure so I pray to God you don't have it too. Although she is doing great now that they got her BP up she walks walks walks and takes her diuretic to get rid of the fluids.

She neven even had any heart pains at all that she knows of (well they were the indigestion pains but you know what I mean none of the stuff you see on tv).  

Has the doc put you on anything to help with the swelling?

I just wanted to mention this to make good and sure you were aware of it because certainly, we were not.

I don't know anything about anemia causing heart damage though - i had it for quite some time pretty seriously and am ok.  The only problem now I have is my cholesterol and damn trigylcerides..........which eventually could lead to failure on it's own.  Have yours been ok?
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Avatar universal
hey, since you are a medic, you may be sharper on this that I, but..... in the PDF I would look at lines;
Cardiovascular Disorders, lines 343 thru 349
Pulmonary Disorders, lines 408-415

Especially this;
Anemia, lines 448-466

I would then further research anemia.

Sorry, you originally posted that you were not on any rescue drugs (I asked in my 1st post).  If it is possible that anemia could have caused your current condition, is it possible that rescue drugs might have prevented it?  Was your anemia monitored closely and were appropriate actions taken?  I don't know the answer, but I hope that the PDF helps you.

best,
Willy
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Avatar universal
Here it is;

http://www.gene.com/gene/products/information/pegasys/  

go to the very bottom of the page to the hyperlink;
"full prescribing information"

That will provide you with a PDF to download.  Check that out.

best,
Willy
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Avatar universal
Thanks! I used the SOC peg/ Copeg (ribavirin/ interferon alpha 2a) mix for 24 weeks. I remember reading every fine detail on possible side effects, but I don't recall heart failure issues being one of them for long-term...I do remember listed risks of heart attack, stroke, death, suicide, autoimmune issues, ect. (lovely, eh?) listed however...But, I was one of the "weird ones" for sides...The interferon caused thyroiditis and a resulting thyroid storm (is what the Dr thought caused the chest pains because of the stress combined with the high heart rate and the anemia) but I wasn't put on rescue drugs because my anemia plateaued and the thyroid was still ticked off...I'll keep digging as well in the hopes there is another explanation for the symptoms...Thanks for your reply! ~MM
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Avatar universal
I would do a search on this board and then broaden it.  Below is one such post;
http://www.medhelp.org/posts/Hepatitis-C/Heart-probs-during-and-after-treatment-/show/86380

Also, when you had anemia, were you put on any rescue drugs?  I believe the rescue drugs can also contain some risk for pulmonary issues, especially when improperly used.  

I believe that the current TX may have some potential for such issues.  I would double check the list of warnings.  By visiting the site of the drug company (I don't know which Peg you took) you can find more detailed information.  Several months back I posted a link by a company that was for the prescribing doctors that was quite detailed and offered more detail and information than is provided to us that treat.

LOL; one of those deals where you don't know if you can find the same link or page again, but I know it is in my back posts and maybe I will take a look later and post it.  Whether it may contain a part of an answer I don't know but some use of a good search engine should.

best,
Willy
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