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Swelling?
I've had problems with swelling of my hands and ankles and it has gotten progressively worse over the years. Anyone else have this problem? I realize it may not be related to HepC at all and I may have other health issues, my family history doesn't indicate any problems with or related to swelling. I will be making yet another appointment with yet another doctor but right now I'm wondering if anyone else deals with swelling and what you have found out about it? My doctor gives me Lasix and Spironolactone. Oh, my last biopsy showed Stage 0 Grade 2 and that was in 2008. In 2005 I had a bx and it showed Stage 1 Grade 2. All other blood work has been within the normal ranges.
Yes the Spironolactone and Lasix are used together to keep the sodium and potassium levels in balance. So that is the right thing to do.
Diuretics, especially long term use, can damage your kidneys and lead to edema.
Sounds like a good plan. UC Davis med center. They should be able to tell you what is going on.
I know you don't have ascites but here is some good info on the diuretics.
First-line diuretic therapy for cirrhotic ascites is the combined use of spironolactone (Aldactone) and furosemide (Lasix). Beginning dosages are 100 mg of spironolactone and 40 mg of furosemide by mouth daily. If weight loss and natriuresis are inadequate, both drugs can be simultaneously increased after 3 to 5 days to 200 mg of spironolactone and 80 mg of furosemide. To maintain normal electrolyte balance, the use of the 100 : 40 mg ratio of spironolactone to furosemide is generally recommended. Maximum accepted dosages are 400 and 160 mg/day of spironolactone and furosemide, respectively.
The response to diuretics should be carefully monitored on the basis of changes in body weight, laboratory tests, and clinical assessment. Patients on diuretics should be weighed daily; the rate of weight loss should not exceed 0.5 kg/day in the absence of edema and should not exceed 1 kg/day when edema is present. Serum potassium, blood urea nitrogen (BUN), and creatinine levels should be serially followed. In the event of marked hyponatremia (sodium concentration in the serum is lower than normal), hyperkalemia 9concentration of the electrolyte potassium (K+) in the blood is elevated) or hypokalemia (concentration of potassium (K+) in the blood is low), renal insufficiency, dehydration, or encephalopathy, diuretics should be reduced or discontinued.
Let us know what you learn.
Good luck to you.
Hectorsf
Diuretics, especially long term use, can damage your kidneys and lead to edema.
Sounds like a good plan. UC Davis med center. They should be able to tell you what is going on.
I know you don't have ascites but here is some good info on the diuretics.
First-line diuretic therapy for cirrhotic ascites is the combined use of spironolactone (Aldactone) and furosemide (Lasix). Beginning dosages are 100 mg of spironolactone and 40 mg of furosemide by mouth daily. If weight loss and natriuresis are inadequate, both drugs can be simultaneously increased after 3 to 5 days to 200 mg of spironolactone and 80 mg of furosemide. To maintain normal electrolyte balance, the use of the 100 : 40 mg ratio of spironolactone to furosemide is generally recommended. Maximum accepted dosages are 400 and 160 mg/day of spironolactone and furosemide, respectively.
The response to diuretics should be carefully monitored on the basis of changes in body weight, laboratory tests, and clinical assessment. Patients on diuretics should be weighed daily; the rate of weight loss should not exceed 0.5 kg/day in the absence of edema and should not exceed 1 kg/day when edema is present. Serum potassium, blood urea nitrogen (BUN), and creatinine levels should be serially followed. In the event of marked hyponatremia (sodium concentration in the serum is lower than normal), hyperkalemia 9concentration of the electrolyte potassium (K+) in the blood is elevated) or hypokalemia (concentration of potassium (K+) in the blood is low), renal insufficiency, dehydration, or encephalopathy, diuretics should be reduced or discontinued.
Let us know what you learn.
Good luck to you.
Hectorsf
Yeah I was told to stay away from salt and I was given the Lasix years ago with Klor-con as my potassium supplement. My doctor retired and this newer doctor that I have now, gave me the Lasix but wouldn't give me the Klor-con because he said my blood work doesn't show that I'm deficient from potassium. I told him that I didn't want it because I'm deficient, I told him that it forced me to drink more water and thereby let the Lasix work better. I am terrible when it comes to drinking water!! I tried my other doctor (Gastro) and he prescribed the Spiro because he said it was a potassium sparing direutic and may help. I figure if I start seeing a doctor who is hooked up with UC Davis med center I'll be better off and hopefully I can find out why my system is sooo clogged up.
Good info from Hector, as usual. I think it’s important to underscore that edema might be a yellow flag to a serious underlying issue that requires attention; simply wringing you out with diuretics will unlikely cure whatever caused it to begin with.
Good luck—
Bill
Good luck—
Bill
Fret,
How bloated are you? If you press on the swollen area does it slowly rise back up but with a mark where you pressed. Is is called pitting.
Why does your doctor give you Lasix and Spironolactone? Did they say? I don't know how much you are taking, but you can increase the dosage of both meds and that should get rid of any edema you have. I take 200mg of Spiro and 80 of lasix. I find it takes about 2 weeks for the chance in fluid retention to take place.
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Edema occurs when tiny blood vessels in your body (capillaries) leak fluid. This leakage can result from damage to or increased pressure in the capillaries, or from lowered levels of serum albumin, a protein in your blood. When your body senses the capillaries are leaking, your kidneys begin to retain more sodium and water than normal to compensate for the lost fluid from your blood vessels. This increases the amount of fluid circulating through your body, which causes the capillaries to leak more. The fluid from the capillaries leaks into the surrounding tissue, causing the tissue to swell.
Are you eating a lot of salty food? It will override the benefits of the diuretics if you ingest too much sodium.
Diseases and conditions that may cause edema include:
Congestive heart failure. When one or both of your heart's lower chambers loses its ability to pump blood effectively — as happens in congestive heart failure — the blood can back up in your legs, ankles and feet, causing edema.
Kidney disease. When you have kidney disease, your kidneys may not be able to eliminate enough fluid and sodium from your blood. The extra fluid and sodium increases pressure in your blood vessels, causing edema. Edema associated with kidney disease usually occurs in your legs and around your eyes.
Kidney damage. Damage to the tiny blood vessels in your kidneys (glomeruli) that filter waste and excess water from your blood can result in nephrotic syndrome. One result of nephrotic syndrome is low levels of protein (albumin) in your blood, which can lead to fluid accumulation and edema.
Inadequate lymphatic system. Your body's lymphatic system helps clear excess fluid from tissues. If this system is damaged — either due to lymphedema that occurs on its own (primary lymphedema) or because of a disease or medical condition, such as cancer or an infection (secondary lymphedema) — the lymph nodes and lymph vessels draining an area may not work correctly and edema results.
Fret, I would check with your doctor to see what he thinks is the underlying cause and why he is prescribing the diuretics. Could be something serious so you should check it out.
Do you have any recent blood tests with albumin, creatinin,sodium, etc? A urinalysis? These tests should indicate what is going on.
Good luck. Keep us informed as to what you learn.
hectorsf
How bloated are you? If you press on the swollen area does it slowly rise back up but with a mark where you pressed. Is is called pitting.
Why does your doctor give you Lasix and Spironolactone? Did they say? I don't know how much you are taking, but you can increase the dosage of both meds and that should get rid of any edema you have. I take 200mg of Spiro and 80 of lasix. I find it takes about 2 weeks for the chance in fluid retention to take place.
--------------------------------------------------------------------------------------------------------------
Edema occurs when tiny blood vessels in your body (capillaries) leak fluid. This leakage can result from damage to or increased pressure in the capillaries, or from lowered levels of serum albumin, a protein in your blood. When your body senses the capillaries are leaking, your kidneys begin to retain more sodium and water than normal to compensate for the lost fluid from your blood vessels. This increases the amount of fluid circulating through your body, which causes the capillaries to leak more. The fluid from the capillaries leaks into the surrounding tissue, causing the tissue to swell.
Are you eating a lot of salty food? It will override the benefits of the diuretics if you ingest too much sodium.
Diseases and conditions that may cause edema include:
Congestive heart failure. When one or both of your heart's lower chambers loses its ability to pump blood effectively — as happens in congestive heart failure — the blood can back up in your legs, ankles and feet, causing edema.
Kidney disease. When you have kidney disease, your kidneys may not be able to eliminate enough fluid and sodium from your blood. The extra fluid and sodium increases pressure in your blood vessels, causing edema. Edema associated with kidney disease usually occurs in your legs and around your eyes.
Kidney damage. Damage to the tiny blood vessels in your kidneys (glomeruli) that filter waste and excess water from your blood can result in nephrotic syndrome. One result of nephrotic syndrome is low levels of protein (albumin) in your blood, which can lead to fluid accumulation and edema.
Inadequate lymphatic system. Your body's lymphatic system helps clear excess fluid from tissues. If this system is damaged — either due to lymphedema that occurs on its own (primary lymphedema) or because of a disease or medical condition, such as cancer or an infection (secondary lymphedema) — the lymph nodes and lymph vessels draining an area may not work correctly and edema results.
Fret, I would check with your doctor to see what he thinks is the underlying cause and why he is prescribing the diuretics. Could be something serious so you should check it out.
Do you have any recent blood tests with albumin, creatinin,sodium, etc? A urinalysis? These tests should indicate what is going on.
Good luck. Keep us informed as to what you learn.
hectorsf
Great, I appreciate the information and now I have more to work with when I go see this new guy who's hooked up with the Univ! With my PCP I get the impression that b/c I have HepC I only deserve substandard treatment and evaluations. Wish I could prove it but I guess I just have to let this one roll off my back and look for a new doctor.
I also experienced edema in my ankles; but not in my wrists as you report. My hepatologist felt that my liver wasn’t to blame, given that I’d SVR’d when the swelling was noted.
I was sent for a heart echo (ECG) to rule out right side heart failure, labs to determine if protein was spilling over into urine, which would have suggested kidney failure. Both of these were found to be negative, and most of the swelling is now gone. Oh, and they also ordered a U/S scan of my legs, to determine if clots had formed; the scan determined the veins were patent, so no problems there.
These are a few items I suppose you could discuss with the doctor; it sounds as though cirrhosis isn’t an issue with you at this point,
Bill
I was sent for a heart echo (ECG) to rule out right side heart failure, labs to determine if protein was spilling over into urine, which would have suggested kidney failure. Both of these were found to be negative, and most of the swelling is now gone. Oh, and they also ordered a U/S scan of my legs, to determine if clots had formed; the scan determined the veins were patent, so no problems there.
These are a few items I suppose you could discuss with the doctor; it sounds as though cirrhosis isn’t an issue with you at this point,
Bill
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