PCOS-MEDICATION Messages for January, 2002: Re: Diabetic Neuropathy....in response to Renee's answers..A big thank-you! from Barbra

Re: Diabetic Neuropathy....in response to Renee's answers..A big thank-you! from Barbra

From: Barbra (anonymous@obgyn.net)
Fri, 18 Jan 2002 18:17:29 -0600 (CST)

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At Fri, 18 Jan 2002, Renee wrote: >
>In layman terms, what I was saying is that because the problem is worse when
>your leg is down and gravity is pulling blood into your leg, it does not match
>the typical presentation of arterial (heart-to-extremities) problems. With
>arterial problems, having the leg down is good, since gravity pulls blood into
>the leg. Elevating it results in gravity pulling blood out of the leg, making
>it hurt more, and get very pale. This is not what happens to you, so arterial
>insufficiency (blood going into your leg) is probably not what you have.
>
>It seems to me that it sounds a lot more venous (blood coming out). Is your
>leg swollen? Is the skin and tissue under it on your lower leg firm and
>woody? Do you have a mottled rust/brown discoloration of your lower leg?
>Those are signs of more severe venous insufficency (blood coming out). That
>would match your description of what happens with elevation and putting it
>down. If they did a venous study, did they just look for clots (the typical
>study), or did they look at the direction of blood flow as well? They can do

Barbra's response to above:No,my legs aren't swollen,but I do get pitting edema in my ankles when sitting or standing,No the skin and tissue in my lower leg is not firm and woody.I don't have a mottled rust /brown discoloration of my lower leg/legs at all.They did do a venous study and they did look for direction of blood flow as well,unfortunately,I am not in posession of those records ..I guess I should ask for them.I am unsure if they looked for clots.HOnestly'I don't really know what they looked for,as I don't have the records and was told it was normal.I do know they stated "venous study" on the report that I had seen at my MD's office,as he tried to explain the results of the tests to me.Since the vascular surgeon said it was normal,I gather he didn't feel the need to explain things to me. You have given me a tremenous amount of advice,and with that,I think I will now be able to ask more questions and go in more informed ,and with questions,rather than just listen to them.Seems you know more about this that my MD does.

I assume,that the surgeon that I seen,;if he had seen anything really bad he would have sought out further investigations,as he was my grandmothers surgeon and she suffered with her one leg for over a decade before finally being diagnosed by him that she had no pulse in the leg,and without surgery;she may have had to have it amputated.I think it was actually that she had no pulse in the foot.Herfoot was so painful that she would cry.Her doctor at the time suggested using ice packs which was the worst for her condition.She is lucky now that she has had no problems with the artificial artery.

>that with a non-invasive test, but it's not what they usually look for with a
>"venous doppler" test; they usually just look for clots. If you haven't had a
>venous flow study, ask for it. You don't need varicosities to have venous
>insufficiency. And, moving your legs helps venous insufficiency, because
>moving your calf muscle helps the blood to only go up in the veins, not
>back-wash. It makes more sense as I think about it.
>

Please let me know what a Venous flow study is....I am certain that is what the doctor had sent me for.He did a test himself on me,as I had explained to you...testing me with having me constrict my hands and make fists,while he took my pulse rate etc.Checked the pulses on my feet and proved to be equivical on both.Strong pulses he had said.He also had his stethescope on my arteries in feet,legs and arms and hands.I am unsure of what he was looking for. This is the most advance Vascular lab here in Winnipeg.It is mainly for diabetics,or so,that is what I was told.Also,he looks for systemic disorders that would cause this,that is when I was referred to a rhematologist.

Although,I look strong,legs are muscular-my god-they are so weak.

It feels as if to me,that I am not getting any bloodflow to my muscles.After I do my excersing,which is so difficult,after a while;I limber up some and it becomes less weak and I feel better afterwards.It is as if I am helping the legs get proper blood flow by moving them.I even have a mini-stair stepper under my desk ,so that when I am on the computer;I can keep them moving,as to prevent them from pains.

>Have you seen a vascular surgeon (they deal with all vascular problems, not
>just the ones that need surgery)? I don't remember if that was on your list of
>docs seen. They might be able to determine the exact problem. It sounds
>circulatory to me.
>

Yes,I seen a vascular surgeon-he is the one that reccomended that I go to the vascular lab at the St.Boniface Hospital to rule out the above.Dr.Carter at the vascular lab is considered to be the best vascular surgeon around here. It sounds circulatory to me too.I don't quite understand the concept of why when I stand,they change colors,usually really red when I am warm and if I am cooler when standing,then they are blue or purple,so that may be why they say:"Raynauds",but my descriptions and their findings are not fitting with the diagnosis of any of these disorders.The clinical studies show/or so,I was told,that I don't present with venous/arterial insufficiency.I suppose they are still trying.They refer to my toess being "cyanotic".I have to then believe that this is from my connective tissue disorder(lupus},but certainly,there should be some relief from this.

Have you ever hear of anyone describing their pains as I do:"Pulsation,pulsing,like a toothache,as if I can feel the pulses in my legs a feet,especially upon standing,which is the worst for me.?Or,like nerve pains?I just cannot find that right desription to explain the feelings to them.I have to say,worst when legs are down,when sitting-I just don't know what do do with them.

Thank -you for your information,as it was most informative for me. Since I am not in possession of my medical records from the above tests;I think if would be wise for me to possibly go over them with my MD.But,seems as if when he did go over them with me;he was not comforable with the results of such.

I ask:"I told you about the tests with the ultrasound and then these blood pressure cuffs on,I was told it was Doppler test.When I had asked the tec what they were looking for,he said that it was to do with output and input/blood supply to my legs and of course he said he was not in the position to answer any questions,but he did tell me not to worry. As you may or may not know-I did have early signs of Heart Failure-EF was below fifty,now is 70 something and told that it is normal.But still,this is quite baffling to me,as I am a 40 year old presenting with symptoms of that of an 80 year old. I was told that I had poor cardiac output from one specialist.Then what would that mean?This is all too confusing and I am sorry for taking the time to ask about these problems that are not PCOS related-but since I do have PCOS,I think it may be wise to ask,as it there a possibility that some of these problems may be contributed to myself not being diagnosed with PCOS till a couple months agao,and some damage had been done?Or it may just be that I am a women with more than one health issue here. I came to this support goup,as I realized that this syndrome can cause all these diseases,especially diabetes,and I had insipidus that just cleared up once the medications were seized,but the other problems did not. I asssumed that since SLE lupus is different from medication induced lupus and that I often wonder.Since I was told that my lupus was induced from medications,it would be acceptable for one to agree,that my lupus should have corrected it'self upon discontinuing the meds and it has not.

So,one should only say,that anything is possible,in regards to illnesses induced by medications,Perhaps,I was just chemial sensitive,with an over taxed immune system to begin with,or I already had lupus at the beginning.

Big question here"ISIT NORMAL FOR ONE'S FEET TO CHANGE TO RED UPON STANDING/SITTING? Seems that when I present my legs to the doctors at times'they are just a nice reddish color that looks somewhat like a little sunburn,they do miss the purple at times.Last week while at the new specialist,even after all the tests for PCOS related hormonal problems,as I was undressed and sitting in the check-up bed,the doctor had asked me how long I had these discoloration problems in my feet and said to me that they were cyanotic,that would fit with a poor cardiac output....or maybehe said input...sorry,this is confusing to someone that does not even know how to spell all the medical terms out there.

Seems I don't fit with many of the symptoms at all.

Thanks for the time for reading my "book" Renee....you are most helpful!

I wish you were a doctor.......I feel better already just talking to somone that knows what they are talking about!

Tell me,what are the degrees that you have? Are you pre-doctoring?Can you prescribe meds? You had mentioned that you weren't a doctor,but one would tend to agree,that you certainly know your terminology and I commend you on that> Thanks again>>>((hug}}..sorry about the book!So many questions. >Renee
>
>Barbra Camara wrote:
>>
>> I'm with you that the gravity dependency is significant. That would
>> rule out arterial insufficiency (that gets pale with elevation, then
>> cherry/brick red upon lowering down below the heart, then it resolves a
>> little bit later. People with arterial insufficiency prefer their legs
>> dependent, because gravity helps blood flow. However, your description
>> of claudication (pain with walking) is consistent with arterial
>> insuffiency, where the pain is muscle being damaged because the blood
>> flow is not sufficient for metabolic need. Walking can improve
>> circulation through the development of new collateral circulation.
>> >
>>
>> Hi Renee,
>>
>> I am sorry-I still don't understand it.
>> You state that you possibly agree with the gravity dependency being
>> significant,which rules out arterial insufficiency.I am a bit
>> confused....so can you just elaborate a little.I am definitely not
>> familiar with this type of terminology when it comes to arteries and
>> veins.
>>
>> What I basically am asking advice on(in just plain laymen terms,,,,I'm
>> illiterate here,,,,lol!),is what do you think caused my legs and feet to
>> turn purple/blue upon standing or sitting?When I move my legs...the
>> color is normal.'
>{snip}
>
>--
>Renee Cordrey, MSPT, MPH, CWS
>
>---
>
>Don't follow in the footsteps of the masters. Seek what they sought.
> --Zen saying
>

--
Sincerely,
Barbra Camara

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In reply to: Renee: "Diabetic Neuropathy"
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