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Avatar universal

not sure what to do next

Hi, I am a 48 year old female with a major chronic health situation that is debilitating, however, I have been unable to find a cause or cure.  
Stats are: I am obese-about 90 lbs overweight and have been so all of my life without any health repercussions.  I did have a gastric stapling procedure 30 years ago and lost a great deal of weight which gradually came back.  
I am diagnosed asthmatic, mostly controlled with daily Advair.
During a hospital stay for asthma, I  had an echo which showed a grade 1 diastolic dysfunction.  Even though I had +2 edema in my ankles, nobody even mentioned the DD until my doctor eventually read the report when he couldn't' figure out the edema.  I was treated with Lasix and told it wasn't really a big deal and there was no suggestion of following up with a cardiologist.
My health after that seemed to rebound and I was fine for a couple of years. 4 months ago, I was laid off from my job of 13 years and have suffered some moderate depression for which I was treated.  I am very sedentary and in the last 3 months I have become almost immobilized by muscle weakness and extreme shortness of breath (no wheezing or asthma like symptoms) on mild exertion.  I am fatigued much of the time.  At least one day per week, I suffer from chills and headache so intense that I sleep all day.
I have been tested for everything including epstein barr, h pylori, anemia, thyroid..etc.  all of it. Everything was normal except a significantly low b12 for which I am being treated with intranasal spray (i cannot absorb the vitamins).  
Let me say that I have had b12 deficiency before and pernicious anemia but never felt as sick as I do now.  Also, I have been treated for several weeks now with no reduction in symptoms.  
I am wondering if I am in heart failure?   Recent trip to pulmonologist showed my lungs in great shape.  
I am just very weak and sob and cannot walk up 3 stairs without great effort.  Please help
2 Responses
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1884349 tn?1353814998
MEDICAL PROFESSIONAL
Hello and welcome to the forum.

First, I am sorry to hear about your struggles. I imagine this has been extremely difficult for you.

Second, I also suspect that some of your symptoms may be physical manifestations of depression.  This is a very real concept and affects millions of people---you have many reasons to be depressed and you also might have a tendency for depression in the first place.  Bottom line, regardless of the other medical conditions, please do everything you can to ensure that you are addressing this with a psychiatrist that you trust.

Finally, it is difficult for me to tell you whether you do/dont have a "component" of congestive heart failure.  You may though.  Being overweight for many years along with other conditions can over time result in mild forms of heart failure.  But often these are fairly easily managed with diuretics, weight loss (I know, easier said than done), blood pressure control, etc etc.  I would start by seeing a cardiologist (again, one who you trust and are confident in) and allow he/she to take it from there.  Depending on when your last echocardiogram was, it may be reasonable to repeat it.  Checking a "BNP" blood test can sometimes help as well.

Hope this helps and that you begin to feel better soon.

Best,

Dr. Rich
Helpful - 1
Avatar universal
Thank you so much for your words.  Many people who know me have suggested that depression and inactivity may be a big cause of my problems but it is difficult to believe that depression would make me unable to walk up three steps without heaving for breath.  
I am being treated for depression and I do see a psychiatrist who is incredible (he diagnosed and treated my pernicious anemia).  
I just figured that my LVDD must have progressed.  My pulmo told me to take my Lasix whenever I begin to swell up. He said that it is hard on the kidneys and I shouldnt take it if not needed.    I do have some mild signs of edema in lower legs, I take a Lasix and it's gone.  
I will start with a cardiologist and then maybe an internist?  
Thanks again
Helpful - 0

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