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Medical Forum / General / Cardiology / July 2007update. saw my pulmonologist friday...
ok, so i saw my pulmonologist on friday. id had the appt. setup ahead of time from a couple of months ago. anyways, he saw the copy of my echo and said it looked good. i asked him about my PAS and he said "well, the cut-off is 25, but 27 isnt a big deal and it could be off either way by a couple numbers... and all your other tests dont confirm PH.." well, that makes no sense. because ive heard of many people have PAS's in the 60s and 80s, severe types and be able to pass all those pulmonary tests.. like the stress tests, 6 minute walks, PFT's, etc with flying colors. i passed all of mine. but still... those xrays and VQ results were odd. why on earth would it show retention an those prominent markings if something wasnt wrong? could this just be how my lungs are normally? when they did give me that inhaler during the PFT, i swear, i felt MUCH better and could get in an out more air. so he asked me about that and i said yeah, it did.. and he gave me this other stuff.. Advair.. the powder version, but it doesnt help whatsoever. so, im gonna see if he can re-order me the other stuff instead. he said its possible i could have some extremely mild version of asthma, but he doubted it. would a CT scan w/o contrast still be able to rule out interstitial lung involvement from something like Lupus or Scleroderma? (which they think i might have. i am TRYING to get an appt. with the rheumy. my old one freekin left the practice since the last time and im trying to find one nearby that i dont have to wait 2 months for an appt.) on my xrays and CT scan they didnt mention anything about pruning or anything with the blood vessels or anything regarding my pulmonary arteries. but here's my other main question... ***can lung blood pressure be very similar to systemic blood pressure in which it can elevate (within normal limits) and lower and not stay around the same number? without exercise? what other reasons, other than PH, could cause PAS's to raise to high normal levels like that? then again, my systemic blood pressure is weird.. it goes everywhere from 96/63 to 120/80 within one day with hardly any exercise or stress or whatever. maybe theyre right and i have some strange rheumotological vascular issue or hormonal thing effecting my blood vessels. like when my leg starts acting up around my period and the onset of all of this crap back in december around my period. thanks again! > ok, so i saw my pulmonologist on friday. id had the appt. setup ahead > of time from a couple of months ago. [quoted text clipped - 8 lines] > pulmonary tests.. like the stress tests, 6 minute walks, PFT's, etc > with flying colors. Your clinical history simply is not consistent with pulmonary hypertension. > i passed all of mine. but still... those xrays and VQ results were > odd. why on earth would it show retention an those prominent markings > if something wasnt wrong? could this just be how my lungs are > normally? It still remains possible that instead of something chronic like pulmonary hypertension, that you were having transient small pulmonary embolic events because you are hypercoagulable and were having thomblophlebitis in your legs. > when they did give me that inhaler during the PFT, i swear, i felt > MUCH better and could get in an out more air. so he asked me about [quoted text clipped - 3 lines] > possible i could have some extremely mild version of asthma, but he > doubted it. Folks with IR/PCOS tend to have exacerbation of what otherwise would be milder asthma. > would a CT scan w/o contrast still be able to rule out interstitial > lung involvement from something like Lupus or Scleroderma? (which they > think i might have. i am TRYING to get an appt. with the rheumy. my > old one freekin left the practice since the last time and im trying to > find one nearby that i dont have to wait 2 months for an appt.) Scarring of the lungs (increased interstitial markings) is a non- specific radiological finding that will not be helpful for diagnosing either lupus or scleroderma. > on my xrays and CT scan they didnt mention anything about pruning or > anything with the blood vessels or anything regarding my pulmonary > arteries. Then it is less likely you have pulmonary hypertension. > but here's my other main question... > [quoted text clipped - 3 lines] > what other reasons, other than PH, could cause PAS's to raise to high > normal levels like that? Small clots (PEs). > then again, my systemic blood pressure is weird.. it goes everywhere > from 96/63 to 120/80 within one day with hardly any exercise or stress > or whatever. maybe theyre right and i have some strange > rheumotological vascular issue or hormonal thing effecting my blood > vessels. like when my leg starts acting up around my period and the > onset of all of this crap back in december around my period. You may be more hypercoagulable around your periods when your PCOS acts up. > thanks again! You are welcome. Redirecting all thanks and praises to GOD so that we will both be that much more blessed (hungrier). Be hungry... be healthy... be blessed: http://HeartMDPhD.com/PressRelease Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist > It still remains possible that instead of something chronic like > pulmonary hypertension, that you were having transient small pulmonary > embolic events because you are hypercoagulable and were having > thomblophlebitis in your legs. could be very possible. just wish they had a better way of testing me to see if that is indeed the case. it would answer everything... and finally put a rest to this non-stop hell and worry. > Folks with IR/PCOS tend to have exacerbation of what otherwise would > be milder asthma. hmm. interesting. with asthma... i know usually they have attacks and all, but is it possible for someone to kind of feel like that all the time or 90% of the time? not severe, like gasping or wheezing.. just feeling kind of pressured in the lungs or strained? thats kind of what i feel a lot of the time. i dont end up coughing or wheezing or anything like that at all. just feels very "stressed" in there. like as if my lungs were muscles that were tense and sore from laying in the wrong position for a long time. > Scarring of the lungs (increased interstitial markings) is a non- > specific radiological finding that will not be helpful for diagnosing > either lupus or scleroderma. well, i meant could this be a sign of damage from my already known connective tissue disease? > > on my xrays and CT scan they didnt mention anything about pruning or > > anything with the blood vessels or anything regarding my pulmonary > > arteries. > > Then it is less likely you have pulmonary hypertension. yeah, even i saw them and they looked okay. > > but here's my other main question... > [quoted text clipped - 5 lines] > > Small clots (PEs). what else other than PE's? ive read on the net regular people mentioning having elevated normal PAS's too, like mine. > > then again, my systemic blood pressure is weird.. it goes everywhere > > from 96/63 to 120/80 within one day with hardly any exercise or stress > > or whatever. maybe theyre right and i have some strange > > rheumotological vascular issue or hormonal thing effecting my blood > > vessels. like when my leg starts acting up around my period and the > > onset of all of this crap back in december around my period. > You may be more hypercoagulable around your periods when your PCOS > acts up. isnt there also a type of a hormonal thing.. that can cause vasconstriction of the blood vessels? too little estrogen or too much.. or was it progesterones. i remember a doctor telling me something about this a very long time ago... and reading some things like that. god, its like ever since i got off the birth control pill for the PCOS, all of this stuff started. one after another. now that i think about it, i should have probably just stayed on it. even though it felt like it wasnt doing its job. i probably created a shock to my system by doing that. arent youo supposed to be weaned off the BCP's? i just pretty much just took myself off of them cold turkey. i was on them for 9 years just about. eek. > > It still remains possible that instead of something chronic like > > pulmonary hypertension, that you were having transient small pulmonary [quoted text clipped - 4 lines] > to see if that is indeed the case. it would answer everything... and > finally put a rest to this non-stop hell and worry. The answer to everything will not come from better ways of testing you but from GOD. HE is the Source of that peace that ends all worry and gives rest to the weary. It is HIS peace that surpasses all worldly understanding. Ask HIM to help you... receive HIM into your heart... and you will receive HIS peace. May HE touch your heart to let you know this: http://www.interviewwithgod.com/forgiven/ > > Folks with IR/PCOS tend to have exacerbation of what otherwise would > > be milder asthma. [quoted text clipped - 3 lines] > time or 90% of the time? not severe, like gasping or wheezing.. just > feeling kind of pressured in the lungs or strained? That heaviness is common for folks with IR/MetS/PCOS. > thats kind of what i feel a lot of the time. i dont end up coughing or > wheezing or anything like that at all. just feels very "stressed" in > there. like as if my lungs were muscles that were tense and sore from > laying in the wrong position for a long time. It is likely that you are feeling the inflammation that is happening because of the pro-inflammatory cytokines coming from your visceral adipose tissue (VAT). > > Scarring of the lungs (increased interstitial markings) is a non- > > specific radiological finding that will not be helpful for diagnosing > > either lupus or scleroderma. > > well, i meant could this be a sign of damage from my already known > connective tissue disease? Yes. > > > on my xrays and CT scan they didnt mention anything about pruning or > > > anything with the blood vessels or anything regarding my pulmonary [quoted text clipped - 16 lines] > what else other than PE's? ive read on the net regular people > mentioning having elevated normal PAS's too, like mine. Elevated left ventriculular end-diastolic pressures from a stiff left ventricle. Folks with IR/MetS/PCOS have stiff left ventricles. > > > then again, my systemic blood pressure is weird.. it goes everywhere > > > from 96/63 to 120/80 within one day with hardly any exercise or stress [quoted text clipped - 17 lines] > i just pretty much just took myself off of them cold turkey. i was on > them for 9 years just about. eek. Your risk of thrombophlebitis was higher while you were on BCPs. Be hungry... be healthy... be blessed: http://HeartMDPhD.com/PressRelease Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist > That heaviness is common for folks with IR/MetS/PCOS. wouldnt that be from problems with weight.VAT issues, though? i am very thin walled and thin in general. > It is likely that you are feeling the inflammation that is happening > because of the pro-inflammatory cytokines coming from your visceral > adipose tissue (VAT). what would they normally do to treat this other than losing VAT? say i it was caused by somethng other than VAT? > > well, i meant could this be a sign of damage from my already known > > connective tissue disease? > > Yes. but most likely its nothing serious, or enough to cause PH, right? > Elevated left ventriculular end-diastolic pressures from a stiff left > ventricle. but they said all my pressures appeared perfect on that end? and wouldnt a 'stiff heart' show up on an echo? could a stiff heart be what they're seeing as LVH on the EKG all the time? > Folks with IR/MetS/PCOS have stiff left ventricles. never heard of that. how would they go about treating such a thing? since PCOS is extremely hard to control but, to help along with the patient's own personal lifestyle changes? medications? or can it reverse itself if everything becomes stable? > Your risk of thrombophlebitis was higher while you were on BCPs. yeah... during the first few years of being on the pill, though.. i was in the best of shape. everything felt more serene inside my body. but i think in the end, i did need a break off the stuff for a while, but didnt know exactly how to safely do this or what else to go on. the doctor was leery about alot of the other stuff and i was hearing conflicting things. but when a woman is on the pill, it tricks her body into thinking its pregnant, in other terms.. and when i went off of it, it could have been a real shock to my system and hormones and resulted in some crazy post-partum-like health decline. or triggering other conditions that were lying more dormant previously. im always hearing about things like this after women stop HRT and after they give birth. anyways, my cardiologist called me up around lunchtime and to let me know the echo came back just fine. i asked him about the pressures.. he just said it was a high normal.. their system is 15(20-30). i asked if he thought i might still have some PS and he said no, because the lung pressures were normal, but.. couldnt i still have a mild type of PS and its just slightly elevating them? also, like when im at the doctors.. and they listen to my lungs and ask me to keep taking deep breaths.. and let it out. when doing that, i get a really weird feeling in my head like as if i was out of oxygen. wtf is this? > > That heaviness is common for folks with IR/MetS/PCOS. > > wouldnt that be from problems with weight.VAT issues, though? i am > very thin walled and thin in general. It seems to be coming from the inflammation that is being promoted by the VAT. For some folks, even a few ounces of VAT is too much. > > It is likely that you are feeling the inflammation that is happening > > because of the pro-inflammatory cytokines coming from your visceral > > adipose tissue (VAT). > > what would they normally do to treat this other than losing VAT? say i > it was caused by somethng other than VAT? With steroids. > > > well, i meant could this be a sign of damage from my already known > > > connective tissue disease? > > > > Yes. > > but most likely its nothing serious, or enough to cause PH, right? Can't reassure you here. > > Elevated left ventriculular end-diastolic pressures from a stiff left > > ventricle. [quoted text clipped - 4 lines] > could a stiff heart be what they're seeing as LVH on the EKG all the > time? The LVH on the EKG with no LVH on echocardiogram would be explained by your having very little subcutaneous adipose tissue (SAT). > > Folks with IR/MetS/PCOS have stiff left ventricles. > > never heard of that. how would they go about treating such a thing? By helping you lose your VAT. > since PCOS is extremely hard to control but, to help along with the > patient's own personal lifestyle changes? medications? or can it > reverse itself if everything becomes stable? It tends to reverse when you become healthier by losing your VAT. > > Your risk of thrombophlebitis was higher while you were on BCPs. > [quoted text clipped - 19 lines] > because the lung pressures were normal, but.. couldnt i still have a > mild type of PS and its just slightly elevating them? Would defer to the cardiologist who has examined you and has told you "no." Be hungry... be healthy... be blessed: http://HeartMDPhD.com/PressReport Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist since the EKG probably was an obvious false positive for LVH, could it also apply to the right heart issue as well? but what about that whole inverted st-t wave? i still cant get over that. its been on every single EKG. well, they didnt do a repeat EKG this last time though. might not even be there now for all i know. > since the EKG probably was an obvious false positive for LVH, could it > also apply to the right heart issue as well? but what about that whole > inverted st-t wave? i still cant get over that. its been on every > single EKG. well, they didnt do a repeat EKG this last time though. > might not even be there now for all i know. Actually, acute changes during the setting of acute symptoms would not be a false positive for a chronic problem like LVH but may rather be a true positive for the acute event (ie PE) in your case. Be hungry... be healthy... be blessed: http://HeartMDPhD.com/PressRelease Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist |
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