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Question

Can I get Dr. Douglous who helped me yesterday?

Submitted: 43 days and 5 hours ago.
Category: Health
Value: $50
Status: CLOSED
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Posted by Dr. Douglas, MD, PLLC 43 days and 5 hours ago.

Answer

Hello,
I'm here.

43 days and 5 hours ago.

Reply

Ok, I am going to give a tip again but I have some things to go over again. I am very worried.

 

I went to my oncologist/hematologist who drew blood for his tests and a cardiolgist I saw. As I said, my cholesterol levels all went down since last year and my liver enzyemes that were high are all normal. Last year my internist checked me out with an ekg and blood work and said my leg,ankle mostly swelling was from weight gain and I never felt comfortable with that. Now, I have a 5.8 crp. The cardiolgist I saw a couple of weeks ago did an ekg, normal and said it was just probably veins not working great, I am 59 years old but my mother had the vein problem and ended up with congestive heart failure in her mid 80's and died from that. I have no problem breathing when exercising etc. but my crp has been under l.0 until last year when it was 1.1. Now it is 5.8 bt the oncologist just said over the phone everything was ok but the crp was high. Friday, I got a copy of the results and when I saw 5.8 I was concerned and talked with you.

 

My husband died 2 months ago and am under tremendous stress. I also have had a hight RA factor (24) but have had x-rays and no bone degeneration. I have googled all of this and it says it could be from my arthritis which only flares occasionally.

 

Could this be from stress, the 5.8, should I be worried. I am having an echo, vein test and think stress test on Tuesday. But I do not understand why all of the previous yea5rs when I was under stress and had a 24 RA factor which is high, why all of a sudden, everything is normal, liver, hdl 110, ldl, 91, trig 131, why is my crp 5.8. I have no trouble breathing and my oncolgist who I see to make sure my mgus does not turn into myeloma, says the swelling in my ankles mostly and some calf is from lack of exercise. I used to be an athlete and the last t hree years have been so depressed that I have not done a lot of exercising but have done some lately and no breathing problems. Can the xanax I am on for anxiety over my husband's death and was on it for about a year before cause this, or the arthritis be causing this???

43 days and 5 hours ago.

Reply

I am all alone handling everything since my husband's death and am totally stressed out, thought I should add this.

43 days and 5 hours ago.

Reply

Also, I sit at the computer for 12 hours a day so I was told that could bhe reason for the leg swelling but the cardiologist said I may just have bad veins and there is nothing to be done and he did not think it was serious. I also have had my thyroid removed years ago and am on levythroxine but all my thyroid tests were normal. Sorry for all of the questions, but I will give you a tip like yesterday.

Posted by Dr. Douglas, MD, PLLC 43 days and 5 hours ago.

Answer

Hello,
Like I said yesterday - given your CRP and other things you talked about - I had mentioned CHF - Congestive Heart Failure - now you might NOT have CHF at this point, but it is pointing in that direction given the swelling in your lower extremities. Yes, arthritis too - but - and like I said yesterday I mentioned an ECHO should be done and I see that you are doing this - GREAT!
Yes, swelling in the lower extremities can mean just about anything - but I would go with family history AND with what the ECHO says - and you might need to improve your cardiac function - and there are ways to improve that - such as exercise and even some medications.
Unlikely the xanax is causing this - but the xanax could be slowing your down - hence a change in medication that might give you more energy and to help you with the anxiety and depression would be a better choice and perhaps Welbutrin might be a better choice here - I have many on my patients on Welbutrin and this could help you. For the Arthritis - this could raise the CRP - but probably NOT alone to the 5 range especially since you are only 59 - and your levels of cholesterol - well the only thing I would correct would be the LDL - and here I would only change a bit - and a statin medication such as lipitor might be beneficial - and perhaps might even help with the possible CHF you have if you have some 'clogging' in your arteris around your heart - so depending on what your cardiogist says about the ECHO - ask about taking Lipitor and even ask about switching from Xanax to Welbutrin - you might see some major improvement here.

43 days and 5 hours ago.

Reply

So, you cannot say if I should be worried at this point. I don't know why my oncologist did not make more of an issue with this but maybe because he knows I am seeing a cardiologist. You don't think it is from the lack of exercise? HOw high can crp go to? Is 5.8 a really bad number. I know over 4 is not good. Sorry, but I am very axious. You don't think it could be from stress? The cardio did not think a statin would be good for me since my liver enzymes were elevated last year but the tests done a week ago were normal so I could take Lipitor?

Accepted Answer

Hello,
Actually, I would not be too concerned at this point - this is probably a combination of things from menopause, family genes, arthritis, possible start of CHF, depression/anxiety (YES, this can have EXTREME effects on people - hence why I recommended a change in medication), to changing cholesterol profile. So, the CRP number of 5.8 is really not that bad, and it is elevated. Also, CRP is still a VERY misunderstood number because it is NOT a VERY specific test like for example a pregnancy HCG test - WE KNOW if HCG is elevated you are pregnant - PERIOD. But, for CRP - there is NO specific diagnosis.
And you have have every reason to be anxious - but, try doing one thing at a time and do enjoy life - you have to - because if you concentrate on the 'other' things in life you will have no time to enjoy what life has to offer you. You are Still YOUNG - now start from there.
As far as the statins - if your liver enzymes are normal - they are okay to take - just follow the liver enzymes every 6 months or so.
I hope this helps, please take care.

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Expert: Dr. Douglas, MD, PLLC
Pos. Feedback: 98.2 %
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Answered: 10/10/2009

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Board Certified in 2 Medical specialties and US Medical School Graduate

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