Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
This is a post I compiled in 2004, that somehow got deleted with the last LymeNet housecleaning. Many of us seem to be experiencing this disorder now, so I thought I would revive it.
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Edema and related disorders...
I know that edema is a common lyme symptom...many of us experience it for various reasons. What I did not know about edema has surprised me.
So, here is what I have discovered...and I am hoping that many of you will also add your experiences to this thread so we may all learn more.
Definition Peripheral edema is an abnormal buildup of fluids in ankle and leg tissues. See also swelling, overall.
Alternative names Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral
Considerations Painless swelling of the feet and ankles is a common problem, particularly in older people. It may affect both legs and may include the calves or even the thighs. Because of the effect of gravity, swelling is particularly noticeable in the lower legs.
When the swollen area is squeezed, the fluid will move out of the affected area and may leave a deep impression for a few moments.
Swelling of the legs is many times related to *systemic causes (for example, heart failure, renal failure, or liver failure).
*systemic... Systemic means "affecting the entire body," rather than a single organ or body part. For example, systemic disorders such as high blood pressure or systemic diseases such as influenza affect the entire body. An infection that is in the blood stream is referred to as a systemic infection. In contrast, an infection pertaining to one body part or organ is referred to as a localized infection.
Common causes * Long airplane flights or automobile rides * Menstrual periods (for some women) * Sunburn * Generalized allergy * Prolonged standing * Injury or trauma to the ankle or foot * Venous insufficiency (varicose veins) * Pregnancy (mild to severe swelling) * Environmental o Burns o Insect bite or sting o Starvation or malnutrition * Medical treatments o Body fluid overload o Infiltration of an IV site o Extremity surgery * Medications o Estrogens and progestin oral contraceptives o Blood pressure-lowering drugs o Certain antidepressants (such as Nardil) o Estrogen - oral o Long-term corticosteroid therapy o Nifedipine o Testosterone * Diagnostic tests o Venogram * Congestive heart failure * Glomerulonephritis or other kinds of kidney disorders
Home care Elevate the legs above the heart while lying down. Avoid sitting or standing without moving for prolonged periods of time. Avoid putting anything directly under the knees when lying down, and don't wear constricting clothing or garters on the upper legs.
Exercising the legs causes the fluid to work back into the veins and lymphatic channels so that the swelling goes down. Elastic bandages or support stockings can provide pressure to help reduce ankle swelling.
A low-salt diet may help reduce fluid retention and decrease the ankle swelling.
Call your health care provider if Call your health care provider if ankle swelling persists or worsens after the above measures have been taken.
What to expect at your health care provider's office
The medical history will be obtained and a physical examination performed.
Medical history questions documenting ankle, feet, and leg swelling in detail include the following:
* Location o What specific body part(s) swell? o Is there ankle swelling? o Is the whole foot swollen? o Is there swelling over the small bones of the feet? o Is there swelling of the toes? o Is the knee swollen? o Is the whole leg swollen? * Time pattern o Is the swelling always present? o Is it worse in the morning or the evening? * Aggravating and relieving factors o What makes it better? o Does the swelling go down when the legs are elevated? o What makes it worse? * What other symptoms are also present?
The physical examination may include emphasis on the heart, lungs, kidneys, and legs.
Diagnostic tests that may be performed include the following:
* Blood tests such as a CBC or blood chemistry (Chem-20) * ECG * Chest X-ray or extremity X-ray
The specific treatment will be directed at whatever underlying cause is found. Diuretics may be prescribed. These are effective in reducing the swelling but have some side effects. Home treatment for benign causes of leg swelling should be tried before drug therapy under medical supervision.
Definition Phlebitis is an inflammation of a vein; thrombophlebitis is vein inflammation related to a blood clot.
Alternative names Phlebitis
Causes, incidence, and risk factors Common causes of vein inflammation include local irritation (for example, because of an IV line), infection in or near a vein and blood clots.
See the specific disorders associated with thrombophlebitis:
* superficial thrombophlebitis (affects veins near the skin surface) * deep venous thrombosis (affects deeper, larger veins) * pelvic vein thrombophlebitis
Prevention Routine changing of intravenous (IV) lines helps to prevent phlebitis related to IV lines. See the specific disorders associated with thrombophlebitis for other preventive measures.
Symptoms The following symptoms are often associated with thrombophlebitis:
* tenderness over the vein * pain in the part of the body affected * skin redness or inflammation (not always present)
Signs and tests The health care provider makes the diagnosis primarily based on the appearance of the affected area. Frequent checks of the pulse, blood pressure, temperature, skin condition, and circulation may be required.
If the cause is not readily identifiable, tests may be performed to determine the cause, including the following:
Definition The lymph system is a network of organs, lymph nodes, lymph ducts, and lymph vessels that produce and transport lymph from tissues to the bloodstream. The lymph system is a major component of the body's immune system.
Information Lymph is a clear-to-white fluid made of: * chyle (fluid from the intestines after digestion that contains proteins and fats) * some red blood cells * many white blood cells, especially lymphocytes (lymphocytes are the cells that attack bacteria in the blood
Lymph nodes are small, bean-shaped, soft nodules. They are not usually visible or easily felt. They are located in clusters in various parts of the body, such as the neck, armpit, and groin.
Lymph nodes produce immune cells (such as lymphocytes, monocytes, and plasma cells). They also filter the lymph fluid and remove foreign material, such as bacteria and cancer cells. When bacteria are recognized in the lymph fluid, the lymph nodes enlarge as they produce additional white blood cells to help fight infection.
The organs within the lymphatic system are the tonsils, adenoids, spleen, and thymus.
*Lymphatic obstruction involves blockage of the lymph vessels, which drain fluid from tissues throughout the body and allow immune cells to travel where they are needed.
Alternative names Lymphedema
Causes, incidence, and risk factors There are many causes of lymphatic obstruction, which is also known as lymphedema (swelling of the lymph passages). These include certain infections ( for example, chronic cellulitis or parasitic infections such as filariasis), trauma, tumors, certain surgeries, and radiation therapy. In addition, there are rare forms of congenital (present from birth) lymphedema which probably result from abnormalities in the development of the lymphatic vessels.
In Western societies, one of the most common causes of lymphedema is mastectomy with axillary dissection (removal of the breast and underarm lymph tissue for breast cancer). This can cause lymphedema of the arm in 10-15% of patients. This occurs because the lymphatic drainage of the arm passes through the axilla (armpit), and tissue in the axilla has been removed during mastectomy.
Recurrent cellulitis, or infection of the skin, can damage lymphatic vessels and lead to lymphedema of the affected area. This is more commonly seen in obese patients.
Symptoms Chronic swelling, usually of the arm or leg, is the clinical hallmark of lymphatic obstruction.
Signs and tests Physical exam and history are most important for diagnosis. In some cases, lymphangiography may be performed. This involves injection of dye into lymphatic vessels followed by X-rays of the area.
Lymphangiography requires surgical isolation of the lymph vessels to be injected and is therefore a difficult procedure.
Lymphoscintigraphy is an alternative technique in which a radioactive substance that concentrates in the lymphatic vessels is injected into the affected tissue and mapped using a gamma camera, which images the location of the radioactive tracer. Lymphoscintigraphy is less invasive and more easily performed and is often used as a substitute for lymphangiography.
MRI is being explored as a means to image lymphatic vessels.
Definition The term "swollen glands" refers to enlargement of one or more lymph nodes. In a child, a node is enlarged if it is larger than one centimeter (0.4 inch) in diameter. See also lymphadenitis and lymphangitis.
Alternative names Swollen glands; Swollen lymph nodes; Swollen lymph glands
Considerations The lymphatic system is a complex network of thin vessels, valves, ducts, nodes, and organs. It helps to protect and maintain the fluid environment of the body by producing, filtering, and conveying lymph and by producing various blood cells.
The lymph system is present throughout the body. Common areas where the lymph nodes can be felt (palpable nodes) include:
* the groin area (inguinal region) * armpit (axilla) * the neck (there is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck) * under the jaw and chin * behind the ears * over the prominence on the back of the head (occiput)
Lymph nodes play an important part in the body's defense against infection. Swelling might occur even if the infection is trivial or not apparent. Swelling of lymph nodes generally results from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. By far, the most common cause of lymph node enlargement is infection.
As a rule, when swelling appears suddenly and is painful, it is usually caused by injury or an infection. Enlargement that comes on gradually and painlessly may result from malignancy or tumor.
Common causes * infectious o infectious mononucleosis (behind the ears or neck) o rubella also known as German measles (behind the ears) o tuberculosis (above the collar bone) o mumps (salivary glands) o ear infections or sore throat (neck glands, sometimes) o infection in the scalp (behind the ears or in back of the head) o impacted tooth (swollen gums) o HIV disease or AIDS * immune or autoimmune o juvenile rheumatoid arthritis o serum sickness o HIV disease * malignant o leukemia o Hodgkin's disease o non-Hodgkin's lymphoma * other o canker sores o drugs (such as phenytoin) o typhoid vaccination o salivary duct stones
Home care Soreness in lymph glands usually disappears in a couple of days without treatment. If the glands are painful, it is because of the rapid swelling of the gland in the early stages of fighting the infection. It takes much longer for the gland to return to normal size than to swell, so be patient.
Follow prescribed therapy, if appropriate, to treat the underlying cause.
Call your health care provider if * After several weeks of observation the glands don't get smaller. * Swollen glands are red and tender. * Swollen glands are hard, irregular, or feel fixed in place. * Swollen glands are located just above the collar bone. * Swollen glands are located behind the ear. * One or more glands get larger over a period of 2 to 3 weeks. * There are symptoms of fever, night sweats, or weight loss with swollen glands. * Nodes larger than 1cm in diameter in children should be followed by a physician. It should shrink noticeably within 4-6 weeks, and should be less than one centimeter within 8-12 weeks.
What to expect at your health care provider's office
Your medical history will be obtained and a physical examination performed. Medical history questions may include:
* location o Which node(s) are affected? o Is the swelling the same on both sides? * time pattern o When did the swelling begin? o How long has it lasted (how many months or weeks)? o Did it begin suddenly? o Did it develop gradually? o Is the swollen node increasing in size? o Is the number of nodes that are swollen increasing? * associated complaints o Is the node painful? o Is the skin over or around the node red? o Is the node tender when you gently press on it? * other o What other symptoms are occurring at the same time?
The physical examination may include pressing on many of the lymph nodes to look for size, texture, warmth, tenderness, and other features.
Diagnostic tests that may be performed include: * liver function tests and kidney function tests * CBC with differential * lymph node biopsy * chest Xray * liver-spleen scan
After seeing your health care provider:
If a diagnosis was made by your health care provider related to swollen lymph nodes, you may want to note that diagnosis in your personal medical record.
Definition Serum sickness is a group of symptoms caused by a delayed immune response to certain medications or antiserum (passive immunization with antibodies from an animal or another person).
Causes, incidence, and risk factors Serum is the clear fluid portion of blood. It does not contain blood cells, but it does contain many proteins, including antibodies, which are formed as part of the immune response to protect against infection.
Antiserum is a preparation of serum that has been removed from a person or animal that has already developed immunity to a particular microorganism. It contains antibodies against that microorganism.
An injection of antiserum (passive immunization) may be used when a person has been exposed to a potentially dangerous microorganism against which the person has not been immunized. It provides immediate, but temporary protection while the person develops a personal immune response against the toxin or microorganism. Examples include antiserum for tetanus and rabies exposure.
Serum sickness is a hypersensitivity reaction similar to allergy. The immune system misidentifies a protein in antiserum as a potentially harmful substance (antigen), and it develops an immune response against the antiserum.
Antibodies bind with the antiserum protein to create larger particles (immune complexes). The immune complexes are deposited in various tissues, causing inflammation and various other symptoms.
Because it takes time for the body to produce antibodies to a new antigen, symptoms do not develop until 7 to 21 days after initial exposure to the antiserum. Patients may develop symptoms in 1 to 3 days if they have previously been exposed to the offending agent.
Exposure to certain medications (particularly penicillin) can cause a similar process. Unlike other drug allergies, which occur very soon after receiving the medication for the second (or subsequent) time, serum sickness can develop 7 to 21 days after the first exposure to a medication. The drug molecules probably combine with a protein in the blood before being misidentified as an antigen.
Blood products may also induce serum sickness.
Serum sickness is different from anaphylactic shock, which is an immediate reaction with more severe symptoms.
Prevention There is no known way to prevent the development of serum sickness.
People who have experienced serum sickness, anaphylactic shock, or drug allergy should avoid future use of the antiserum or drug.
Note: The symptoms develop 1 to 3 weeks after exposure to antiserum or medication.
Signs and tests The lymph nodes may be enlarged and tender to palpation. The urine may contain blood or protein. Blood tests may indicate a vasculitis, or inflammation of the blood vessels.
Definition The immune response is the way the body recognizes and defends itself against microorganisms, viruses, and substances recognized as foreign and potentially harmful to the body.
The immune system protects the body from potentially harmful substances by recognizing and responding to so-called antigens. Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, or bacteria. Some non-living substances such as *toxins, chemicals, drugs, and foreign particles (such as a splinter) can be antigens. Substances that contain these antigens are recognized and destroyed by the immune system . Even your own body cells have proteins that are antigens (these include a group of antigens called HLA antigens). Your immune system learns to see these antigens as "normal" and does not usually react against them.
*toxins... Substances that are created by plants and animals and are poisonous to humans. Most toxins that are problematic for humans are formed and excreted by microorganisms, such as bacteria and viruses. Related topics: toxic dilation of the colontoxic epidermal necrolysistoxic hepatitistoxic injury of the kidneytoxic megacolontoxic nodular goitertoxic shock syndrome
INNATE IMMUNITY AND INFLAMMATION
One's innate immunity are the barriers that keep harmful materials from entering your body and form the first line of defense in the immune response. Some of these barriers are: the skin, stomach acid, mucous (traps microorganisms and small particles), the cough reflex, and enzymes in tears and skin oils. If an antigen gets past the external barriers, it is attacked and destroyed by other parts of the immune system. Innate immunity also includes those things that make humans resistant to many of the diseases of animals.
The immune system includes certain types of white blood cells. It also includes chemicals and proteins in the blood (such as complement proteins and interferon). Some of these directly attack foreign substances in the body, and others work together to help the immune system cells.
The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat, or any other cause. Chemicals including histamine, bradykinin, serotonin, and others are released by damaged tissue. These chemicals cause blood vessels to leak fluid into the tissues, resulting in localized swelling. This helps isolate the foreign substance from further contact with body tissues.
The chemicals also attract white blood cells that "eat" microorganisms and dead or damaged cells. The process where these white blood cells surround, engulf, and destroy foreign substances is called phagocytosis, and the cells are collectively referred to as phagocytes. Phagocytes eventually die. Pus is formed from a collection of dead tissue, dead bacteria, and live and dead phagocytes.
ACQUIRED IMMUNITY
In comparison to innate immunity, acquired (adaptive) immunity develops when the body is exposed to various antigens and builds a defense that is specific to that antigen.
Lymphocytes, a special type of white blood cell, contain subgroups, B and T lymphocytes, that are key players in acquired immune responses. B lymphocytes (also called B cells) produce antibodies. Antibodies attach to a specific antigen and make it easier for the phagocytes to destroy the antigen. T lymphocytes (T cells) attack antigens directly, and provide control of the immune response. B cells and T cells develop that are specific for ONE antigen type. When you are exposed to a different antigen, different B cells and T cells are formed.
As lymphocytes develop, they normally learn to recognize the body's own tissues (self) as distinctive from tissues and particles not normally found in your body (non-self). Once B cells and T cells are formed, a few of those cells will multiply and provide "memory" for the immune system. This allows the immune system to respond faster and more efficiently the next time you are exposed to the same antigen, and in many cases will prevent you from getting sick. For example, adaptive immunity accounts for an individual who has had chickenpox for being so-called 'immune' to getting chickenpox again.
PASSIVE IMMUNITY
Passive immunity involves antibodies that are produced in someone's body other than your own. Infants have passive immunity because they are born with antibodies that are transferred through the placenta from the mother. These antibodies disappear between 6 and 12 months of age. Gamma globulin is another form of getting passive immunity that is given by a doctor. Its protection is also temporary.
IMMUNE SYSTEM DISORDERS AND ALLERGIES
Immune system disorders occur when the immune response is inappropriate, excessive, or lacking. Allergies involve an immune response to a substance that, in the majority of people, the body perceives as harmless. Transplant rejection involves the destruction of transplanted tissues or organs and is a major complication of organ transplantation. Blood transfusion reaction is a complication of blood administration. Autoimmune disorders (such as systemic lupus erythematosus and rheumatoid arthritis) occur when the immune system acts to destroy normal body tissues. Immunodeficiency disorders (such as inherited immunodeficiency and AIDS) occur when there is a failure in all or part of the immune system.
SIGNS OF INFLAMMATION: * localized redness * pain in the area * swelling of the affected area * warmth of the affected area * pus (sometimes)
Note: In many cases, no observable symptoms develop.
Additional symptoms may include: * fever * general discomfort, uneasiness, or ill feeling (malaise) * muscle aches * agitation or confusion
TESTS:
During an infection, a CBC usually shows increased numbers of white blood cells. A blood differential count may reveal an elevated percentage of phagocytes, indicating that the body is responding to a need to fight infection.
If a problem is suspected, other tests may be performed to determine complement levels and the levels of specific immunoglobulins (antibodies).
THERAPIES:
Usually, the immune response is desired. In some cases, suppression of the immune system is necessary (for example, in the treatment of autoimmune disorders or allergies). This is usually accomplished by administering corticosteroids or other immunosuppressive medications.
Suppression of the immune system may be an undesired side effect of certain treatments or disorders.
Vaccination (immunization) is way to trigger the immune response. Small doses of an antigen (such as dead or weakened live viruses) are given to activate immune system "memory" (activated B lymphocytes and sensitized T lymphocytes). Memory allows your body to react quickly and efficiently to future exposures. As noted above, this means that if you are exposed to a microorganism, it will be destroyed before it can cause illness.
Passive immunization involves transfusion of antiserum, which contains antibodies that are formed by another person (or animal). It provides immediate protection against an antigen, but does not provide long-lasting protection. Gamma globulin and equine (horse) tetanus antitoxin are examples of passive immunization.
COMPLICATIONS:
An efficient immune response protects against many diseases and disorders. Inefficient immune response allows diseases to develop. Inadequate, inappropriate, or excessive immune response causes immune system disorders.
Complications related to altered immune response include:
Definition A cough is a sudden, often involuntary, forceful release of air from the lungs.
Considerations The cough reflex is one of the body's best defense mechanisms. Irritation or obstruction in the airways activates this reflex, and the strong rush of air helps clear material from the breathing passages.
A cough is more helpful if it is producing and expelling something, such as yellowish pus. This kind of cough is termed "productive" and usually should NOT be suppressed by drugs.
Minor irritations in the throat can start the cough reflex, even though normal mucus/spittle are the only material to be expelled. (This is called a "dry" cough.)
Mucus from the nasal passages can drain into the throat and lungs (post-nasal drip) and trigger the cough reflex. Such coughs are also not helpful and may be treated with cough suppressants.
In infants, coughing is unusual and may indicate a serious lung problem.
In diagnosing the cause of a cough, it is important to notice details about the cough, such as the type of cough, does it bring up mucus or pus, and so on.
A cough that is caused by bronchitis or similar infection commonly lasts for up to 2 weeks. However, a cough that persists longer than this should be evaluated by the health care provider.
A cough may occasionally indicate a serious condition:
* When blood is coughed up * When it is accompanied by chest pain * When there is difficulty breathing or shortness of breath * If there is also unintentional weight loss Common causes * Smoking (smoke destroys the cells in the lining of the breathing tubes so that mucus cannot be expelled normally, leading to a chronic cough) o Includes exposure to second-hand smoke * Common cold, influenza, and other viral infections (with yellow or white mucus) are the most common causes * Drugs (such as ACE inhibitors or expectorants) cause persistent, dry, non-productive coughs * Stress (if the cough disappears during sleep, then stress may be the cause) * Allergies * Aspiration (see foreign object aspiration or ingestion) * Atelectasis * Bacterial infection (bronchiectasis, bronchitis, pneumonia, sinusitis or tracheitis) o Often with rusty or green mucus * Viral infection (bronchiolitis, croup, pneumonia, upper respiratory infection) * Congestive heart failure * Environmental pollution * Gastroesophageal reflux * Postnasal drip * Asthma * Diagnostic tests (such as bronchoscopy or pulmonary function tests) * Medical treatments (such as intermittent positive pressure breathing, or incentive spirometry) * Lung cancer * Emphysema
Home care Increasing humidity in the air may help. A vaporizer and a steamy shower are two ways to increase the humidity.
Drink extra fluids to help thin secretions and make them easier to cough up.
Glyceryl guaiacolate (guaifenesin, such as in Robitussin) is available without prescription and may help liquefy the mucus. Drink lots of fluids if taking this medication.
When a cold and a stuffy, runny nose accompany the cough, it is often caused by mucus dripping down the back of the throat. A decongestant that opens the nasal passages will relieve this postnasal drip, and is the best treatment for that type of cough.
Decongestants such as phenylephrine, pseudoephedrine or combinations of these two decongestants are available as over-the-counter cold medications. Don't give decongestants to a child under six years of age unless prescribed by the doctor. It is important to talk to your healthcare provider before using any cough medications for children under two.
If you have high blood pressure (hypertension), consult your doctor before taking decongestants.
Coughs due to chronic postnasal drip are probably caused by either sinus infection or allergy. If allergy is the cause, this is typically treated by avoiding the trigger (allergen) that is causing the allergy. In addition, anti-histamines and a steroid nasal spray are sometimes used to suppress the allergic inflammation.
Dry, tickling coughs can be relieved by sucking on cough lozenges or hard candy. (However, never give a lozenge or hard candy to a child under 3 years old because it is a choking hazard.)
Codeine is a very effective cough suppressant, but has some negative side effects, can lead to physical dependence and addiction and requires a prescription. Dextromethorphan (such as in Vick's Formula 44 of Robitussin DM) is an effective cough suppressant that is available without prescription.
Call your health care provider if * A violent cough begins suddenly, or there is a high-pitched sound (stridor) when inhaling. (The person might have inhaled a small object.) * The cough produces blood in any form. This should be treated as an emergency. * There is a cough in an infant less than 3 months old. * There is shortness of breath or difficulty breathing. * Coughing is accompanied by other symptoms such as fever or abdominal swelling. * A cough is accompanied by unintentional weight loss. * The cough is producing thick, foul-smelling, rusty or greenish mucus. * Frequent coughing lasts for more than 10 days.
What to expect at your health care provider's office
In emergency cases, the patient will be treated first to stabilize the condition. After the condition is stable, the medical history will be obtained and a respiratory assessment performed.
Medical history questions documenting your cough in detail may include:
* Type o Are you coughing up blood? Is visible blood coughed up? Is there blood-streaked sputum? Are you coughing up large amounts of blood? Are there repeated episodes of coughing up blood? o Do you bring up any mucus/sputum when you cough? Does the sputum contain pus? Does the sputum contain pus and have a foul odor? Does the sputum look like clear, sticky mucus? Is the sputum white and frothy? Is pink, frothy material coughed up? Is the sputum adhesive, thick, hard to cough up? Are you coughing up brownish plugs? How much sputum is produced (about how many cups per day)? * Quality o Is the cough severe? o Is the cough dry? o Does the cough sound like a seal barking? * Time pattern o Is the cough worse at night? o Did it begin suddenly? o Has it been increasing recently? o How long has the cough lasted (for how many weeks?) o Has the cough been chronic and has it changed pattern recently? o Do spells of coughing occur repeatedly (recurrent)? o Are coughing spells composed of a sequence of separate episodes? o Does the cough change? Is it variable over hours? * Aggravating factors o Is the cough worse when you are lying on one side? o Is it worse when first arising from sleep? * Associated complaints o Are there sudden periodic attacks of coughing with gagging and vomiting? * Other o What other symptoms are also present? The physical examination will include emphasis on the ears, nose, throat and chest. Do not expect antibiotics to be prescribed for a routine viral or allergic cough because they will not help.
Diagnostic tests that may be performed include:
* Bronchoscopy * Lung scan * Pulmonary function tests * Sputum analysis (if the cough produces sputum) * X-ray of the chest
Definition Swelling involves the enlargement of organs, skin, or other body structures caused by excessive buildup of fluid in the tissues. This buildup can lead to a rapid increase in weight over a short period of time (days to weeks).Swelling can occur throughout the body (generalized) or it may be limited to a specific part of the body (localized).See also: Ankle, feet, and leg swellingAngioedemaSwollen gumsSwollen glandsFacial swellingSwelling in the abdomenBreast enlargementScrotal swellingJoint swelling
Alternative names Edema; Anasarca
Considerations Slight edema of the lower legs commonly occurs in warm summer months, especially if a person has been standing or walking a lot.
Generalized swelling, or massive edema (also called anasarca), is a common sign in severely ill people. Although slight edema may be difficult to detect, especially in an overweight person, massive edema is very obvious. Edema can indicate a chronic and progressive medical illness.
Edema may be generally described in one of two ways:
* Pitting edema -- When you press a finger against a swollen area for 5 seconds and then quickly remove it, an indentation is left that fills slowly. * Nonpitting edema -- When you press a finger against a swollen area for 5 seconds and then quickly remove it, no indentation is left in the skin.
Common causes * Too much salt or sodium intake * Burns * Sunburn * Too little albumin in the blood (hypoalbuminemia) * Malnutrition * Pregnancy * Drugs o Androgenic and anabolic steroids o Antihypertensives o Corticosteroids such as prednisone (causes sodium retention) o Estrogens o Nonsteroidal anti-inflammatory drugs (see NSAIDs) o Calcium channel blockers * Nephrotic syndrome * Acute glomerulonephritis * Chronic kidney disease * Heart failure * Liver failure from cirrhosis * Thyroid disease
Home care Follow prescribed therapy to treat the underlying cause of the swelling. Discuss with your health care provider the options to prevent skin breakdown (for chronic edema) such as a pressure-reducing mattress, a lamb's wool pad, or a flotation ring.
Maintain everyday activities. When lying down, keep limbs above the heart level, if possible, to facilitate drainage. Do not do this if shortness of breath results -- see your doctor instead.
Reduced sodium (salt) in the diet may be recommended.
Call your health care provider if If you notice any unexplained swelling, contact your health care provider.
What to expect at your health care provider's office
Except in emergency situations (such as cardiac failure or pulmonary congestion), your health care provider will obtain your medical history and will perform a physical examination.
Medical history questions documenting swelling in detail may include the following:
* Time pattern o When did you first notice this? o Is it present all the time? o Does it come and go? * Quality o How much swelling is there? o When you poke the area with a finger, does the dent remain? * Location o Is it overall or in a specific area (localized)? o If swelling is in a specific area, what is that area? * Other o What seems to make the swelling better? o What seems to make the swelling worse? o What other symptoms are also present?
Diagnostic tests that may be performed include the following:
* Albumin levels * ECG * Echocardiography * Serum electrolyte tests * Urinalysis * X-rays * Liver function tests * Kidney function tests
Treatment may include fluid and sodium restriction, diuretics, or water pills. Your fluid intake and output should be monitored, and you should be weighed daily.
Avoid alcohol if liver disease (such as cirrhosis or hepatitis) is causing the problem. Vascular support hose may be advised.
Definition Disorders caused by an immune response against the body's own tissues.
Causes, incidence, and risk factors The immune system protects the body from potentially harmful substances (antigens) such as microorganisms, toxins, cancer cells, and foreign blood or tissues from another person or species.
Antigens are destroyed by the immune response, which includes production of antibodies (molecules that attach to the antigen and make it more susceptible to destruction) and sensitized lymphocytes (specialized white blood cells that recognize and destroy particular antigens).
Immune system disorders occur when the immune response is inappropriate, excessive, or lacking. Autoimmune disorders develop when the immune system destroys normal body tissues. This is caused by a hypersensitivity reaction similar to allergies, where the immune system reacts to a substance that it normally would ignore. In allergies, the immune system reacts to an external substance that would normally be harmless. With autoimmune disorders, the immune system reacts to normal "self" body tissues.
Normally, the immune system is capable of differentiating "self" from "non-self" tissue. Some immune system cells (lymphocytes) become sensitized against "self" tissue cells, but these cells are usually controlled (suppressed) by other lymphocytes. Autoimmune disorders occur when the normal control process is disrupted.
They may also occur if normal body tissue is altered so that it is no longer recognized as "self." The mechanisms that cause disrupted control or tissue changes are not known. One theory holds that various microorganisms and drugs may trigger some of these changes, particularly in people with a genetic predisposition to an autoimmune disorder.
Autoimmune disorders result in destruction of one or more types of body tissues, abnormal growth of an organ, or changes in organ function. The disorder may affect only one organ or tissue type or may affect multiple organs and tissues. Organs and tissues commonly affected by autoimmune disorders include blood components such as red blood cells, blood vessels, connective tissues, endocrine glands such as the thyroid or pancreas, muscles, joints, and skin.
A person may experience more than one autoimmune disorder at the same time. Examples of autoimmune (or autoimmune-related) disorders include:
Prevention Prevention may not be possible at this time for most autoimmune disorders.
Symptoms Symptoms of autoimmune disease vary widely depending on the type of disease. A group of very non-specific symptoms often accompany autoimmune diseases especially of the collagen vascular type and include:
* tire easily * fatigue * dizziness * malaise (nonspecific feeling of not being well) * fever, very low grade temperature elevations
Specific autoimmune disease results in:
* destruction of an organ or tissue resulting in decreased functioning of an organ or tissue (for example, the islet cells of the pancreas are destroyed in diabetes) * increase in size of an organ or tissue (for example, thyroid enlargement in Graves disease)
Note: Symptoms vary with the specific disorder and the organ or tissue affected.
Signs and tests Signs vary according to the specific disorder. This disease may also alter the results of the following tests:
* platelet aggregation test * eosinophil count - absolute
Posts: 7052 | From Colorado | Registered: Mar 2003
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bettyg
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posted
thanks melanie; yes, many posts on edema!!
glad you kept in a SEPARATE file and could just copy/paste here
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Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
Thanks Miss B for always topping my posts so they can try to help others...I do appreciate it. Posts: 7052 | From Colorado | Registered: Mar 2003
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Marnie
Frequent Contributor (5K+ posts)
Member # 773
posted
Our kidneys and liver are our major "detox" organs (though we can rid some toxins thru our skin and our breath).
If those organs are over stressed by trying to rid so many toxins AND trying to breakdown abx. in addition, they can take a "hit" and albumin(protein) will come out of the blood.
"Low protein levels *in the blood* that can be seen in malnutrition, kidney and liver disease.
The proteins *in the blood* help *hold salt* and water inside the blood vessels so fluid does not leak out into the tissues.
If albumin (the most abundant blood protein) gets too low, edema occurs especially in the feet, ankles and lower legs."
Is the body trying hard to keep salt away from you-know-who?
Posts: 9481 | From Sunshine State | Registered: Mar 2001
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Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
Thanks Miss M for adding such valuable information. I especially was interested in the link you provided and in this specific note:
"Severe chronic lung disease such as emphysema or chronic bronchitis increase the pressure in the blood vessels to the lungs. This pressure backs up in the right side of the heart and the higher pressure causes swelling in the legs and feet."
I do tend toward chronic bronchitis, in fact at my last apt. the doc said my throat was angry red and wrote on my take away a diagnosis of bronchitis. (although it was obvious that I was having an asthma attack, and doc prescribed more asthma meds) I suppose we can have both?
Do you think that low protein in the blood has any correlation with Babesia?
Posts: 7052 | From Colorado | Registered: Mar 2003
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