Edema for over 6 months. Dr seemingly disinterested

[WhiteJellycat]

I have posted about this before but I can think under what user name. I have edema on my hands, on my face, my wrists, and my ankles. I'm pulling on weight ( did intermittent fasting last week and put on four pounds).

I have been to the Dr multiple times. Lots of tests. So far nothing is wrong with me. I'm awaiting a heart echo result from a echo over two months ago ( I'm assuming that cant be heart failure or they wouldnt take two months to look at the echo??) Bloods for heart, kidneys liver fine. Leg doppler fine. The Dr said its non pitting but I think it is pitting now?

I have put three stone on since first going to the gp about this. I saw a Dr in training today but she was the most dismissive of all the Drs.

Any ideas on
A) what this could be?
B) anything I can do to relive it?

Today's dr didnt belive I was swollen as she not seen me before so she thinks this is just fat. Including my hand. Could it just be fat? If so i went on a calorie restrictive diet for two weeks i would loose weight surely? That's about the only option i have left now

Do you have a rough record of your weight changes over the past 2 years or so?

Do you have any other symptoms?

I have put on three stone in the last two years roughly but I'm.not sure if its fat or water.

I'm breathless on any exertion and very tired. Apart from the echo no signs of heart failure.

I have high blood pressure that's a long term issue. I have sleep apnea and used cpap for just over a year

Sounds like it’s fat, and possibly some excess water retention caused by your body not being in peak health. Sorry.

The breathlessness is likely caused by being overweight and unfit, possibly some anaemia too.

Are you able to lose some weight, commit to moving more and getting your fitness up, and obviously speak to the doctors if anything seems amiss?

If its fat and I did say 1000 calories a day for two weeks I should loose weight? I know that sounds bonkers but I'm doing 1800 cals a day and still putting weight on. So maybe I just need to cut back even more. I'm not active right now because I'm out of breath. I'm ok once I get going and the blood gets pumping but the first 10-15 are hard. I could do 10000 steps day but its job to fit a hour of walking in

Ooh, that looks uncomfortable! I would hazard a guess it was heart related.

Few questions....
Height?
Weight?
What are you eating on a normal day?
Have you just seen the one Doctor?

In terms of walking, don't worry if you can't manage a full hour every day. 10 minutes here and there will soon add up. Park at the far end of the supermarket car park. Put some music on and march on the spot while you wait for the kettle to boil. Take the stairs at work and not the lift. I manage to walk about an hour almost every day and it has become ingrained habit. I miss it if I don't get out.

There are also lots of videos online that might help. I haven't done Walk at Home by Leslie Sansone on You Tube but have seen quite a few recommendations on here about her. Also British Heart Foundation has lots of useful advice and they also have a few exercise videos online

www.bhf.org.uk/informationsupport/support/cardiac-rehabilitation-at-home/cardiac-rehabilitation-exercise-videos

I'm 5,4 weigh 15 14 right now. Like I say that was a shock after a week of only eating three meals on three of the days. Four days of only evening meals

Typical days food ( when not fasting)
Porridge or cereal / weetabix and semi skim milk. No more than 40g as I have weighed it enough to eyeball portion size

Sandwich with either two or three slices of bread, marg, ham and salad with low fat mayo
Snacks low fat yogurt ( under 100 cals) and apples
Dinner is typically carb heavy cooked from scratch pasta, noodles or rice based. About 100-150g of protein, cereal bowl full up to 1" from top in a tomato based sauce made from scratch. Hardly use any oils. Drink really drink alcohol, dont snack ( maybe now and again but not every week)

I did maticulesly follow a 1800 cal diet for two weeks and put on weight.

Seen five different Drs. The only person who raised eyebrows was the one who though heart failure but my chest xray, bloods and leg doppler was all fine. Ecg fine.

I think I noticable but on 1 stone in a short space of maybe two weeks but it will not shift now. My boots wont do up but the skin is so stretched it no longer hurts.

I am convinced the gp thinks I'm loopy. They was a step change in dismissing today. Told me I need to chase my heart echo even though pals told me it has to be the referer and they can chase it for me, only for my gp. I saw my leg turn white and stay indented which is new and the gp said it wasnt pitting. I could see her thumb indent and said "that is pitting. I have had pre eclampsia I know pitting edema".

Would fat pit? This is the back of my hand. Gp would commit to it being fat or water.

Sorry for typos. Gp wouldnt commit on my hand being fat or water.

Hospital will not let me chase my echo. Gp not interested in chasing it either and told me to chase it. Even when I told them.that the hospital have said they can deal with me directly

Could it be lymphoedema?. Not life threatening, but distressing because of the swelling, poorly resourced & understood by most doctors.

Op, I'm about your height and weight, but my hands and feet don't look anything like yours - they're much slimmer, with no swelling.

Not saying this to be nasty, but I think you should pursue this with your gp. It doesn't look right, and with what you've been eating, you should be losing weight.

I'm going to have to keep going back to the gp but I'm brushed off at every appointment. Last time I went before Christmas they wanted me discharged from all my other conditions ( opthology from damage to eyes from BP, sleep apnea team, neurologist as got degeneration in spine - God knows why ) all three said they are unrelated to my swelling. Now I have rule out heart failure but they wont chase the echo, but maybe they will now? The gp didnt fill me with faith.

So if i do a fourth night of exercise, low calorie diet and monitor my weight, do you think they will listen if I'm still gaining weight? Should I measure my limbs? I just dont know what would be taken seriously.

I dont know if I'm extremely fat or unwell anymore.

I’m 5’ 4” and was always between 9st 5lbs and 9st 12lbs. In the last couple of years I have gone up nearly a stone and feel too heavy (menopause related) so can’t imagine how you feel.

Throughout my life my weight has been consistent. I know some people swear by fasting but I’m not honestly convinced myself. I eat three meals a day; breakfast, lunch and dinner. I do sometimes have the odd snack but it is the exception rather than the rule. It also makes quite a difference to my waistline when I don’t indulge.

I’m not a diet expert by any stretch of the imagination but it does sound like you are eating quite a lot of processed carbs.

In terms of breakfast, the porridge is quite good. I would try to cut down on the cereal so maybe just have a handful of cereal with full fat yoghurt and some fruit. Eggs are really good too so a couple of eggs scrambled with some spinach (frozen will do), cherry tomatoes and a small bit of seeded/wholegrain bread.

Lunch – You would be better off to have a slice of bread and make an open sandwich with full fat butter and mayonnaise (in moderation) and then pile salad stuff on top and then a protein like ham, chicken, tuna, salmon or cheese (which is good as a sprinkling with the ham).

Dinner – A palm sized portion of protein and a carb like rice or pasta then lots of veg with some of your tomato based sauce. I’d have a few tablespoons though not a cereal bowl!

The thinking behind low fat has changed as often low fat foods are often laden with sugar. You’re actually better to eat full fat in moderation as it is far more satisfying and will sustain you for longer. I eat full fat butter, yoghurt, cheese, mayonnaise, etc.

Also, consider eating protein for breakfast, lunch and dinner because again that will help to sustain you and keep your blood sugar even. Try to reduce the amount of simple carbs you eat (bread, pasta, etc.). You don’t have to give them up completely but just eat more veg and green stuff. Of course, drinking water is excellent too.

Where did you get the figure of 1800 calories? I’ve never calorie counted but that does sound like a lot. British Heart Foundation recommend 1500 for a woman but I guess that is average intake so if you want to eat lose you need to eat slightly less.

The British Heart Foundation have some great leaflets you can download. One of them explains portion size which would probably be a good one for you to look at. As a nation, we’ve got into real bad habits and we actually don’t need to eat as much as we think we do!

www.bhf.org.uk/informationsupport/publications?keyword=&tab=publications&subject=healthy-eating&lang=english&run=1

What work do you do? Is it quite sedentary?

The 1800 calories was of the nhs weight loss app.. it gave me a range of calories I could choose and loose weight and this was in the middle. The more you weigh the more calories you can eat and still loose weight so maybe that's why it's high?

I have had under 200 calories today so I'm unlikely to ever get near 1800. A more normal day where I'm not thinking and grabbing food I would only have had 400-500 calories. I dont snack between meals so its lot left for dinner. I couldnt eat a few tablespoons of food for dinner. I'd feel famished! A cereal bowl size of dinner is a reasonably small serving size I think. The cereal bowl holds 600ml up to the brim so I'm never having more than 500g of dinner. So even if I had 500g of pasta in tinned tomatoes and 100g of mince that wouldnt all fit in the bowl and comes in 1090 cals so a normal day looks more like 1600 calories.

Yes I should definitely eat less refined carbs. I dont really eat much meat and pasta is just easy.

I dont work. I'm taking a career break while I look for my disabled sons secondary school. Im not very active really. I volunteer inna charity shop but its just standing up on the days I'm in.

Oh okay, I don’t honestly know how the calorie thing works as I’ve never actually counted them.

One thing that does strike me is that you’re not very consistent. You’re saying that you were eating 1800 calories the other week, under 200 calories today and other days 400 to 500 calories. Sometimes your dinner alone is 1090 calories. That will really confuse your body so if you’re not eating consistently your body will panic and store that food as fat as it literally doesn’t know where your next meal is coming from. Could you start to eat breakfast, lunch and dinner consistently? I know people successfully lose weight by fasting but if you’re going to follow that approach then you probably need to do it properly and follow Fast 800 or something similar which focuses on protein and complex carbs with not much bread or pasta!

No, the few tablespoons referred to the sauce. I thought you were eating a cereal bowl of sauce! I just checked and your cereal bowls are the same size as ours. We generally don’t eat out of bowls but I wouldn’t say that is a small portion. That would be a normal sized dinner for us I think. If you put your dinner on a dinner plate I think it’s probably easier to gauge exactly how much food is there. In terms of make up, 50% should be mixed veg, 25% protein (fish, meat, eggs, etc.) and 25% starch (pasta, rice, potatoes, etc.). It’s explained in a bit more detail here:-

blog.mypacer.com/2019/12/05/are-portion-control-and-serving-sizes-your-keys-to-losing-weight/

Yes, pasta is easy but too much won’t be helping you. You need to bulk up on the veg so either fresh, frozen or tinned (in water) is all good.

That’s very honest of you in terms of the exercise. Are you sitting for most of the day? If so, that’s a habit you really need to break as it is potentially going to have a real impact on your health. It really is as simple as setting an alarm for how long you sit down (20 minutes?) then getting up and doing a bit of housework/pushing the hoover around/walking up and down the stairs/going for a walk around the block. You don't need to be running a marathon or walking 10k in one go but literally any movement will help with your weight and metabolism. Bit of info about sitting down too much here:-

www.bhf.org.uk/informationsupport/heart-matters-magazine/activity/sitting-down

www.nhs.uk/live-well/exercise/why-sitting-too-much-is-bad-for-us/

Have you considered cutting out wheat? DIL is from a different culture and told me that they consider cutting out bread/pastry etc to be likely to get good results, whatever the problem is. I thought I'd give it a go for a couple of days and it made such a difference that I've been (mostly) wheat-free for two years now. Rice, baked potatoes etc instead. I eat nuts, beans and a huge amount of raw veg. Admittedly it's probably not as easy if you've got young dch, which I haven't. But your diet does seem a bit carb-heavy.

Ah I'm dyslexic so I dont think I'm explaining myself very well. I had 200cal SO FAR today before dinner. So add on between 800-1200 cals for dinner. On a fasting day it's just dinner so just the 800-1200 cals. I was only fasting to see if I would loose weight ( to see if this fat) alas no. Having between 1200 - 1800 cals a week put on 4lbs.

I do a lot of housework so I'm pottering around for 45 minutes of each hour during school hours. I just dont get many steps in ( but i measure them on my phone and that's not on me while pottering doing housework.

My BP is getting higher too. I'm very stressed. 4 kids three with SEN.

Good idea about wheat.in theory. I love my carbs! I might try to cut them out but next week as it would take a lot of planning.

Let's see if I put more weight tomorrow. I feel like I'm going to pop. Also I lay down for a snooze with my cpap on as soon as I drift off I choke now. That's new this week. I feel asleep in front of the TV on Sunday and felt like I had been suffocating. So the fluid / fat round my airways is also getting worse

Sorry snoozing without my cpap mask I choke

Well, personally I would distribute my food intake a bit more evenly through the day. You're virtually eating nothing all day then eating the bulk of your calories in the evening. A few hours later you're in bed.

It's good that you're not sitting but you need to do more during the day than just pottering. You need to build in activity that raises your heart rate which will in turn help your blood pressure and stress.

Have a look at some of the stuff Michael Moseley has written. I think you would benefit on doing some reading on what a healthy diet and portion size should look like.

Try a whole foods plant based diet. It will help your body heal and you will lose weight. Fruits, veggies, brown rice, oatmeal, beans.

Have you tried making soup for lunch instead of sandwiches? This is a good book

Miracle Soups: Over 70 Recipes for Great Health https://www.amazon.co.uk/dp/0600609537/ref=cmswwrcppapigltti2HB1R51FNMJ4EDET5B2B

It takes longer initially than making a sandwich but then you can make a big batch, keep in fridge, and eat it for several days.

Some really delicious ideas and I find soup keeps me fuller for longer than a sandwich or salad. Plus lots more veg and less added salt/sugar if you make your own.

Could you ask your GP for a referral to a nutritionist?

Based on your stats (which I'm not sure are correct as 15 14 would be 16 stone), your base metabolic rate (calories your body burns if you stayed in bed all day) is probably around 1650-1700 so eating 1800 a day and no /minimal exercise is only just below what you need in a day so probably not going to result in a huge weight loss, but you shouldn't be gaining any and definitely not at the rate you are!
www.diabetes.co.uk/bmr-calculator.html
I would take a note of your body measurements - wrists, ankles, waist, bust and track everything you eat and drink (weight it accurately) and how much exercise you do over the next 2-4 weeks and make a follow-up appointment with your GP.
I agree with the PP about the carbs, you're eating a high proportion of carbs for someone who doesn't do much exercise.

Squeaky wheel and all that OP…

Don't be put off trying your GP again.

I agree with the PP, be that squeaky wheel OP!! It sucks that we have to do that to get taken seriously though, doesn’t it :(

I am no expert on edema, but I would look at the connection between edema and inflammation in the body.

Quite a lot of what you are eating, regardless of the calories, is inflammatory. Processed carbs, processed meat (ham), high quantities of dairy (especially low fat dairy or dairy substitutes that usually has added sugar etc), is all inflammatory. Even high quantities of tomatoes can be inflammatory if you are sensitive to nightshades.

Have you tried a whole foods, plant based diet before? Perhaps take a look at the traditional Mediterranean diet, or something like the Autoimmune Protocol Paleo Diet (this is much more strict though!) to get some ideas of how you could start to adjust and see if eating that way for a week or two starts to bring the swelling down?

I'm making cauliflower soup today. See if I can make soup for seven days.

I have looked up some more calorie calculators and it does seem that my intake needs to be nearer 1300 calories a day to have noticable weight lose over a week. So I'm going to aim for 1200 -1300 a day. Measure myself eat less carbs then see what happens over two weeks. At least I can go the Dr with it all written day if I dont loose weight. I went on a hours walk this morning which was cross country and hilly but it was still only 7000 steps.

That’s all a great start OP! And yes good idea to measure and track everything so at least you can go in with data. Doctors love data and it will make it much harder to fob you off!

Make sure you up your intake of healthy protein and veg as cutting carbs can make you feel ravenous at first!

I'm starving already