[45F] With recurrent swelling, abdominal pain, and severe cough

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Congestive Heart Failure (CHF)

• Rationale: CHF can cause fluid retention leading to swelling in the legs, feet, and abdomen. The dark urine and reduced output could be due to decreased kidney perfusion. The severe cough, especially when lying down, could be due to fluid accumulation in the lungs (pulmonary edema).
• Typical Treatments/Testing: Diagnosis often involves physical examination, blood tests (like BNP), chest X-ray, echocardiogram, and possibly a stress test. Treatment may include medications like diuretics, ACE inhibitors, and lifestyle changes.

2. Liver Disease (Cirrhosis or Hepatitis)

• Rationale: Liver disease can cause fluid accumulation in the abdomen (ascites) and legs, light-colored stools, and dark urine. The lack of appetite and fatigue are also common symptoms.
• Typical Treatments/Testing: Blood tests to check liver function (LFTs), imaging studies like ultrasound or CT scan, and possibly a liver biopsy. Treatment depends on the underlying cause but may include medications, lifestyle changes, and in severe cases, liver transplantation.

3. Kidney Disease

• Rationale: Kidney issues can lead to fluid retention, swelling, and changes in urine output and color. The abdominal pain could be related to kidney function or other associated conditions.
• Typical Treatments/Testing: Blood tests to check kidney function (creatinine, BUN), urine tests, and imaging studies. Treatment may include medications, dietary changes, and in severe cases, dialysis.

What you can do

Swelling and Abdominal Pain

• See a doctor as soon as possible: Given the severity and duration of your symptoms, it's crucial to seek medical attention promptly. Your doctor will likely perform a physical examination and order tests to determine the underlying cause.
• Elevate your legs: When sitting or lying down, try to keep your legs elevated to reduce swelling.
• Limit salt intake: Reducing salt in your diet can help decrease fluid retention.
• Stay hydrated: Drink plenty of water unless advised otherwise by your doctor.

Cough

• Monitor your symptoms: Keep track of any changes in your cough, especially if it returns or worsens.
• Avoid lying flat: Use pillows to prop yourself up when sleeping to help reduce coughing.

General Health

• Track your symptoms: Use MDandMe to journal your symptoms, track progress, and get insights. This can be very helpful for your healthcare provider.
• Maintain a healthy diet: Focus on a balanced diet rich in fruits, vegetables, and whole grains.
• Stay active: Engage in light physical activity as tolerated, but avoid overexertion.

What you should look out for

Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Shortness of breath or difficulty breathing
• Severe or worsening abdominal pain
• Significant changes in urine output or color
• Sudden weight gain or loss

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.