[46F] Experiencing severe edema, frequent urination, and other symptoms

Patient Description

A 46-year-old female presents with severe edema in legs and feet, frequent urination exceeding 10 times daily, nocturnal enuresis, extreme thirst, and dry mouth. The edema, noted since April 2023, worsens with sitting and improves only with rest, predominantly affecting the left side. The patient experiences difficulty donning pants and shoes due to the swelling. Frequent urination began in March 2023 and occurs regardless of fluid intake. Bed wetting has been an issue for 8 months, occurring despite pre-sleep bathroom visits. Thirst and dry mouth have been persistent since April of the previous year, with the mouth dryness severe enough to cause the lips to adhere to the gums. Toenails, particularly the middle and those adjacent to the pinkie toes, have been growing sideways and taking on a cylindrical shape for the past 6 months. The patient also reports excessive sweating for nearly a year, unrelated to activity levels. Medical history includes mild asthma, chronic sinusitis, and chronic bronchitis diagnosed last year. Family history is significant for diabetes. Allergies include bees, poison ivy, oak, sumac, and Z-Pak. The patient is not on any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Diabetes Mellitus: Your symptoms of frequent urination, extreme thirst, and dry mouth are classic signs of diabetes. Diabetes is a condition that impairs the body's ability to process blood glucose, also known as blood sugar. In uncontrolled diabetes, your kidneys try to get rid of the excess sugar by excreting it in your urine, leading to frequent urination and subsequent dehydration, which then causes excessive thirst.

    • Treatment for diabetes typically involves lifestyle changes like diet and exercise, and may include medication or insulin therapy.
  • Chronic Venous Insufficiency (CVI): This condition occurs when your leg veins don’t allow blood to flow back up to your heart. Symptoms can include swelling in the legs and ankles, pain that gets worse when standing and gets better when raising the legs, and changes in the skin color or texture. CVI is a long-term condition that is sometimes associated with varicose veins.

    • Treatment for CVI can include lifestyle changes, medications, or procedures to improve blood flow.
  • Onychogryphosis (Ram's Horn Nails): This is a condition that causes one or more of your nails to thicken, become discolored, and curve. The most common cause is injury to the nail bed. It can also be caused by poor circulation, such as from peripheral vascular disease, or diabetes.

    • Treatment for onychogryphosis typically involves trimming or removing the affected nails.

Please note that these are possible diagnoses based on the symptoms you've provided and you should consult with a healthcare professional for a formal diagnosis.

What you can do

  1. Schedule an appointment with your primary care provider as soon as possible to discuss your symptoms. They may order blood tests to check your blood sugar levels and kidney function, among other things.
  2. Monitor your symptoms and take note of anything new or worsening symptoms to report to your doctor.
  3. Try to maintain a balanced diet and stay hydrated. This can help with your symptoms of dry mouth and excessive thirst.
  4. Elevate your legs when you can to help with the swelling. Avoid standing or sitting for long periods of time.

What you should look out for

Seek immediate medical attention if you experience:

  • Chest pain or discomfort
  • Trouble breathing or shortness of breath
  • Fainting or loss of consciousness
  • Confusion or difficulty waking up
  • A sudden, severe headache

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare professional for accurate information.

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1 yr ago

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People Also Ask


What are the common symptoms of diabetes mellitus?

Common symptoms of diabetes mellitus include frequent urination, excessive thirst, extreme hunger, unexplained weight loss, fatigue, blurred vision, slow-healing sores, and frequent infections.


How can chronic venous insufficiency be managed at home?

Chronic venous insufficiency can be managed at home by elevating the legs to reduce swelling, wearing compression stockings to improve blood flow, avoiding long periods of standing or sitting, and maintaining a healthy weight and diet.


What causes onychogryphosis and how is it treated?

Onychogryphosis, or ram's horn nails, can be caused by injury to the nail bed, poor circulation, or conditions like diabetes. Treatment typically involves trimming or removing the affected nails, and addressing any underlying conditions.


Why might someone experience excessive thirst and dry mouth?

Excessive thirst and dry mouth can be caused by dehydration, high blood sugar levels as seen in diabetes, certain medications, or conditions affecting the salivary glands. It's important to identify and treat the underlying cause.


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