[46F] With chronic swelling and multiple symptoms

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations:

Swelling in Legs, Feet, and Abdomen

• Chronic Venous Insufficiency (CVI): This condition occurs when the veins in your legs are not working effectively, making it difficult for blood to return to the heart. This can cause swelling, especially after sitting for long periods.
• Heart Failure: Given your history of hypertension and the fact that Lasix (a diuretic) hasn't alleviated the swelling, heart failure could be a concern. Heart failure can cause fluid retention, leading to swelling in the legs, feet, and abdomen.
• Lymphedema: This is a condition where lymph fluid builds up in tissues, causing swelling. It can be firm and hard, making movement difficult.

Dark Spots on Skin

• Hyperpigmentation: This can be due to various causes, including hormonal changes, sun exposure, or certain medications.
• Venous Stasis Dermatitis: This condition is related to poor blood flow and can cause darkening of the skin, usually around the ankles.

Pain in Feet and Neuropathy

• Peripheral Neuropathy: This can be caused by various factors, including diabetes, vitamin deficiencies, and certain medications. It often presents as pain, tingling, or numbness in the feet.
• Plantar Fasciitis: This is a common cause of foot pain, especially in the heel area.

Headaches and Depression

• Chronic Pain and Stress: Chronic pain and stress can contribute to both headaches and depression. The use of fentanyl for pain management also suggests that your pain levels are significant.
• Medication Side Effects: Some medications, including those for hypertension, can cause headaches and mood changes.

What you can do

Swelling

• Consult a Doctor: Given the chronic nature and severity of your swelling, it's crucial to consult a healthcare provider. They may recommend further tests, such as blood tests, echocardiograms, or ultrasounds, to determine the underlying cause.
• Lifestyle Changes: Elevate your legs when sitting, wear compression stockings, and avoid prolonged periods of sitting or standing.
• Diet and Exercise: Maintain a balanced diet and engage in regular physical activity to improve circulation.

Pain in Feet and Neuropathy

• Foot Care: Wear comfortable, supportive shoes and avoid walking barefoot. Consider seeing a podiatrist for specialized care.
• Pain Management: Over-the-counter pain relievers like ibuprofen can help manage pain. However, consult your doctor for a comprehensive pain management plan.

Headaches and Depression

• Mental Health Support: Consider speaking to a mental health professional for support with depression. Cognitive-behavioral therapy (CBT) and medications can be effective.
• Headache Management: Keep a headache diary to identify triggers and discuss them with your doctor. Over-the-counter pain relievers can also help.

General Tips

• Symptom Tracking: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
• Avoid Tobacco and Fentanyl: Both can have serious health consequences. Seek help for smoking cessation and discuss alternative pain management options with your doctor.

What you should look out for

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

• Shortness of Breath or Chest Pain: These could be signs of heart failure or other serious conditions.
• Severe Pain or Sudden Changes in Symptoms: Any sudden worsening of your symptoms should be evaluated immediately.
• Signs of Infection: Redness, warmth, or discharge from swollen areas could indicate an infection.

Remember, while I can provide information and suggestions, it's essential to consult a healthcare professional for a formal diagnosis and treatment plan.