Re: Re: shortness of breath question

[Guest guest]

This part really caught my eye, I've been complaining to my Drs about

shortness of breath for years...they always just brush it off, what does it

have to do with Igan?

Ginger

>From: cyrkle@...

>Reply-To: iga-nephropathy

>To: iga-nephropathy

>Subject: Re: inflammation question

>Date: Fri, 26 Jan 2001 15:43:18 -0000

>

Actually the reason my IgAN was detected

>almost a year ago was because I was complaining of fatigue and

>shortness of breath. My haemoglobin was then found to be around 100

>g/L (normal for my age would be 150 g/L).

>

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[Guest guest]

There are two ways chronic IgAN can *eventually* cause shortness of breath,

if the kidneys become damaged or inflamed enough:

Fluid retention:

When the kidneys are impaired, you may retain more fluid than normal. This

fluid can accumulate in various parts of the body and cause swelling.

Sometimes you can't even see it because for some reason it only accumulates

in the abdomen (you would notice that as abdominal distention). That can

affect breathing because it can interfere with the free movement of the

diaphragm, which you use when breathing (the diaphragm can move down enough

when breathing in). Another way it can affect breathing is when you lie down

to go to bed. What happens is that fluid that has pooled in the extremities

during the day will flow back to the chest during the night and begin

accumulating in the lungs. So you wake up short of breath or coughing, just

like congestive heart failure patients do. Sometimes this fluid retention

isn't very obvious. Nephrologists will check for that by squeezing your

ankle to see how the skin bounces back, among other things. When you have

this problem, it is treated with a diuretic to help the kidneys eliminate

the extra fluid. This problem with extra fluid most often occurs when you

lose a lot of protein in your urine.

Anemia:

Impaired kidneys progressively lose their ability to produce a hormone

called erythropoetin (EPO for short). This hormone is needed by the bone

marrow as a signal for them to produce red blood cells. Red blood cells are

what carries oxygen in the blood, so if your red blood cell count is low,

you may feel short of breath very easily, on the slightest exertion.

Of course, usually, the kidney impairment has to be more than mild for these

things to happen. But they can and do happen sometimes in more acute cases,

especially in nephrotic syndrome, where one of the symptoms is fluid

retention (edema).

Pierre

Re: inflammation question

> >Date: Fri, 26 Jan 2001 15:43:18 -0000

> >

> Actually the reason my IgAN was detected

> >almost a year ago was because I was complaining of fatigue and

> >shortness of breath. My haemoglobin was then found to be around 100

> >g/L (normal for my age would be 150 g/L).

> >

>

> _________________________________________________________________

> Get your FREE download of MSN Explorer at http://explorer.msn.com

>

>

>

[Guest guest]

Thank You Pierre... how can I find out if my shortness of breath episodes

are caused by either of these things? My Dr knows very little about Igan and

didn't think anything of it... they prescribed me an inhaler awhile ago. Now

my thoughts on it are this, and of course this is a touchy subject... I do

have a weight problem, could that be related? The drs won't say one way or

the other... and I have shortness of breath just sitting, doing nothing. I

tend to try to drink more water when it happens because its like a temporary

relief.

I have noticed swelling of the ankles at times and once had sever swelling

in my fingers one morning...accompanied by intense pain (couldn't move my

fingers very well for a couple hours).

Ginger

>

>Reply-To: iga-nephropathy

>To: <iga-nephropathy >

>Subject: Re: Re: shortness of breath question

>Date: Sun, 28 Jan 2001 21:08:10 -0500

>

>There are two ways chronic IgAN can *eventually* cause shortness of breath,

>if the kidneys become damaged or inflamed enough:

>

>Fluid retention:

>When the kidneys are impaired, you may retain more fluid than normal. This

>fluid can accumulate in various parts of the body and cause swelling.

>Sometimes you can't even see it because for some reason it only accumulates

>in the abdomen (you would notice that as abdominal distention). That can

>affect breathing because it can interfere with the free movement of the

>diaphragm, which you use when breathing (the diaphragm can move down enough

>when breathing in). Another way it can affect breathing is when you lie

>down

>to go to bed. What happens is that fluid that has pooled in the extremities

>during the day will flow back to the chest during the night and begin

>accumulating in the lungs. So you wake up short of breath or coughing, just

>like congestive heart failure patients do. Sometimes this fluid retention

>isn't very obvious. Nephrologists will check for that by squeezing your

>ankle to see how the skin bounces back, among other things. When you have

>this problem, it is treated with a diuretic to help the kidneys eliminate

>the extra fluid. This problem with extra fluid most often occurs when you

>lose a lot of protein in your urine.

>

>Anemia:

>Impaired kidneys progressively lose their ability to produce a hormone

>called erythropoetin (EPO for short). This hormone is needed by the bone

>marrow as a signal for them to produce red blood cells. Red blood cells are

>what carries oxygen in the blood, so if your red blood cell count is low,

>you may feel short of breath very easily, on the slightest exertion.

>

>Of course, usually, the kidney impairment has to be more than mild for

>these

>things to happen. But they can and do happen sometimes in more acute cases,

>especially in nephrotic syndrome, where one of the symptoms is fluid

>retention (edema).

>

>Pierre

>

> Re: inflammation question

> > >Date: Fri, 26 Jan 2001 15:43:18 -0000

> > >

> > Actually the reason my IgAN was detected

> > >almost a year ago was because I was complaining of fatigue and

> > >shortness of breath. My haemoglobin was then found to be around 100

> > >g/L (normal for my age would be 150 g/L).

> > >

> >

> > _________________________________________________________________

> > Get your FREE download of MSN Explorer at http://explorer.msn.com

> >

> >

> >

[Guest guest]

It's hard to tell Ginger. Did you tell your doctor about your ankle and

finger swelling? You should do that (and the best is to see the doctor while

you have it). Now, shortness of breath can be caused by many things, and

only a doctor can evalutate that. I don't recall exactly -- but I think you

have high blood pressure don't you? Sometimes high blood pressure can cause

shortness of breath, or the medications for it can. What do you take for it?

When you were prescribed an inhaler, did it help when using it? It will help

if it's asthma, but not if it's anything else. Have you had pulmonary

testing? Shortness of breath is not nothing, it's always something, even if

that something turns out to be anxiety (very common, and I don't mean to

imply that it's just anxiety in your case). But that is a medical condition

too, and it needs to be treated like anything else.

If you can, can you refresh my memory about your IgAN numbers, do you know

what your serum creatinine is, and your protein?

In my opinion, symptoms like shortness of breath should absolutely never be

ignored by a doctor. It is never nothing. It is always something, even if,

as I said, it turns out to be anxiety. Other things that have to be looked

at are asthma, blood pressure, heart-related things. Having swelling of the

ankles and fingers is typical of any glomerulonephritis (of which IgAN is

one type) if it causes you to retain water (this is what they call " edema " ).

It sounds like maybe you need to be a little more insistent with your doctor

about this shortness of breath at rest thing -- to find the cause, and then

work on it, even if it just means that you have to lose the extra weight.

It's impossible for me to tell without knowing more if it could be related

to the IgAN. If the IgAN is still mild to moderate, like with a serum

creatinine under 2.5, I would suspect the high blood pressure more, or the

medications.

As for weight, well, it depends how overweight you are. Sometimes being

overweight can cause a feeling of shortness of breath, for example, if it

hinders to movement of the diaphragm and the lungs.

Do you smoke? I seem to recall that you do. Listen, I'm not an evangalist

about smoking, but smoking is a definite no-no when you have a disease like

IgAN. And it's not a matter of what it does to the lungs. It's that it

reduces the oxygen-carrying capacity of your blood. If you're already

tending toward the low end of the acceptable hemoglobin (red blood cell)

range, smoking my be just enought to tip the balance and make you feel short

of breath. In the longer terms, it accelerates the damage caused to blood

vessels, and, when you realise that the filters in the kidneys are just

little bundles of very tiny blood vessesls, you can see that these would get

damaged even more quickly than just with the IgAN. I don't mean to sound

preachy about it, but I do think a combination of being overweight, having

high blood pressure and smoking could all combine together to make you feel

short of breath.

You know that I'm not at all one to advocate giving up life's pleasures

unecessarily, I mean, I have big trouble with severe high blood pressure,

and I still haven't given up real coffee completely. But I'm afraid smoking

should be at the top of the list if you have IgAN.

Finally, if your doctor knows nothing about IgAN, perhaps you should be

referred to one who does, like an internist at least, if not a nephrologist.

I hope this helps.

Pierre

Re: inflammation question

> > > >Date: Fri, 26 Jan 2001 15:43:18 -0000

> > > >

> > > Actually the reason my IgAN was detected

> > > >almost a year ago was because I was complaining of fatigue and

> > > >shortness of breath. My haemoglobin was then found to be around 100

> > > >g/L (normal for my age would be 150 g/L).

> > > >

> > >

> > > _________________________________________________________________

> > > Get your FREE download of MSN Explorer at http://explorer.msn.com

> > >

> > >

> > >

[Guest guest]

Ginger, I also get short of breath, but at odd times of the day and night

and it is not related to exertion as I don't get short of breath running up

stairs. Thanks Pierre for your comprehensive summary. I am going to speak

to my doctor again as the inhalers don't make a bit of difference.

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[Guest guest]

You're welcome . If you were prescribed inhalers because of suspected

asthma, it could also be that the doses are not big enough. So many things

can cause shortness of breath. ACE inhibitors used to do it to me every

time.

Pierre

Re: Re: shortness of breath question

> Ginger, I also get short of breath, but at odd times of the day and night

> and it is not related to exertion as I don't get short of breath running

up

> stairs. Thanks Pierre for your comprehensive summary. I am going to

speak

> to my doctor again as the inhalers don't make a bit of difference.

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

>

>

[Guest guest]

Not asthma Pierre - just a really long drawn out cold involving 2 courses of

antibiotics for chest infections. I sometimes wonder if the chest infection

is still bubbling away in there and that's why I have shortness of breath

and wake up coughing in the night, but when you add in the swollen bits and

the fact that I don't want to go see a lung specialist on top of everything

else... My blood pressure is low (105/75) so I had to stop taking the ACE

inhibitors, though I wonder how long the effects will continue for.

_________________________________________________________________________

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[Guest guest]

It will be interesting to see if it all resolves now that you're off the ACE

inhibitor. Most people have no problems, but these drugs have been known to

cause bronchitis. Of course, it could be completely unrelated to any of this

or to the IgAN. A couple of years ago I had a bad case of bronchitis that

only finally responded to the antibiotic Zythromax.

Pierre

Re: Re: shortness of breath question

> Not asthma Pierre - just a really long drawn out cold involving 2 courses

of

> antibiotics for chest infections. I sometimes wonder if the chest

infection

> is still bubbling away in there and that's why I have shortness of breath

> and wake up coughing in the night, but when you add in the swollen bits

and

> the fact that I don't want to go see a lung specialist on top of

everything

> else... My blood pressure is low (105/75) so I had to stop taking the ACE

> inhibitors, though I wonder how long the effects will continue for.

>

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

>

>

[Guest guest]

I get the feeling that all the drugs they keep trying out on me just make me

worse, and that if I had kept to my own exercise and nutrition routines as

well, then everything would be fine. Still I expect that moving to the big

smoke didn't help either!

Reply-To: iga-nephropathy

To: <iga-nephropathy >

Subject: Re: Re: shortness of breath question

Date: Thu, 1 Feb 2001 09:12:23 -0500

It will be interesting to see if it all resolves now that you're off the ACE

inhibitor. Most people have no problems, but these drugs have been known to

cause bronchitis. Of course, it could be completely unrelated to any of this

or to the IgAN. A couple of years ago I had a bad case of bronchitis that

only finally responded to the antibiotic Zythromax.

Pierre

Re: Re: shortness of breath question

> Not asthma Pierre - just a really long drawn out cold involving 2 courses

of

> antibiotics for chest infections. I sometimes wonder if the chest

infection

> is still bubbling away in there and that's why I have shortness of breath

> and wake up coughing in the night, but when you add in the swollen bits

and

> the fact that I don't want to go see a lung specialist on top of

everything

> else... My blood pressure is low (105/75) so I had to stop taking the

ACE

> inhibitors, though I wonder how long the effects will continue for.

>

>

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

>

>

[Guest guest]

You know, it's frustrating, but there may be some validity in what you are

thinking. When it's just mild IgAN, we never know for sure, do we? The only

thing we know for sure is that if there is high blood pressure, it will

likely get worse faster.

Pierre

Re: Re: shortness of breath question

> I get the feeling that all the drugs they keep trying out on me just make

me

> worse, and that if I had kept to my own exercise and nutrition routines as

> well, then everything would be fine. Still I expect that moving to the

big

> smoke didn't help either!

>

>