Edema, Lasix and Insulin Resistance - HELP!

Hi. I am a 37yo male and I am “Borderline Diabetic” (my Hemoglobin A1c was 5.5, back on 8/15/07), according to my doctor. He tells me that I’m “Insulin Resistant” and that there is only one medication available. He adds that the medication is extremely dangerous and is already involved in a class-action lawsuit, and therefore doesn’t recommend my taking it.

Practically every system in my body has gone haywire and my blood tests are always out of whack (RBC, HGB, HCT, PLT, MCH, MCHC, %EOS, Cortisol, FSH, LH, Sed Rate, Testosterone (Free), Testosterone (Free, Percent), Testosterone (Total), DHEA, TSH, Triiodothyronine(Free, Serum), BUN, Chloride, CO2, Creatinine, Glucose, Insulin, Total Protein, AST, ALT, Alk Phos, Anion Gap, Globulin, A/G Ratio, Bun/Creat Ratio, Triglyceride, HDL, CHD Ratio, HDLD, LDL, LDL/HDL, HDL Risk, Complement TOT and Complement C4 (I’ll add specific details, later).

In addition, my Gall Bladder has “Sludge” in it and is only operating at 50%. I have Hepatomegaly, Dermatofibrosarcoma, Peripheral Neuropathy, Raynaud’s Phenomena, Migraine, Fibromyalgia, Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, Venous Insufficiency, Gynecomastia, Erectile Dysfunction, Hypogonadism, Cushing’s Syndrome, Addison’s Disease (Temporarily brought on by Prednisone Therapy, which I was on for two years), Obstructive Sleep Apnea, Sleep Paralysis and Eczema (among others, which have slipped my mind for the moment, though I will add them later, as I think of them).

My main symptoms include: Itching (all over), Difficulty Urinating (Difficulty starting stream, difficulty maintaining flow, going frequently, burning pain), Neuropathy Pain (Pins & Needles and Cutting, Burning and Water Sensations - also, when I scratch my knee, I feel a tickling feeling in my neck, kinda like the feeling you get in your stomach when you go really fast down a hill, in your car . . . except that the feeling is in your neck), edema (all over), blurred vision, excessive gas, increased sense of smell, night sweats, hot flashes followed by chills, gynecomastia (enlarged male breasts), abdominal pains, back pain, exhaustion, tremors (mainly in the arms), darkened skin in the armpits, loss of body hair (not total loss, but significant), visual hallucinations, auditory hallucinations, balance problems, numbness (especially in the hands and feet - in fact, I am constantly losing my sandals), extreme thirst, dry and scratchy eyes, extremely dry mouth, rapid tooth decay (I had to have all but two of my teeth removed because I have no saliva when I’m sleeping - I have very little saliva when I’m awake).
I’ve lost nearly three inches from my height, in recent years. I had gained a tremendous amount of weight, while I was on the Prednisone, but since I came off it last year, I have lost one hundred pounds. I am slowly, but steadily losing weight, at a rate of two to three pounds per month. Here again, I’m sure there are symptoms which I have forgotten, but I will post them as they come to mind.

I’m taking the following medications: Provigil, Atenolol, Oxycontin, Oxycodone, Furosemide (Lasix), Potassium Chloride, Spironolactone (Aldactone) and I sleep with a Bi-Pap machine.

Anyway, my question is this: Since dehydration is an issue for people who are insulin-resistant, what can be done about having to take Lasix? It’s important to know that I had problems with dry mouth and thirst long before I started taking any medications.

Also, if anyone has any ideas as to what my diagnosis might be (other than the ones mentioned above), PLEASE share them with me. NO doctor has been able to tell me what’s wrong with me and I am desperate! I suffer every minute of every day (even my nights are tortuous - I have horrifying nightmares, including unearthly smells that would turn anyone’s stomach). I only get a few hours of sleep each night.

Whatever is wrong with me, it seems to have something to do with “regulation”. For example, my temperature used to be 97.6 and now it is 100.2. It’s as if my temperature “dial” has been turned up to a higher setting. The same thing applies to my pain levels. I’ve heard of an illness where the person can’t feel pain. It’s as if their dial was turned down to a much lower level. I picture the “pain dial” as having a scale of -10 to +10, with 0 (zero) being the “normal” setting; mine is set for +10.

Well, I must close for now. I know that I’ve forgotten many important pieces of information, but I will have to add them as I think of them. In the meantime, I want to thank anyone who is reading this. I realize that it is quite a bit of information, but if there’s one thing that I’ve learned through all this, it’s that sometimes the seemingly most insignificant piece of info can be the most important key of all.

Thanks again for your time. I appreciate all responses.
Have a great day. :slight_smile:
Joe

Definitely sounds like something’s set you on “overdrive”…

I have had such serious issues with Lasix, and I’ve never heard anyone with good experiences with it, that I worry it’s overprescribed. If I take any sort of diuretic, I end up with swollen and painful calves, which limits circulation to my feet and toes, causing a loss of sensation. (In short – for me, they do exactly the opposite of what they are prescribed to do.) What works for me there is reducing my sodium intake and wearing medical compression hose. (The compression hose are almost the greatest thing since sliced bread :slight_smile: )

I would speak to your doctor about the “regulation” issue; there may be some overarching issue that is causing all the other problems you are having.

I would also talk with your pharmacist (I sincerely hope you are getting all those medications from a single branch of a single pharmacy); he or she may be research the possibility of odd interactions and side effects that don’t appear in the literature given to most prescribing physicians or in the general “contraindications” databases pharmacists use before dispensing prescriptions. If you get your prescriptions through a mail-order pharmacy, find a local drugstore with a real pharmacist, and see if you can get a consultation.

As far as dehydration, did your doctor tell you that you needed to drink a certain amount of fluid with the Lasix? I found that if I didn’t drink enough while on a diuretic, I would swell up even worse. Check your sodium intake: if you haven’t already, try reducing it to under 1500 mg/day. If it’s already under 1500 mg/day, try reducing it to under 1000 mg/day.

Have your kidney functions and your prostate checked, also. The urinary symptoms, combined with the altered liver tests, suggest there may be some issues with kidney function. Also, the TV ads for the various “enlarged prostate” medications suggest that the urinary symptoms may be indicative of either enlarged prostate or prostate cancer. The elevated body temperature also suggests a persistent infection… again, check the kidneys and prostate.

I’m not a doctor or a medical professional (or even male) – this is just based on what you’ve mentioned in your cry for help. Hope this gives you some thoughts on ways to proceed.

The other thing that pops into my mind is, have you ever had a DNA test? The hypogonadism and gynecomastia suggest the possibility of being an XXY male (either that, or maybe you’ve been exposed to too much bovine growth hormone in your milk)…

Hi Joe! I can’t help too much… but have you had your blood sugar checked after eating (not just your A1c or fasting)? Perhaps buy a blood sugar meter (if you don’t have one) and check it 1.5 to 2 hours after eating. This will at least give a picture of what your blood sugar episode is doing during the day. I hope someone else is able to help more!!!

Hi Joe,
I am very sorry for all the problems you are having. While i deeply rrespect everything tmana says I would ask you please do NOT restrict your sodium intake to less than 1000mg per day. That is only 1 gram per day and it is not enough. As a kidney patient for several years, the average restriction is a 4 gram per day restriction. It may seem like a lot, but there are all kinds of things in your body that depend on sodium. You can go a little lower, that is an average restriction. A dietician can help with whatever restriction you need.
The next thing I would tell you is that i can’t diagnose anything. I do have a few questions about the medicine you take. Are you aware that the Provigil is to keep you awake? do you actually have Narcolepsy? Do you fall asleep every few minutes no matter what you are doing? It will definitely keep you awake at night. Also the Atenolol is a beta blocker used for hypertension. But it is contraindicated in liver disease, kidney disease, thyroid problems and neurological problems like Reynauds. The problems with the pins and needles as well as other symptoms may be coming from your medicine. Any testosterone products you are taking may also be increasing the size of your prostate and causing the problems with urination for you. Next, the problem with the Lasix. Have you had a GFR (glomerular filtration rate) done? The Lasix works on the glomeruli in the kidney and if your rate is a problem like it sounds, the Lasix will actually put you deeper into kidney failure causing more of your problems including the increase in edema… There is another medication called Bumex that works on a diferent part of the kidney, that will help with the edema much better. You can actually see the Bun and Creatinine decrease over time with the Bumex. The next thing you need is a thyroid function test, not just a TSH, but also a T4 as well. The blood work you have had done is good, but you need someone to actually see the whole patient and treat accordingly, not just spot treat.
Your dry mouth problems, tremors and also the hallucinations can be the Provigil and the codeine. A very simple treatment is a warm water and salt solution rinse several times per day and definitely before bed after brusing the two remaining teeth. Do not swallow any of the solution. The extreme swings with the medication you have can cause the whole body aches to intensify. Please do not use any ibuprofen as this will probably increase the kidney problems and edema.
The suggestion about a glucose meter is a very good one. Also I suggest that you watch the amount of carbs and also the amount of protein you take in. I don’t know what your Bun and Creatinine readings are, but you can help them by cutting these back. You are on target with the exercise and weight loss. Keep moving. Not to do so will let the pain win and will eventually start knocking out your joints.
I am truly sorry Joe for all the problems. But I welcome you to our family and am glad you are here.

I forgot to add the advise about the itching. Many of us have itching when our blood sugars are nuts and also with a high uric acid level (BUN). You need to shower or bath when you have a little time to spare. Do not rush this part. Use a cream oil shower gel or extremely mild soap and one of the puffy balls to rid your body of old skin cells. After the bath or shower use some plain, unscented almond oil and massage into your skin. It will absorb slowly. The unscented is important. You can more likely find it in the cooking oil section or at a natural or whole foods market. This will soften and hydrate your skin and will not bother the eczema areas either. Make sure you are not wearing wool. Also make sure you are getting plenty of fluids and i know this may seem contrary because of the edema. Please cut out or cut back severely on the caffeine. My best wishes to you.

Joe, I was looking up something on sodium metabolism and ended up diverting to a discussion of Cushing’s Syndrome. According to Pathophysiology: Concepts of Altered Health States (Sixth Edition), a lot of the symptoms you describe (including the impaired glucose tolerance/borderline diabetes) could be directly related to Cushing’s (discussed pp. 920-922). If you haven’t already, I would suggest you work with an endocrinologist who understands both pituitary and adrenal disorders.

Hi everybody,

Thank you for your great responses. I apologize for my delay in responding. I look forward to replying to each of you. Have a great day. :slight_smile:

Joe

Dear Tmana,

I’m not surprised that you had some issues with Lasix. I often wonder if it’s doing more harm than good, but on the few times that I have forgotten to take my medicine, I swelled up much more than usual. So, I’m assuming that it’s working like it should (although, I’ll be glad when I no longer have to take it).

As far as my sodium intake, I have been using sea salt and low sodium seasonings. However, today, my doctor told me to eliminate salt, altogether. She’s also increasing my aldactone dosage, in an attempt to normalize my potassium level, which she said, should help me get rid of some of this excess fluid. Next week, she has asked me to have my blood tested, to check my potassium levels. She’s also making sure that the medicine doesn’t shut down my kidneys. If all goes well, she wants me to increase my dosage, once more.

I do have a problem with drinking too many soft drinks, which I’m trying to cut back on. I’m starting out, by switching to caffeine-free drinks.

Your suggestion about wearing compression hose is a great one; in fact, I’m already wearing some. And, I highly recommend them to anyone who suffers from fluid retention in their legs.

Like you, I also believe that there may be some single illness that’s causing all the problems that I’m having.

Getting all ones medications from the same pharmacy is great advice; and fortunately, I already do that. Also, I checked with my Pharmacist, a while back, about any possible contraindications; he told me that he automatically does that every time I fill a prescription. Personally, I find that hard to believe because, when I checked for Drug Interactions online, it brought up half a dozen serious interactions (this was back when I was taking fifteen different medications at one time). Since then, I always check for interactions, any time I get a new prescription.

That’s all I can do, for today, but I’ll be back. Thanks again, to all of you. Your kindness has renewed my faith in mankind.

Have a great day. :slight_smile:
Joe

The following is Part 2 of my reply to tmana:
When I asked my Dr. how much fluid I should be drinking, she told me" if you’re thirsty, drink something; if you’re not, then don’t". I’m always extremely thirsty and I drink a lot of fluids, but try not to overdo it because I go to the bathroom way too often as it is. It’s certainly a “catch 22” situation.

I had my kidneys and my bladder checked, last year, and I was told that it was my pain medication that was causing my urinating difficulties. This is odd, considering that I’ve been taking pain medication much longer than I’ve had the urinating problem. Regarding my prostate, I had a digital rectal exam shortly after the problem began and everything was normal. A few weeks ago, I have a PSA test done and it was normal as well. So, according to the Dr., I don’t have an enlarged prostate or prostate cancer. I’m like you, in that I also pay attention to TV ads for medications, every time a mention them to my Dr., He gets aggravated with me.

It’s so weird that you would mention a DNA test, because I’ve often thought that the root of my problems could very well be a chromosome issue. In fact, I recall reading that dermatofibrosarcoma is thought to be caused by a chromosomal mutation.

The following is regarding your later post:
When I first found out that I had Cushing’s Syndrome, I did quite a bit of research on the subject. But, since then, I haven’t given it much thought. I’m so glad that you brought it up. I’m definitely going to reexamine the information. I haven’t been to an endocrinologist yet, but it’s a great idea. I have an oncology appointment on Monday, so I’m going to ask her for a referral .

You’ve really given me a lot to think about. Thank you so much for your time and information. You’ve been a lot of help. :slight_smile:
Joe

Dear Kristin,

I’ve always fasted for my blood tests, but I like your idea. I can’t afford to buy a glucose meter, but my Medicaid or Medicare might cover one (depending on whether borderline diabetics qualify). If they do buy me one, I’m definitely going to try your method.
Thank you so much, Kristin. Your advice is very useful to me. I’m so glad that I posted my question on this site.

Have a great day. :slight_smile:
Joe

The following is Part 1 of my reply to Saundra:
Dear Saundra,

My Dr. simply told me to eliminate table salt, but I can still eat food that has salt in it. Do you think that I will get enough sodium in my diet?

I am aware of the affects of Provigil and I take it for narcolepsy. Before going on Provigil, I was constantly going to sleep at the drop of a hat. Must scariest episode was while driving one day when I woke up in the path of an oncoming vehicle. I can’t tell you how many times I would wake up, with no recollection of driving for long stretches. I can sleep anywhere, at any time, and I had no control over it. But, I’m so thankful for Provigil, as it has made such a difference in my life. And, it has no apparent side effects. As far as my sleeping difficulties, I discovered the cause. For several days, last week, I overdid things a bit and I retained more fluid than usual. Apparently, the more edema I have, the less sleep I get. But, I’ve rested since then and the sleeping problem is gone.

Speaking of sleep, I better close for now. But, I will return as soon as I can. I want you all to know how much your responses mean to me. I greatly appreciate your time and and compassion.

I’ll be back soon. :slight_smile:
Joe

Joe,
It is wonderful to hear from you and sounding better. That is a tremendous encouragement to all of us. Keep working on things and keep us posted… You have apparently accomplished a great deal in a short time. Good work.

I see that you have Fibromyalgia and CFS. I have fibro, and weird blood sugar issues (and other things). What you may not know is that a low vitamin D level has been linked to both fibromyalgia and CFS. If they have not checked you, get them to pull both a 25-OH vitamin D and a calcium level. I have low levels, and my step-mom, who has long term CFS, just got hers pulled, and they are even lower!

I did a bunch of research on this. Apparently people who have been so bad they have been in wheelchairs got out of them after building their D levels up sufficiently. For some people it has made all the difference. I myself had trouble with an allergic reaction to the mega D dosage that I was given; I am now attempting to get as much D in me as I can, building up slowly, and I am feeling somewhat better. I am still having fits with blood sugar (they took me off the meds, and my exhaustion after eating and edema returned), but at least something has improved.

I know how hard it is to be so young and have to deal with all of this stuff. I got sick when I was 29, and it’s been a long road with many setbacks. Good luck to you…

Hi Joe,

Just a thought about the itching. Codine of any kind makes me itch, a lot. It also makes me hyper not sleepy. Also following surgery and a bad reaction to morphene the codine that they sent me home with gave me terrible nightmares.

Also I have fibr and CFS and have been diagnosed with low vit d levels too.

Maybe this will be a piece to your health puzzle.

Mel

I wish you well Joe. Big HUG

To Mel and Dianne: Thank you for your replies.

To Mel: It’s funny that you mentioned side effects. I’m actually in the process of researching my current medications. If I find anything that matches my symptoms, I’ll post it here. Thank you for the information. Every bit helps. I really appreciate you taking the time to post a reply. I hope you’re having a good day. :slight_smile:

To Dianne: Thank you for your kind wishes. You’ve really brightened my day. :slight_smile:

Sincerely,
Joe

Joe – I recently read some interesting things about atenolol that suggest your doctor might want to do some additional reading. This link is to an article in Diabetes in Control, a Web-based publication aimed at medical doctors. Apparently there are some issues specific to atenolol. FWIW, I was on atenolol from shortly after diagnosis for about a year and a half. I think it may have contributed to my peripheral circulation issues.

Now, because you have a number of medical issues, I would approach this more on the order of, “this is what I saw, this is the audience it’s aimed at, could you check a bit further into this?” than taking it automatically as the Gospel Truth.

hello! hope you will be well!!! take care!!!

Joe, as a licensed massage therapist, I hear medical histories every day from clients. I research everything about which I am unfamiliar. I strongly urge you to get your Vitamin D3 level tested! I believe you are severely deficient! Vitamin D3 will make your body more insulin sensitive, improve mood; reduce itching; improve bone health, and a long list of other things. I could tell you several stories shared with me by clients who have been on Vitamin D3 supplementation. Do not be fooled by the FDA’s LOW dose recommendation, it is completely out of touch! The blood test is not expensive and may just save your life! My son is diabetic, but not insulin dependent. He’s been taking 6,000 IU of Vitamin D3 for over a month and has not been taking ANY of his prescribed medications. His BP has improved; he’s lost 10 lbs. He has not tested his blood sugar recently, but he has not felt sick. Also, be religious about taking Cod Liver Oil or gel caps. It will reduce triglyceride levels.

Is there an update to your situation? Are you still looking for answers?? Have you been checked for a pituitary tumor? Hypothyroidism/hyperthyroidism/Graves and Hasimotots disease? You say you have Cushings?? That, from what Iknow, is caused by a tumor on your pituitary secreting hormones. Let me know an update or if you want more information, i dont want to be redundant.
jen