Very swollen legs and abdomen - any idea?

[thehunter]

Hi there
My brother is suffering very badly and the medical team don't seem to be able to help him or work out why things are happening.
He is in quite a lot of pain. It gets much worse when he eats or lies down.
His abdomen and legs are very swollen - he should be around 11 stone maybe less but is weighing in at 12 stone due to the excess fluid.

He had a pericardial effusion to remove fluid from around his heart but this has not helped with pain or fluid. Though they said it should. Despite Obv symptoms they ignore this until a cr scan showed the fluid build up around the heart.

He has tumours in liver, lungs, pelvis and peritoneal seeding. They say they are not huge but are growing aggressively.

Does anybody have any idea what could cause the swelling??

Obv it is caused by cancer but we are trying to find him some short term relief: by reducing the swelling / trying to reduce pain.
The doctors don't seem to know..what I'd like to find is a name for the symptoms so we can check with the doctor.
Thank you in advance if anybody has any ideas.

[mypinkheaven]

I'm so sorry. Did they put him on any heart medications? Did they mention congestive heart?

[thehunter]

Hi there,
thanks for your fast reply.
Until a few weeks ago apart being in quite bad pain for months - left shoulder/neck/back - he seemed strong. He is 43.

Docs ignored this until he got very breathless and had a fever - then a routine ct scan showed up fluid in the sac around the heart. This fluid was removed on Monday.

He is not on any heart melds.

Can heart problems cause swelling?

[aja1121]

Is anyone from palliative/hospice involved in your brother's care? In my experience they are more helpful about this kind of stuff.

Clinically, I think swelling from fluid is just referred to as "edema" regardless of why it's happening. You probably already found this on your own, but here are a couple of links I came across.

http://www.cancer.net/navigating-cancer ... n-or-edema
http://www.cancer.org/treatment/treatme ... e-swelling

I will keep your brother in my thoughts.

[thehunter]

Thank you for the links.
We haven't seen any palliative care people as yet - the care has been very disjointed (to say the least) and we are just catching up with things like this now. They will come next Thursday hopefully.

Thanks

[aja1121]

I sent you a private message...

[Lee]

Don't know if this will help, butt water pills to take fluid out of body. Diuretics.

Hope he gets relief soon.

Lee

[MissMolly]

Your bother's condition sounds concerning for ascites. Ascites involves fluid accumulation due to cancer metastasis of the lymphatic system.

The lymphatic system is similar to the vascular system - it drains and cycles interstitial fluid, fluid that is within and between tissues and organs. Lymph nodes serve as filters, analogous to filters in a water purification system. When lymph nodes are overcome with cancer, the lymph fluid cannot pass through the lymph vessels - the interstitial fluid cannot recirculate and fluid back-ups, typically in the abdomen and legs but can also involve the neck and face.

As an analogy: In years past, women who had mastectomies typically also had radial lymph node resection. The result was lymphatic edema (terms lymphedema) in the affected upper extremity. Today, lymph node resection is generally avoided in order to avoid the secondary effect of lymphedema.

In the situation of cancer, lymph nodes can become "clogged" by cancer cells with resulting lymphedema in the downstream extremity or abdomen or neck/face.

Typically diuretics are not effective for ascites fluid.

Palliative Care, care and comfort care, would be an appropriate and supportive service for your brother. Options would include periodic draining of accumulate lymphatic fluid, including placement of permanent drainage tube. However, be aware that the fluid will re-accumulate; each drainage is designed for symptomatic relief but is not a permanent "fix". Opiates/narcotics for pain control. Pressure gradient support stockings for the legs and/or inflatable leg cuffs that turn on/off and massage the legs and encourage lymph circulation.

I am sorry to hear of your brother's struggles. Lymphedema and ascites can require a multi-faceted approach from a smart medical team to provide relief.
- karen -

[thehunter]

Hi miss Molly and everybody else who has replied.

I think it sounds like a combination of Ascities and the pericardial effusion.
My brother has an appt on Monday at the hospital so I will be sure to make sure he clarifies and questions everything. Unfortunately he does not want to see any medical professionals at present - and I cannot blame him. Everything they have so far said or promised him has been wrong. He's exhausted. The care has also been very uncaring. If that makes sense.

I really hope they can drain the fluid and he gets some relief and quality of life back.

Does anyone know anybody has had Ascities drained? Does it relieve the swelling/pain?

[mypinkheaven]

I really hope they can drain the fluid and he gets some relief and quality of life back.

Does anyone know anybody has had Ascities drained? Does it relieve the swelling/pain?

Ascites can be drained by inserted a tube in the abdomen. It would relieve the pain. Are you sure your brother won't go to the emergency room today????

[thehunter]

im afraid so. He doesnt want to see anyone apart from his kids. its very difficult and i can understand fully how he feels, though its very hard. do you think it can wait till monday?

[mypinkheaven]

im afraid so. He doesnt want to see anyone apart from his kids. its very difficult and i can understand fully how he feels, though its very hard. do you think it can wait till monday?

I can understand how he feels. But if he goes to the ER he may get in touch with a doctor who can help him feel less pain - rather than waiting until Monday to see the doctor who can't seem to help him.

Is he having trouble breathing?

[thehunter]

Hi there my pinkheaven
I'd love him to go down (at least by tomorrow )rather than wait until Monday but he definely won't go. It's frustrating and worrying but I also understand how he feels.

He is breathless when he walks and also cannot lie down. He is Really tired. I hate this whole thing beyond belief.

[mypinkheaven]

Hi there my pinkheaven
I'd love him to go down (at least by tomorrow )rather than wait until Monday but he definely won't go. It's frustrating and worrying but I also understand how he feels.

He is breathless when he walks and also cannot lie down. He is Really tired. I hate this whole thing beyond belief.

I wish he would go, just so he'd be more comfortable and could lie down and rest. I'm so sorry that he and you and your family are going though this. Maybe he'll reconsider tomorrow. I hope you all have a good night.

[jhocno197]

I wish he would go to the ER now, too.

I agree with it sounding like ascites...