Increasing Swelling in legs and face

[Kshiprakapoor]

Hi All,

My father got UTI and now already did the antibiotics course, plus he got his PSA test done and that shows normal level but still he is getting swelling in his leg plus face which was less earlier and now it is increasing but no pain. Plus all the scans are normal. His Blood pressure is coming high inspite of taking BP medicine daily.

What can it be, he is again going to see Doctor tomorrow. Let's see what Doctor says this time. Can it be lymph edema due to radiation side effect after 2 years? I am so worried, please help. My family is so worried we are so tensed how to help.

[Kshiprakapoor]

The doctor is the same who is regularly checking him for prostate treatment since beginning. He is the specialist for that

[tango65]

How is his renal function, albumin, albuminuria, creatinine? He may be in renal failure with edema and hypertension. His electrolytes should be monitored. The doctor has to study him and determine what is going on with his kidneys.

[Kshiprakapoor in reply to tango65]

You are right, doctor just prescribed dytor for edena saying liver swelling/fatty liver. His PSA level is normal then is it alarming? He will be going tomorrow for further investigation with doctor. We are so scared, he seems to be taking tension due to my brother's office politics recently, can that be the cause of this sudden thing?

[tango65 in reply to Kshiprakapoor]

Is he still taking Zytiga (abiraterone)? If he is they need to adjust the dose of prednisone or give him spironolactone (Dytor has spironolactone).

[Kshiprakapoor in reply to tango65]

Okay so this means if he takes Dytor daily this will solve the problem? Can dytor be long term along with abiraterone? Yes he is taking abiraterone daily

[tango65 in reply to Kshiprakapoor]

What is the dose of prednisone? They could increase prednisone if he were in 5 mg/day to 10 mg/day and see what happens with the edema and hypertension. They should check potassium and treat him if it is low.

Zytiga causes an increase in aldosterone. Aldosterone increases reabsorption of sodium and elimination of potassium which eventually leads to edema, hypertension and low potassium.

The increase in Aldosterone can be avoided giving an adequate dose of prednisone ( to 10 mg a day). Other possibility is to block the action of aldosterone with spironolactone or with eplenerone. These drugs block the receptors of aldosterone. The increased reabsorption of sodium, and the increased elimination of potassium, the hypertension and the edema do not happen even when aldosterone is elevated.

Dytor has spironolactone. I believe it could be given chronically along zytiga. If his problem with edema and hypertension is caused by zytiga, Dytor may help to control the edema and the hypertension. They still have to check his potassium.

[Kshiprakapoor in reply to tango65]

Great thanks a lot, your reply seems logical, this input is really great and we will check with doctor this week during our appointment, amazing support on this platform

[tango65 in reply to Kshiprakapoor]

Best of luck.

[Kshiprakapoor in reply to tango65]

Thanks a lot, we need the best wishes

[Tall_Allen]

Perhaps he is not taking enough prednisone with his Zytiga? These are typical symptoms of that. His doctor should check his blood potasssium levels to see if it is low. Some men need more prednisone for replacement.

[Kshiprakapoor in reply to Tall_Allen]

OK will check that with doctor, he just said liver swelling /fatty liver and started dytor for edima. Not sure if that is alarming. He is going for further investigation tomorrow. Recently he was tensed for my brother's bad office environment can this be the cause?

[Kshiprakapoor in reply to Tall_Allen]

Great suggestion will check with doctor this week, thanks for your support and time

[Tall_Allen]

How much prednisone is he taking?

[Kshiprakapoor in reply to Tall_Allen]

Not sure, will check with him and doctor, can this be related?

[Tall_Allen in reply to Kshiprakapoor]

Did you read my reply?

[Kshiprakapoor in reply to Tall_Allen]

Yes you mentioned these are typical symptoms of that. Sorry just that going crazy by thinking non stop, but is this alarming or can be controlled. From your reply it looks like it can be controlled

[Magnus1964]

Is he on any medication? some ADT drugs will have side effects of swollen ankles. Prednisone has a side effect of a swollen face if he is take it in conjunction with Zytiga.

[Kshiprakapoor in reply to Magnus1964]

Yes he takes daily arbiterone 1000 mg, plus prednisone but I have to check dosage of that, so how to remove this side effect since 2.5 yrs there was no such side effect. Last night he started dytor and passing too much urine

[Magnus1964 in reply to Kshiprakapoor]

Usually the Prednisone dose is 5 or maybe 10mg. It should not have the swollen face side effect, but everyone responds differently.

[Kshiprakapoor in reply to Magnus1964]

Thanks, will check potassium level with doctor this week

[2dee]

May be no help but since 2002 and heart bypass surgery I have fought lower leg swelling, especially in Summer. Can get fairly serious and painful. Looks like they are ready to burst sometimes.

BP medications are the culprit. I've been through 3 and minimized dosage to seek a balance between lowering BP and reducing swelling in legs. Never have found the right med and dose. The best help for ME is long compression socks and elevating legs whenever possible.

2Dee

[Kshiprakapoor in reply to 2dee]

He started BP medicine 2 yrs back, not sure if that's the case but can check with doctor this point too

[Hidden in reply to 2dee]

Yes I was going to suggest raising legs too. I came back from an overseas trip / flight with edema which is very unusual for me. Too much sitting? Someone suggested too much salt in the cruise ship food?

[Kshiprakapoor in reply to Hidden]

Not sure, today is Sunday and now we are checking with hospital for admitting him for heart checkup as his BP is still 150 and BP medicine can not bring it down and now he feels like vomiting but cannot vomit and once got nausea too

[Hidden]

Agree Potassium short highly suspect. "Low Normal" is NOT enough to fix water retention from all these poisons. Get it up above average (low High) and see if that helps.

[Kshiprakapoor in reply to Hidden]

Okay thanks

[Tua32427]

My father had really bad face swelling and very bad swelling in his legs. He was on a steroid to help with bone pain. They tapered him off that figuring would get better. It still didnt. The doctor then said it was from his heart (torn aorta) or kidneys. He was on hospice so they didnt do any further testing. Does your father have any heart conditions?

[Kshiprakapoor in reply to Tua32427]

No heart conditions and kidney test is also normal, just high BP is there and little liver swelling whic doctors said is not an issue, he again showed the results to kidney specialist which is normal

[Tua32427 in reply to Kshiprakapoor]

I sure hope they figure this out for your father. Keep being your fathers advocate. Best of luck

[Kshiprakapoor in reply to Tua32427]

But if there is problem in kidney or heart it will come in reports right?

[Tua32427 in reply to Kshiprakapoor]

Well honestly my dads case in different. It took 3 trips to the hospital before they realized he had a torn aorta with anerysm. Everytime he had same symptoms. Confusion. Could barely speak. High blood pressure and paralysis. Each time they supposedly check his heart i mean we all believed it was a stroke. They would tell him low iron or was his pain meds making him loopy. He would always get better like the next day. Finally 3rd time we took him his blood pressure was 202/101. And after extensive testing. They found the heart problem. Every person is different though. I dont tell you this to scare you but its just worth maybe taking another look.

[Kshiprakapoor in reply to Tua32427]

So BP medicines were not working on him? And what was the reason for high BP

[Tua32427 in reply to Kshiprakapoor]

The bp meds werent working bc his heart was torn. They needed to do surgery but couldnt because of the cancer. It took almost 4 days in ICU to stabilize his blood pressure. Im guessing the drs didnt see it on test until 3rd time at hospital.

[Kshiprakapoor in reply to Tua32427]

Ah OK, so for a cancer patient heart surgery is not possible?

[Tua32427 in reply to Kshiprakapoor]

I am not a doctor so i cant answer that. I know the doctors informed us because my fathers prostate cancer was so advanced that he was not a good option to have surgery. He told us the surgery would be very difficult to do on a healthy person let alone someone with advanced cancer. I cannot stress enough every person is different. Your fathers case is different than my father. I am just suggesting if the swelling is still there to ask the doctor again about the heart and kidneys just to double check. Its worth a shot. Goodluck inreally do hope you get your answers!

[Kshiprakapoor in reply to Tua32427]

Yes definitely it's a great input as kidney tests are done and normal for heart they just said bp is still high so today changed BP med. But now I will ask them to do heart test, great input thanks

[Tua32427]

I should add to my reply that his swelling didnt go down until a week before he passed. And then tons of fluid started leaking and he became confused. At that point my mom, the nurse, and I believed it was his kidneys because he was also not urinating. Every person is different but I would def make sure his heart and kidneys are checked out. I sincerely hope they figure it out for my father was very uncomfortable like that.

[Kshiprakapoor in reply to Tua32427]

So was it not showing in the tests for kidney or heart?