Enlarged spleens and dehydration – A Cautionary Tale

[PaulaS]

There can be complications of enlarged spleens, that we don’t always think of…

Last week I went down with a nasty tummy bug… Usual symptoms - stomach cramps, explosive watery diarrhea, nausea etc. I thought it was something I’d eaten (probably some fish that had been in the fridge too long). I’d give it a few days, and it would pass... But it didn’t.

Then my temperature shot up to 38.8, and I felt TERRIBLE… Nasty headache, extremely whoozy… I could hardly stand up, never mind make it to the loo... I alternated between feeling cold and shivery, and hot and sweaty. Ached all over.

Hubby said my face looked ghostly white – so unlike my usual rosy complexion. I couldn’t think straight, but he rang 111 (The UK service to discuss whether medical attention is necessary), and they sent paramedics round. They arrived in an ambulance… Bit OTT, I thought, and all the neighbours would notice…

Anyway, the medics checked me out and said I was VERY dehydrated. Blood pressure 84 over 48! I MUST start drinking more or I'd need hospital admission... So, they waited a while to see if I could keep some water down. (At first I’d felt too nauseated to even try). After sipping my way through a glass of water, I felt a bit better, and the ambulance left without me. Phew...

I have a nursing background, and am familiar with the problems of dehydration. I should have realised what was happening… But it had been a busy Bank Holiday weekend… Hubby had fallen off a ladder and broken his arm (which is now in a plaster). We’d had family staying, and I wanted to be well, for them. With so much going on, I hadn’t noticed how little I was drinking.

And because of my enlarged spleen, my stomach is squashed and has very limited capacity. It’s much harder to drink enough fluid, when there isn’t much room in your stomach…

On Tuesday I phoned my GP (as instructed by the paramedics), and he sent a nurse round to take bloods. (FBC, U&E, Creatinine, & CRP). A stool sample was also sent off. But by then my BP was up to 100/60, and temperature almost back to normal. So, things were going in the right direction.

The next morning, I was very surprised to get a phone call from my GP. The blood tests had come back very awry (not just the WBC), and he wanted to do repeat tests. He wasn’t specific about what was wrong, but said not to worry - it was probably due to the dehydration. So, this morning I had some repeat tests. I’ll be interested to see how they turn out.

I’ve had my grumbles about the NHS in the past but on this occasion, I feel I’ve been very well cared for.

I have written all this as a warning. Dehydration is not good for us. If prolonged, it can permanently weaken kidney function - something none of us want, especially when facing treatment for CLL. If you have diarrhea, remember to DRINK PLENTY OF WATER (maybe with a touch of salt and sugar in it, or buy some re-hydration salts from the chemist). Yes, we probably already know that, but maybe some of us, like me, don’t always act on it… specially those of us with enlarged spleens.

Keep safe everyone,

Paula

P.S. Some tummy upsets need more active treatment than just keeping hydrated of course, but we certainly don’t help ourselves if we forget to drink.

P.P.S. The photo of the little Welsh waterfall,and all the lush greenery around it, is a reminder of the richness that water brings...

[Kwenda]

Just had another colonoscopy and of course the preparation is several large doses of a laxative to clean out the colon.

The laxative in these large doses has the obvious effect and a day is spent with rapid urgent toilet visits.

Again the instructions are to DRINK LOTS OF WATER… The wording is plastered all over the instruction sheets in big red letters.. It was tough to keep drinking the volumes they told us to drink.

So yet another reason to keep drinking almost as much as we can..

Glad your now feeling better Paula..

Dick

[PaulaS Volunteer in reply to Kwenda]

Sorry you had to have the colonoscopy, Dick. I hope it didn't show any problems.

Yes, the laxatives they give before colonoscopies are pretty violent... Thanks for reminding us of another reason for needing to drink lots of water.

It's made me think about other times that extra fluids might be needed... Hot weather, vigorous exercise, sweating a lot...

Gotta keep drinking...

Paula

[London_Girl]

Sounds awful Paula..hope you feel better soon. Thanks for the advice..keep us posted on your progress

Maria xx

[PaulaS Volunteer in reply to London_Girl]

Thanks Maria. I'm continuing to improve, though not quite as quickly as I'd hoped. Could have been worse though, and the very fact that I'm improving encourages me that something still works in my immune system

Take care,

Paula

[PeterMasih]

As the Student Prince sang, Drink, drink, drink!

[PaulaS Volunteer in reply to PeterMasih]

Nice song... I don't think it's water that it's about though.

[AussieNeil Partner Administrator]

Paula, glad to hear that you are on the mend and I hope that the blood test results of concern are resolved when you get your latest results back.

Love the waterfall photo. That water does look good enough to drink from the stream, but I'm sure we all know that with CLL, that would be very unwise and we would likely end up sharing your symptoms...

Neil

[PaulaS Volunteer in reply to AussieNeil]

Yes Neil, I wouldn't advise drinking from that waterfall. Though it actually comes from a source not much further up that mountain, so it's probably a lot cleaner than some - unless there's a dead sheep in it, a bit higher up.

[jangreen]

Hi yes what you say about dehydration is right. When I caught a nasty germ and could not keep anything down (I have reflexing due to a hernia just above my stomach) I had to have a drip which worked wonders. Dehydration is serious and sometimes you need medical intervention. Hope you feel on the mend. Best wishes

[PaulaS Volunteer in reply to jangreen]

Hi Jangreen,

Yes, when we have any condition that stops us keeping water down, drips are usually the only answer (unless we recover quickly). Sorry to hear you needed one. As you say, dehydration is serious... That was why the paramedics waited with me that night, to see if I could keep down the glass of water. If I hadn't done, they would have taken me to hospital for a drip.

I was interested to see the Wikipedia info re dehydration. All rather sobering...

"Dehydration occurs when water loss exceeds water intake, usually due to exercise or disease. Most people can tolerate a three to four percent decrease in body water without difficulty. A five to eight percent decrease can cause fatigue and dizziness. Over ten percent can cause physical and mental deterioration, accompanied by severe thirst. A decrease more than fifteen to twenty-five percent of the body water is invariably fatal... as organs fail, starting with the kidneys....

However, In people over age 50, the body’s thirst sensation diminishes and continues diminishing with age. Many senior citizens suffer symptoms of dehydration (without realising it). Dehydration along with hyperthermia results in the elderly dying suddenly during extreme hot weather."

I had been surprised that I did not feel thirsty, when I was getting dehydrated, but now I see it's probably because I'm a "senior citizen".

Paula (drinking a mug of hot water)

[BLEVINSheritage]

Hi Paula, My name is Lorrie. I reside in Ohio, USA . My heritage is Welsh. So your picture just makes me want to visit Wales that much more. I write to ask why or how did you come to the conclusion your spleen was enlarged ?

I had 18 inches of my colon removed as a result of reoccurring diverticulitis. During the recovery, an ischemic bowel being the trigger ,I am told, caused a Portal Vein Thrombosis and enlarged spleen. Sometimes , and more and more, I feel pressure, bloated like a barrel when I eat. Even the smallest of meals. I have extreme thirst and I am not diabetic. Lastly, extreme fatigue has returned. My immune system is way down. I am followed for Lupus Erythmatosis. American medicine is reactionary at best. I belive in being proactive. I just wondered your symptoms? I feel talking to others gives me the power to be my own health care advocate. It helps me form a thought process to ask the best questions in the two minutes I am given with the doctor. I hope you are feeling better. I have never replied or signed up on any of these things. But when I saw Welsh. I just did it! Be blessed.

[PaulaS Volunteer in reply to BLEVINSheritage]

Hi Lorrie,

I'm glad my photo made you want to vist Wales. It is a very special place - everyone should visit at least once in their lives.

I'm sorry to hear about your various health problems. It sounds very complicated. As you say, it's good to be proactive about our health, get as much information as possible so we can be our own advocates.

You ask how and why I knew that my spleen was enlarged. There are many different reasons for enlarged spleens, but mine was due to having Chronic Lymphocytic Leukaemia (CLL). This site is specially for people who have that disease so there are many of us here with that problem.

You don't mention having CLL so the reasons for your enlarged spleen will probably be very different. But many of the symptoms will be similar whatever the cause of the enlargement.

When a spleen gets bigger it presses on the organs around it. There is often a feeling of pressure in the abdomen, particularly the left side. The stomach can get squashed, giving less room for food and fluids. People with enlarged spleens often feel very bloated after eating. They feel full after the smallest of meals, so eat less and often lose weight (as I did). They may not be drinking enough and are more likely to get dehydrated (like me in the story above). I also found myself burping a lot!

As the spleen gets more enlarged, it can be felt as a mass in the abdomen. Doctors could feel the tip of my spleen when it was just slightly enlarged - I could feel it myself later on, when it was much bigger. It was only after I had an ultra sound scan though, that the doctors were absolutly sure.

You have a very different set of health issues from me, so any solutions will be different. For people on this site, when they start on treatment for their CLL, their spleens and other enlarged lymph glands usually shrink back to normal size. That won't work for you of course, as the reasons for your enlarged spleen are different. You've had complications from bowel surgery and Lupus... A lot to deal with...

I do hope you'll have some good, lengthy consultations with your doctors, where you can ask all your questions and be listened to.

I'm glad you felt you could come to this site, even though you'd never signed up to such a thing before. It made such a difference to me when I found this group of people, and had others to talk to who are going through similar problems. We all need to know we're not alone.

However, this isn't really the most appropriate support group for you, as you don't have CLL, and the issues here will be very different to yours. Maybe you could look at other groups on Health Unlocked, and see if there are any for Lupus, and/or bowel problems.

I'd be interested to know how you get on. You can send personal messages via "chat" if you click on the speech bubbles (then "compose") in the menu bar at the top.

Be blessed,

Paula

P.S. It's 4 years since I wrote this original post. A lot has happened since then! But I'm now on treatment for my CLL and am feeling a lot better.

P.P.S. My heritage is partly Welsh too, though I live in Sheffield, England.

[BLEVINSheritage]

Thank you so much for taking time to speak to me. I will be seeing my doctors. Have blood work and scans scheduled. Your support that I did ok reaching out. That you agree we must be our own advocate. This was encouraging. Thank you again. I will see if there is another site. Take care.