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#1 miocean

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Posted 22 January 2010 - 10:29 AM

In previous posts I have mentioned that I have Interstial Lung Disease and was put on oxygen upon exertion. With the advent of the cold weather I had had difficulty breathing and experience shortness of breath upon minimal exertion. I went to my pulmonologist and had a CT scan and chest X-ray. He told me for the first time in 5 years that my lungs had no crackles and that he didn't think that the lungs were the problem because my CT scan an pulmonary function tests haven't changed in a year. I went to the scleroderma specialist and she said the same thing and they both suggested I see a cardiologist. She also mentioned that my hemoglobin was low and that it could be the cause of it. It was a 9. My cardiac cath came back clear as I just posted.

My hemoglobin has been dropping. It is now at a 7. They are reluctant to transfuse me because of being so close to a kidney transplant. My Procrit dose has been increased and they hope that will bring it up. I know I haven't been eating right for the past couple of months and have been losing weight. That was in another post. Too much fluid around the lungs can cause shortness of breath but they have been taking a lot of fluid off in dialysis and it doesn't seem to help.

Any experience of low hemoglobin causing shortness or breath? Is there something my doctors and I are missing? It is very frustrating.

miocean
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#2 warmheart

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Posted 22 January 2010 - 02:31 PM

Hi Miocean,

Sorry to hear you're having more problems; hope the increased Procrit dose works quickly so you're feeling better soon!

Absolutely, anemia can cause SOB. The red blood cells are what carry oxygen. When my hemoglobin dropped to 6 my O2 sat went down and I had to have an emergency hospitalization to have transfusions and prevent a heart attack. The doctors thought it was puzzling that my heart couldn't tolerate the anemia, but it turned out that my DLCO had dropped a lot, so it must have been the combination of factors.

Hope you hear about your kidney soon! :VeryHappy:

Hugs,

warmheart

#3 Margaret

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Posted 22 January 2010 - 03:15 PM

Hi Miocean ,
Shortness of breath, tiredness and fatigue can all be signs of anemia.  If you google 'symptoms of anemia' lots of sites come up that say shortness of breath as a symptom.  Sure hope you get that kidney soon.  Will keep you in my thoughts. Take care, Everyone. Margaret

#4 miocean

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Posted 23 January 2010 - 04:50 AM

Dear warmheart and Margaret,
Thank you for your responses. I immediately went on line and looked up anemia and sure enough I have some of the symptoms. One of the causes can be renal failure. The complications of scleroderma never end.

miocean
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#5 janey

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Posted 23 January 2010 - 05:58 AM

miocean,
My hemoglobin has also been low for quite while now. My rheumatologist last week said that PPIs (GERD medications) reduced the acid in the stomach and that can prevent proteins from being absorbed since proteins need an acidic environment to break down. His recommendation was to be sure to eat something with vitamin C along with the proteins.

Have you look through our page on Anemia of Chronic Disease? There is quite a bit of information on the symptoms and causes. Shortness of breath and fatigue are listed as symptoms. Here's an abstract you might find interesting.

Increased risk of anemia in dialysis patients with comorbid diseases.

With everything you have going on, it's no wonder that your hemoglobin is low. I hope you find something that helps you.
Janey Willis
ISN Support Specialist
(Retired) ISN Assistant Webmaster
(Retired) ISN News Director
(Retired) ISN Technical Writer for Training Manuals
International Scleroderma Network (ISN)

#6 warmheart

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Posted 23 January 2010 - 07:49 AM

Hi again miocean,

Yes, and exhaustion is also a symptom, which I'm guessing you must also have. I'm hoping for your kidney!!

Janey, that's interesting what your rheumatologist said about PPIs. I already knew that they decrease vitamin B12 absorption because of lowering the stomach acid, and also the disease can cause decreased B12 absorption. The silver lining in the cloud when I had anemia was that they discovered that I had a B12 deficiency, and within a few months after I started medication for that the neuropathy and cramping in my hands, which had been really, really bad for years, improved a lot.

Hugs,

warmheart

#7 MaryFanPhilly

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Posted 23 January 2010 - 10:00 AM

Greetings miocean and everyone, I too am going through a similar issue with severe anemia. In my case they are thinking it may be a slow bleed from the GI tract. Do you have gastic involvement? It seems (unfortunately) that you have everything else so I would imagine so. It may be GAVE or Watermelon Stomach, where the blood vessels that line the stomach sometimes bleed. If they haven't considered that as a possible cause you may want to ask... and are they recommending iron supplements? I've been on them for about 10 days and the change in my fatigue level, while not dramatic, is a whole lot better. There are so many issues, and so many possiblities of where different symptoms and compliations have come from, it's hard to know up from down.Good luck and we're all behind you!
Love,
MaryFan
Diffuse sclero; diabetes; hypertension; GERD with Barrett's

#8 miocean

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Posted 05 February 2010 - 04:23 AM

Thank you everyone for your responses. After a couple of weeks of increased Procrit, protein shakes and trying to eat better my hemoglobin is now up to 10.6. 12-16 is normal so I am getting closer. I am still a little short of breath but not gasping like I was. Hopefully, as my hemoglobin goes up that will go away.

miocean
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#9 CraigR

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Posted 05 February 2010 - 09:08 AM

Miocean,

I have had trouble with low hemoglobin since I went through chemotherapy for lymphoma 7 years ago. In addition, I have pulmonary hypertension to make breathing more difficult.

I can almost guess my hemoglobin level by how quickly I get out of breath. There is a direct correlation.

Your level of 7 is very low! It is know doubt that you are short of breath at that level. I would be surprised if I could walk across a romm with so low a level!

Procrit helps me a great deal.

Here is a simple way that I use for undertanding the effect hemoglobin and breathlessness:
Hemoglobin is the measure of red blood cells. Red blood cells carry oxygen to the tissues. Think of the red blood cells as little "trucks" that deliver the oxygen. When you have fewer "trucks" (low hemoglobin), the same trucks must make many more deliveries by "driving" much faster. The trucks can only drive faster if the heart speeds up to push them along. Thus the heart must work much harder to push the smaller number of "trucks" along to make the oxygen deliveries. The result is that the heart and lungs are working much harder and become exerted much sooner.

Years ago some athletes engaged in a (dangerous) practice called "blood packing", where they had transfusions of red blood cells (usually their own, which had been saved), even though their level was normal. The higher than normal level gave them much more endurance. However, the risk of fatal blood clots hadly makes it worth it...

Have you been tested for pulmonary hypertension? The only truly accurate and reliable means is by right heart catheterization. Echocardiogram is also used, but is much less reliable.

Good luck,

Craig

#10 warmheart

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Posted 05 February 2010 - 09:38 AM

Hi miocean,

That is awesome! Thanks for sharing the good news!

Hugs,

warmheart

#11 Snowbird

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Posted 05 February 2010 - 10:45 AM

I'm a little late in this Miocean...but was happy to get to end of the trail here to see that you doing somewhat better and your levels have increased. I hope the SOB goes away too as your levels increase.
Sending good wishes your way!

#12 miocean

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Posted 06 February 2010 - 03:17 AM

Craig,
Thank you for your informative response. I had a right heart catherization a couple of weeks ago. It showed no blockages but the doctor said I have minor pulmonary hypertension. The pressure on the right side of my heart is 45% instead of 50%. I see him Wednesday and have a lot of questions. I am not sure what minor pulmonary hypertension means although I have been reading about it on the internet. Thanks.

miocean
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#13 miocean

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Posted 12 February 2010 - 05:31 AM

Good news today! I am going to see my cardiologist today and had blood work for my hemoglobin on Monday. I called for the results and I am now at 12.6 which is in the normal range. I am feeling a lot better. I still get short of breath but I am not gasping like I was. Thank you for all of your responses. they really helped me. I was getting scared. I will find out what minor pulmonary hypertension means today
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#14 Snowbird

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Posted 12 February 2010 - 01:06 PM

Hi Miocean

Glad to hear you are feeling at least somewhat better and your hemoglobin levels are normal....do tell us what you discover.
Sending good wishes your way!