Overnight Weight Gain

[MikeO]

Hi,

I gained literally 5 lbs overnight night. Not the first time this has happened. I do notice a change in my urinary output/habits when this happens I also bloat up a bit. Cardiology assures me this is not due to any heart failure and has me take Lasix for a few days to dump the water weight.

Can this happen when the NS is not firing on all cylinder?

Pretty sure i did not get into any really salty either as i have been only grazing on some homemade tomato soup "made from fresh tomatoes"

Mike

[MikeO]

Well the good news is the Lasix worked and the weight for the most part is off and the bloating went down.

[Pistol]

@MikeO - I would be concerned if that happened to me, Gaining 5 lbs in one day is NOT normal. Thankfully your cardiologist has ruled out any heart failure, but there is still a cause for it. Have they checked your kidneys? Your liver? Both of these organs can cause fluid retention if there is something wrong with them. 

[MikeO]

@PistolI just had the Blood tests for both my Kidneys and Liver back in June. Both came out normal. So not sure what is up. I did notify the Clinic as my BP's are up as well "180/115" at one point over the weekend. So some quality time on the "evil recliner" kept me from going in to the ER. I dropped down to 103/70. (this drives me nuts)

[Pistol]

@MikeO - as a former nurse my personal opinion is to not try to avoid the ER when you are that ill. There maybe more to check than simple blood work. Sudden weight gain with an increase in BP that much would totally qualify you for a justified ER visit. Yes, we often can avoid ER visits by doing things at home, but what you are describing certainly warrants immediate examination by a physician! If it happens again I would go, that is just my personal opinion.

[MikeO]

@PistolI will follow your advice next time this happens. My only concern is when my BP spikes high it can and will drop low. When i was in Cardo rehab this would drive the Nurses up the wall. On one of the days I squeezed a 180 so we waited then i went to 190 so we waited then hit 200 which got me wheeled down to the ER. When they took my BP it dropped to 135.

[Pistol]

@MikeO - the fact that your BP goes up and then drops is probably due to dysautonomia. Plus dring cardio you were probably exercising and when being wheeled to ER you were resting - that theoretically also could affect the BP. I have HPOTS and during several stress tests my BP would go really high to where they had to stop the treadmill because I was close to having a seizure and as soon as I sat down it came back down. The scary thing is that the increase in BP occurs at the same time as an increase in HR, which then makes the pressure that much more dangerous! The thing that concerns me is the weight gain - that does not really happen with dysautonomia alone, it may mean there is something else going on that could be complicated by your dysautonomia. The benefit from being in ER while this happens is that they can do testing WHIE you are symptomatic. I would definitely request to have orthostatic BPs taken next time you are in this bad shape - lying down we often have lower readings than being upright. 

[MikeO]

@PistolI have had 2 TTT tests both of these indicated a Neurogenic origin of the hypotension as i had the BP drop with little of no change in HR (3 beats or less). have done the ortho tests at the clinic i am at now with the same results. One other thing to note is I have consistently had sudden drops in BP. This has been observed in the Hospital setting numerous times while being monitored "nurse will alway come rushing in to see what is up" also the supine hypertension has been noted as well and will have the head of the bed raised to 30 degrees (always bring down the bp"  

At Cardio we have seen the drop in bp after exercising 170/90 and after 108/70ish. The one day i described i never even got out of the gate. Weight gain does concern me as well.

I have had 4 stress tests first two i failed 2nd one is what got me the 4x Cabg. second two we did with not withholding the Metoprolol and i passed them. BP's were not exactly stellar but the heart rate was under control as i could not hit my adjusted HR.   

This month i do have a lot of support going on. This week i see a Neurologist (hope this is not a waste of time) and next week i go in for a ultrasound study for my PVD. I will be seeing the Vascular/Cardiologist right after. Also the clinic will be calling today in response to this weekends issues.

I can imagine when your HR went up was scary. How high did you get?. I have had issues getting tacky while taking certain med combo's think the worst i saw then was a HR of 132 while getting up from the couch. 

[Pistol]

@MikeO 

11 hours ago, MikeO said:

I can imagine when your HR went up was scary. How high did you get?.

I was monitored several times with a BP 160/100ish along with a HR of above 150 - this was during and after several episodes of either passing out or having seizures. Neither is particularly concerning by themselves but if they occur TOGETHER you can imagine the pressure present in the vessels! Other times I would get these high readings but they would be followed by a sudden DROP in BP and HR - resulting also in loss of consciousness. As you see - there are many, many ways for the ANS to go haywire! --- I hope your appointments this week will be fruitful and productive! Hang in there!

[MikeO]

@PistolThank You! Attached is a two day log as an FYI: 

[Pistol]

I will pm you

[Passing out]

MikeO - I have had the same weight gain problem 2x this last month both times it was 8 lbs in one day.  I went nuts.  Two of my doctors believe my problem is autonomic because I keep passing out, I have severe night sweats, horrid cold sweats, BP won't stay in one place.  The only good thing that has happened is a pace maker was 'installed' to get my heart rate from 30 up to 60.  I thought that might solve my problems, but everything else stuck around.

[MikeO]

@Passing outSorry to hear you are still having problems. The sudden weight gain for me is not new just does not happen very often till lately. last episode i gained 9 lbs overnight. Nurses will always cite the uptake of salt as a possible culprit and to an extent is a valid statement but i do push back as i watch my salt intake. So when this does happen the Cardiologist has me take a Lasix as needed to remove the excess fluid normally takes 2 days.

Glad to hear your pacemaker is working out, I have not had a low HR in quite awhile. When i had my 4x Cabg i thought it would fix all my issues Boy, was i wrong has been an uphill battle since.

[MikeO]

well if this has not come back to haunt me. over the last few weeks or more i have seen my weight fluctuate from 178 to 189. today i went from 180 out of bed to 187 as i write this. not sure what is up but i did message my cardiologist as i have reported this already and continued to monitor. only thing i did was drink a liter of water.

sure a water pill is coming.

[Pistol]

@MikeO I hope not! Diuretics could be bad for your NOH! 

[Sarah Tee]

This reminds me of an article I read, although it’s not quite the same as MikeO’s problem and more drastic.

https://www.washingtonpost.com/health/medical-mysteries/nearly-100-doctors-have-tried-to-diagnose-this-mans-devastating-illness--without-success/2019/09/20/0cb0e8c6-aeef-11e9-a0c9-6d2d7818f3da_story.html

When reading it, I thought there might be something autonomic involved, with the cold extremities and the blood volume dysregulation, even if it did go up rather than down. I presume they’ve tested him for connective tissue disorders genes, the ones known so far.

@MikeO did they do a bladder scan ultrasound and emptying study? I had an incident in which I suddenly stopped urinating for 12 hours and then had very low output for 12 hours, and that’s what my doctor ordered. (It was all normal and we later realised when it happened again that it was a medication side effect from OTC sleeping pills, which I was taking once in a blue moon.)

[MikeO]

1 hour ago, Sarah Tee said:

did they do a bladder scan ultrasound and emptying study?

I did have a kidney ultrasound and part of that they look for spray coming from the kidneys. well i was well fasted so nothing was noted. My Cardiologists nurse today did note that my weight is liable but then so is my BP's and blood sugars. not sure if they will do a diuretic but i know i am retaining fluid so for now i will back off the water. for some reason i am retaining it. i have stopped peeing like i normally do. go figure.

@Pistolyou are right a water pill is not good for a nOH person but the weight gain is stressful.   

[MikeO]

Update. we made some progress with some of the spikey weight gain. Cardiology is holding off on the lasix and has me trending my just out of bed numbers. last six days i have kept it stable at 179. What i have done was reduced my water intake and only drink if i feel thirsty or a bit dry mouthed or if my urine is on the yellow side. during the day i have only seen a couple of pound variance so IMO something is working. not sure why the increased fluid intake affects me or why i retain fluids but last week i did have a new high during the day of 190 so i hope i am on the right track.

Last two evenings i switched what i have been drinking to a flavored water drink mix (stevia) and have made it thru the night without the need to get up and pee multiple times

More to come i am sure. 

[MikeO]

well back on a trial of lasix. weight went back up again so to debug the issue we are going to try and dump some fluid. high has been 196 just out of bed (sigh) norm has been 179 cardiology also wants a metabolic blood draw after a few days on the diuretic to see how my kidneys are handling the med.

doubt this is dysautonomia again not all our issues are. all i can say is keep pushing for your health care.