Something Strange Is Going On

[delphicdragon]

Hi Everyone-

It's been a while since I've posted here. I was doing quite well I thought. I started my PhD program and had a wonderful 6 months, then yesterday all heck broke loose. I wasn't feeling well, kinda shaky, and I took my bp, it was 98/83, with a pulse of 142. I called my cardiologist and was told that I needed to go to the ER, which I didn't want to do, but she called the ER and since I work at a hospital I needed to go. Well, the ER wasn't too happy with me. They said I had high blood pressure (130/72) and a high heart rate (160) and I was immediately given a bed. Apparently when I stood up, my heart rate would drop out and then climb.

Well after 2 liters of saline, my heart rate was still at 115 laying down. I was told I have low potassium and a high D-Dimer level and the doctor came in and told me that I probably had a pulmonary embolism (!!!!!). Well the CT scan for that was normal, but I still have the fast heart rate even after the liters of saline and then a potassium infusion (I couldn't stomach the oral potassium) Now, I've been called a "healthy enigma" and no one knows what to do for me. I'm going to start getting weekly IVs to try to keep the heart-rate down. Blood pressure and heart rate are still high. Thanks for letting me vent. Any suggestions? Has anyone ever had a high D-Dimer or low potassium before?

Sara

[flop]

Hi Sara,

the first question to ask is when did they take the blood sample for the potassium level? If it was after they gave you a load of IV saline then it could be low because of the IV fluids. However if it was taken before the IVI was started then that wouldn't be the case.

D-dimers are often a very controversial test. The levels are high when there is a blood clot in the body such as a DVT (deep venous thrombosis) or a PE (pulmonary embolus). The test is very sensitive, but not very specific - this means that lots of people have a raised D-dimer but that doesn't mean that they all have PEs/DVTs. (Can you tell that I have been investigated for a high D-dimer??). A consultant said that the test should only be done if it is really a possibility that you have a PE/DVT (you should have symptoms before they do the test). He also said that lots of things like the common cold virus will cause your D-dimer level to go up.

Hope you're feeling better soon,

Flop

[doctorguest]

Agree with Flop about the D-dimer. I think the reason for ordering it was that the tachycardia was suspicious to the ER doctors for PE. I am glad that the CT of the chest ruled that out. Are you taking birth control pills? Have you taken any new medications or herbal supplements recently? These may also cause D-dimer elevations.

Are you being treated with a beta blocker? It would be very helpful for the elevated heart rate and blood pressure.

[morgan617]

I see you take licorice? It can lower your potassium. I find it interesting that they felt your BP was high. I've gone in with bp's of 200/120 and they didn't even put me on a monitor.

Not sure what to tell you, maybe pots is rearing it's ugly head, I hope not. I don't know anything about D-Dimers, but it sounds like one of those non specific things that really don't help much, unless you have something else specific to go with it. Then, if you don't, it gets completely ignored.

Hope you feel better soon. Did you get some K+ supplements and are they doing anything to see why it's low (except suggesting you stop the licorice and then retest?)

That BP thing is really throwing me.....morgan

[dizzygirl]

i often have issues with low potassium...echoing morgan potassium pills can help get your potasium levels to wear they need to be.. your potassium being off even alittle can knock you body out of whack...you can also try eating veggies high in potassium....

hope ya feel better soon

[Poohbear]

Sara,

Yep...I've had both of those problems too. I was told the D Dimer can also elevate with any inflammation in your body. I was told that typically if a person has a clot or a heart issue that the D dimer will be WAY elevated and/or climb over a period of several hours. If your level was "mildly" high and did not elevate you probably have nothing to worry about in that dept. but you may want to ask for a repeat in a week or so just to check on it.

As for potassium, I have found that the increase in Sodium does lower the potassium and it's a fine balance. What works best for me is eating a meal and taking K+ supplements. (Klor-con is the only thing my stomach will tolerate though).

HOpe you feel better soon!

[cardiactec]

I am with the group here in regard to d-dimer. i personally have had d-dimers several times in the recent past come back 5x the normal limit - a follow up chest CT always proved negative for a PE (clot in lung). i have seen more false positive ddimer's both on myself and on my patients than any other diagnostic. I wouldnt be too concerned about the ddimer.

as for everything else you're going through, i'm sorry to hear you're having a rough haul. feel better.

an interesting theory would be that of any correlation or connection between ehler danlos and false positives with d-dimers.....i know there are people who do not have ehler danlos that probably have elevated ddimer, but i just noticed you signature that says you have ehler danlos. i do as well. would be a cool research project. i am such a nerd!

[MomtoGiuliana]

I don't know about D-Dimers, but I often have slightly low potassium when I am feeling badly and end up having it checked. I think this is common in POTS?

[Megan]

I have low potassium, I believe due to being on florinef, but I take Klor-Con and try to eat foods like baked potatoes and such when I'm feeling off to lift my potassium levels. I just have to make sure I eat full meals every day, or the med makes me a bit sick to my stomach. I hope things get worked out for you!

Meg

[calypso]

Interesting ... I have had both high D-dimer and low K too. Never was found to be anything significant.

Amy