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Edema
Edema means swelling caused by fluid in your body's tissues. It usually occurs in the feet, ankles and legs, but it can involve your entire body.
Causes of edema include:
- Eating too much salt
- Sunburn
- Heart failure
- Kidney disease
- Liver problems from cirrhosis
- Pregnancy
- Problems with lymph nodes, especially after mastectomy
- Some medicines
- Standing or walking a lot when the weather is warm
To keep swelling down, your health care provider may recommend keeping your legs raised when sitting, wearing support stockings, limiting how much salt you eat, or taking a medicine called a diuretic - also called a water pill.
Heart Failure
What is heart failure?
Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.
Heart failure can affect one or both sides of your heart:
- With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
- With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
- Too weak to pump enough blood.
- Too thick or stiff to relax and fill with enough blood.
Left-sided heart failure is more common than right-sided heart failure.
What causes heart failure?
Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.
Conditions that can cause heart failure include:
- Arrhythmia (a problem with the rate or rhythm of your heartbeat)
- Cardiomyopathy
- Congenital heart defects or other types of heart diseases that you are born with
- Coronary artery disease
- Endocarditis
- Heart attack
- Heart valve diseases
- High blood pressure
- A blood clot in your lung
- Diabetes
- Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
- Obesity
Over time, left-sided heart failure can lead to right-sided heart failure.
Who is more likely to develop heart failure?
Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:
- You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
- Your family health history includes relatives who have or have had heart failure.
- You have changes in your genes that affect your heart tissue.
- You have habits that can harm your heart, including:
- Smoking
- Eating foods high in fat, cholesterol, and sodium (salt)
- Having an inactive lifestyle
- Alcohol use disorder (AUD)
- Illegal drug use
- You have other medical conditions that can affect your heart, including:
- Any heart or blood vessel conditions, including high blood pressure
- Serious lung diseases
- Infection, such as HIV or COVID-19
- Obesity
- Diabetes
- Sleep apnea
- Chronic kidney disease
- Anemia
- Thyroid disease
- Iron overload disease
- Cancer treatments that can harm your heart, such as radiation and chemotherapy
- You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.
What are the symptoms of heart failure?
The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.
Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.
Symptoms of heart failure may include:
- Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
- Fatigue or weakness even after rest.
- Coughing.
- Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
- Difficulty sleeping when lying flat.
- Nausea and loss of appetite.
- Swelling in the veins of your neck.
- Needing to urinate (pee) often.
At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.
What other problems does heart failure cause?
Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:
- Breathing problems from fluid in and around your lungs (also called congestive heart failure)
- Kidney or liver damage, including cirrhosis
- Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
- Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
- Pulmonary hypertension
How is heart failure diagnosed?
To find out if you have heart failure, your health care provider will
- Ask about your medical history, including your symptoms
- Ask about your family health history, including relatives who have had heart failure
- Do a physical exam
- Likely run heart tests and blood tests, including a brain natriuretic peptide (BNP) test
In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.
What are the treatments for heart failure?
Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.
Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.
Most treatment plans include:
- Taking medicine
- Eating less sodium and drinking less liquid to control fluid buildup
- Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your provider recommends
- Treating any conditions that may make heart failure worse
You may need heart surgery if:
- You have a congenital heart defect or damage to your heart that can be fixed.
- The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
- An implantable cardioverter defibrillator.
- A biventricular pacemaker (cardiac resynchronization therapy).
- A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
- Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.
As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.
Can heart failure be prevented?
You may be able to prevent or delay heart failure if you:
- Work with your provider to manage any health conditions that increase your risk of developing heart failure
- Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease
NIH: National Heart, Lung, and Blood Institute
Diabetic Eye Problems
What is diabetes?
Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.
With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.
What eye problems can diabetes cause?
Over time, high blood glucose may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetic eye problems include:
- Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
- Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (the part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
- Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
- Cataract, which is the leading cause of blindness worldwide. It happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.
Who is more likely to develop diabetic eye problems?
Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you have diabetes and:
- Have had diabetes for a long time
- Don't have good control over your high blood glucose or high blood pressure
- Are pregnant
- Have high blood cholesterol
- Smoke tobacco
What are the symptoms of diabetic eye problems?
In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.
You should also watch for sudden changes in your vision that could be signs of an emergency. Call your eye care professional right away if you notice any of these symptoms:
- Many new spots or dark wavy strings floating in your vision (floaters)
- Flashes of light
- A dark shadow over part of your vision, like a curtain
- Vision loss
- Eye pain or redness
Talk with your eye care professional if you have these symptoms, even if they come and go:
- Spots or dark wavy strings floating in your vision
- Blurry or wavy vision
- Vision that changes a lot
- Trouble seeing colors
How are diabetic eye problems diagnosed?
Eye care professionals do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your eye care professional can look for signs of eye problems and treat them before they harm your vision. They will also test your vision and measure the pressure in your eyes.
What are the treatments for diabetic eye problems?
Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:
- Lasers to stop blood vessels from leaking
- Injections (shots) in the eye to stop new, leaky blood vessels from growing
- Surgery to remove blood and scar tissue or replace a cloudy lens
- Eye drops to lower fluid pressure in the eye
But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Lung Diseases
When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.
The term lung disease refers to many disorders affecting the lungs, such as asthma, COPD, infections like influenza, pneumonia and tuberculosis, lung cancer, and many other breathing problems. Some lung diseases can lead to respiratory failure.
Dept. of Health and Human Services Office on Women's Health
Cancer Chemotherapy
What is cancer chemotherapy?
Cancer chemotherapy is a type of cancer treatment. It uses medicines to destroy cancer cells.
Normally, the cells in your body grow and die in a controlled way. Cancer cells keep growing without control. Chemotherapy works by killing the cancer cells, stopping them from spreading, or slowing their growth.
Chemotherapy is used to:
- Treat cancer by curing the cancer, lessening the chance it will return, or stopping or slowing its growth.
- Ease cancer symptoms by shrinking tumors that are causing pain and other problems.
What are the side effects of chemotherapy?
Chemotherapy does not just destroy cancer cells. It can also harm some healthy cells, which causes side effects.
You may have a lot of side effects, some side effects, or none at all. It depends on the type and amount of chemotherapy you get and how your body reacts.
Some common side effects are:
- Mouth sores
- Fatigue
- Nausea and vomiting
- Pain
- Hair loss
There are ways to prevent or control some side effects. Talk with your health care provider about how to manage them. Healthy cells usually recover after chemotherapy is over, so most side effects gradually go away.
What can I expect when getting chemotherapy?
You may get chemotherapy in a hospital or at home, a doctor's office, or a medical clinic. You might be given the medicines by mouth, in a shot, as a cream, through a catheter, or intravenously (by IV).
Your treatment plan will depend on the type of cancer you have, which chemotherapy medicines are used, the treatment goals, and how your body responds to the medicines.
Chemotherapy may be given alone or with other treatments. You may get treatment every day, every week, or every month. You may have breaks between treatments so that your body has a chance to build new healthy cells.
NIH: National Cancer Institute
High Blood Pressure in Pregnancy
What is high blood pressure in pregnancy?
Blood pressure is the force of your blood pushing against the walls of your arteries. Your arteries are blood vessels that carry blood from your heart to other parts of your body. High blood pressure, or hypertension, is blood pressure that is higher than normal. Having high blood pressure can put you at risk for other health problems, such as heart disease, heart attack, and stroke.
During pregnancy, high blood pressure can cause problems for you and your baby. To keep you and your baby healthy, it's important to get treatment for high blood pressure before, during, and after pregnancy.
What are the types of high blood pressure in pregnancy?
There are different types of high blood pressure in pregnancy:
- Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. If it becomes severe, it can lead to a preterm birth or your baby having a low birth weight. Some women with gestational hypertension do go on to develop preeclampsia, a more serious type of high blood pressure in pregnancy.
- Chronic hypertension is high blood pressure that starts before the 20th week of pregnancy or before you became pregnant. Some people may have had it long before becoming pregnant but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
- Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. Preeclampsia also often includes signs of damage to some of your organs, such as your liver or kidneys. The signs may include protein in the urine (pee) and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.
- If preeclampsia becomes severe enough to affect your brain function and causes seizures or a coma, it is called eclampsia.
- In rare cases, preeclampsia symptoms may not start until after delivery. This is called postpartum preeclampsia. If this type of preeclampsia becomes more severe and causes a seizure, it is known as postpartum eclampsia.
- When a person with preeclampsia or eclampsia has damage to the liver and blood cells, it's called HELLP syndrome. It is rare, but very serious.
Who is more likely to develop high blood pressure in pregnancy?
You are more likely to develop high blood pressure in pregnancy if you:
- Had chronic high blood pressure or chronic kidney disease before pregnancy
- Had high blood pressure or preeclampsia in a previous pregnancy
- Have obesity
- Are under age 20 or over age 40
- Are pregnant with more than one baby
- Are African American
- Have a family history of high blood pressure in pregnancy
- Have certain health conditions, such as diabetes or lupus
What are the symptoms of high blood pressure in pregnancy?
High blood pressure usually has no symptoms. People usually find out they have high blood pressure when their health care provider measures their blood pressure.
Preeclampsia can cause other symptoms, including:
- Too much protein in your urine (called proteinuria).
- Swelling (edema) in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
- A headache that does not go away.
- Vision problems, including blurred vision or seeing spots.
- Pain in your upper right abdomen (belly).
- Trouble breathing.
Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output.
If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.
What problems can high blood pressure in pregnancy cause?
High blood pressure in pregnancy can lead to complications such as:
- Placental abruption, where the placenta (the organ that brings oxygen and nutrients to the baby) separates from the uterus (the place where a baby grows during pregnancy)
- Poor fetal growth, caused by a lack of nutrients and oxygen
- Preterm birth
- Your baby having a low birth weight
- Damage to your kidneys, liver, brain, and other organ and blood systems
- A higher risk of heart disease for you
How is high blood pressure in pregnancy diagnosed?
Your provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high (140/90 or higher), especially after the 20th week of pregnancy, your provider will likely want to order some tests. These may include blood tests and other lab tests, such as a test to look for extra protein in your urine.
What are the treatments for high blood pressure in pregnancy?
If you have high blood pressure, you and your baby will be closely monitored to lower the chance of complications. You may need to:
- Check your blood pressure at home.
- Keep track of how many times you feel the baby kicking each day.
- Adjust your physical activity. Talk to your provider about what level of physical activity is right for you.
- Take medicine to control your blood pressure. Talk to your provider about which medicines are safe for your baby.
- Take aspirin in the second trimester, if you are at risk of preeclampsia and your provider recommends aspirin.
- Visit your provider more often to monitor your condition and your baby's growth rate and heart rate.
If you have eclampsia, HELLP syndrome, or a severe case of preeclampsia, you will most likely need to go to the hospital. Treatment often includes medicines. Your provider may also recommend delivering the baby early. They will make the decision based on:
- How severe the condition is
- The possible risks to you and your baby
- How far along the pregnancy is
The goal is to lower the risks to you while giving your baby as much time as possible to mature before delivery.
The symptoms of preeclampsia can last after delivery, but they usually go away within 6 weeks.
Retinal Disorders
The retina is a layer of tissue in the back of your eye that senses light and sends images to your brain. In the center of this nerve tissue is the macula. It provides the sharp, central vision needed for reading, driving and seeing fine detail.
Retinal disorders affect this vital tissue. They can affect your vision, and some can be serious enough to cause blindness. Examples are:
- Macular degeneration - a disease that destroys your sharp, central vision
- Diabetic eye disease
- Retinal detachment - a medical emergency, when the retina is pulled away from the back of the eye
- Retinoblastoma - cancer of the retina. It is most common in young children.
- Macular pucker - scar tissue on the macula
- Macular hole - a small break in the macula that usually happens to people over 60
- Floaters - cobwebs or specks in your field of vision
NIH: National Eye Institute
Lymphedema
Lymphedema is the name of a type of swelling. It happens when lymph builds up in your body's soft tissues. Lymph is a fluid that contains white blood cells that defend against germs. It can build up when the lymph system is damaged or blocked. It usually happens in the arms or legs.
Causes of lymphedema include:
- Infection
- Cancer
- Scar tissue from radiation therapy or surgical removal of lymph nodes
- Inherited conditions in which lymph nodes or vessels are absent or abnormal
Treatment can help control symptoms. It includes exercise, compression devices, skin care, and massage.
NIH: National Cancer Institute