I have Autoimmune Hep, with stage 4 chirosis. Last month I also had pleurisy.
It started with a trip to the ER cause I could not breathe, they diagnosed bronchitis gave me tons of meds (cause I am on immune suppresents) and did an xray. The Dr looked at the xray and said I was fine. Two hours later he calls me on my cell phone and says the radiologist saw a "nodule" on my lung and to contact my primary Dr. and get a ct scan.
3 days later I went to my primary cause I thought I was having a heart attack. He checked me out and said it was pluerisy and that it is common to mistake it for a heart attack.
I had the Ct scan and it was ok.
He said the pain is known as the "devils grip" and it certainly was. When the pain would start it was unbearable the only thing I could do was lay down and not move.
The only thing that helped was taking advil (which I am very limited to taking) and I tied a shirt around my chest as tight as I could which sort of held my lungs tighter (if that makes any sense at all) I read some where on the interenet that it would help.
The bottom line is I had it for a month, and it will eventually go away but it is horrible.
I would rather have a root canal with no novacaine than have pain from the pleurisy.
I did read on the Mayo clinic web site that it could be liver related/ autoimmune Hep.
I hope some of this helps.
Mer, I am hoping that this explanation of what's going on with your hubby will help you a little. Pleurisy is an inflammation of the pleural lining or pleual sac (which is like a clear sack with one side attached to the back of the lung and the other attached to the chest wall and the two surround the lungs. The pain is quite severe and is increased when the person affected breathes in. It is not uncommon to assume that the patient is having a heart attack and until x-rays , labs, an EKG, and a physical exam is completed by the Dr. there is no way to be certain. So no matter what if someone has chest pain they should go to the E R. The lung itself doesn’t have any pain receptors but the lining of the lung is filled with them so the pain is usually quite intense. When it is really inflamed it can cause shortness of breath and it may even hurt to push on the chest. The usual causes are infection and/or viruses but other things that are less common can cause pleurisy. Usually pleurisy is treated with antibiotics as the most common cause is infection. Splinting the chest seems to help a lot of people too. It reduces the pain but must be done carefully.
Pleurisy is different than a pleural effusion however. The lining of the lungs has a small amount of fluid that fills that space, in pleural effusion there is too much fluid and this can be life threatening. In this scenario it is usually caused by fluid accumulation secondary to ascites which causes the fluid to seep thru teeny holes or perforations in the lining of the lungs. This causes the lungs not to be able to expand properly. Another cause is venous hypertension, also low protein or hypoproteinemia.
When there is way too much fluid then the Dr may perform what’s called a “THORACENTESIS” which is the procedure that drains the fluid.
Like the lungs the heart has a sac that surrounds it too. When the sac becomes inflamed the diagnosis is “PERICARDITIS”. There are several causes but it is usually treated with ibuprofen and/or antibiotics. Fluid can also enter that sac and like hep93 says it's called an pericardial effusion but ultimately is still a pericarditis. If diagnosed early and treated early it normally resolves without any long term problems.
It seems like you went to the ER in a timely manner and also kudos for having further testing done. This was in your husband’s best interest because they found the pericarditis. If undiagnosed and the condition worsens this can be fatal so you did great!!!!!!!!!!!
As for questions that need to be asked, I would want to know if both are caused by infection? Virus? or what? Treatment? Plan of action? Follow up? Mild case or severe? Find out at what point they want you to bring him back to the ER, what should you be looking for as far as far as symptoms? Of course if his breathing becomes worse or he has worsening shortness of breath DO NOT HESITATE-just get to the ER. THe most important thing I think is not to panic, if you panic he will panic which makes it worse. Keep us posted.
“Life is not the way it's supposed to be. It's the way it is. The way you cope with it is what makes the difference."
We went to the appointment this last Thursday with the hepatologist, and then a whole chain reaction of events occurred. The day before the appt, our 4 year old tested positive for strep throat. So, the morning we went to the hepatologist office, my hubby woke up just not feeling well. In the doc's office, we told the doc about our son having strep, etc and they prescribed a z-pac for my husband as a precautionary measure. So, we get home, and I get him settled in and went to the pharmacy. While there, I got a phone call from our transplant coordinator stating that my husband's while blood cells are very very low and that they have paged a hemotology/oncology doc to call us and to be expecting the call and in the meantime keep checking his temperature, and if he runs a fever over 100 to call immediately. When I got home and checked his temp, it was 101.2!!!! So, called them back and also called the hemotology doc's office and the nurse pulled up the bloodwork and said his neutrophils were only 20 and for me to get him to the ER and have them paged when we got there. So, rush him down to the ER and they have admitted him. He is neutropenic, in that his white count and neutrophils have dropped even lower. He basically at this point has no immune system and has an infection. They have been running a lot of cultures, etc to determine the source, but yeterday did do a bone marrow biopsy. This is all very unnerving in that we were just there for a routine visit with his hepatologist!! Now, he is in isolation, etc at the hospital. Guess mainly I just needed to get all this off my chest. This whole thing is such a roller coaster ride. What I have found through all this process with the liver disease is that literally anything can happen....any part of the body's systems can be affected. Any words of wisdom at this point would be helpful......has anyone ever experienced the neutropenia???
Mer, never a dull moment, huh? These are the types of things that make dealing with the disease so stressful. I experienced leukopenia when I was on interferon for my hep C--white count so low that I was pulled off treatment. This happened twice. I wasn't told if my neutrophils were low. I hope the cause of your husband's low immune system will be found and that they can get any infection under control. I hope your son will also be well soon.
Absolutely trust your gut when something doesn't seem right to you. And don't forget to take care of yourself, too.
It sounds like the doctors are aggressively trying to determine the source of your husband’s infection. This is very important to his course of treatment. Early diagnosis is critical in successfully ridding his body of infection. If he develops sepsis, it may be very difficult to resolve. I pray this is not the case.
Pace yourself, you may be in for a long road. I hope you have family available to help you through this. You’re in my thoughts and prayers. May God bless you and keep you.
The transplant team just ordered Neupogen shots for Harvey because his white blood count is low. They want him to resume wearing his mask and avoid crowds. They made several other changes to his meds. So far, he has no signs of fever so I’m trying not to panic.
I hope thing are improving for you. I’ve been very concerned about you husband’s condition and I’m praying things turn around for you. Let us know how things are going.
Mer, I'm sorry your husband is having such a rough time. You did the right thing in leaving your car at the hospital. Sometimes just one more thing can send us over the edge. I hope you are getting some good sleep tonight.
How's your husband doing? I hope he is improving. Look forward to hearing from you.
Penny....thank you for asking. He was disharged home from the hospital today. He still is dealing with a severe headache, but his white count has stabled off. We have been told he will need to have it checked pretty regularly, though. We have been told that the cause of all this was medications......anything in the NSAID group (non steroidal anti-inflammatory medications) and that includes over the counter stuff. Very rare side effect, and they said that the fact he has liver disease just did not help the situation. This last week and a half has been very crazy!! We will follow with the liver specialist in a week or so and go from there......so no more anti inflammatory medicine for him! How is Harvey doing?? Have the neupogen shots helped? Any side effects?
Talk to you soon!
I’m so glad to hear he is out of the hospital. I’m glad his white blood cell counts have improved. I imagine you are a wreck. I’ve been very concerned about you. Did they get the pneumonia under control?
So far, Harvey is fine. No fever or signs of any infection. I essentially have him quarantined. None of the local pharmacies had the Neupogen shots. The transplant team finally ran some down at a Walgreens about 20 miles away. He got his first shot Friday and was instructed to have a shot once a week. No side effects thus far.
I gotta go to work. I’ll check back with you later.