ArcaMax

DEAR DR. ROACH: I am a female under 30 years old. For over a decade, I have been having severe health concerns. I am constantly retaining water and also have difficulty moving and completing simple tasks, difficulty breathing, fatigue, and numbness in my legs, arms and face. These are the main symptoms. This has been going on for over a decade.

Recently, I had a horrible episode with intense numbness that left me unable to move with water retention. My stomach has been hurting and became huge (which I believe is the water retention). I have not been able to get out of bed for a week, trying to recover from this. I have been to many different doctors with these concerns, but they all say that I am young and look fine. Is it possible that this is heart failure? This is the only diagnosis that makes sense to me.

I cut out dairy and gluten a long time ago, but these problems persist. I am ambitious but have had to spend most of my time lying down due to these symptoms. -- L.T.

ANSWER: Heart failure is a constellation of symptoms that comes from one of the many kinds of heart disease. Difficulty breathing and fatigue are cardinal symptoms of congestive heart failure, although they are very nonspecific and common to many types of disease.

"Retaining water" -- which I take to mean excess fluid, such as in the feet or abdomen -- can be due to heart failure. However, large amounts of fluid in the abdomen typically happen with extremely severe heart failure. Furthermore, heart failure is uncommon for a person in their 20s; congenital heart disease would be the major cause, but it is seldom diagnosed in adulthood in the United States and Canada.

Numbness, however, is not a common symptom of chronic heart diseases. I am concerned that it seems like your doctors have not been taking your symptoms seriously. Women are more likely to be mistreated this way.

While I can't be sure of any diagnosis from your description, it sounds to me like a fresh start with a new provider who will listen to you and conduct a careful exam, as well as appropriate follow-up lab tests if indicated. Most of the time, heart failure can be diagnosed with moderate certainty, but an echocardiogram is the appropriate test when there is clinical suspicion for heart failure.

Large amounts of fluid in the abdomen always makes me concerned for ascites, which can represent liver disease or tumors, such as those in the ovary. However, the fact that this has been going on for 10 years argues against a progressive disease.

DEAR DR. ROACH: Is it safe to take an over-the-counter (OTC) plant sterol along with gabapentin? I'm having trouble finding answers. -- J.M.B.

ANSWER: I did not find any drug interactions between OTC plant sterols or stenols (these are commonly used to lower cholesterol) with gabapentin. Gabapentin has a large number of drug interactions, but fortunately, yours is not among them.

Let me recommend your pharmacist as an excellent resource for drug-drug, drug-food and drug-supplement interactions. It takes expertise to interpret the various sources available. Not all listed drug interactions require you to stop one of the medicines you take.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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