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lunabean's avatar

What is happening to my mother?

Asked by lunabean (625 points ) March 16th, 2010

Last Monday (March 8) my mom woke up around 11pm unable to breathe well. I called 911 and when the ambulance got here she was only at 70% oxygen. (She has hyperthyroidism and now she has a goiter). She was released from the hospital on Friday and the next day her blood pressure was really high (182/107) and had chest discomfort (pressure, not pain) and was short of breath (but not as bad as Monday) so we took her to another hospital (the other one has a bad reputation). The hospital staff took a chest x-ray, and had her do a stress test and it came back abnormal. She is having a cardiac catherization today. Is it possible that she had a heart attack and didn’t know? Perhaps it happened last Monday before she woke up and couldn’t breathe? Maybe a thyroid storm? No one is giving us a straight answer, so hopefully someone here can help.

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29 Answers

grumpyfish's avatar

You’ll find out more after the cardiac cath. For now, all you can really do is wait.

Sophief's avatar

I’m really sorry to read that. It must be very upsetting for you both. How old is your mum and does she smoke?

CyanoticWasp's avatar

No one—not even the physicians who frequent the site—is going to be able to give you any real diagnosis, but they might be able to ask you questions that can help you give more information to your mom’s doctors than is evident here.

For example, your mom’s age figures into this, and her past cardiac history, if any. How has her thyroid condition been treated? (I’m assuming that the presence of a goiter means: “not very successfully”, but I’m not a doctor; I don’t know.)

What has been her typical blood pressure, and has she been receiving treatment for hypertension?

Etc.

I’m guessing that this sounds like congestive heart failure, but only because it seems similar to my former wife’s grandmother’s condition from many years ago.

Good luck to you all.

hudsong's avatar

Does she eat well and exercise?

JLeslie's avatar

What was her TSH? High blood pressure and slow heart rate are symptoms of a very high TSH (which means you are in a state of hypothyroidism). As long as they increase her thyroid medication for the high TSH number, she should feel significantly better in 3–4 weeks, hopefully stabilizing in about 6 to 8 weeks. The goiter will shrink, blood presure will correct itself, unless she has other health problems going on, but everything you described could be related to her thyroid, except her oxygen number was VERY Low, that I am not sure about. She may be having otehr symtoms currently like her hair falling out, dry skin, dry eyes, feeling paranoid, or just not quite right mentally. All will fix with thyroid medication if her TSH is high.

JLeslie's avatar

Oh, and yes, you can have a heart attack and not know it. But, you said she did a stress test and it was fine, and the hospital would have taken blood tests to watch heart enzymes, and if they were fine, then it is unlikely she had a heart attack or heart damage from what I understand, but I am not a doctor.

When I was diagnosed with hypothyroidism I had a doctor who wanted to put me on blood pressure medicine, and I insisted on a thyroid test before I would take it. I was right. My blood pressure is always normal when my medication is correct and my thyroid hormones are in line.

I have a heart arythmia which I really only notice when my thyroid is off, and when my heart is screwing around with the beats I feel like everything in my body stops, can;t breath, can’t anything for a moment. I notice it when I am at rest, just before I go to sleep, even the middle of the night. When it is very exaggerated I feel like I am going to wake up dead.

lunabean's avatar

@Dibley she is 54 and she was a smoker before last monday.

@CyanoticWasp no history of anything except breat cancer and hyperthyroidism (her doctor adjusted the dose of medicine up and down, she got in touch with a endocrinologist last night but only once prior to this which was a few years ago). my grandmother has congestive heart failure so I can assume it’s hereditary if there’s a heart problem involved.

@hudsong she eats fairly well and doesn’t exercise regularly but she does keep busy around the house and she’s also a nurse so she’s busy at work too.

@JLeslie i’m not sure of the TSH level if I remember corresctly from last night the nurse said either T3/TSH was 38. my mom has been acting confused ever since last monday but no other mental problems.

Sophief's avatar

@lunabean I’m no doctor, but it sounds like Emphasema (sorry can’t spell it), my ex boyfriends mum had it. Check it out and see what you think. Keep going back to the hospital.

JLeslie's avatar

@lunabean OK. look, that is causing most of the problems. It should not be above 5 or 5.5 can’t remember according to normal ranges, most endocrinoligists like to see it below 3. She will be much better when she ups her medicine, it will take a few weeks for her to feel better, biggest flippin’ annoyance about thyroid, it does not correct with the pop of a pill in one day. She may also have other health complications, but most of what is happening will correct when her thyroid is back in normal ranges.

jrpowell's avatar

There is no way that any of would know better then people then have seen your mum and looked at test results. If you are not getting a straight answer it is probably because they don’t know exactly what is going on. But if you run into the doctors office with a list of things people on the Internet told you it could be you will probably piss the doctors off.

JLeslie's avatar

She needs to get blood work for her thyroid every 6 months in the future, more often right now while they are adjusting her meds, should be every 6–8 weeks, until she stabilizes.

What is her heart rate? It is probably very slow I am guessing, less oxygen and blood circulating. Take her pulse, you can check it yourself.

Also, regarding what @johnpowell mentioned, I am not saying that she did not have a cardiac episode that needs to be addressed. Even if it was brought on by her thyroid, it still needs to be looked at. Again, I am not a doctor. But, for sure many of her symptoms will fix, or at minimum change when her TSH is between 1 and 3.

JLeslie's avatar

Let us know what happens.

autumn43's avatar

If she had a stress test that was abnormal, the EKG that goes along with that would have shown the abnormalities of a heart attack. Sometimes in the nuclear part of the stress test some ischemia shows up in arteries and that is most likely why she is having a cardiac catheterization – to see if any of her arteries are blocked. If any are, they will be opened up with a stent(s).

My Dad had chest pressure and went right to the doctor. They determined that he had a mild heart attack. He immediately underwent cardiac catheterization, got two stents, left the next day and has felt great ever since. That was over a year ago.

Good luck to your Mom. She should be feeling better soon if there were blockages that were making her feel short of breath or causing angina. Her cardiologist will have all the answers for you when he’s done the procedure.

Rarebear's avatar

Please don’t assume you’re getting reliable medical information from Fluther. I’m reading a lot of responses on this thread, some are reasonable and some are not. If you really want to know what is happening to your mother, go with her to the doctors appointments and ask good questions of the medical staff.

lunabean's avatar

@JLeslie her heart rate has been in the 60s. she doesn’t need any oxygen now. she only has trouble breathing if she lays flat on her back or on her side. The endocrinologist told her the thyroid problem would go away on it’s own while she’s not taking any medicine in about two weeks. Then there’s going to be blood tests and a CT scan.

I haven’t heard from her this morning so I assume she’s still having the cardiac cath. I’m in school now so I should know something this afternoon/evening.

JLeslie's avatar

60’s is good, so that’s good. If they feel the cardiac cath is necessary then I am not here to argue with that, but I would be in a wait and see mode for other more minor concerns reltaed to the problem, that you can wait a few weeks to se if they resolve with her new medication dose regarding her thyroid.

Thyroid medication MUST be taken on an empty stomach or it is not absorbed correctly. No other meds, nothing. Easiest to acheive first thing in the morning only water, wait at least a half an hour before taking other medications or eating. Do not take iron supplements for at least 4 hours from the time the thyroid medication is taken.

She should get her thyroid checked again in 6 to 8 weeks, promise me. I feel optimistic that your doctors are taking this into account, since they did check her thyroid levels. Many times it is ignored.

If her dose is actually too high, she might start to feel like her heart is racing, that is the thyroid medication, very common, but not to be ignored, sometimes it is the med itself, sometimes it is that she has had too much medication and she is moving from hypothyroid to hyperthyroid (meaning her TSH is getting driven down too low, below 1). She might feel very dizzy in this case, light headed, and her blood pressure might drop too much. I need to take two doses to stay in range, 88 MCG 5 days a week, and 100 2 days a week. It took a while to figure this out, but I am hard to stabilize, most people aren’t.

shilolo's avatar

@JLeslie Psst. The OP says her mom has hyper thyroidism, not hypo thyroidism. The former is associated with a fast heart rate and low TSH, while the later is associated with a slow heart rate and high TSH. Both can lead to congestive heart failure.

JLeslie's avatar

@shilolo TSH of 38 is hypo. Whatever her initial diagnoses, things have changed. I am hypo, but when I was overmedicated I was in a state of hyper, with a TSH of .003 (my initial diagnosis my TSH was 95.6). Her symptoms sounded Hypo to me (high blood pressure, not being able to breath or get enough air) that is why I made that assumption, but many thyroid symptoms are the same when you are hypo and hyper. But the 70% oxygen is very low, seems like there is more than just that going on, as I stated above.

shilolo's avatar

@JLeslie Notice that she said above “i’m not sure of the TSH level if I remember corresctly from last night the nurse said either T3/TSH was 38”. Not knowing what she meant, it seems much more consistent with an moderately elevated T3 value than a very high TSH value. Note also the both hyper and hypo-thyroidism can cause hypertension and cardiac/respiratory difficulties. It seems highly unlikely that her thyroid is the issue anyway. Anyone with severe thyroid storm (hyperthyroidism) or myxedema (hypothyroidism) would not be so readily treated and released. There is more to this than the thyroid, for sure.

JLeslie's avatar

@shilolo if it is her T3 number then you are right it would be hyper, but very off, T3 normal ranges are at my lab .6 – 2.2, but I think free T3 is a little higher as stated in your link; and, of course it might vary by labs. Possibly the number was 3.8, and not 38, but I am going to assume she heard it correctly. 38 could either VERY high or VERY low, depending on where the lab puts their decimal I figure. She has a goiter, so that means to me her thyroid condition is not under control. The goiter typically goes away when you get into normal ranges, unless you have a cyst or some sort of growth that is not the actual gland. Since they mentioned the TSH/T3 number, I am guessing they too think it is way off.

I just went back and read that @lunabean wrote The endocrinologist told her the thyroid problem would go away on it’s own while she’s not taking any medicine in about two weeks which I had not read carefully previously, until you pointed out again the hyperthyrodism diagnosis, so she has medically, possibly, put herself into a state of hypothyroidism, don’t you think? She might have been taking medicine to slow her thyroid, and it is now too slow. So she would not have been given synthroid as I had presumed previously. that is my mistake. Thank you for bringing it up.

Why do you think her symptoms are more consistant with hyperthyroid? I read your link, but nothing jumped out at me. I agree, more than one thing probably going on.

I am not sure why you say she would not be readily released? I walked myself into the emergency room asking for a thryoid and kidney blood work, I knew less then, but I knew I had severe muscle pain, a goiter (although the doctor in the ER said my neck looked fine) my skin on face and chest felt itchy, like I had a rash, and a general feeling something was very wrong, very off, a little paranoid. my hair had been falling out, and I had had high blood pressure results when I had a recent check up at a doctors office, very unusual for me (I had asked him to run a thyroid test, and he didn’t do it). Not to mention I kept feeling like my heart was stopping and I could not get enough oxygen. That day in the ER they came back with the 95.6 TSH, and every other part of the thyroid panel out of whack. They sent me home with a prescription and told me to see an endocrinologist.

shilolo's avatar

Well, acute shortness of breath plus hyperthyroidism could mean thyroid storm, which is a life threatening emergency that typically takes a while to resolve. Likewise, myxedema, if the cause of her hypertension and shortness of breath can be very serious.

Bottom line, her mother’s problems are likely unrelated to her thyroid. Without much more information on her cardiac/pulmonary workup, I wouldn’t even venture to give a diagnosis, let alone an endocrine explanation for what is much more likely to be run of the mill cardiovascular disease.

JLeslie's avatar

@shilolo That’s why I wrote I am not a medical professional :). We are kind of agreeing, I don’t think the thyroid problem was thyroid storm. But, I still think her thyroid is at play in some way, just my opinion. Could be it was not really the problem at all, but because of this other problem, she was lucky to get diagnosed with her thyroid medication needing to be changed. Not that this sounds lucky really, sounds scary. The best possibility would be it is her thyroid, because that is easily corrected hopefully.

I am not disagreeing with her doctors, or you for that matter. It sounds like they are covering all bases, which I think is good.

Rarebear's avatar

@shilolo is right. Thyroid problems don’t cause hypoxia except in possibly a very roundabout way. Actually, come to think of it, I see hypoxia all the time, and I’ve never, ever, in 20 years, ever seen it due to a thyroid problem.

JLeslie's avatar

@Rarebear I agree, not sure if you are talking to me, I said from the start, my first post, the very low oxygen I did not know about, it seemed not likely to be caused by the thyroid. Cardiac problems I am sure could explain it. I also see that I misread her original question, crap I am screwing up big today, too much on my mind, and her stress test was abnormal, I had thought normal as I stated above. It does all sound like heart related, but just wanted to add that thyroid problems can affect the heart. Meanwhile, just ignore me today. Good you and Shilolo chimed in.

Rarebear's avatar

@JLeslie No, not talking to you. Just agreeing with @shilolo

lunabean's avatar

ok guys, the cardiac cath came out with everything fine. apparently the stress test gave a false abnormal result. my mom is home now and seems to be doing ok but she still can’t lay flat because it obstructs her airway. maybe her thyroid is just so big that it’s messing with her trachea?

@shilolo & @JLeslie yesterday the endocrinologist said that she had gone into hypothyroidism because of the dose her regular doctor was giving her. also at the other hospital they were going to give her synthroid but she declined it because she didn’t know she had crossed over to hypothyroidism.

well, i think in two weeks when she goes to the endocrinologist, everything will get worked out and if not, there may be something else the doctors are missing.

Rarebear's avatar

Glad to hear the cath came out okay.

autumn43's avatar

YAY! Always glad to hear good news! It’s great you are so informed about your Mom’s health too.

Have a good day, lunabean! (and everyone!)

JLeslie's avatar

Thanks for the update. I’m glad to hear she will be going to the endocrinologist in two weeks, sounds like all of the doctors are on top of things. If I understood you right previously she was on medication for hyperthyroid, so maybe just stopping that medication will be enough and she won’t need synthroid? No matter what I am glad they are going to closely monitor her. Once her thyroid is lined up maybe if there is something else wrong it will become more apparent. It is so hard to figure out what is wrong when multiple things are at play.

Hope you and our mom feel a little better knowing that there was not a major blockage or damage to her heart. :)

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