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Possible second autoimmune disorder?
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Possible second autoimmune disorder?

Hello.

35 year old female here with psoriasis since infancy, wondering if the following symptoms can be associated with a possible second autoimmune disorder?

Exacerbation of Reynaud's phenomenon - first diagnosed at 30
Abnormal upper GI series 31 jan 13 - esophageal dsymotility, possible scar/spasm/ulcer in stomach pouch (gastric bypass surgery in June 2011)
Stomach pain
Migraines
Balance issues
Tinnitus
Lightheadedness
Joint pain - behind legs and lower back

Everything but the joint pain has been going on since January of this year. When I told my rheumatologist's office what was going on, they got me an appt for one week from tomorrow! I say that's pretty good.

All my doctors are part of the same clinic system and have my records.

In the mean time, if there are suggestions to offer before a week from tomorrow, please offer them.

Thank you!

K
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434278_tn?1324709825
Sometimes when someone has gastric bypass surgery, it creates a malabsorption situation.  I feel sure they are addressing any nutritional problems and have you on vitamins.  Could the stomach pain be a result from the surgery?  
14 Comments Post a Comment
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434278_tn?1324709825
I guess my greatest concern is w/ the esphageal dysmotility.  Are they thinking this might be sceladerma?  
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778037_tn?1377989800
Thank you for your concern. I don't know what they are suspecting...just hope for answers soon. My stomach hurts and  I can barely eat. Next Wed seems like an eternity, even though it's a drop in a bucket considering how long it normally takes to get in. My feet and hands are freezing and and I just feel like something is terribly off. Nurse practitioner today felt I should see rhuemy, guess I did the right thing by calling.
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434278_tn?1324709825
Sometimes when someone has gastric bypass surgery, it creates a malabsorption situation.  I feel sure they are addressing any nutritional problems and have you on vitamins.  Could the stomach pain be a result from the surgery?  
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1756321_tn?1377771734
Nutrient deficiencies are common with a gastric bypass. Most of your symptoms can be found under one deficiency or another.  A common late complication after gastric bypass surgery is ulcers.

Magnesium deficiency is of note as this is the cause of 50 - 60% of migranes (migraines). That alone is a red flag. Other listed symptoms of magnesium deficiency include esophageal dysmotility, worsening of Raynaud's, tinnitus, feeling off balance, lightheadedness, joint pain (can be due to vitamin D deficiency as well - magnesium is essential for vitamin D absorption).
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778037_tn?1377989800
Please forgive any typos; my computer broke some time ago and I am using a tablet. In fact, I selected a post as a best answer prematurely in error due to this and my extreme physical / mental fatigue. Also, I need to use a stylus because my fingers are too swollen to use a touch screen; the sensitivity is just not there. Even the stylus is a challenge to work for me.

Thank you for the suggestions regarding nutrition. I take vitamins and have my levels monitored regularly. They were drawn about a month ago and all were normal, save for a slightly low potassium level. A CBC was done last week when I went to my primary care's nurse practioner and it came up normal.
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778037_tn?1377989800
Hello. I did more research on nutritional deficiencies. Even potassium deficiency can cause some of my symptoms. My potassium was only slightly low according to the doctor who tested me last month.  I have been eating ample amounts of chicken, broccoli, red meat, and milk. Therefore  I feel my intake is OK.

What I am worried about is the potential for another autoimmune disorder, like scleroderma. Two nights ago, it was like a light switch was turned off. The skin around my neck tightened up and got numb. All this has been coming on fairly quickly, with the exception of the Reynaud's which  I had since 2008. Now, I am really feeling it in my neck and face. The feeling is hard to describe; it's a cross between losing feeling and the skin feeling tighter. Also, over the past week or two, I have developed all over body pain that hurts more when I turn a certain way. It even burns in places.

I understand my situation is very complex. The doctor I am going to see on Wed talks very fast and asks a lot of questions; therefore I need to be prepared. What should I tell him? I want to ensure the most important things are communicated.

Thank you!

K



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434278_tn?1324709825
Yes, any one of us would share the same concerns.  I would encourage you to write your questions down on paper (make a copy for you and for the doc)  Then hand him a copy.  The other one, jot down notes.  If he goes too fast, just ask him to wait so you can write it down.  This is very helpful for us who deal w/ brain fog to organize everything.  

Are there certain things you are having trouble swallowing, or is it everything?
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778037_tn?1377989800
Thank you again. I typed up a list of my symptoms and printed two copies on my break. I will keep one copy and give one to the rhuemy.

Everything gives my trouble going down; solid foods are the worst.  Even though  I take tiny bites and chew them into tiny pieces, I still feel like the food gets stuck for a bit before making its way down. I practically choke on my pills and have for some time. Also, I get wicked indigestion every time I eat (no reflux). I follow the rules of waiting 45 minutes to an hour after I eat to drink and 30 minutes after I drink to eat. I eat what I am supposed to and avoid sweets, fatty foods and soda pops.

K

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778037_tn?1377989800
The rhuemy said I was having a flare up of fibromyalgia. It came as a surprise considering I had no problems with it since I lost 100 lbs from the bypass. Also, I feel a lot worse than I did when my fibro used to act up.

He tested my CK and TSH levels to make sure something else is not mimicking my symptoms. Hypothyroidism runs in the family as well as Hashimoto's; therefore I would not be surprised if my levels were off.
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434278_tn?1324709825
Praying that they find what is going on w/ you.  It's no fun when things start getting stuck going down.  Maybe you might need to eat a lot of yougurt and stuff like that 'till they figure it out.  Keep us posted.
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778037_tn?1377989800
Thank you, I really appreciate it. The thyroid test came back normal and the CK a little low. I was told there would only be a concern if the CK was high. The rhuemy did not want to see me back since he is having my psychiatrist put me on Cymbalta.

Meanwhile I saw the GI doc and he seemed more concerned. He ordered an upper endoscopy and an ultrasound of my gallbladder. He said I may need my gallbladder out and that gastric bypass patients tend to develop problems with them. Ugh. However he wanted to look first, it is scheduled for tomorrow. The endoscopy is a week from Wed.
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434278_tn?1324709825
How did the ultrasound go.  Another test that y'all might consider is the HIDA scan.  

The information I had on CK (creatinine) is that creatinine is a water-soluble waste product largely from muscle breakdown that is excreted via the kidney tubules and there are reasons for too high and too low levels.  Too low: rule out severe liver disease, anorexia for several days and pregnancy.  

Please keep us posted.
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778037_tn?1377989800
I have not gotten the ultrasound results yet. Th test was yesterday (Friday) at 9am. I asked if I would get a call or a letter, to which I was told I could get either. No timeframe was specified and I did not get a letter in  today's mail.

I wonder how long it takes to get the results of a gallbladder ultrasound?

Thank you for the CK info. I had a hyster last year, so no chance for pregnancy here. :)
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778037_tn?1377989800
The test was normal. Since they don't know what's going on yet, they don't know how to advise me about what to eat or not to eat. I have an upper endoscopy scheduled for Wednesday 20 March. My stomach hurts and bloats whenever I eat; the nurse said she would tell the doctor when he gets in sometime tomorrow.

Even though my rhuemy has put me in the care of my psychiatrist and is has only diagnosed me with fibromyalgia, I am keeping an open mind that there is more to this. So far the cymbalta is helping a little bit with the body pains...not much. I hope someone figures it all out soon.
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