Daughter suffering chronic symptoms with no clear diagnoses

[bgorniak]

I have a daughter who just turned 21.  She lives at home and attends a local university full-time.  She has a boyfriend who has three cats and she has also has various reptile pets such as a snapping turtle, a salamander, a Chinese water dragon and various fish.  

She became ill quite suddenly in late July/early August, becoming nauseous during a 4-hour car-ride.  She returned home, aborting the trip half-way and felt ill for about 3 days.  After that, every time she rode in a car, she got nauseous, and the symptoms would last for a day or two.  Then she began having acute pain in the gall-bladder area.  She had an ultrasound done, which was negative.  The doctor gave her ulcer Prevacid, which did not help.

She then went to a different doctor.  Blood tests showed an elevation of some kind of pancreatic enzyme.  A CAT scan of her abdomen was performed with negative results.  Again, Prevacid was prescribed.

She then had a severe tooth infection and was on antibiotics for three weeks.  We thought for sure the infection had been the "sleeper" cause of all of her illness, but even having a root canal done and getting the infection under control did not alleviate her symptoms.

She returned to her doctor, who blew off her symptoms as "the flu" and totally unrelated to her previous, now chronic symptoms.  

Her abdominal pain has changed to a generalized feeling of nausea.  It is worse when she does not eat, but she feels consistantly ill after eating pretty much all of the time.  The most disturbing symptom remains that she becomes lightheaded and nauseous during and after riding in a car.  Motion-sickness meds don't help.

Her lizzard died unexpectedly shortly before these symptoms first appeared, and I can't help but wonder if she has contracted a virus from handling its disposal and aquarium (in which she now has a turtle), but no blood tests have shown any viral indications.

She is becoming very tired of constantly feeling sick.  She is trying to keep up with her college courses even though frequent lightheadedness and acute nausea make it difficult sometimes even to attend class let alone study.  Doctors dispensed Prevacid for ulcers, which does not seem to be helping. The next step, which they seem reluctant to perform, is an endoscopy to perform a biopsy of her stomach for bacteria, etc.  All we know is that this condition is now chronic, having plagued her for over 5 months, and she is willing to undergo ANY proceedure as long as it would mean she would find out what is wrong with her so that it can be treated and she can return to feeling normal again. The lightheadedness, blurred vision and nausea are the worst symptoms to deal with.

She does not drink OR smoke. She takes birth control pills that she has been on for a couple of years with no trouble. She is slightly overweight...perhaps about 15 lbs. She has otherwise been extremely healthy her entire life.

Any suggestions you may have would be most helpful!

Barbara

[Kevin Pho, MD]

I would agree that the endoscopy would be a reasonable next step.  This can evaluate for H Pylori - which is a bacteria associated with inflammation or ulcers - that can be treated with antibiotics.  Nausea and abdominal pain are such generalized symptoms that may be the result of inflammation in the stomach.  

With lightheadedness, blurred vision, and nausea, you may also want to consider a neurology referral to evaluate for any neurological conditions of her symptoms.  

A last thought would be to test for mononucleosis, which can also result in these chronic, non-specific, complaints.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[CINDY4]

Sorry to hear your daughter is having so much trouble.  I can certainly empathize.  My daughter, 10 yrs old, also has the same trouble.  Every time we are in a car for more than a few minutes she gets very sick.  She has been this way for 2 years.  Like your daughter she has constant stomach problems.  She has had surgery for reflux and still has problems, and also had her gallbladder out which showed to not be functioning correctly on a hidascan.  If they have not done this scan ask for it, it shows that the gallbladder is not processing fat right and malfunctioning.  A sonogram only rules out stones.  I would ask for the scope to rule out other problems like inflammation, ulcers, reflux, etc.  Also has her eosinophil counts ever been elevated on her CBC.  A rare condition is eosinophilic gastoentritis.  These past 2 years it has been found that my daughter has a rare eosinophilic disease, mostly attacking her lungs.  Although biopsies from many other organs all show chronic inflammation. Her stomach, colon, and gallbladder all showed chronic inflammation.  Her lungs and sinus are infiltrated with these cells and more severely damaged.  It is very rare to have it all over but more common in just the GI.  Also have they checked for parasites?  They could cause all her symptoms, and high eosinophils too, and can take several stool samples to come back positive. Maybe the reptiles could have carried parasites.

It is miserable to live like that.  My daughter's drs have been aggressive to find out what is going on, and if your drs are dragging their feet move on to another dr.

Cindy

[kevinmd]

I will be away until January 4th. I will answer your question when I return.

Happy holidays,
Kevin, M.D.

[chey101]

could your daughter possibly be pregnant? maybe should get tested, birth control are not 100% effective.
good luck
chey

[yoshi]

a breath test for h pylori bacteria would be a good idea.

[mely]

My son had very sim problems.  Thou he is very slim 114lbs 5'10 but when his symptoms started he was normal wt.  Symptoms and testing went on for approx 3 years - finally a cardiologist, thought to test his cortisol level.  He know takes cortisol and has lost almost all symptoms.  Prior to the med, he was passing out 2 to 3 times a month.  Oddly enough we too had a lizard that died, and both he and I caught parrot fever (From our bird), prior to his getting sick (I was assured this has nothing to do with his illness) but it was always suspect in my mind.

[bgorniak]

I will make a note of the H-Pylori bacteria.  She was tested for mono and for pregnancy, both negative.  She is experiencing a slight alleviation of symptoms right now, but last week had the flu, so it's hard to tell what symptoms are coming from what.  It's just so exasperating.

I can't help but wonder about the coincidence of the lizzard's death even though her doctors thought it "unlikely"...I am a firm believer that there is no such thing as coincidence...and in that no possibilities for cause should ever just be dismissed as unlikely.  Test for it and rule it out, yes, but don't just shrug it off and ignore it.  It is exasperating me that these doctors are being so vague and are not more interested in finding the root of her problem.  She is a full-time biology major in her junior year at college and can't afford to be feeling constantly ill like this...

What, exactly is Cortisol and what do the levels indicate?  What is normal, and how is it tested?  And what are normal levels of eosinophil and what would an abnormal level indicate?

She was told on one of her visits that her levels of something related to her pancreas were elevated and she was counselled on trying to avoid becoming pre-diabetic.  They told her to limit her cholesteral, stay away from dairy products and fat and caffeine and to drink lots of water.  She has adhered to this fairly strictly and has not really found it to make any difference...

She had an ultrasound and a CAT scan of the entire stomach area and related organs and nothing showed up on the tests.  The doctors seem reluctant to pursue any further testing and continue to pass this off as possibly ulcer-related.  The last doctor accused her of lying when she said she doesn't drink alcohol, insinuating that the college-party-lifestyle was probably the culprit.  She still lives at home and is home by 10 pm every night, has a long-time boyfriend and a monogamous relationship with him and does not party, but the doctor, again, found that to be "unlikely"...

It's enough to drive a person nuts...


Thanks for everyone's input...

~B~

[CINDY4]

Cortisol is what the adrenal glands produce.  It is what helps you recover from illness and injury.  Low levels can produce all kinds of symptoms, and be life threatning should you be injured.    Eosinophils are one of the white blood cells.  When you have a parasite, eosinophils engulf them and destroy them.  Also eosinophils are present in inflammatory diseases like asthma, and certain autoimmune diseases. Your blood counts of these would be high if you had a parasite infection or one of the autoimmune diseases related to eosinophils.

Also has anyone considered a problem like vertigo?  With the motion sickness and nausea, maybe it is a problem with her equalibrium. Hope she improves.

Cindy

[squeeky]

Well sure sounds like what I have been through.  I do not have (and have not been around) animals, however.  I also had CAT scans and ultrasounds done, with nothing abnormal found.  From a blood test, dr's were able to determine that I had, at some point in time, had the H.Pylori bacteria in my system.  I was given Prevacid and a whole slew of other meds that seemed to make the nausea worse, not better.  I went to 5 or 6 drs, none of whom were particularly helpful.  I did finish the 3 months of prevacid + 2 other meds (totaling 13 or so meds per day)....a really tough time as the meds only made my nausea worse.  I found the nausea particularly bad in car rides, too, but that was certainly the least of the problem.  It is very frustrating to endure constant nausea with no relief.  If it gives you hope, I can tell you that only now am I starting to feel better on a daily basis (this being a little over a year later).  I finished my meds, and really feel like although they made it worse for a while, they must have done their job.  But, it takes FOREVER to heal.  Today, I only occasionally have problems with nausea etc...much better than the constant agony.  I will mention that I, too, had doctors suggesting endoscopy, but were very reluctant.  I did not end up having it done, but DO recommend it.  It is bad enough to go through this, and I'm willing to bet that the short amount of pain it takes to do one is worth knowing and dealing with this any longer.  Good luck.

[squeeky]

Well sure sounds like what I have been through.  I do not have (and have not been around) animals, however.  I also had CAT scans and ultrasounds done, with nothing abnormal found.  From a blood test, dr's were able to determine that I had, at some point in time, had the H.Pylori bacteria in my system.  I was given Prevacid and a whole slew of other meds that seemed to make the nausea worse, not better.  I went to 5 or 6 drs, none of whom were particularly helpful.  I did finish the 3 months of prevacid + 2 other meds (totaling 13 or so meds per day)....a really tough time as the meds only made my nausea worse.  I found the nausea particularly bad in car rides, too, but that was certainly the least of the problem.  It is very frustrating to endure constant nausea with no relief.  If it gives you hope, I can tell you that only now am I starting to feel better on a daily basis (this being a little over a year later).  I finished my meds, and really feel like although they made it worse for a while, they must have done their job.  But, it takes FOREVER to heal.  Today, I only occasionally have problems with nausea etc...much better than the constant agony.  I will mention that I, too, had doctors suggesting endoscopy, but were very reluctant.  I did not end up having it done, but DO recommend it.  It is bad enough to go through this, and I'm willing to bet that the short amount of pain it takes to do one is worth knowing and dealing with this any longer.  Good luck.