UPdate - Dr. Visit

[Super_sally888]

Hi All,

Thought I would post in a new thread, so the other one is not too long.
Saw the endo Dr. Mike today.  He offered me coffee - which I accepted.  Talked  / went through all the testing so far.  Said "your case is getting complex, let's take this step by step".  

Have bloodwork done today - complete electrolytes (ionized ca, K, Mg, na), BUN, creatinine, creatinine isoenzymes MM & MB.  Results on Thurs.

Have referal for neurologist.  Dr. mike says the pituitary adenoma 'should' be too small to be causing the symptoms I am having.  Says the white spots are a concern.  Will try to see her on Thursday. She is to evaluate the eye symtoms, MRI, fatigue/weakness, etc.

He has increased the parlodel (now on 1/2 tab /day).  This is still a low dose.  I get nausea as a side effect, he also said it can cause fatigue / weakness - so this may explain.

We are playing with the thryoid meds... will increase slightly (mixture of desicated and T4 - he would prefer me to be on T3/T4 and I would - but it is not available here).

Has asked me to take a few days off training and focus on hydration.

Let's see.  Hope you are all having a good day.

Sally

[Super_sally888]

Here's a timeline (will sumarise the medication hsitory/ test results separately for my neuro consult). Any input would be welcomed?

Medical Timeline

1992 Consult with rheumatologist for back and joint pain (wrist / hips).  
No specific findings.

1999 Consult Gastroenterologist for reflux, hyperacidity.
Diagnosis Gastritis.  Use PPIs, Motilium.  Symptoms continued.

1998-1999 Rapid weight gain despite diet and continuing exercise.  Progressive
fatigue, depression, exercise intolerance.  Disrupted menstruation.

Mid 2000 Weight up to 210+ lbs. Diagnosed hypothryoid, polycystic ovarian syndrome, IBS.Treatment levothyroxine, continued PPIs, Diane 35, metformin. (stopped Diane 35, Metformin, PPIs after about 1 year).  Parathyroid problems? Treated with calcitriol (calcium and iPTH levels returned to normal after about 2 years and discontinued the calcitriol).
Gastric symptoms continued – but improved.  Continued with diet and exercise.

2002 Galactorea noted.  Pituitary microadenoma noted on MRI.  Started on parlodel. Discontinued due to side effects (after about 6 months).

Mid 2004 Commenced triathlon activities.  Weight about 165 lbs.
Continuing stomach problems.  Chronic D-C.  Nicknamed “El Cubetta” – the toilet by team mates.
Muscle cramping on-going problem –particularly in swimming.  Improves a little with continued conditioning.
Thyroid med dose adjusted up.

End 2006. Training for Iron-Man.  Tummy problems dramatically worse – daily chronic D, bloating, reflux, belching, pain, continual nausea (affects training).
Chronic itching - no rash.
Chronic non-productive cough.
Throid meds adjust up to try to get FT3 and FT4 into normal range, TSH low normal.  Started desiccated thyroid.
Consult Gastro – Endo/Colonoscopy carried out.  Diagnose IBD from colonoscopy biopsy, no endoscopy biopsy carried out.  Pt. declined medication.  Decided to trial gluten free diet.  Near complete resolution of gastric symptoms with diet change. .
First notice visual symptoms: flashes of light, movement in peripheral vision.  Intermittent only.  Occassional base of skull headaches.

Early 2007 Consult allergy asthma dr. Asthma diagnosed. Started steroid inhaler & ventolin.  Skin allergy testing +ve for rice, chicken, mango, tilapia, fish paste, dust mites.  Systemic response to allergy testing.  Treated with oral steroids.  Prescribed daily antihistamine.  Have not done strict elimination diet yet…. Simple observation have not been able to identify allergens (except possibly fish paste… had another systemic reaction last time I ate a dish with that in it… will try again shortly to confirm (with antihistamines on hand)).

Mid 2007 Visual symptoms become much daily event.  
Strange sensation: occasional feeling that face is numb (in places), prickling sensations (over head), burning sensations in legs.  Base of skull headaches become more frequent.  More tired than usual / concentration poorer.  Delayed training recovery compared to teammates, muscles always sore, numbness in hands.  Often catch feet when walking (have put it down to shoes???)… am famous for bumping into things / dropping things / being clumsy… disassociated from body feelings…
Muscle cramping much worse.  
Started on parlodel early June 2007 (galactorea since 2000 but prolactin levels were tested within range), when prolactin levels tested above normal range.  Nausea side effect.

[T-lynn]

Your appointment sounds very productive and your Endo seems to be on top of things.

Seeing a neuro is a great step in the right direction,plus with the additional blood work.

Maybe a few days off to rehydrate ,getting a little extra rest does us all good.I had to give in a call my neuro over the weekend for something for fatigue,I usually wait it out,but I couldn't do it anymore.It has helped.