Good day and I appreciate your taking the time to read this post. I am concerned about my 46 y/o husband. I am not sure where to begin and will try to be brief. He is retired US Navy Diver with obstructive sleep apnea that he "blames" on deep dives. He has had sinus and UPPP surgery and wears CPAP every night. Mid-summer he started "feeling tired" all the time. The fatigue was so bad that he was not able to stay awake during the day. Over Labor Day he was admitted to the hospital for a small bowel obstruction which was relieved with medical management (NG to LWS and steroids.) An endoscopy and colonoscopy showed GI tract ulceration and inflammation. Follow up testing and visit one month later showed the problem to be resolved. The fatigue has continued along with severe headaches and increased sleep problems. He has also been diagnosed with restless leg syndrome BUT from my perspective (laying beside him in bed each night) it is more like he is running a marathon while asleep. His legs jerk wildly to the point they are coming apx 12 to 18 inches off the bed.He was given Mirapex that has not improved this problem. Two weeks ago our family Dr. ran additional blood test for the fatigue which showed he was barely producing any FSH, LH or testosterone. MRI revealed normal pituitary gland. This is the point where I am becoming more concerned. The MRI of the brain shows (word for word from MRI rpt):
MRI of brain w/ and w/o contrast:
Findings: Sagittal T1-weighted images show normal appearance of the corpus callosum, brainstem and craniovertebral junction. Pituitary gland is normal in size and contour on the sagittal images.
Structures in the posterior fossa are normal. Ventricles and sulci are slightly prominent, suggesting mild atrophy. There are scattered white matter lesions bilaterally, consistent with small vessel ischemic changes, No major infarct pattern or mass is seen. Posterior fossa are normal. Periorbital structures are normal. There is an opacified posterior ethmoid air cells on the left with mucosal thickening in the frontal sinuses bilaterally. Mucosal thickening is seen in the floor of both maxillary sinuses.
Following contrast administration, no areas or abnormal enhancement are seen within the brain parenchyma.
Conclusion: Paranasal sinus disease, Mild parenchymal atrophy, Small vessel ischemic changes, periventricular white matter lesions. Normal MR appearance of pituitary gland.
The Dr. told us on the phone that the MRI was "normal"...however, we make it a point to get copies of all of our medical records. Upon reading this my husband asked the Dr to interpret what it said and means....the Dr's response was "it is normal age related changes that occur in the brain and you don't need to see a neurologist"
. Of course I am not a doctor but some of the findings seem worrisome to me especially when his subjective symptoms and lab values are taken into consideration.
After writing a small book to get to my point, the question is simple; If you had a patient with my husband's complaints and MRI report like the one above, would you refer to a Neurologist for further work up?
I do not know if his various health issues are linked in anyway or not. What I do know is that my husband is normally full of energy and life and he is out of bed at 6 am but sleeps until 9 am(and at times later) now. He is old school military and use to NEVER be late for anything. Now he fights to get out of bed and has been late for work. Something is wrong with him and I am worried sick. Your input is greatly appreciated.
I truly need some advice on this post. My husband is feeling so bad but he does not feel he needs further follow up because " Dr. ??? said I was fine"...if he is fine why is he sleeping all the time, joint pain, headaches...something is going on and I am worried about him. Please help!
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