Abnormal PET (heart), loss of 90 lbs (rapid), cognitive changes (brief) and little answers?

[LUNA_1]

I went from 190lbs(5'8) and ended up about 100lbs in 6mnths. Large lump appeared between my chest with infrequent chest pain. Next,insomnia and fatigue and I was so exhausted that it felt like work to hold my head up and function. Next,muscle aches, joint pain and cognitive changes. I would be incoherent or stare blankly (couple minutes). My T3 free was slightly high but only by.5?, a MRI of the pituatary was done and essentially negative except states "small vessel ischemia or early demylenation cannot be ruled out in this setting", prolonged QT rhythm, loss of small muscles in one hand and facial muscle, CT showed possible ankolizing spondilitis, pain when neck is bent backwards, PET showed medium upgrades near medianstinum in heart does not correlate with CT and repeat CT due soon, fasting glucose(79) and non-fasting glucose(83) almost match each other after 12 hr fast. Something still feels off-sweat a lot, chest pain-still present,neck hurts when tilted backward, brief burning feeling through body from head to toe(lasts couple of minutes), brief vision changes where everything is hard to read like when your eyes are dilated,  joint/muscle pain and there may still be blank periods because I know when they told me I had them I would get this sharp pain between my eyes and occasionally I still get that pain and wonder if that is still present. What would show on a PET that would not show on a CT? and does that explain my chest pain and whatever a prolonged QT rhythm is? Is your blood sugar supposed to be that close with fasting and non-fasting? Thanks

[Kevin Pho, MD]

To answer your questions:
1) A PET scan is normally used to detect cancer and evaluate the effects of cancer therapy.  It has a different use than a CT scan - which is simply used to image the affected area.  Uptake in the mediastinum may suggest possible cancer - further evaluation with an MRI can be considered if the CT is non-diagnostic.  

2) A mass or abnormality may lead to the chest pain.  Problems with the heart itself can be considered as well.  Further evaluation with an echocardiogram can be considered.

3) A prolonged QT is a congenital disorder indicating possible abnormalities in the electrical conduction of the heart.  It causes one to be more prone to arrhythmias.  Further evaluation with an electrophysiology study can be considered.

4) There can be variation between values of the fasting and non-fasting sugars.  Repeating these tests can be considered if this is of concern.  

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.

Kevin, M.D.
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