Wednesday, April 25, 2012

Same old, same old

Lets see...had another Doctor appointment yesterday.

The infected cut on the back of my thigh is a lot worse, so she prescribed an antibiotic ointment to put on it three times a day.  If it isn't better by next week, then she is going to refer me back to the surgeon, so he can cut it open and clean it out...not looking forward to that, so hopefully this works.  Just an FYI, you really need to be careful shaving your legs!

She changed the antibiotics again for the kidney infection and edema.  Since the Keflec was making me so sick and it appears not really working (she's using it to clear up my leg too), she switched me to Bactrum.  She checked my urine and is convinced the kidney infection is almost gone, although I am having a lot of trouble with just going to the bathroom.  It feels like I need to go really bad, but sometimes nothing happens...I just can't go.  Although she thinks some of this may be caused from the Lasix pills (diuretics).  Other problems still going on and not sure if related to the water pills, infection or what, but  I'm really thirsty and my mouth gets really dry, to the point, I'm still having trouble swallowing.  The infection on my tongue, which she says is not thrush, is still there, although it has let up a bit and has stopped bleeding, but its still there.
I can truly say, I had absolutely no idea how much water my body was holding.  Between the last appointment and this one, they weighed me in the office, and I actually lost 15 pounds that was all water.  Can you believe that?  No wonder my weight has been fluctuating so much over the last couple of months.  Even my calves look thinner than they ever have, so I'm guessing I've been retaining water for a while. I have to keep taking the water pills for a while, even though she isn't quite sure what caused the edema, it is finally starting to clear up, but its not all gone yet and the muscle cramps, charlie horses, or whatever you want to call them, that are occurring as the water goes away is really painful.  My feet still feel and look like they are bruised making it extremely painful to walk...not sure how long that will last.  With the water loss, I'm at risk of losing potassium, so I have to eat a banana every day and if needed, she will give me supplements for that too, when she checks my blood again next week. Plus I have to take 400IU of magnesium every day.

The blood results from last week, according to her looked pretty good, except for my Vitamin D.  Even though my previous family practice doctor had me take 50,000IU once a week for 8 weeks because it was registering at a 7 then (anything below 20 is a deficiency), it registered as a 0 this time, meaning I have none in my system. The doctors will have to figure out why my body is not storing it, but in the mean time, she is having me take 2000IU 3 times a day to see if it registers next week. Currently, I am risk for Ricketts, plus having a deficiency in Vitamin D causes all kinds of problems, such as depression, muscle cramps, dental problems,  nausea, etc. which are all symptoms I have now.  Not sure how this is all related....so, as usual, more questions, no answers.

Anyways, Next week will be busy.  I see the pain specialist again on Monday, on Tuesday my gastroenterologist is doing an EGD scope on me,  and then on Thursday I see the family practice/internal medicine doctor again.  Guess we go from there. I'll update again soon.

Friday, April 20, 2012

Changes and tests

Hi everyone,
This is the first chance I've had this week that I've been able to stay awake long enough to even write up a post. Between both doctor appointments from Monday and Tuesday, they switched all my medications around and I've been so sick that all I'm doing is sleeping.

The first appointment on Monday was with the pain specialist.  Since the Percocet was not really working and wasn't lasting long enough, he changed me over to a long-acting pain medication.  I have to admit, this scared me a bit, since he prescribed methadone. When he first mentioned this, I freaked a bit, since all I've ever heard about is the stuff junkies use on the streets.  In actuality, this is not the same thing at all.  In some cases, doctors actually use this same drug to help people that are addicted to heroin, morphine or other drugs, since it stops the euphoric affects, but still stops the pain.  For patients like me, it stops the pain and lasts for a long time, stopping the need to take pain pills every 4 hours and now I'll be able to go every 12.  Plus, once I get used to it,  it  will stop the "fuzzy brain" feeling that I hate.  With still being in school, I have to be able to think, which the other pills were making it really difficult for me to do, but right now it makes me really, really tired, along with the other stuff they changed, I can hardly keep my eyes open.  He didn't change the Neurontin, so still taking that 3 times a day, plus he added Cymbalta, which I take every night before I go to bed.  Cymbalta is a anti-depressant, but it also helps to reduce muscle pain, which this doctor thinks is part of the problem.   He thinks I have chronic neuropathic pain, along with some muscle damage from all of the abdominal surgeries I've had.  The Neurontin stops the nerve pain, while the Cymbalta stops the muscle pain. He wants to try the combination of these 3 for a month or so and then go from there, depending on what is working and what isn't. Time will tell.  His priority is stopping the pain until the other doctors can figure out what is causing it all and fix it, then hopefully I can stop taking all of this stuff.

On Tuesday, I had my first appointment with my new family practice doctor.  She is actually a Internal Medicine doctor and my gastro specialist referred me to her.  Her specialty is figuring out complex cases and solving puzzles, kind of like Dr. House on the television show, LOL.  She seems nice, but has a tough demeanor, I think she's Russian or maybe Ukrainian, definitely makes decisions quickly, tells you what to do, and my daughter and I kept waiting for the whip to come out, so she could crack it, since I had not been following doctor's orders over the years.  She wasn't too happy that I haven't had a pap in over 4 years, I skipped my last mammogram, so its been 8 years on that, plus I have a cut on the back of my right thigh that I had been trying to clear up on my own, but is now infected.  With all my stomach problems, I didn't think these were important...to her that was wrong, so those will be getting taken care of soon.

First thing she did was draw blood, testing for vitamin deficiencies, and she wants to check my kidneys. She prescribed a really strong anti-biotic (Keflec 500MG, 4x a day)  that I have to take for 2 weeks and these are making me so sick, I feel like I have the flu and I'm running a fever. Since the abdominal pain issues are under control for right now, she wants to clear up the infections and the edema first, then she'll concentrate on whats causing the other problems.   The edema in my feet, ankles and lower legs was really bad, so I went Thursday morning for a venous ultrasound to check for clots. That came back negative, so her office called in a prescription for a diuretic (water pill) to start clearing up the retained water. Never thought it was possible to go to the bathroom this much,  but its amazing that with only taking one pill, most of the swelling went down, but now they feel like they a bruised and broken, I can hardly put any weight at all on my left foot...its hurts really bad. I go back to see her again on Tuesday and then she'll decide the next step, since she should have all the results back from the blood tests.  In terms of my stomach, she said, if necessary they can actually do a reversal of my gastric-bypass.  Her guess right now is that I have mal-absorption, causing the vitamin deficiencies, and low blood sugar, there is more going on with my kidneys than just a simple infection...so, one step at a time.

I'll update again when I know more, for now, I'm going back to bed :)









Sunday, April 15, 2012

FRUSTRATION...I needed to vent.

Just a short update this time... feeling very frustrated and needed to vent a little.

 I have two doctor appointments this week, Monday and Tuesday, so hopefully one will get somewhere.  The edema is really bad right now...my feet and ankles, plus half way up to my knees looks like it belongs on a elephant instead of me.  I can barely walk.  Plus my eyelids are swollen too...certainly doesn't make me feel like leaving the house...which, since I can't really walk, I'm not doing anyways.

As of Tuesday, I will have a new family practice doctor.  The last one, as it turned out, left little to be desired.  I actually received a threatening letter?  WTH, is that how doctor's practice now...what happened to the Hippocratic oath?  Over the last few weeks, I have left voice-mails and actual messages with her office staff and never received a return phone call.  Tried to set up appointments, only to be told they had no openings, not even with the other doctors in the office, so if I really needed to be seen I should go to urgent care.  So, I sent her an email...which I guess was a sin.  The letter I received in return stated that if I needed to reach her, I should call, leave a message or set up an appointment...(I tried all three), but that if I sent another email, she would "discharge" me, as her patient.  Hmmm...well....I don't respond well to threats...so I'm "discharging" myself.

Anyways, I saw the gastro specialist last Thursday.  He recommended this new doctor I am going to on Tuesday (I see the pain specialist on Monday).  The Hida Scan was normal..no sphincter of oddi dysfunction, which is a good thing.  But, he wants to take a look to see if anything has been missed by the other doctors, so I am scheduled for another EGD scope on May 1st.   I am supposed to go get blood drawn on Thursday, so they can see if the kidney infection is gone...which, as of right now, since I am still running a fever and still have burning and flank pain, I know its not, plus the thrush is back.  My immune system is shot to hell. I am just so tired of being sick...someone has got to figure this out.

Will update again later in the week...hopefully with better news.

Tuesday, April 10, 2012

A lot can happen in just a few days...

Mini Update---A lot can happen in just a few days.

Since I posted on Wednesday, the swelling in my feet and ankles is getting much worse (I don't think I've mentioned this in previous posts, not sure why, guess I didn't think it was really important until now).  This has been happening since I had the CT scan. When I saw the surgeon for the CT Scan results, he said its because I'm not getting enough protein, since I can barely keep food down. Its the protein that holds salt and water in the blood vessels and when it gets too low, edema occurs.  So basically, this means I have malnutrition. I have to keep my feet elevated above my heart, which means laying down a lot, which is hard for me. On Friday this swelling was so bad, my feet actually hurt and it was hard to walk. Plus, I started to have a lot of pain and burning, whenever I went to the bathroom, with pain on my right side and in my lower back.  I tried to push both off, figuring I could wait until I saw my gastro specialist on Thursday.  But, by Monday morning, I didn't think I could wait, dealing with the burning, because it was getting really bad and the swelling (edema) is constant now.  As usual lately, haven't been able to reach my family practice doctor (so much for thinking this one cared...guess she's another one that thinks this is all in my head), so I decided to go to urgent care, after the hida scan, and its time to find another doctor (I'll start working on this today).

So anyways, I had the Hida Scan yesterday (Monday) morning.  I truly hope I don't have to do another one of those anytime soon, let me tell ya, it was not fun.  Since narcotic medications affect the outcome of the test, I was told I had to be off all pain medication for 24 hours before it.  So, needless to say, this completely ruined my Easter Sunday, as once the pain medications wore off, I spent the entire day and night (didn't even manage a half hour of sleep---zip, zero, none) in pain, pain, pain. The test itself wasn't painful, although the first injection of the CCK enzyme caused a lot of nausea (usually this is used to cause the gallbladder to contract, but for me they were looking at the sphincter of oddi), after this they injected a radioactive isotope, but that didn't cause any reaction. This appointment took about 2 hours all together (registration, getting the IV and injections and then the scan--which believe it or not, I slept through.  I don't think he gave me any pain medication, guess I was just that tired from not sleeping and relieved to be getting it over with).  I'll get the results on Thursday when I see the gastro specialist.

I went urgent care afterwards and that doctor was really nice.  I wish she had her own office, but she only works there :(   During this appointment I had to pee in a cup (big surprise), she pressed on my abdomen and back, etc. and she looked at my feet and ankles too. I had a fever, even though I didn't know it, and the results showed bacteria & blood in my urine.  She explained that it was a good thing I didn't wait until Thursday, since what once started as another bladder infection (I had one in November) was now a kidney infection. A kidney infection can be really serious if it is let go for too long, since the infection can enter the blood stream and it risks serious damage to the kidneys.  So she put me on anti-biotics for the next 14 days, plus she gave me this great numbing medicine, so I can go to the bathroom without the burning...although, my pee is orange now, LOL.  As for my feet and ankles, she gave me a prescription for these special socks to wear and she insists I need to tell the gastro specialist to check my blood work. The malnutrition is wreaking havoc with my immune system and I keep getting sick:  the edema, bladder and kidney infections, the thrush infection, colds and flu, and I'm at risk for worse.

Anyways, I'll update again after I talk to him on Thursday and see what he decides to do next.

Obviously, this isn't in my head, someone needs to figure out what is wrong with me before I get too sick.







Wednesday, April 4, 2012

Sphincter of Oddi Dysfunction?

Hi everyone, its been a rough week and this weekend is going to be tougher, I'm afraid...for me anyways (hopefully those of you that celebrate Easter, have a nice holiday).  Since I posted last, I was still waiting for my CT scan results.

This past Monday I had my first visit with the surgeon my gastroenterology specialist is working with. He went over the scan and even pulled it up on his computer so my husband and I could see it.  As usual, it was normal. It did show some loops of redundant distended colon, but he doesn't believe that is causing my pain. The x-ray tech noted a small benign lesion on my liver, but this doctor believes its actually a bruise that hasn't healed yet from my last surgery, so no worries there either.

So, onto more tests.  On Monday, April 9th, I am scheduled for a Hida Scan. He thinks I may have a problem called a Sphincter of Oddi Dysfunction. I couldn't find a lot of information regarding this online, since its pretty rare, but I do know there are clinical trials for bariatric patients that have had their gall bladders removed. For some reason, it seems this happens to a lot of people that have their gall bladders removed with or without bariatric surgery. According to the surgeon, and I may be a little off on understanding this, but this little muscle controls the flow of bile between the duodenum and the intestines.  It causes a form of spasms within the biliary tree which equal the majority of my symptoms. The problem will be, if this turns out positive, they have no way of getting to it to repair it, since I had gastric bypass.  Normally a patient with this problem can have it fixed with a scope, but the scope won't reach where they need to go on me anymore. Guess we'll have to wait and see. I will get these results when I go back to the gastro specialist on the 18th.  He also had me double the amount of Prilosec I'm taking, since he believes I may still have an ulcer, but in the lower portion of my stomach that doesn't receive food anymore.  They have no way of viewing this part of the stomach any longer because of my bypass surgery, so its guess work. My biggest fear right now is Sunday though, since in order to have the test, I have to be off all narcotic pain medications for 24 hours.  This is not going to be fun, since lately, pain has been my life.

Now, another update, although I was quite against seeing a pain specialist, I did yesterday.  I had the old opinion that when doctors suggested this, that they were treating me as though the pain was all in my head---now granted, I have had doctor's say that outright, but that isn't the case now. Seeing the pain specialist actually wasn't at all what I thought.  This doctor is actually going to work with my gastro specialist and he is even going over all of my past medical records to assist in figuring out what is wrong with me.  In the mean time, his job is to manage pain.  Up until now, the doctors that have prescribed pain medication have only tried one...a version of Vicodin and no one has tried anything else. He changed my medications yesterday and although this will take some adjustments, he is going to try to give me a life free of pain, which I haven't seen in almost 3 years. He believes I have chronic neuropathic pain. My understanding is, this is when the nerves become over sensitive or damaged and it signals to the brain pain, even when there isn't a reason for it. I've had so many abdominal surgeries, its possible this is happening. So now, in addition to pain medication (which he switched to a different kind and will probably switch again) he also added a nerve block medication. I believe I will figure out if this is helping over the next few days as it gets into my system.  Although he didn't prescribe it yet, he is also considering adding a anti-depressant. I'm not depressed or at least I don't think I am, but anxiety and depression can lead to abdominal pain and these medications also help to calm the nerves down when they are hyperactive. Anyways, we'll see what happens once he figures out what my body needs to be pain free.

Hope all have a great holiday, if you celebrate it, otherwise a nice weekend. And, I will update again, once I know more :)