Thursday, March 05, 2009

Paging Dr. House, Stat!

Today I had a visit with my PCP who, by the way, I absolutely love. Not in a let's-have-sex-on-the-exam-table sort of way, but rather in a you-always-make-me-feel-like-you-really-truly-care-even-when-I've-taken-way-too-much-of-your-time-to-describe-a-bunch-of-random-and-mostly-minor-symptoms-that-probably-make-you-think-I'm-a-hypochondriac-if-not-a-total-whack-job-and-leave-you-wondering-what-the-hell-you-can-offer-me-so-I-won't-be-back-to-bother-you-for-at-least-a-few-weeks sort of way. OK, I lied. It's really the sex-on-the-exam-table sort of way. Seriously.

But, alas, there was none of that today. Just the usual awesome bedside manner. In fact, even though Dr. B could offer up nothing in the way of a treatment, or even in the way of a diagnosis, I left the office happy because he didn't minimize my symptoms. He said something like, 'You are the best judge of your body so if you say there is something wrong then there probably is.' And not in a condescending way either. Did I mention that I love this guy?

Anyway, seems I've stumped him and he needs to take a few days to review the umpteen test results and consult notes that have accumulated in my chart in the past few months and then contemplate next steps. I figured in the meantime I'd use the power of the Internet to see if my constellation of symptoms means anything to anyone out there. If not, comments saying 'get well soon' or even 'die, bitch, die' are also welcome.

What Ails Me (Head to Toe)

  • Hair loss
  • Intermittent lightheadedness and dizziness
  • Excessive fatigue (even when I haven't stayed up all night blogging)
  • Episodic insomnia of the early waking variety (actually this has been somewhat better ever since I tried staying up until 2 a.m. to ensure I don't wake up every night at 3 a.m.)
  • I'm fucking losing my mind or at least I am not able to concentrate, can't remember stuff two seconds after it happens, and sometimes even have difficulties carrying on an intelligent conversation because words seem to, um, um, escape me
  • Facial rash (longstanding, comes and goes, diagnosed previously as rosacea)
  • Heart palpitations/arrhythmia that freaked me out so much in mid January that I went to the ER and ended up being kept overnight because a run of A-fib showed on the monitor (no subsequent A-fib and the palpitations are now mostly controlled with metoprolol, though I still feel funky beats now and then)
  • Pain and weakness, left elbow (the right one is fine), so far not really helped by PT (though, admittedly, I never remember to do the exercises the physical therapist told me to do)
  • Finger swelling/stiffness, both hands (almost every morning, resolves by lunch, through some stiffness remains)
  • TMI, but in the interest of medical science, until last week I would have said severe constipation (almost requiring me to dig in my ass just to make the little buggers pop out) but now it's more like neighboring on diarrhea and smells worse than shit
  • Numbness, two smallest toes of right foot

Poked and Prodded

  • CBC - normal
  • Comprehensive metabolic profile (CMP) - basically normal x 2 (one time potassium was just under the cutoff for normal)
  • SED rate - normal
  • Thyroid level (TSH) - normal
  • Lead level - normal
  • Vitamin B12 level - normal
  • Vitamin D level - borderline low (just under the cutoff for normal)
  • Magnesium level - normal
  • Rheumatoid factor - normal (negative)
  • Antinuclear antibodies (ANA) - 1:40, repeated with same result (technically positive, but so low as to not be especially meaningful per the docs), type was speckled
  • Yet more antibody tests (SS-A, SS-B, RNP, Smith, Anti-DNA) - all normal
  • Urinalysis - normal
  • Cardiac enzymes - normal
  • Echocardiogram - normal
  • Nuclear cardiac stress test - normal
  • X-ray, left elbow - normal

Expert Opinions

  • Cardiologist - 'You are the healthiest patient I have seen all day. The arrhythmia was probably just a one-time thing, but you should keep taking the Beta blocker I prescribed for the next 6 months because it is my duty as a doctor to support the pharma industry.' (OK, he didn't really say the last part, but he was probably thinking it.)

  • Rheumatologist #1 (Who gets perks for giving me possibly the most thorough physical exam I have ever had in my entire life, but major demerits for making me wait four fucking weeks to get her consult report. But, hey, Dr. Stampfer, it's not like I was waiting for those results or anything.) - 'You have flat feet.' (Um, OK ...) 'You have tennis elbow.' (But I don't play tennis!) 'You should take vitamin D supplements.' (OK, will this cure all my symptoms?) 'You do not have lupus.' (Great news! So, what the hell do I have?)

  • Rheumatologist #2 - 'You may have something brewing but right now your symptoms do not meet the diagnostic criteria for lupus or any other condition known to modern medicine, so stop reading crap on the Internet because it's making you think you have conditions that you do not have.' (I paraphrase, but he really did say something like that, even though I prefaced my comment regarding reading about 'brain fog' by saying I was well aware how easy it is to think you have every vague symptom described on the Internet but, regardless, that I think my brain is foggy, god damn it.)

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