Doctors Lounge - Gastroenterology Answers
"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."
Forum Name: Liver Diseases
Question: Symptoms don't match blood work
|Doctors Baffled - Wed Nov 14, 2007 1:53 pm||
Past Diagnoses: Hepatitis “B” (August 1987) sick 2 ½ months, recovered, not chronic.
2 Herniated Disk in lower back (January 2006), COPD (January 2007)
Past Surgeries: None
Father: High Blood Pressure (Medication kept it under control)
Past away from Complications of Clear Cell Cancer.
Mother: Thyroid Cancer (Removed) 25 + Years ago,
Skin Cancer removed.
Grandfather: Heart disease, past away from Heart attack.
Grandmother: Past away from complications of lung cancer.
Siblings: Both brothers healthy.
Suboxone, 2mg, 1 tablet twice daily due to pain medication addiction.
Spiriva & Pro-Air HFA, Albuterol Sulfate for mild COPD.
I will make this as brief as possible.
Since I was 16 years old, I have abused alcohol. I would go out and drink 3 or 4 times a week. In 2002, I became a heavy daily drinker consuming 8-12 beers every night from 6 pm to 11 pm. In July 2005, I was prescribed Loratab 10-650’s for pain in my back.
I gradually became addicted to the pain medication also.
My first symptoms appeared in September 2005. I woke with a severe constant sharp stabbing pain in my right side, radiating around to opposite side of my back. It would hurt worse if I slept on my back or right side, the only way to relieve pain was to sleep on my left side or get up. This usually lasted 1 or 2 nights and would go away.
After this happened several times, I went to my doctor, she referred me to the GI specialist. I told the GI Doctor I was worried about my liver because of my alcohol consumption and loratab usage. She said the pain I was describing sounded more like a gallbladder issue. She could not confirm this because Abdominal Ultrasound, Ct scans & Comprehensive Metabolic Panel came back normal.
January 2006 I switched my Primary care doctor. I told the new Doctor my past symptoms and I felt I was addicted to the pain medication. I wanted to come off the Loratab but every time I tried I had withdraw symptoms. She prescribed me Suboxone 2mg and sent me for an MRI because of back pain and my right leg was going numb.
MRI showed two Herniated Disk in my lower back.
I was prescribed Xanax for anxiety in March, then In June, I was also prescribed Ibuprofen 800 mg for pain because the Suboxone helped with some pain but there were times it was worse.
So now a typical day for me until early November was:
Started drinking coffee - 0630 until 2-3 pm.
Suboxone 2mg – 1 tablet 3 times day for pain med addiction.
Xanax 1mg - 3 times day for anxiety.
Aspirin 80 mg - 1-2 times a day because I thought it was good for you.
Ibuprofen 800 mg – 1 tablet 2 times a day for pain.
Nose spray - 3 or 4 times day for constant runny nose.
Lunesta or Ambien CR – 1 or 2 tablets @ bedtime to help me sleep.
I was also given other sample medications to try, Cymbalta was one of them, however I cannot remember them all.
From May 2006 through January 2007 I usually only ate once per day, Dinner. I thought this was because of the coffee and the medication I was on.
Then I noticed was my stool was almost white 2 or 3 different times. Each time it lasted for about 3 or 4 days and then returned to normal, so I did not think anything else about it. I was also becoming lactose intolerant. Every time I had dairy products, I would become bloated and produce a lot of foul smelling gas.
August 2006 I stopped drinking alcohol completely, I told my doctor I felt I had lost some of my sex drive and my eyes were dry and irritated all the time. She said sex drive would come back when I stopped taking the suboxone and eyes were probably allergies.
Then a month or so later in September my wife and I noticed new symptoms:
Several horizontal raised ridges in my finger and toenails.
Both of my leg calves, ankles and feet were swelling up leaving indentions from my socks. I thought maybe I was overdoing things at first but by late October, I started bruising much easier too. I received a large bruise instantly on my nose just from squeezing a blackhead and I had several large bruises on my legs. I had never bruised easily before. All of these symptoms were new to me; I had never had any of them before.
Then in December 2006, I noticed my ears were ringing all the time, and every time I took an aspirin or Ibuprofen, I would come down with a flu-like reaction that lasted the entire next day. I called and scheduled another doctor’s appointment. While I was waiting for the appointment, I noticed I was going to urinate much more often with less output than normal. Then somehow I drank too much juice and water, I became real bloated and full in my stomach. The next day I woke with a pounding headache, threw up all day and was extremely tired. This has happened 4 different times since. I did not drink any more fluids than I had in the past. It was as if my body was not processing the fluids as fast as it had before. When I saw my doctor I told her about everything that was happening and I also told her I thought I might have had a cholesterol deposit two different times on the top of my wrist a week or so ago. She said she did not think that was what I had. I thought it was a blister or something at first but I saw one online and noticed what I think it was. The ones I had were kind of a reddish rectangle shape. I think this is when I first time I told her I was itching all over a lot of the time now also. I also told her that I thought maybe the xanax were causing me to feel unwell and told her I wanted to cut back to 15 per month. My doctor checked my urine, sent me for blood work, and said both came back ok.
On 1/21/2007, we went to the ER because I was bloated and urinating only a very small amount even though I was drinking a lot of water. They told me everything was ok with blood and urine test and sent us home. The ER Doctor put Possible kidney failure for diagnosis.
I went back to my Doctor and told her I was worried about my urine output and that something is not right. I asked her to send me for more test on all my blood counts to see if it would show something that would explain. She sent me and said all came back ok for the most part except for B12 low. Start taking B12 supplements. Still waiting on rest of test results.
On 02/17/2007, I went back to Primary Care Doctor for follow up; she stated I was hypoglycemic (Glucose Tolerance Test - 1st hour 150, 2nd hour 90).
She said my body was using up all the sugar at once and I was crashing. If I did not change my dietary habits, I would be diabetic within a couple of years. She gave us a diet plan; I could have little or no sugar. No fruit juices, cookies, candy etc. I need to watch the carbs I was eating. Said I needed to re-train my Pancreas. We went home thinking this was all that was wrong.
On 03/13/07, I was feeling stressed and anxious again over finances. I called Doctors office and they filled xanax again. I reassured myself that all was ok and the Doctors were right, it was all in my head. I was cutting back on suboxone; I was not having the problems urinating (looking back I was drinking more coffee again) and was looking for employment again etc. I felt fine except for a little anxiety. Picked up xanax on the 14th. By the 3rd day, my ankles were swelling again and by the 5th day, I was having some body aches. I thought that maybe I was overdoing things again. By the 21st, my body aches were getting much worse. I started thinking the worse and flushed the rest of my prescription.
By the 24th, I had a constant low-grade fever (98.9 – 100.4) and my joints ached. This lasted for 2 months. Stool was a light color again, almost yellowish, goes back and forth from loose, watery to constipated. They smelled like ammonia, floating, it also looked as if whitish grease was floating around it with a lot of undigested food particles.
Seem to have more trouble thinking and lose thoughts easier when we have chicken several days in a row. I became dehydrated somehow during same time even though I drink about a gallon of water per day.
When I stop drinking coffee, within 3-4 days I have trouble urinating again, feel real bloated and cannot eat. Urine has been very foamy lately and dip test at Doctors office confirmed protein every time lately and keytones were found some of the times. Foam worse after eating high protein or drinking Boost. Urine looks like a cloud or something is floating in toilet.
Since all this started I have experienced all the following:
For two weeks after the 24th, I could not eat anything fattening without feeling as if I would throw up.
Have pain in center by breastbone after eating
Low grade fever between 98.9 – 100.4 everyday, am ok, by 2-3 pm temp goes up
Night sweats – (had to change shirts 2-3 times due to sweat sometimes)
Ears ringing all the time
Sleep patterns have changed several times
Weight loss – I weighed 225 one and a half years ago, now 176
Multiple medication/chemical sensitivities Aspirin, Xanax, Coffee, Flexeril,
Coated tongue that will not go away
Itchy skin (was worse at night on fingers and feet)
Couple of spider veins on chest - (I was told wrong type for liver disease)
Testicles seem smaller - (multiple varicose veins visible)
Lack of sex drive
Dry red itchy eyes for over a year
Starting to get headaches a lot (never used to get any)
Skin on face breaks out – (Butterfly Rash)
Tips of fingernails turning reddish color
Hair thinning out
Urine foam is getting worse
Cannot think clearly
On 04/10/07, I was very bloated from fluids staying in my stomach. They are not reaching the bladder for some reason. I called the pharmacy and the recommended a mild diuretic. I took 1 of these and within 2 hours, I was urinating about every half hour. My stomach shrank and I was able to breathe easier. I found out later that day this was dangerous because of potassium and to go to ER.
All this has happened within the last year and a half. Somehow, after each medication usage since August 2006 it seems like I have become worse than the time before. I know it does not make sense but these symptoms are real and not something I created. Obviously, something is not right which is why I am so concerned. I have quit all other medications.
Since then, I have seen another GI Doctor, Infectious Disease Doctor, Neurologist and Endocrinology Doctor. All checked blood work and say nothing is wrong.
I know you are busy, but if this were happening to you, what would you do. What do you suggest I do for all these unexplained medical issues? Where or who do I turn to now? I have asked for a liver biopsy but because of the blood work, they will not consider.
Thanks, any help would be appreciated.
|Debbie Miller, RN - Sat Jan 19, 2008 11:23 am||
I think you are in good hands with the various professionals you have consulted. Sometimes you have to trust their judgment when they say there is nothing more needed in the way of diagnostic tests. There is a leap of faith involved and sometimes we never do get the full answers we would like. We often have to learn to live with a condition even when we don't know what to call it. The important thing is that they have investigated the potential serious problems and if they believe they have covered all the bases, I doubt anyone on the internet would try to second guess them on it.
This may not be the answer you are seeking but you asked for an opinion and this is what I think. Stay in touch with your primary doctor so if new symptoms develop you can follow up on those.
|| Check a doctor's response to similar questions|
Are you a Doctor, Pharmacist, PA or a Nurse?
Join the Doctors Lounge online medical community
Editorial activities: Publish, peer review, edit online articles.
Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.