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Friday, February 4, 2022

The Latest

 Quick and dirty list to catch everyone up:

1. Saw the pandemic coming because I read literally everything and caught wind of it early. We locked down and have avoided covid so far. I put everyone in N95s asap. I did not wash my groceries, though. It's a coronavirus...fomites aren't going to be huge. The CDC did a shit job and continues to be shit despite the change in administration. I mostly follow Israel's science...they don't do a lot of spin.

I will say, appropriate or not, I chuckle at the covid long haulers who are just shocked at how bad medicine is. I feel for them, but it's like, where have you people been? This isn't new. You haven't discovered anything we didn't already know. It's like knowing hell is bad and then complaining when you get there. What did you think was going to happen?

Welcome to chronic and rare disease...a physician will be along shortly to tell you it's all in your head.  

I do hope they'll drive some good innovation for the rest of us though. But the fact so many physicians are already defaulting to telling patients it's a psych thing is concerning...says a lot more about the group think and bias in medicine than it does about patients' mental health.

2. Grew a synovial cyst that pushed on my spinal cord and had to be removed. I believe somewhere on this antiquated blog that no one reads that I mentioned a hip injury. Nope. It was a cyst on my spine. A fairly unusual thing given my age and also a very strange looking cyst per my surgeon but biopsy wasn't exciting (see #5 for more on that).

3. Kiddo is showing signs of inheriting some of my crap, starting with PCOS and  the same weird reactions to Metformin. She was also bit by a tick and had Lyme which had a delayed diagnosis making it all worse.

(No. We don't do woo. There's no evidence I can find that the herbs and whatever the alternative quacks are selling work and I'm not willing to experiment on a child. Unfortunately, mainstream medicine isn't much better with Lyme. 

 She was diagnosed at a major international medical center and we did the doxycycline. We followed the science, but even that required me advocating my ass off. Unfortunately, the delayed treatment means we don't really know how much better she'll feel. 

Despite a classic bullseye rash and living in a wooded area, her peds failed to diagnose her even though we asked specifically about Lyme.

As you can imagine, I was furious. This was all preventable.

While chronic Lyme isn't yet officially recognized, if you are paying attention it's clear there's some level of long term something with this for some patients. And now my kid is on track to deal with an illness that is often denied by physicians or used to deem a patient 'mental', in part because of how extreme the woo gets with Lyme.

What a terrible thing to condemn a child to. Shame on the pediatricians. Shame on the woo quacks. Shame on mainstream medicine too. Everyone is failing patients.

I see the nuttiness with the patients too. I had to join all the groups. The group think is particularly...well, ignorant I'm sorry to say. Lyme has attracted a lot of folks who probably do have a psych diagnosis OR another medical issue altogether and are falling through the many many cracks in the medical system. They are the least sophisticated patient population I've come across for some reason, but even so, if you have more than one brain cell, you can clearly see the science is also lacking and there IS something going on.

But medicine uses the Lyme nuts as an excuse to ignore their shortcomings and shirk their duty to care for patients who actually do have Lyme. Do better.)

4. We are living in and DIY remodeling a massive Victorian house. We love it and we hate it. It's been a major life change and because of the synovial cyst, I haven't been as much help as I would've liked. But it's a fun project and it kept us busy during the pandemic. No time to burn out or feel down when you need to gut an almost 200 year old house down to the cladding. You're too busy to worry about much of anything. So there's my mental health pro-tip for you. Buy a gut job. 

5. I finally was referred for genetic testing. I don't know why medicine was such a bag of dicks about it, but four years later, I'm finally getting what should have been done a long time ago. I do actually qualify for genetic testing, and of all things,  VHL is actually possible.

If it surprises you that I was right, you haven't been paying attention. Medicine continues to be terribly fallible. It's really horrifying to see how much fail there is in the science and the system around the science. Doctors don't just gaslight patients, they gaslight themselves into thinking they know everything. Wake up!

If * I * can see the patterns forming, but the doctors can't and * I'm * right, what does that say about medicine? Nothing good! 

And how is it that it's never the specialists or PCPs facilitating my care? You know who has helped me the most? My OB and my kid's specialist. Yes! My kid's doctor is doing more than my own physicians!  It's not the GI doctors or the PCPs or the endocrinologists. It's random folks outside the specialty my problem is in. That's INSANE! 

Again, do better!

I'm tired of dealing with medicine's bullshit. I hate living in a world where I'm somehow more competent than people with way more education than I'll ever see and where the person who will help is not the person who's supposed to help and where it's starting to hurt my child. It's exhausting, and I can never trust anyone to know what the fuck they're doing, and all I can do is tell my kiddo to make sure she knows her science because she can't trust the doctors to.

There are not enough smart AND awesome people in the world. Not nearly enough.

Anyway, I found the VHL diagnosis years ago and was struck by how much overlap there was with my medical history. I knew I needed genetic testing, but until this past week, I didn't know my family medical history qualified me to be tested for VHL. Huh.

Of course I may not have VHL and I can even see the test coming up negative. But testing will tell. It's just interesting to see everything line up for it even superficially.

Right now I'm waiting on a call back to learn what all testing they're going to order.

6. Latest liver MRI was stable. The tumor that was acting up has resolved (thank God). The other tumors aren't disappearing but they aren't getting worse either, which is good. So hopefully I won't need as many MRIs going forward. 

It turns out the contrast is a massive asthma trigger for me--because you know with this body, it's always gonna be weird in some way--and slamming back 150 mgs of prednisone in one sitting was WOWZA. I think I destroyed all inflammation in the known universe for about a week. Yikes. I'd like to not do that very often. Please and thank you.

7. I continue to participate in what medical studies I can for the various things I've been diagnosed with, however, the researchers have their own agenda and don't take feedback from the patient community on what science would actually provide an improvement for us. I really wish there was a way to truly integrate patients into the research side of medicine in a more material way. We are just told what to do and when to do it and no one is much interested in what we have learned on our end of the experience.

For example, there's a possible relationship between PCOS and hepatic adenomas in the patient population. No one cares. The research isn't looking. Correlation isn't causation, but you don't know that until you do the damn research.

And that's the latest. If you or your loved ones are sick...good luck and godspeed.

Wednesday, November 20, 2019

Today's Roulette Menu

Tumor board says...more MRIs to see how it goes. So no surgery, which is a relief (that was beyond brutal last year). We're hoping the bleeder will just go away vs. rupture. So that's a fun roulette wheel to ride.

Thankfully, it's not as symptomatic as the one they removed. I just have to take it easy when it acts up, not get hit in the stomach, and go to the ER if it gets worse so they can look at me and go 'we've never heard of that.' Them's the rules.

Which, by the way, the second you absolutely cannot get hit in the stomach, you know what happens, right?

The universe just comes for you no holds barred.

I have taken more hits to the stomach this year than I have in my entire life. I could be in a padded room, wrapped in bubble wrap, and there'd be something walloping my gut. The universe knows what's up.

Anyway, I've been doing a 'dirty' anti-inflammatory diet this week to see if I can find something sustainable that might help persuade the tumors to go away. 

It turns out, the anti-inflammatory diet is basically plant based vegan with a lot of nightshades for flavor so that limits my options (for anyone who doesn't remember, I love tomatoes but they hate me). So there's been a lot of sweet potatoes. A lotta orange glop, man. So much orange glop.

Dirty =  some butter, some cheese, diet rootbeer and more sugar than I'd like to admit. I'm working on it. 

In other news, kiddo has PT and neuro set up. Knock wood, she hasn't had any bad falls since the one that prompted me to ask for the neuro appointment.


Friday, November 8, 2019

Up to Date


Hello! Long time, no post. But like, no one ever makes it to the front page of this blog, so really I'm just talking to myself. Per my stats, there are just a handful of posts that see all the traffic.

Anyway...

When last I posted, I was working submitting my case to the NIH for a study, trying to get a uterine ablation set up as well as an MRI for a tumor check.

That particular tumor check was uneventful.

I finally got a letter for the NIH from the endo I like and sent NIH everything. (Surprise, surprise the endo I thought was an ass couldn't even spell my name right making their letter unusuable. Lovely attention to detail. Just lovely.)

NIH called me several times. Yes. The actual researchers called and talked to me and then...crickets. The last time I heard from them, they wanted to know how often I was on prednisone. So I'm guessing the steroids disqualified me.

Womp womp.

They didn't outright refuse my case, so maybe I'm on a reserve list...if they can't find any better candidates maybe I'll get a call??? I don't know.

Life goes on.

I had the uterine ablation. I love my OB/GYN. We work well together and they are just magic. Super easy procedure. Very little pain. Absolutely the right move to head off heavy cycles due to the inability to use birth control pills. In fact, my body still manages to have some kind of cycle despite the ablation, and I have no doubt that, without that procedure, I'd be having all sorts of issues with anemia.

Only downside...getting back to exercise after recovery, I messed up my hip and I've had problems for the last 6+ months. It's been really frustrating and I haven't been able to be as active as I'd like.

I had another MRI tumor check last week. I didn't know what to make of the report. I could tell a tumor about the size of a walnut was bleeding internally. The other tumors showed 'fading', they weren't registering as bright, which I thought might be a good sign.

I actually convinced myself it was all good news. The mental cloud that lifted was huge. I could think about the future in a way I couldn't before. I felt like I could make plans.

Buuuut...then I heard from the hepatologist aaaaaand my case is going back to the tumor board.

Womp womp.

I am hoping it won't be a liver resection. I am not up for brutality like that again. I know I had it easier than many people, and it was still too much for me.

My asthma also flared with the last MRI. I don't know if it was the MRI or what, but I got really sick. I even had trouble holding my breath in the MRI, which I don't usually have issues. So I ended up on prednisone and am still not 100%. Naturally we went on vacation right after the MRI and that was pretty much a shit show. I stayed at the hotel the first three days, too short on oxygen to walk.

And if that wasn't enough...my kiddo is having issues with her neurological stuff. She was good for quite some time and now it's all gone kablooey on her. I'm working on getting her back into a neurologist. It's scary to see it happening again and I worry that maybe there was a misdiagnosis. Maybe they missed something. The neuro team we started with way back when was a bag of dicks, so I would not be shocked if they decided it was actually something else.

I told the ped we needed PT again, but they didn't register what I was saying. So I brought it up again and had to clarify it's a motor thing because they are used to it being more cognitive in presentation. I got the PT order, but now I'm asking for the neurology consult because things are much worse than when I first started asking for help.

End result...I don't know what's next. I don't know what plans I can make that won't be interrupted by medical fuckery. So I'm kind of stuck...not sure which way to go. Waiting.

I should hear from the tumor board later this month. As for the kiddo, I'm not sure how long it will take to get her into a neuro.

At least we met our deductible for the year! But then, we always do!

Thursday, March 14, 2019

Breakthrough

Today stretched to infinity and beyond.

Waking up at 5 am the week Daylight Savings Time hits will do that to you.

I schlepped my tired ass to endo #2 at the butt crack of dawn this morning. This time I also brought an entourage of support with me. Yes, I called in the troops. I asked the baddest mofos I know to be the heavys at my appointment.

"Don't let them dismiss me."

"You can say things I can't."

"You're the bad cops. I'm the good cop."

Aaaaaand I didn't even need to do any of that.

The endo was a brilliant physician. Which I knew, as I'd seen them before, but that first 'diagnose and ditch' endo appointment made me panic a bit.

The highlight reel...

1. I have support for my efforts to qualify for the NIH study. They'll write a letter and help me with switching around meds for additional blood work. After two doctors looking at me like I was crazy to even consider the NIH, this was a welcome surprise.

(Also, I feel like more doctors needs to use the Yes Principle of Parenting. Say yes whenever possible. What does it hurt them if I go to NIH? Sure, I get not wanting to mess with the meds and have that liability, but we aren't even at that bridge yet.

Let the NIH decide if I'm a candidate, just give me the chance, we can dither about managing meds and all that IF I actually qualify. Trust me, I'll keep going to docs until I find one who will work with me on this...I just need you to facilitate this interim introductory step. That's it. I'm not asking ya to marry me, and I'm sure the NIH would be super thrilled to know you're keeping patients away from their studies...for what?)

2. I saw my adrenal glands on the CT scan. OMG. It made me so sad. They are so atrophied. So so so atrophied. I had NO idea this was what the steroids were doing to me. None. The endo showed me and explained the devastation. There are literally black, empty holes that should be filled with adrenal gland. It was really sobering to see that.

Here's a pic I found online. Mine are like the ones on top. (Middle is normal. Bottom is excess cortisol production as in Cushing's.)



3. The tumor is teeny tiny. I might not even be a surgical candidate, and with as atrophied as my glands are, I'm no longer sure it's the right move anyway. (I still want to go to the NIH though and have them tell me what they think.)

4. I probably do have some periodic adrenal insufficiency going on in the background. This was an interesting part of the conversation. I was told I should always have steroids on me...basically act as if I'm insufficient.  Unfortunately, I know this is a controversial stance that 99.99999% of other physicians will never support. However, I did a little googling, and it does appear to be the case that standards are changing and understanding is expanding with regards to adrenal insufficiency.

5. First physician to question if all the tumors and cysts and my health history are connected somehow. This is my question, too. My body is going in a million different directions all at once. I'm growing a lot of different things and it's all happening in a vacuum??? Naw. That would make me a pretty special snowflake. We just don't have any answers for this question...we need the NIH for that.

6. My DHEA is low, no question, but there's no way to really fix it and supplements are not recommended.

7. I'm guessing I'm going to end up with full time Secondary Adrenal Insufficiency at some point. There is little adrenal gland left. My next bout of SAI is likely to be permanent. We didn't discuss this, but between our conversation and my reading, this is my sense of things. Time will tell.

Next steps...wait for the letter, call obsessively about the letter...on all fronts. I've requested letters from all endos. I don't care who gets it to me so long as one shows up.

Also, I need to see an eye doc for my eyeballs.

And I guess call the OB's office because they seem to have dropped off the face of the earth. I had one call about the uterine ablation promising a date and then...crickets.

Last, time to get the next MRI scheduled. Let's see what the tumors have been up to since October.

Wednesday, March 13, 2019

Hip with the Hep

Saw the hepatologist and got the blessing to run another MRI to see how the tumors are behaving six months out. If it's all good, no surgical menopause.

Crossing fingers.

Come on tumors! Shrink!

At some point, something has to be in the textbook majority. I can't be the 1% outlier for every fucking thing, right?

That has to be statistically improbable, right?

RIGHT?

Saturday, March 9, 2019

Tired

This was my week.

Monday:
Ob/Gyn appointment to set up uterine ablation because of the liver adenomas.
Corresponded with lots of hyperaldosteronism patients.
Researched an NIH study a lot of hyperaldosteronism patients apply to and sent an email to lead researcher.

Tuesday:
Heard back from NIH. They are actually interested in my case, but I still have things to do to qualify.
Got a phone call from the Ob/Gyn nurse to start the process of getting a procedure date.
Called diagnosing endo to start gathering what I need for NIH.
Called second opinion endo and got appointment moved up to next week.
Called the hospital to order records.
Went to hospital to pick them up.

Wednesday:
Met with primary care physician to update them and discuss NIH study.
Went for mammogram--it's time and I'll need to prove I don't have breast cancer for NIH.
Ordered more hospital records trying to find imaging for NIH.

Thursday:
Ran to hospital to pick up more records.
Spoke with pastor and explained everything. Somehow triggered a meal train that makes me both grateful and ashamed at the same time.
Took kiddo to the dentist for a filling.
Called endo again as they still had not returned my call.

Friday:
Endo's fellow called and we discussed what I needed for NIH to decide if they should proceed with me or not.

In between I homeschooled the kiddo, felt guilty about not working much, and didn't cook any meals--we lived on take out this week. I just couldn't handle cooking.

My eyelids continue to be swollen. My right eye seems to be enlarged now, but it's subtle and maybe I'm crazy. I almost went to urgent care, but am trying to hang tough until the second opinion appointment next week. I don't feel good, but I don't feel as heinous as I did last weekend. I keep hoping this will resolve.

Also, no one wants me to go to NIH. The lack of support is stunning and I don't understand it. I keep getting asked 'why do you want to go to NIH?'

Ummm...so I don't die because of y'all?

Medicine has been so god awful at diagnosing ANYTHING, and I have a strange pattern of tumors and cysts that I think medical care that looks at ALL THE THINGS just sounds SMART at this point.

I am not looking for 'you're fine' blow offs. I want empirical data that proves I'm fine. I don't care what medicine thinks, I want data. Prove that medicine works and that I'm full of shit. PROVE IT.

NIH will scan the shit out of me. Blood work me like a starving vampire. Genetic testing. AND I can donate my tumor (if they decide to take it out) to help others. I donated my liver tumor to research. I am HAPPY to give science more if they want it.

PLUS...it's free. It is a major financial burden to max out our insurance two years in a row. If I can save us money, I need to do it. My biggest fear is destroying my family financially with all the sick.

AND it's not an experimental study. No meds. No crazy anything. They are collecting data on these tumors so the care is standard but very thorough. No worries that I'll get cancer or lose a limb from some untested drug or anything.



Monday, March 4, 2019

Stockholm Syndrome

I'm no longer able to reliably tell a doctor anything. My idea of normal is so warped that I don't even know what to say anymore.

"Do you have muscle pain?"

"No."

What I fail to add is... "Not beyond the normal every day muscle pain."

See the problem?

Being sick is my normal. I can't report my symptoms accurately.

*face palm*

At least the blood work tells the story on this latest round of medical mayhem.