Went To The Doc Yesterday

[terre]

I went to see my Internal Medicine doc yesterday. He asked about my weight loss and colitis. He ordered blood work and has suggested I see a Gastro specialist in Memphis.

I didn't know which blood tests he was doing, but magnesium was one.....which we know is going to show "normal"....why do they even run this test? It seems they should know the blood is going to have normal levels.

He ordered a Sed Rate, Automated - my value was 95 (Ref Range 25-115 U/L) In his comment, he noted "The sed rate is a marker of inflammation and is usually high in autoimmune conditions."

My Vitamin D 25-OH value was 59.

The only tests low (and not much) were:

ALP: 49 (Ref Range 50-136 U/L)
Lymphocyte Percent: 16.5 (Ref Range 20.0-40.0%)

Only one high was:

Monocyte Percent: 9.0 (Ref Range 0.0-6.0%)

His comments were:

Overall your labs look stable. Your protein levels are fine and the liver and kidney function tests are fine. The pancreas enzymes are normal and the sed rate is low at this time. Your bone marrow function tests look fine. Your thyroid level is just right and the coagulation values are in the normal range. You are doing well with the vitamin D level as well. He is going to set up an appointment with the Gastro specialist.

I'm thankful for good results. He told me to stay on the Budesonide at this time. After being on this site, I'm wondering if a Gastro specialist would have any new insights on the MC? Would it be a waste of time and money?

Norman, Norman where are ye?

Thanks for listening,
Terre

[tex]

I'm wondering if a Gastro specialist would have any new insights on the MC? Would it be a waste of time and money?

Statistically, it would take a rather exceptional GI specialist to come up with any insight that you are not already aware of, but whether it would be a waste of time and money depends on what it will cost you. With those test results (normal SED rate especially), she or he is not likely to find Crohn's or UC, or any other reason why you are still having symptoms. Your only hope would be that she or he happens to know a lot more about MC than is typical in the profession. But of course I could be all wet.

Tex

[terre]

That is exactly the reason I think it would be a waste. I think of all the members on this site and all the different locations they are from and it seems we hear the same thing from the GI docs.

My doctor said they may want to do another colonoscopy to rule out that something was missed....I just don't know. The only thing that I would ask is if they would do the special stain (need to do reading to refresh my brain on that). I'm with you...I don't think it's Crohn's or UC.

I love my doc and I know he's trying to help me, but I think when the meds he prescribed did not put me in remission, he wants someone else to have a go at it.

BTW, if the colon is inflammed and having other inflammatory issues, how can SED be normal? Just curious.

Thanks for posting.

Terre

[tex]

The stain used to make it easier to see mast cells in the samples is a tryptase-based stain.

With MC, inflammatory markers such as SED rate often remain within the normal range, especially if the patient is avoiding inflammatory foods. Yours appears to be in a typical location for MC patients, in the upper part of the normal range. With Crohn's or UC, SED rate or C-reactive protein test results are typically above the normal range.

You're most welcome,
Tex

[brandy]

Hi Terre,

I think they can still do the special stain from your original biopsy slides. The mast cell count was not listed in my first pathology report that I got from GI doc #1 which GI doc #2 found unacceptable. GI doc #2 requested the original slides from GI doc #1 and had another pathologist run the special stain to test for mast cell numbers. The stain results showed I did not have mast cell issues. I did not have to have a second colonoscopy.

I'm not sure if your internal medicine doc can get this done for you? I'm not sure what the Dr. etiquette is in these situations.

[terre]

Brandy, this is very good info to have....how long had it been since your colonoscopy that GI doc #2 requested the stain? It has now been 3 years since the colonoscopy that resulted in my MC diagnosis.

I'll be traveling to another city if I see the new GI doc....so I don't know what protocol is. I know that in other circumstances, they want to run their own tests....not that I agree with this....no wonder our health care costs are out of control.

Thanks so much,
Terre

[brandy]

Hi Terre,

Timetable was 7 months. I don't know what the longevity of the biopsy samples are.

Brandy

[tex]

I've heard that most hospitals/clinics save the samples for a decade or 2, but that may vary by institutions. And I'm not sure how long the biopsy samples can be remounted and stained, but I have a hunch that they are well-preserved, so it could probably be done many years later. Of course things can change, so it's not surprising that many docs might want to see more current samples.

Tex

[terre]

Thanks for your input Brandy and Tex.

This information will be helpful in my discussions with doc.

Terre