Monday, the 29th into Hospital

[Tessa]

Hi all

I went to the Internist today and shared my symptoms with her. I thought and insisted about a Thyroid problem (Hyper) but she rejected the idea by telling me that If I had Hyperthyroidism I would not feel better when eating after feeling hungry...

Her first answer to my explanation was that she was thinking to take me into Hospital for some tests.

I felt scared and thought she wanted me in Hospital straight away.

It was so sudden that I just said "no".

Then she explained that to her belief I have hypoglycemia and that she wants to carry out a test called Whipple´s triad (an exteded fasting in a hospital setting).

I remember that test. In 1995 I stayed in Hospital for the same test. The initial results showed a fasting Hypoglycemia... But I had to return for the main results (I never did)
(Yes, I know. I should have done)

So, here we are again. On Monday, the 29th at 8.30 I am going into Hospital for this test (fasting overnight) and will remain there for at least 2 days... Oooops... Sincerely, I feel a little worried and scared... But, I admit she might be on the right way.
Furthermore, she agreed testing for a Thyroid problem during my stay in Hospital, just to rule it out.

Love,
Tessa

[celia]

Tessa, It's terrific that your doctor is taking you seriously and trying to get to the bottom of the matter. In America, many doctors don't even beleive in hypoglycemia. Going to the hospital isn't so much fun, but I'm sure you will do fine. Good luck! Celia

[artteacher]

I'm marking it on my calander, Tessa,

I'll be thinking about you the whole time, so be sure to email us the minute you get back. Going to the hospital is sort of eventful . . .

Long distance support,
Marsha

[tex]

Hi Tessa,

That sounds like a good plan--maybe you will finally get a correct diagnosis. Your internist may be correct--the symptoms certainly match. I'm glad you convinced her to do a thyroid test also, because it is certainly possible that you might have both hypoglycemia, and thyroid problems.

I'll be anxious to hear the results of the tests.

Love,
Wayne

[Tessa]

Oh, my dear friends (mis queridos amigas)

Thank you so much for your words of support. I feel much better when reading your comments.

I do not feel well when I am fasting. In fact, I have to carry many sweets, juice, biscuits, etc. because I am eating most of the time... That´s the reason for being afraid of such a long time fasting, though in Hospital, it makes me feel a little scared.

Yes, Celia, I felt really impressed about her being so helpful and trying to get to the real problem.

Thank you, Marsha for your long-distance support. I am sure I will feel I am not alone when going to Hospital on Monday (though, of course, my husband will come too. He even wants to overnight with me). I prefer him being there to assure everythings goes on well, cause I can feel dizzy...

Thank you,
from my heart,
Love,
Tessa

P.S.: Yes, I will confirm when I am back.

[Tessa]

Hi, Wayne, dear friend (querido amigo)

I think we were writing the same time

I have been reading on the Net and yes, I agree. I might have both problems. That´s what I think could be the cause of it.
The internist does not believe it because she said my TSH level would show any misfunction. I do not agree with her. She tried to convince me doing the fasting test and I asked her to carry out both, the fasting test and the cervical ecography for checking the Thyroids (that´s the only thing she accepted in relation with the thyroids).
I did some private blood tests, but they were negative... I would bet it is caused by the immune system... Again.

Thanks for your support, Wayne,
you are always so helpful,

What about you? I hope you are fine.
We´ll keep in touch
Take care,
Love
Tessa

[starfire]

So glad you are having the test done. I'm hoping you will finally be able to actually "treat" something and get better!!

Love, Shirley

[Tessa]

Thank you, Shirley

Yes, I hope we finally know what to treat and how.

Love,
Tessa

[tex]

Hi Tessa,

I wonder if your internist is using the latest, sensitive test for TSH levels. That number, (the TSH value), is only meaningful for diagnosing hyperthyroidism, if the T4 RIA and T3 RIA test results are also considered. If not, then she needs to give you a TRH test.

I assume that the cervical ecography refers to an ultrasound scan. That scan will show if the thyroid is enlarged, or contains an abnormal growth, but it won't show how well the thyroid is doing it's job.

You are probably familiar with this website:

http://www.endocrineweb.com/tests.html

which describes those tests.

I'm feeling fine these days--thank you for asking.

Love,
Wayne

[Tessa]

Wayne, she told me we would not be able to use that test to check if the Thyroid is working right or wrong, but I insisted because I hoped that, at least, it could show something... But, you are right, it will not show if it is working well...

In 1995, when they carried out the fasting test (72 hours), I showed 43 of sugar (in 50 hours) with several symtoms of Hypoglycemia...
I assume it will be similar to that test and hope that the results oblige them to continue testing the Thyroid. I suppose they have to determine the cause for having hypoglycemia. At that stage, how do you think they will manage to know if it is, for instance, caused by the Thyroid?

Love,
Tessa

PS.: Thanks for the link... T3 & T4 results I have were carried out by "quimioluminiscencia" (Copied literally). I have no idea if that corresponds to RAI.

[tex]

Hi Tessa,

No comprendo quimioluminiscencia, but luminiscencia means luminescence in english, which usually refers to a non-incandescent light source, such as radioactive or ultraviolet glow. RAI stands for radioimmunoassay, which, in the tests I'm familiar with, refers to determining the quantity of a test element, by noting the point in the light spectrum at which a processed sample causes a luminescent response to a black light source. It appears that we are talking about the same type of test.

In the corn processing industry, for example, we use that type of test to measure the amount of aflatoxin in a sample of corn.

If the equipment is properly calibrated, the sample is properly prepared, and the operator knows what he or she is doing, the tests are quite accurate, as a rule. There are a lot of places where errors can be made, though, especially in calibration, and operator error in processing the sample.

The Whipple's triad should determine once and for all, if you have hypoglycemia. It's a shame that it's such a long and unpleasant proceedure, but it's probably still the best way to diagnose, (or rule out), hypoglycemia.

I'll be thinking of you on Monday, and hoping that everything goes well.

Love,
Wayne

[Mars]

Tessa,
I'll be wishing only the best for your tests and well-being during your hospital stay. I'm glad you will be monitored if you don't feel well when not eating.

I know that being sick and being in the hospital are not fun but I am glad your doctor is listening to you and trying to find the problem instead of leaving you "not knowing" and constantly sick.

Good luck to you my friend!

Love,
Mars

[Polly]

Tessa, mi querida amiga!

I think the hospital is the best course to take, although I know you will not be looking forward to it.

I just had a BRAINSTORM when reading that they are going to do the Whipple's triad test for hypoglycemia.

There is an illness called Whipple's disease, which certainly could fit all of your symptoms. It is a rare disease in which a specific bacteria causes intestinal malabsorption in addition to many other generalized problems - like heart inflammation/problems, chronic cough, insulin resistance/hypoglycemia, fatigue, etc. One of the symptoms is "swollen glands", and I think I remember you saying that you have had them off and on for years. Check out this website for further info:

http://www.wrongdiagnosis.com/w/whipple ... /intro.htm

I think you should mention this possibility to your docs., because if you have it, it is very easily treated. Usually with a course (or 2 or 3) of
penicillin followed by Bactrim. It is a very rare disease and one that is often missed. I think that sometimes on the biopsy obtained during colonoscopy they can see the little bacteria if they are looking closely for it. It might be worth it for them to have another look at your biopsy specimens.

Check out the list of symptoms and see what you think. It sure looks possible to me. If I were you, I might want to push for a trial of appropriate antibiotics to treat Whipple's disease, since it is such an easy thing to do - and could quite possibly be lifesaving, if that is the problem.

I also think it is an excellent idea for your husband to stay with you in the hospital. I'd want someone by my side, too, if I knew I'd be getting hypoglycemic.

Hang in there, dear. My thoughts and prayers are with you.

Love,

Polly

[tex]

According to this Merck site, the biopsy should be of the small intestine, or an enlarged lymph node, (but that doesn't mean that a sample from the colon could not also contain the bacteria):

http://www.merck.com/mmhe/sec09/ch125/ch125e.html

Love,
Wayne

I couldn't get the "List of Symptoms" page to load at the Wrong Diagnosis site, so here are a couple more sites with a list, if anyone else has the same problem:

http://www.nlm.nih.gov/medlineplus/ency ... 000209.htm

http://www.gastromd.com/education/whipplesdisease.html

[Polly]

Hi Tex!

Yes, thanks for clarifying that point. If Tessa's doctors were going after a diagnosis of Whipple's Disease from scratch, they would probably biopsy the small intestine. But, as you indicated, since the bacteria could be everywhere in the body, my thought is that they might show up in an old colon biopsy specimen. Or an old biopsy of a swollen gland (lymph node). I'll bet Tessa had that done too, so maybe those old slides could also be tracked down.

I seem to remember something else. Tex, didn't Tessa have some kind of finding on an earlier test (was it the colon biopsy? or did she also have a small intestine biopsy?) that you and I thought was unusual in MC? I forget now what it was, but you and I emailed back and forth a few times about it. Do you remember? Tessa, do you have a copy of the pathology report?

Love,

Polly