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-   -   29 y/o, very sick for 8 months, just diagnosed w/ Non-Length Dependent SFN.. (https://www.neurotalk.org/peripheral-neuropathy/174783-29-sick-8-months-diagnosed-length-dependent-sfn.html)

daniella 09-13-2012 03:35 AM

Hi
On the thought about chronic pancreatitis. I had this about 6 years ago pre all of this. Anyhow I did not have all the symptoms either but after testing I was dx with it. Im not saying you do but I dont think you have to have all the symptoms. I was placed on a special diet and my bloodwork was monitored etc.
I am sorry you are not getting answers and in my experience it seems that most doctors only stay in the speciality they are in. What I mean is that they dont connect symptoms always. So it does not surprise me that the neuro felt the gi is separate. It may not be connected but sometimes I feel they just dont want to go out of the specialty they are in.
Have the doctors suggested any type of meds or treatment? Have you been tested for Lupus?

pg600rr 09-13-2012 10:18 PM

Quote:

Originally Posted by daniella (Post 914099)
Hi
On the thought about chronic pancreatitis. I had this about 6 years ago pre all of this. Anyhow I did not have all the symptoms either but after testing I was dx with it. Im not saying you do but I dont think you have to have all the symptoms. I was placed on a special diet and my bloodwork was monitored etc.
I am sorry you are not getting answers and in my experience it seems that most doctors only stay in the speciality they are in. What I mean is that they dont connect symptoms always. So it does not surprise me that the neuro felt the gi is separate. It may not be connected but sometimes I feel they just dont want to go out of the specialty they are in.
Have the doctors suggested any type of meds or treatment? Have you been tested for Lupus?

Do you recall what testing they did to uncover this? I actually just saw my GI doc today, had a double dip endoscopy and colonoscopy (everything was fine),and I mentioned a possible gallbladder, pancreatic, etc. issue since the colon, stomach and esophagus have checked out ok... Iaskedabout doing an MRCP, I read this is very effective at evaluating those organs for any issues.

My Neuro (atleast one of them) has been good at working with my GI, I guess because he specializes in neuropathies and sees a lot of gastroparesis that sometimes accompanies them, but besides that its like all the specialists are disconnected from eachother like you said, my care feels very fragmented and I believe that is a large reason why things have yet to be figure out.

Docs have not suggested any meds really...zofran for the nausea and the midodrine but thats about it.

I think lupus has been ruled out, CRP consistently 0.1, ESR usually 2-5 (think those are markers?) ANA (tested x6), ANCA, anti ro/la, and Myeloperoxidase Ab all negative, but I checked the lupus website and there are more marker tests that have not been done, although I'd think one of the above would be off...thought I read that ANA is positive in about 90% of cases.

ShannEL 09-14-2012 03:30 AM

Quote:

Originally Posted by pg600rr (Post 905758)
Background:

I was a very healthy 29 y/o, best shape of my life, gym every other day, running every morning, zero health problems and no meds. Started having 'off' days last August, maybe every other week were I would have GI upset. Then had a few prolonged periods in Sept.-Jan. of 3-5 periods when I'd feel pretty bad.

Mid-Feb. everything went downhill fast. First presented w/ extreme GI upset, 24/7 nausea, no appeptite, bloating, gas, fatigue, malaise, etc. Was in/out of ER, given fluids and sent home each time due to CBC being OK. Scope was eventually done, they found mild esophagitis and 3 distal ulcers in esophagus. Thought that was why I was feeling so bad (didnt really make sense tho) and month later recheck showed it had healed itself. Through March continued to feel worse, symptoms included:

Symptoms (past & present):
-GI symptoms (nausea 24/7, gas, bloating, distention)
-mid back pain (dull)
-very fatigued 24/7
-chest tightness
-orthostatic tachycardia [diagnosed with POTS by Dr. Freeman @ Beth Israel]
-lost 18 lbs. 2/25-3/15
-unable to gain much weight back
-not sleeping (getting up sometimes 3x night to urinate 4/6/8am)
-constant varying levels of dizzyness/lightheadedness (usually worse when I stand up from sitting), will get numbness on forehead sometimes, feel like passing out sometimes
-feel very cold alot, especially hands and feet
-whole body feels very sick
-sporadic dull headaches (usually just above/behind eyes but varies)
-muscles in legs, arms upper back feel tight/achey from minute I wake (horrible feeling) worse in the a.m., will have for a week or two then not for a few weeks...
-left side gland under tongue (almost feels swollen on the inside, like something is in there) can pinpoint exactly where this feeling occurs
-usually have feeling of adrenline rush through body upon waking in the a.m.
-neuro noticed left hand temors upon evaul
-very sporadic, non-itchy rash, just blothcy, usually in center of stomach/chest area, sometimes on neck or ribs (havent noticed in atleast 4 weeks) [see pics]
-eye doc has been following left eyelid droop (may be caused from Lasik surgery I had done in 2010)
-sporadic cheek muscle twitch left side
-sporadic eyelid twitch left side
-restricted breathing through nose (often have to sleep breathing only through mouth)
-sometimes get sensation of clogged/forced swallowing @ top of throat, feels farther back in head, around point where sinus cavities emptying into top of mouth/throat (almost like traying to swallow with your nose plugged)

From 2/25 till now I have been to all major Boston-area hospitals, seen 16 specialists trying to figure out whats going on. So far they have not found much except for "mild" POTS, borderline lyme WB's, some atypical lymphocyctes (8%), and most recently, the big finding, NLD-SFN, biopsy was normal at right calf, abnormal at thigh. Currently, many of the symptoms above have changed or lessened. The major ones continue to be the GI and the feeling in my legs (sometimes shoulders/arms to a lesser degree).

Testing I've Had:
90+ pages of blood work
EMG
EKG (multiple)
Echo (multiple)
Holter (multiple)
UGI w/ small bowel
Upper Endoscopy
GES (normal, although doc said it could have been a good day)
Breath Test: SIBO, lactose, fructose
Allergy Blood testing and select skin testing
CT: Abdominal/Pelvis/Chest/Sinus
MRI: Full Spine and Brain
Autonomic Testing x2 (cardiovagal, adrenergic, and auxiliary all normal, sudomotor showed sweat output was normal but QSART showed length dependent pattern w/ a decrease of sweat output distally atleast 33%)
Skin punch biopsy (showed NLD-SFN, nerve density reduced 52% @ thigh, normal at calf)

Questions:
I have yet to really get into see a specialist in SFN or the NLD kind. The nuero that diagnosed mine said that it was "mild" and some with this level of damage might not even experience symptoms, so I dont understand why I feel like I am dying most of the time! So I do have a few questions, any comments, suggestions, thoughts, answers all welcome :-)

1. do the sensations I am describing sound SFN related? I have NO burning, stinging, tingling, numbness, etc. it is like a jello-y, tight feeling, very unpleasent, comes and goes, mainly in glutes, thighs, and calfs (weird because biopsy showed no damage in calfs...) why would it be in the calfs if no damage there?

2. If the sensations are being caused by the SFN shouldnt they be somewhat consistent and not cycle?

4. read about dorsal root ganglia damage sometimes being related to NLD-SFN..how would this present? my neuro said it is not relevant to me, because my EMG was normal, I have no coordination or muscle weakness problems, and no difficulties with sensing heat/cold/vibration...

5. anything specific I should I have my PCP doc testing for to find an underlying cause given the acute onset, the progression, results of above tests, my age/health, symptoms, etc.?

Thank you so much!

I am the same age as you. Were you in a car accident anytime during these symptoms start to occur? I have almost the exact same symptoms, but no diagnosis was made.

pg600rr 09-14-2012 08:12 AM

^Hi, sorry to hear you are having the same issues, I was not in any type of accident prior to this happening, and have never been in a car accident...

daniella 09-16-2012 07:09 AM

Hi sorry for my late reply. I had a ct scan of my stomach where I drank barium I think it is called and this was after my liver enzymes in blood work and other was off.
Have you thought more of sending your records to Mayo?

pg600rr 09-17-2012 12:24 PM

Quote:

Originally Posted by daniella (Post 914852)
Hi sorry for my late reply. I had a ct scan of my stomach where I drank barium I think it is called and this was after my liver enzymes in blood work and other was off.
Have you thought more of sending your records to Mayo?

No worries, I had a CT of my stomach as well, had to drink the barium and also got the injection w/ contrast... didnt show anything, have also hade liver enzyme (LF's?) tested several times, always normal... I am assuming this might rule out chronic pancreatis, but I think I'd still like t get a doc to order an MRCP.

I did actually send my files off to mayo (many months ago, since then a lot more testing hs been done locally so I would have to resend everything) and they said they would see me, however all I have is state medicaid for insurance and they do not take that, so I am kind of in a bind...trying to figure out possibilities to fund a mayo work up at the moment...maybe getting some supplemental insurance thorugh a family member or applying for free care @ Mayo..

ginnie 09-17-2012 12:37 PM

Hi PG
 
Your State senator, or Congressman, may have some options for you regarding getting funding to go to mayo clinic. My friends held an auction for me when I first got sick, which paid for my first surgery. I sure hope you can get to Mayo. that is where I was diagnosed and at least figured out what was wrong with me. I wish you all the best. ginnie

daniella 09-18-2012 08:30 AM

I would call Mayo's billing and explain your situation. They may be able to suggest something or I think some are non profit so will work with you? I am not sure about Mayo though.
As for the pancreatitis and I guess I am asking you this does that create nerve problems? My past pancreatitis issues and now nerve problems I never thought of a connection.
You stated gi issues but what about bowel problems?
I know you stated you are not being treated with any meds but I wonder if you have tried any dietary changes? Have you thought about seeing a pain doctor?

en bloc 09-18-2012 10:03 AM

I really think you should consider adrenal function testing. It can cause nausea, POTS, fatigue, frequent urination...frankly everything you list. I too have some similar symptoms and just asked about it myself. I have a ACTH cortisol/cosyntropin challenge test set up for Thursday first AM. Your mention of the adrenalin rush might be key. They always test adrenal function first am because cortisol increases as soon as you start moving in the morning.

pg600rr 09-18-2012 03:47 PM

Quote:

Originally Posted by ginnie (Post 915166)
Your State senator, or Congressman, may have some options for you regarding getting funding to go to mayo clinic. My friends held an auction for me when I first got sick, which paid for my first surgery. I sure hope you can get to Mayo. that is where I was diagnosed and at least figured out what was wrong with me. I wish you all the best. ginnie

That is a great idea and I will look into it, I was thinking about trying to get medicare as a secondary insurance, though not sure how that would work..

Quote:

Originally Posted by daniella (Post 915385)
I would call Mayo's billing and explain your situation. They may be able to suggest something or I think some are non profit so will work with you? I am not sure about Mayo though.
As for the pancreatitis and I guess I am asking you this does that create nerve problems? My past pancreatitis issues and now nerve problems I never thought of a connection.
You stated gi issues but what about bowel problems?
I know you stated you are not being treated with any meds but I wonder if you have tried any dietary changes? Have you thought about seeing a pain doctor?

Personally I do not know if pancreatis creates nerve problems, I wouldnt think the two are related but rather distinct issues, I think it was another member who mentioned that as a possibility for my GI issues. I don't really have bowel problems (if by that you mean issues actually going to the bathroom, i.e., constipation/diarrhea), I have neither, bowel movements are usually once or twice a day and fairly normal (sorry if TMI, lol).

I have tried some dietary changes, went dairy free for a bit, didnt notice anything, and also tried gluten free for about 4 weeks, didnt notice anything, but from what I hear that would be too short a time.

Havent thought about seeing a paindoc because I dont really have pain...just have the sporadic tightness in leg muscles, so not sure what they would do for me, but I might mention it to my PCP. He did say that he thinks some sort of muscle massage therapy would be useful tho..

Quote:

Originally Posted by en bloc (Post 915401)
I really think you should consider adrenal function testing. It can cause nausea, POTS, fatigue, frequent urination...frankly everything you list. I too have some similar symptoms and just asked about it myself. I have a ACTH cortisol/cosyntropin challenge test set up for Thursday first AM. Your mention of the adrenalin rush might be key. They always test adrenal function first am because cortisol increases as soon as you start moving in the morning.

Funny you should mention that, I was jsut thinking this and looking in to it today, especially because a cyst was seen on the pole of my right kidney (which could mean on the adrenal gland)...

I think I have actually had the test you are describing is it called a cortisol stim test? where they wake you early in the a.m., test your atch and cort, inject you then test it an hour later to see if it doubles?


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