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09-22-2007, 04:40 AM | #1 | ||
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Can anyone tell me if they have come across the term hyperreflexia in connection with their PN? If so, what were the positive/negative associations of hyperreflexia for you? Also I wanted to ask about the merits of the various GTT (Glucose Tolerance Test) lengths! I have been able to slot an extra appointment in with my Endocrinologist this coming Tuesday & I want to run this whole PN thing past him (ie. the events of the past two - three months) and see if he has any suggestions, either in connection to my other medical condition or otherwise. If he suggests a GTT, is there one that is better to 'steer' him towards (if indeed a specialist can be steered) such as the two, three, four or five hour GTT? Also is there any merit in having fasting insulin levels done concurrently? Any other suggestions to help towards a positive outcome for this appointment would be appreciated, as I want this done properly so I can completely lay prediabetes to rest and move on to .... probable idiot-opathy - oops idiopathy! |
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09-22-2007, 05:03 AM | #2 | |||
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Wisest Elder Ever
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a fasting insulin is very useful. Just be sure you do not exercise or walk alot
before it is drawn. The longer GTT will show reactive hypoglycemia, due to elevated insulin levels. Since you are there already, staying for a couple more draws is sensible.
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09-22-2007, 06:32 AM | #3 | ||
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Magnate
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--with glucose tolerance testing, one does need a longer test (at least three hours after the initial baseline "stick", although I generally do five) to really see the patterns of how the bodily process of digesting/releasing the glucose to one's body causes one's individual glucose regulaiton patterns.
I always have them done not only with a fasting insulin level, but with insulin levels drawn concurrently all the way through. That way, when the results come in, one can trace the insulin reaction to the glucose challenge, see if it is measured or exaggerated (the latter is a sign of insulin resistance) and just how exaggerated (which may result in reactive hypoglycemia, as Mrs. D mentions). The reason for the longer testing is to cover everybody's varied alimentary speed--by 4-5 hours most people's systems have gone through a complete cycle and are heading bck to baseline readings, and all the insulin/glucose patterns have been cycled through. Also--while this may make you feel like a pincushion--I have readings taken every half-hour, not every hour. For people with faster systems, taking a reading only every hour may miss some of the rise/fall patterns in glucose and/or insulin that may provide diagnostic clues. (In other words, you want enough "snapshots" taken to see the pattern.) |
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09-22-2007, 06:45 AM | #4 | ||
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Magnate
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--as regards hyperreflexia, or exaggerated reflex response, it can be a feature of certain types of neuropathy, though more often the reflexes are reduced. It is more likely to occur in neuropathies with significant motor neuron involvement (as opposed to predominantly sensory). It can sometimes occur in those with hyperthyroid or hyperparathyroid conditions.
Hyperreflexia is more often associated with spinal cord problems, and is a fairly common symptom of multiple sclerosis, ALS, or degeneration due to B12 deficiency. |
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09-22-2007, 09:04 AM | #5 | ||
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Thanks Glenn and MRSD for those responses. They shall be my armour-bearer as I sally forth to visit my endocrinologist! (...or perhaps I better just sit there demurely and let him decide everything and say yes sir, no sir - see below).
Just looking through my results again tonight from last week and wondered if anyone could cast light upon my ANCA result. The comment on the report says: "Unable to determine the presence of ANCA because of the presence of anti neutrophil nuclear antibodies". However the Proteinase 3-ANCA (the major C-ANCA antigen) was normal at <5 U/mL (range <10), likewise the Myeloperoxidase -ANCA (the major P-ANCA antigen) was also normal at <5 U/mL (<5) Would I be correct in assuming that the antibodies are from some previous infection/immune insult and have no bearing on the present? Also the neurologist who on my second visit basically concluded that she had come to the end of the road with my management wrote in her letter back to my GP....and I quote "The other possibility is that she is developing somatic symptoms secondary to depression or anxiety. I raised this possibility today and she doesn't feel that she is anxious or depressed. Despite this she actually became almost tearful during the consultation". (Yeah sure I did feel shocked when she basically was dismissing me after a couple of minutes in the consultation saying there was no more she could do). I think it is quite laughable and somewhat embarrassing that she should think that. I did prepare for the consultation quite carefully and had learnt a little bit of the basics in the five weeks from the time of my first visit but I was far from know-it-all! Perhaps she felt that my approach of asking questions and wanting a copy of the results constituted anxiety on my part. It seems to me that doctors can all too readily label people as having psychosomatic causes for their symptoms when they fail to diagnose or manage a patient correctly. Perhaps that's a justification on my part, although I have believed that for a long time as I have observed other people's situations. |
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09-22-2007, 11:02 AM | #6 | ||
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And something that can cause either or both (hyporreflexia/hyperreflexia) is B12 deficiency. I can personally vouch for both being possible in the same person. By the time I was diagnosed by the neurologist I finally got to, I had hypo in my elbows and hyper in my knees).
Both are also mentioned in a very long list of possible signs and symptoms, in an unusually accurate (not decades out of date on the B12 subject) medical textbook. Goldman: Cecil. rose
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