Happy 2009, everyone!
I'd like to say that my new year's resolution is to put my medical mystery behind me, but I'm not convinced that mind over matter works in this case. It's a good goal though.
After two weeks of being trapped in the house due to unusual amounts of snow in Portland, I had a flurry of medical appointments last week.
On Dec. 30, I finally made it to the immunologist for the allergy testing to the pneumonia vaccine so we can finish my immune system testing. I cheated. I've discovered that I'm really incapable of going five days without allergy medicine and still having lungs healthy enough to pass the breath test. So I took Allegra all the way up to the testing. Interestingly, when they did the first scratch test of the vaccine, they also do comparison scratch tests of saline and histamines. "Good, you're not blocked," the nurse said when she saw my strong reaction to the histamine. When I asked what that meant, she said that if I had been on anti-histamines, I would not have reacted at all to the test and they would not have been able to continue the allergy testing without that comparison. Although it made me curious about exactly how strong my reaction would have been without my allergy meds, I chose not to tell her or the doctor that I actually was on allergy meds.
Anyway, they did a scratch test and then a test where they put a small amount of the vaccine just under the skin. The immunologist said my reaction to the latter was borderline allergic, but we decided to go ahead and do it anyway. And I'm glad we did, because I don't think I reacted at all to the actual vaccine injection into my left deltoid.
So in early February, I get to go to a special lab to get blood drawn so they can run the same immune testing I had done last spring to see if my immunity to pneumonae has improved. They test 14 serotypes, and my doctor says a healthy person will have immunity to at least 75 percent of them. When he ran the first set of tests last spring, I was only immune to three and was "almost" immune (borderline, just slightly below the numbers they like to see) to two more.
The immunologist said that if I don't have an immunodeficiency now, he thinks I'm headed towards one within five to ten years and that they will need to run tests every six to 12 months to monitor it.
I asked how he would treat me if I do have an immunodeficiency, and he said I can get monthly infusions that would boost my immune system. I'm not sure what, exactly, the infusions would be of, but I suspect it would be IVIG.
In addition to repeating the tests the immunologist ran last spring, he also has ordered some looking at lymphocyte enumeration and functions. The test is apparently rare and complicated, so my blood will have to be flown to Las Vegas for those tests (Wish I could go too!!), which is why I have to go to a special lab. Apparently, there's only two places in the metro area that can handle getting the blood shipped off properly. Anyway, I googled what kind of information the immunologist would be looking for from those lymphocyte tests and decided I didn't like the answers I found. So I'm going to concentrate on hoping those come back perfectly normal.
Then on Dec. 31, I had an endoscopy and my gastroenterologist did biopsies of my stomach lining and duodenum looking for evidence of celiac disease, pernicious anemia and another similar disease I didn't catch the name of. He's looking for the cause of what appears to be an absorption issue since I've been taking megadoses of Vitamin D and iron for almost a year now, I think, but my levels haven't improved as much as they should have. I don't expect anything to come up there, but it will be good to rule those out.
The good news is that there were no signs of a new peptic ulcer. I do, however, still have a large area of scar tissue in the stomach near the entrance to the duodenum that looks red and inflamed. But it doesn't look any worse than it did when I had my last endoscopy in 2006 so it's nothing to worry about.
When Scott asked, however, the gastroenterologist repeated his admonition that I cannot take any NSAIDs like ibuprofin or prescriptions like diclofenac, without risking another serious ulcer. Sigh. It's frustrating because Tylenol really doesn't help at all, and if I'm ruling out narcotic pain relief, I'm really pretty much out of options for meds.
The endoscopy really took a lot out of me. I commented to Scott that for my previous endoscopies, I'd come home and sleep for four to five hours and be a little out of it the rest of the day but I'd be fine by the next day. Definitely not the case this time. I pretty much slept all New Year's Eve day and night, and then slept the vast majority of New Year's Day too. And I'm still feeling the after-effects of it. Scott pointed out that my mystery illness acts like a magnifying glass on everything else that happens to me health-wise, making my recoveries slower.
In theory, I'll have the results of the endoscopy this week. And I should know about my immune system towards the end of February.
Meanwhile, I'm thrilled that for once the meteorologists were right and the snow that was accumulating at bedtime last night really did melt by the time we woke up this morning. So Ellie is back at school after a three week break, and Scott is back to work, and I might stand a chance of building my limited energy stores up again.
I see my internist later today to discuss a whole host of topics, including that elevated D-dimer test I had a few weeks ago. I don't expect to come away with any exciting developments, but I'll be sure to update y'all if there's anything newsworthy from it.
I hope all of you are blessed in the new year with good health, prosperity and much happiness.
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