My journey to diagnosis: LPR and hypoglycemia.
Updated 06-24-2012 02:00 AM by Pastafarian
There have always been two medical mysteries in my life. Occasionally passing out, or coming close to passing out, and gnawing, burning stomach pain. Since my parents are adverse to institutionalized medicine, there was no help in my childhood. It never seemed severe, but these two problems would come and go and I never understood why.
Fast forward to two years ago, I was healthy on paper. No daily meds, no complaints. Over the course of a couple months, I developed a sharp aching pain and rebound tenderness (classic appendicitis symptoms) which was getting worse with every passing day. I went to the ER and an ultrasound came back normal. I was sent home with a script for Percocet (not helpful). I saw my family doc a week later and she sent me to a surgeon. During an exploratory lap, he removed my "angry" appendix and all was well and right in the world.
Well, in the time that I was recovering from surgery, I contracted mono. Apparently, mono in your late twenties is a nightmare. It didn't help that it took three months to get a proper diagnosis. The initial blood test came back false negative. I was hardly eating and, at the advice of my doc, I was taking ibuprofen daily to help with the fever and horrid spleen swelling.
Four months into mono, I develop a difficulty breathing, severe stomach pain, and insomnia. I was even having difficulty standing and walking. Passing out occasionally. My doc sent me for a battery of tests and couldn't find the cause. She just told me to ride out the mono and see if it improved.
Nine grueling months later and fifteen pounds lost, I began to feel like a human being again. Still having breathing problems, stomach pain and insomnia.
First came the allergist. Apparently, I have moderate allergies to everything on the panel, mold, trees, dust, etc. The exception being roaches and dogs, which I am severely allergic to. Well, I didn't live with roaches, but I did have a dog. I also was getting sinus infections monthly, sometimes more. It actually seemed like I had a never-ending sinus infection. He aggressively treated me with antibiotics through nasal irrigation. No success. After a CT scan, he determined that the infection was so bad I would need surgery. I had surgery to unclog my sinuses and correct a deviated septum. But the sinus infections persisted...
Next the GI docs. The first one scoped me and found no problems. He said to take PPIs (Prilosec 20mg) and wait it out. A year later and I'm even worse. The first GI doc said he couldn't help me. The second GI doc says I probably have gastritis from the ibuprofen. Awesome. He scoped me and does a biopsy for h.pylori in a different location. No problems. "Keep taking your PPIs" he says. "We'll switch you to Nexium 40mg BID." Oh, and take Elavil for anxiety since your pain and passing out episodes are more than likely related to anxiety. Whatever.
Meanwhile, the passing out and the sinus problems are becoming increasingly worse. My primary doc was adamant that I had anxiety problems. I should be taking anti-depressants. Eventually, I realized that I didn't pass out if I was eating constantly. After I pressured and pressured over several visits, my doc sent me for a 5 hour oral glucose tolerance test. Eureka! My blood sugar dropped into the fifties and I passed out!!! Finally a diagnosis!!! I've been working with a dietician, taking my blood sugar throughout the day, and eating a diabetic diet. Huge improvements! So wonderful to know it's not a figment of my imagination. I might have anxiety problems, but they certainly aren't making me pass out.
Meanwhile, the breathing problems are still going on. I had been having what I call asthma attacks often and using an albuterol inhaler. My primary doc diagnosed me with reactive airway disease and offered no solution.
Back to the reflux issue. I still wasn't even sure I had reflux. The second GI and primary doc diagnosed me with gastritis and generalized anxiety disorder. The allergist finally said he wasn't giving me any more antibiotics for my sinus infections. The most common drugs didn't even dent it any more. He scoped my nose and throat one last time and asked me a bunch of questions, all related to reflux. It was as though he read my mind. He knew exactly what my symptoms were. Finally, it was all making sense!! He diagnosed me with laryngopharyngeal reflux. In addition to my bid Nexium he gave me a script for 300mg Zantac hs. Apparently, while I was sleeping the refluxed liquid was sitting in my sinuses and also being inhaled into my lungs causing the breathing problems and sinus infections. He also said that it isn't uncommon for reflux sufferers to develop adult-onset asthma.
I follow a good diet which is a compromise between the hypoglycemic needs and the reflux needs. I take my meds religiously now and I have moved to the couch for sleeping. It sucks, but it's better than the alternative. Even with two bricks under the headboard and a wedge pillow, the reflux was going as strong as ever. At this point, I get reflux while standing, so I'm not sure what to think.
I am relieved to have a diagnosis finally, but what the hell took so long?!
Nearly three years later, I have an appointment to see another GI doc. I feel like fundlopication is inevitable. I've been on such an agressive plan of treatment and it's just getting worse. Sometimes I feel like I wish I were more in the dark about the health industry. I am an underling in the medical field and sometimes knowledge just makes you less trusting and more anxious.
The night before my appendectomy I was watching videos of the procedure on YouTube. I have tried watching fundlopication vids and I'm getting nervous. Hopefully, it doesn't go down that road, but I feel the writing's on the wall.
Oh, no cure for the insomnia. It's 3:58am as I type this. I tried Remeron daily but it exacerbated the hypoglycemic symptoms. We'll see where that one leads.
Moral of the story: don't give up.