The Nutty Profressor (Nephro) Has Redeemed Himself

Ok, time for another book. Sorry. I will understand if nobody wishes to read it.

Had a great appointment with my little, nutty professor. He totally impressed me again on Tuesday. If you recall, I was not too happy with him after I called his office a few weeks ago asking about increasing my T3, my magnesium, and my potassium. He did not feel the need to raise any of those things, but instead prescribed gabapentin for the awful neck, shoulder, and back cramps I've been dealing with nonstop for over 3 straight years. I do NOT like to take drugs! I would have much rather tried to raise the magnesium and potassium to see if that might have helped before I tried drugs.

Well, my Tuesday appointment started off with me asking him if he minded that I keep checking off renin and aldosterone on my lab slips when I go for my bloodwork. He never checks them, and I can never understand why, since low renin and low aldosterone are the reasons I started seeing him back in July. Actually, I think I do understand why he doesn't check them, sort of. Fludrocortisone, which is the medication I take for the low aldosterone, causes the body to think there is more aldosterone in the blood, but the fludrocortisone cannot be measured in the blood. So I guess he figures there is not really any reason to test my aldosterone level. He goes by my blood pressure (since renin and aldosterone regulate blood pressure) and by my electrolytes (since potassium is usually high and aldosterone is usually low with hypoaldosteronism). As long as the blood pressure is good, and the electrolytes look good, it appears the fludrocortisone is doing it's job. I had called his office a few months ago and mentioned to the receptionist that the doctor had not checked off renin and aldosterone on my lab slip for my next appointment. She told me if I wanted to have it checked, just check it off myself. ???? I had no idea you could do that! Even though she told me it was ok to do, I was still not sure it was ok with the doctor because I had never actually asked him. So at this appointment, I asked him if he minded that I did that. He sort of scrunched up his nose and said, "No, it doesn't matter. You can do what you want," and he smiled. Wow, that was nice to hear. I was afraid he would be upset with me.

He looked at the water in my legs and was amazed at how much better it looks this time as opposed to at my last appointment 2 months ago. I told him I was trying something new, and it looks like it's working. He asked me what I was doing. I told him that for years I have been asking my doctors about a multivitamin. I told them that even though I am not a frail, little woman, and very healthy looking, I do not eat much at all, and I was afraid I was not getting the proper nutrients from the food that I was eating. They insisted I did not need a multivitamin. They told me the only vitamins I needed were the B vitamins since I was a vegetarian. So for years, I've been taking B vitamins and vitamin D. Last week my 39-year-old daughter had a gynecological appointment. Her doctor told her that it would be a good time for her to consider taking Centrum Silver. I am not sure if you all have Centrum vitamins there in the UK or not. I always thought Centrum Silver was for people 50 and older. My daughter thought the same thing. She was shocked when her doctor told her it was time for her to start taking it. So was I! I started thinking if my 39-year-old daughter needed Centrum Silver, why the heck was I not taking a multivitamin?! So 9 days ago, I started taking Centrum Silver. I was very surprised to see that the water in my legs, feet, and ankles looked noticeably improved the next day! I had gained 8 pounds since this edema got really bad back in June. The scale would not budge downward no matter what I did! We assumed it was all water, but I could not get rid of it! This went on for months. I was taking 3 tablets of ethacrynic acid daily, and the water would not budge! Well, in the past 9 days, I have lost just under 6 pounds!! It is pretty obvious my body was in dire need of something in that multivitamin! If this is the case, it would appear once again that I was right all along when I kept telling my doctors I needed to be taking a multivitamin! This is amazing!! The nepho was very bouncy and energetic at this appointment. When I told him about the multivitamin working so well, he sort of hopped up off of his chair a bit and said, "Well, you keep taking that multivitamin! It's working!" I told him that I was not happy with my other doctors for insisting I did not need any extra vitamins and minerals. I told him I assumed they thought this from my appearance, since I do not look frail and sickly. I told him doctors need to realized that just because someone is not skinny, doesn't mean they eat a lot or eat the right food! They could have a thyroid issue (which I do) or they could be taking medications that cause weight gain or they could be full of water, etc. He agreed with me 100%, and he said, "I can't believe I didn't think to check your vitamins! I should have thought of that!" And this is the difference between him and the rest of my doctors. My other doctors would have told me I was wrong, the vitamins can't be helping, and I should stop taking them, and they certainly would not have admitted that I thought of something that they should have thought of first! Then they probably would have given me more drugs to get rid of the water! This guy is man enough to admit he missed something. This is one more reason why I like him so much! He respects what I have to offer at my appointments. He doesn't treat me like an idiot.

I asked him about raising my potassium level. He looked at my labs, saw it was a bit low, asked me how much potassium I was taking now. I told him. He told me to double it. He said it would be a good idea to get it a little higher. That was easy enough.

I asked him about raising my magnesium a little higher even though it was in the normal range but low/normal. He looked at my lab results, asked me how much magnesium I've been taking. Then he told me to double it. Wow, this was going much better than I expected!

At one point during the appointment, I mentioned to him that had I seen him just a few days earlier I would have been in tears. I told him I have been in so much pain with my neck, shoulders, and back for so darned long, sometimes I get to the point that I just don't want to even be here anymore. I told him a few days ago I told God I had had enough, and if it wasn't in his plans to help me, I would rather he just take me now, because I just can't go on like this any longer. It was a very bad day that day. When I told the nephro this, his big smile left his face. He sort of put his head down and looked very serious. He didn't say anything for a few seconds, then he looked up at me, pumped both of his fists and said, "We ARE going to fix you! We ARE going to make you well again!" He is so kind and sweet.

He was VERY happy with my current blood pressures. He told me we want to keep the systolic number between 110 and 130 and the diastolic number in the 60s and 70s, which is now what my pressures are. He said if the systolic pressure gets down to around 105 or the diastolic pressure consistently goes below 60, we will have a problem, and we will need to rethink my treatment.

I told him I was very excited to see that my renin level had risen, even though it was very slight, since he told me at my first appointment that he felt if we could get rid of the edema, the kidneys would probably start producing more renin, which would trigger aldosterone production in the adrenal glands, and I would be well again. I told him I was disappointed that the aldosterone fell to 2 this time from the 4 last time. It was <1 when we started treatment, so it's still better than it was at that time, but I really wanted to see it go higher, not lower. I asked him if he still thought his theory might work if we could get rid of the edema. He said there was a good possibility of that happening, but he was not sure.

I told him I have been having a lot of aching in the location of my kidneys. This has been going on since last March. It is not constant most days, but it is there. He felt my back where my kidneys should be and asked me if that's where I hurt. I told him it was. He reassured me that my kidneys are functioning perfectly normally, other than not producing enough renin, but he doesn't feel that is an extremely serious problem. Again, he pumped his fists and told me my kidneys are good and strong. I am wondering if it is the adrenal glands aching. It was nice to hear him say my kidneys are good and strong.

I discussed with him the fact that 2 weeks ago I became VERY weak again. This was the kind of intense weakness that makes me nauseous. I felt this when my blood pressure was very low, and before we started treatment for the low aldosterone. I told him I was confused as to why I was feeling so weak again, unless it had something to do with me being deficient in something else. He told me he was not sure why I was weak again either. I do know low magnesium and low potassium can both cause weakness, so maybe that was the problem. I am very glad to say that it is a little better today.

Oh, and here is something I was VERY happy about! I have been wanting to get my reverse T3 checked for years, but none of my doctors would test that for me. I figured I would ask the nephro about it since he is now treating my hypothyroidism. I thought he would probably do like all the other doctors and tell me it was not necessary to test it. He surprised me! He picked up the new lab slip, wrote down a few things, and said, "Oh, we got the TSH, free T3, free T4, and the reverse T3. Did I get everything?" Wow!! So I will now finally be getting my reverse T3 checked the next time I have blood drawn. I am very happy about this!

I also discussed with him my diuretic. I asked him if we could possibly switch to a potassium sparing diuretic now that my potassium is low, and I can't seem to get it up into the normal range. I had been taking a potassium sparing diuretic a couple of months ago, until I read that one of the side effects was neck pain! That was when I asked for a different diuretic. However, the neck, shoulder, and back pain worsened when I made that switch, so it was obvious that it was NOT the diuretic causing my neck pain. Since low aldosterone usually causes high potassium, we both felt a potassium depleting diuretic would be ok for me to take. Now that I'm struggling to get my potassium up, we both felt it would be ok to switch back. He did mention that it was strange my potassium is low, since the low aldosterone causes potassium to be high. I laughed and told him I always like to be different. He laughed. I told him I was wondering if it was the potassium depleting diuretic causing mine to be low now. Actually even when my aldosterone was VERY low, my potassium never did climb above the normal range. It was higher than ever before, but still in the normal range. So he prescribed a potassium sparing diuretic, but told me not to stop taking the potassium depleting diuretic yet. He said it was obviously working, so he wanted me to take both until I see more improvement and then cut back on the potassium depleting diuretic. He was very happy to hear that because of all the water I have lost this past week, I had already cut back on the potassium depleting diuretic by 1 pill. And this is another reason I love this guy! Most doctors would have a fit if you just cut back on a medication without talking to them first. I think he realizes that I have a little common sense, and it makes me feel good that he feels this way. Don't get me wrong, I don't just increase and decrease medications when I so desire, but I have been on diuretics long enough to know when I need more and when I need less. I guess he realizes that.

So it was a GREAT appointment!!! I just LOVE this man!!!

Audrey

Wow Audrey that sounds super. This man is going to fix you up once and for all, I just know it. Is the gaba helping you with the muscle  pains?

Yay, that sounds like a very positive appointment Audrey. You're getting there, it's just taking a while! I am sorry you have had such dreadful down days though. Although I can't help, I can say that I do completely and utterly understand and I'm really glad you got through that low episode. Sending you loads of hugs across the miles. 

Love and hugs (you can never have enough) 

Brigitte xxxx

Audrey I'm glad you had such a great appointment with the Nutty Professor but really sad that you have felt so down. Let's hope he's finally on the right track to sort you out for good.
Love Amanda xxxx

Thank you all for your replies and for once again reading another of my books. I try my darnedest to keep them short, but it just doesn't work!

Yes, I do think this doctor will be the one to crack my case. I'm sure hoping so anyway! I do know he cares, he listens when I speak, and he speaks to me like I have a brain. I just love him!

And that day was a very low day, but I'm doing ok now. It is so sad that we all have to suffer so badly, we get to that point. Hopefully, soon we will all feel great and nobody will ever be that low again!! And if we falter along the way, we'll always have each other to pick one another back up again. Thank you all for that!

Audrey

Audrey,
It always seems such an uphill struggle and goodness knows you have been through an awful lot trying to feel well.  I really do think your nephro guy is a keeper and it is half the battle if they listen and are prepared to get to the bottom of it all. 
Take care and don't overdo it!
Sue x

Audrey, I had a good feeling about your little nutty professor from the start and I think he will be the man to get the job done for you. Hang on in there - you and I both know a little bit about hanging on in there but I feel hopeful that you're going to be well again soon, it's your time and you deserve it.

Jasmine x

Hi Audrey,

I'm really glad your nutty prof has redeemed himself. It's too depressing to think that doctors don't ever listen to their patients or ever think through symptoms logically. He's definitely a keeper. I think that appointment was God's way of encouraging you to keep going.

I really hope you continue to make speedy progress in your quest to resolve all your remaining symptoms. In the meantime, sending you a virtual energy blast to get you through the Christmas season   

Lots of love,
Dee
xxx