Latest Appointment w/The Little Nutty Nephro

As always, my appointment Tuesday started off with this wonderful man entering the room with a big smile and a very cheerful greeting. This never hurts!
He asked me how I was doing. One of these days when a doctor asks me that question, I would LOVE to tell them I feel GREAT! Someday!

He took a look at my lab results and told me everything looked good. He said the renin and aldoserone hadn't really changed. I pointed out that the renin did rise just a bit. As I mentioned in my post regarding these lab results, he was not impressed.

I pointed out to him the elevated RDW. I told him since I have so many symptoms of B12 deficiency and iron deficiency, and elevated RDW can indicate an anemia, I was very concerned. He said it was not that high. He said my B12 level was normal when it was tested a few months ago, so that was not the problem. I told him I read that many times the serum B12 can look normal, when, in fact, there is a deficiency because the body is not properly absorbing what is available to it. I REALLY hated to mention this to him, but I told him I found 2 tests that can be run to determine whether or not there is an actually deficiency. I had them typed on my notes. I pointed them out to him. These 2 tests are for methylmalonic acid and homocysteine. I told him I HATED to ask him to order them, but I would greatly appreciate it if he would. This wonderful man, grabbed the lab slips and his pen, and immediately ordered them for me! I am not used to doctors doing this. He is definitely one of a kind!!

He did ask me to do something which I do not agree with, and I do not understand. A couple of months ago I was taking 3 Edecrin tablets daily for edema. Edecrin is potassium depleting. My potassium dropped too low. I had to take supplements again. I might add here that the edema was not budging, even on 3 water pills a day! Then I asked if I could take a different diuretic which was potassium sparing. He agreed to this and wrote a prescription. The idea was to switch over to JUST the potassium sparing drug, amiloride. He wanted me to take both drugs for a while and make the switch to just amiloride. I agreed. At my last appointment he agreed to let me make that switch completely to the amiloride. The dear, sweet receptionist made a mistake and called in $80 worth of Edecrin to our mail order pharmacy!!! The other receptionist called the pharmacy and canceled the order about an hour after it was ordered. He told me all was well, and it was canceled. A week later I received the $80 worth of Edecrin in the mail!!!!! I called. They would not let me return it, and they would not refund me. So I figured I'd go ahead and continue taking the Edecrin with the amiloride for a while longer. My potassium kept falling, so I added another potassium pill to my daily regimen. Well, at my appointment on Tuesday, the nephro said that my edema was looking MUCH better, but he wanted me to increase the amiloride by 1 tablet daily to get rid of the rest of the water. He said that since it was potassium sparing, and my potassium was now normal (It is at 3.8. Normal is 3.5-5.1), he wanted me to stop taking the potassium pills altogether!!?? Since I'm still taking 1 of the potassium depleting water pills every day, and my potassium is not all that high anyway, I am unsure how this is going to work! He told me since my potassium is now repleted and where it should be, I no longer need the potassium. I have always had trouble keeping my potassium up anyway. I really don't think this is going to work. I haven't yet made these changes. I'm actually afraid to. I wish I would have thought to tell him that even when I was taking 3 water pills a day, the edema was not budging. It was not until I started taking the multivitamin that the water started to REALLY come off. This made me think it was probably a vitamin deficiency causing the edema in the first place. None of my doctors could ever figure out why I had the edema in the first place, so this made perfect sense. I really think if I would increase one or more vitamins (and I'm thinking it's the B vitamins), the edema would probably resolve completely. I really hate to increase the stupid diuretics if vitamins could fix the problem. I'd rather try the vitamins first.

Then I discussed the tingling and itching problem going on here at our house over the past month. That was when he said he felt it was necessary to test me for heavy metals. He said he didn't think it was from mold, like I originally suspected. I was going to ask him to test me for the heavy metals, but I hated to ask him to order more tests. I am very happy he mentioned it.

So today I went to the hospital for the new bloodwork, the routine urinalysis, and to pick up my 24-hour urine bottle. I was brave today. I let a new girl attempt to draw my blood. I wasn't going to let her, but I was in a good mood, so I let her have a stab at it. She tried on the inside of my left elbow where the good vein always is. She hit the vein, but halfway through the first tube, the blood stopped flowing. So she asked me if she could try on the outside of my right forearm. I agreed. She did great and filled the other 4 tubes.

When I left the lab today, I was given 2 urine bottles for the 24-hour urine test. I thought maybe the girl was remembering when I used to need 2 jugs for a 24-hour urine before my parathyroid surgery. I don't need 2 now. She told me that the nephro had ordered TWO 24-hour urine tests!! I have to do 1 on one day and then do the other 1 the next day. One is for heavy metals, and it looks like he is also checking my kidney function.

Now I wait for more results. I have a feeling some will be in by tomorrow, but some will probably take a week or longer. They have to be sent to other labs.

So it was another good appointment with my favorite doctor; all except for the diuretic issue. I think I'm going to wait until I see the results of the vitamin B12 deficiency tests before I increase my diuretic and stop the potassium pills. I still think there is a vitamin deficiency causing the edema.

Audrey