Another Day, Another Diagnosis

I feel like I start every post about my health off with, “a lot has happened in the past month,” but a lot of things keep happening!

The clinical trial I was in was approved for open label, which means I was able to take the medication and know that I was getting it, and not the placebo. Unfortunately, it made me violently ill and caused horrific pain, so I wasn’t able to be on it for very long. On the upside, I felt a lot better once I stopped the medication! I also stopped taking Corlanor since it wasn’t helping my POTS symptoms at all. Right now I’m trying to find a good cardiologist or autonomic neurologist to manage my POTS, but it is much harder than you’d think.

After being diagnosed with fibromyalgia, I felt as if it wasn’t quite the right diagnosis. Most of the suggestions for fibro patients were not doing anything to help me, and I had a lot of weird symptoms that couldn’t be explained by fibro. My GP referred me to a geneticist because she wanted me to have an evaluation for Ehlers-Danlos Syndrome. He was very knowledgable about EDS and spent most of his career focusing on it. In the end he diagnosed me with EDS and suspects hyper-mobility type, but we’re still going to do the genetic testing to rule out classical and vascular, although it’s unlikely I have either one of those. Honestly, I’m very disappointed to have another diagnosis but I wasn’t surprised in the slightest. At least we can be confident that it’s the right diagnosis this time! I’m currently looking into what doctors are good for EDS in my area, and I’m also looking for a good physical therapist to hopefully help control some of the pain.

… and because for some reason I seem to like getting multiple diagnosis’s close together, I saw an allergist that the geneticist recommended, and she diagnosed me with MCAS. If you’ve been reading my blog for a while then you know I’ve had doctors go back and forth on whether or not I have MCAS for quite a long time. I’m already on a lot of antihistamines and cromolyn sodium which controls it fairly well. I’m definitely not a severe case, but without antihistamines things are pretty miserable. She wants me to start Xolair shots in hopes it will improve my MCAS symptoms enough to come off of all or most of the antihistamines I’m taking. I’ve heard mixed things about Xolair, but I’m willing to try it in order to attempt to take less medications and have less allergic reactions.

I’m hoping this will be the end of the diagnosis’s if not forever, at least for a long time. Having a diagnosis for any of my health issues still feels surreal to me after being undiagnosed for so long. I feel like I’m being directed to better doctors to manage my care, which seems really promising that things might improve soon. Now that we have all the diagnosis’s we just need to figure out what to do to actually treat what’s going on!

Advertisements

Clinical Trials and GI Woes and Moving Oh My!

So much has happened in the past month for me health-wise. My Pride Month posts were not as frequent as I had planned, since my health did not corporate this month. I had a lot of ideas for posts for Pride month that I still want to do, they just obviously won’t actually go up in June.

I started taking Corlanor again for my POTS and IST, and this time I didn’t have a bad reaction! I’ve taken it for a month, and haven’t seen any improvement but I’m still hoping I will soon. I’ve been exercising about 3 times per week, which is good! It does take up all of my energy though so on days I work-out I’m not able to do much else besides that which is annoying. My POTS symptoms have only gotten worse since I started making all of the changes they suggested at Mayo, which is really frustrating. At this point I can’t be out of my house for more than one hour before my body starts shutting down. That time is even less if I have to stand or walk a lot, or if I’ve had chores to do around the house.

My GI tract is a bit of a long story. My GI started me on a muscle relaxer for the PFD which seemed to relieve some of the constipation, although I was continuing to feel worse. I had an x-ray done of my abdomen and my entire colon was full of excess stool, so things were not in fact getting better. First they had me drink mag citrate to try and clear it out, but it only cleared a little bit of it. Then I drank colonoscopy prep, which I thought worked for a few days, but it didn’t. My gastroparesis was not a fan of me drinking the prep, because it was a large quantity and you had to drink it quickly, This resulted in me continuously throwing it up every time I drank another glass.

My Gastroenterologist is trying to figure out a long term solution for the constipation since nothing seems to work. He thinks that Dysautonomia is causing me to have really bad intestinal dysmotility. I’ve been WAY more constipated than this many times, but I didn’t have any imaging done so I have no idea how far the stool was backed up then.  I’m so distended I can’t wear jeans or anything without an elastic waistband, and I look a solid five months pregnant. I’m currently drinking more mag citrate in hopes it will work this time, so cross your fingers for me!

In June I started a clinical trial for a gastroparesis medication. It was a double-blind trial that used 50% placebo patients and 50% drug patients. Obviously I can’t know for sure, but I think I may have received placebo because I only became more symptomatic while on the medication. The intestinal issues probably played a role in that too though. The experience has been really interesting, even if it wasn’t helpful for me. It’s still really cool to be contributing to science that could benefit me and others with gastroparesis in the future. I’ve also learned a lot about clinical trials, which will be good to know if I ever participate in another one!

On a more personal and not medical note, we’re moving! I talked about us looking for a new house well over a year ago, but the timing ended up not working out. However, we finally found a house we really like in the city over from us, which is about 30 minutes away. We closed on the new house on the 26th of June, and we put our house on the market on the 22nd. There’s already a contract on our current house so we’re hoping it will sell and close on July 24th. I’m really excited about the move, and feel like the change will be good for me. It’s not far at all from where we are now and I’ll still go to the same college so that’s definitely a plus!

I started an online summer course at the beginning of June and it ends in less than a week. I was nervous that with my health being so poor right now that I wouldn’t be able to do it, but the class has been really easy and the work load is super light. I’m taking Spanish 1 and since I took two years of Spanish in high school it’s been more of a refresher. It feels really good to be able to succeed at something after my bad Spring semester and withdrawing.

Things have been really tough for the last few months. Some days I start to feel like I’m hitting my breaking point. I try not to think about everything too much, but when you spend most of your time alone it’s hard not to think. I’m really trying to stay hopeful that things will improve soon. I hope you all are doing well! What have you been up to lately?

– Alyssa

Life Update: Withdrawing from College

This semester has been incredibly rough for me.

Some of it I have shared with you, like documenting my journey at the Mayo Clinic, but there’s been a lot going on that I haven’t talked about yet. My health has been very poor since around the last few weeks of Fall Semester, and has been continuously getting worse. This was one of the major reasons I chose to go to Mayo in the middle of Spring semester. Unfortunately I missed a lot of class before my trip, and then a whole week for the trip (my first trip was during spring-break so I didn’t miss any class for that). While I was successful in obtaining multiple diagnoses, the treatment options are very limited.

As of right now, they are mainly focusing on the lifestyle changes; things like exercise, following the gastroparesis diet, and eating tons of salt. These things may or may not work, and if they do work it’s going to be months before I see any improvement. Since returning from my trip, I’ve only become more symptomatic and much less functional. I’m honestly not sure what to do right now, since I know if I contact the Mayo doctors they will probably tell me to just keep trying to do these things since it hasn’t been long enough to see results, but at the same time my body is incredibly weak and doing simple life tasks can be very difficult.

Missing this much school has seriously affected my grades. Some of my professors have been great, and others have been awful. I have disability services, but they aren’t very helpful and professors have found loop holes that essentially disregard any accommodations I’m supposed to have. It’s crazy how little legal protection disabled people have, but that’s a whole nother can of worms. I made the decision to withdraw from college, since my Spring semester grades were going to tank my GPA. I really wanted to only withdraw from the two classes I was doing poorly in, and stay in the two classes that I had nearly perfect grades in, but that isn’t an option at my college.

This also means I will not be able to transfer to a University in the Fall. I won’t have nearly enough hours after I lose these 14. Now, I’m going to have to do at least one more semester at community college, maybe two. I’m trying my best to remind myself that I’m only 18, so I’m actually ahead of my peers by at least one college semester, but withdrawing makes me feel so behind. There’s a lot of emotions to process, and I’m doing my best not to fall into a pit of despair, but it’s been really tough. I think hope and positivity are important when it comes to living as a chronically ill person, but I also think it’s okay to recognize that some situations just suck.

I’m planing to return to college in Fall, or even take a Summer class if I’m able to get my health under control enough. As difficult as this decision is, I know it is the right one. This is not the first time I’ve had to withdraw from school, as many of you know, I started this blog right after I withdrew from high school in November of 2016. It’s crazy to think that almost 18 months later I’m having to do the exact same thing. I’ve got to say it doesn’t hurt any less the second time around, but I know from the first time that it will get better.

Mayo Trip 2: Days 1-2

I’m already back at Mayo and a few days into my trip! I flew into Rochester on March 22nd, and had appointments on the 23rd. The flight went smoothly, but walking through the airport takes so much out of me. On Friday I had two appointments, one with a gynecologist to have a consult for the possibility of endometriosis ,and one with an autonomic neurologist to talk about / confirm my POTS diagnosis.

The gynecologist visit went fine, but was super inconclusive. He didn’t think I have endometriosis but had no explanation for my super irregular periods. The only way to truly know if you have endometriosis is to have a laparoscopy, but he kind of beat around the bush when I asked if that was something I needed to do. At this point I’m probably just going to continue tracking my periods, and if it’s still an issue later on go see another gynecologist for a second opinion, but endometriosis isn’t a huge concern of mine right now.

I absolutely loved the autonomic neurologist! He confirmed my POTS diagnosis, by evaluating my autonomic testing results, and doing a very thorough neuro exam. He thinks I have hyperadrenergic POTS, and had me do a weird blood test to test my norepinephrine levels. First they place an IV, which took them over 30 minutes and 3 sticks before they got it, because my veins sucks. Then you have to lay completely still in a quiet, dim room for half an hour, in order to simulate what your norepinephrine levels are like while you are sleeping. After that, a nurse comes into the room very quietly, and you cannot speak to them or move while they draw the blood. When they’re done, you have to walk around for 10 minutes (or at least sit up in a chair if you can’t walk) to raise the norepinephrine levels, and finally they draw your blood again. I’ll get the results back from that by the end of this week.

The neurologist went over all of the “lifestyle changes” that are supposed to help with POTS, like eating tons of salt, drinking a lot of water, exercising and wearing compression garments to keep your blood from pooling. I thought it was interesting that he recommended wearing compression style shorts and a shirt under your clothes, because I’ve seen a lot of people with POTS use thigh-high compression stockings. According to him, the blood pools in your thighs and abdomen mostly, so those stockings won’t be as much help, unless you get the ones that go all the way up above your belly button. I really hope making these changes will be helpful, but I know they don’t work for a lot of people, or at least aren’t enough to make them functional.

He talked about putting me back on corlanor if after I try these non-pharmaceutical things, and they aren’t enough. He believes that it might work better for me, when I have a higher sodium level in my body. I hope all of this helps, because I have not been doing well at all. The gastroparesis has caused me to be widely nauseous and not able to eat very much, and the POTS has made me so incredibly tired and light-headed. Add traveling to the mix, and you get one very exhausted spoonie. The neurologist thinks I have mast cell activation syndrome as well, but since I have so much other stuff going on right now, we’re going to hold off on doing more testing for that. Given the dysautonomia and my symptoms I most likely have it, and the reactions have become more frequent. The past five days alone I’ve had a reaction to a new t-shirt, makeup that I’ve worn for over a year now, marijuana smoke (thanks a lot to the assholes smoking in our hotel), and one every single time I’ve taken a shower. Needless to say, Benadryl is my best friend.

I also saw a nutritionist, but she wasn’t very helpful so there’s not much to say about that. I still have a consult with a different cardiologist this week, as well as an appointment with the fibromyalgia clinic to see if I have fibro. I really want to go home, but I’m grateful to be here and I know I need to be here. This post was kind of long, so thanks for sticking around for the end. I hope you all are doing well!

Mayo Clinic Days 3-6

Day three was pretty simple. The only appointment I had was to see the electrophysiologist. Essentially they confirmed what I have believed to be true for the past two years. They think I have dysautonomia and postural orthostatic tachycardia syndrome, and had me do autonomic testing to confirm the diagnosis. I do not yet have those results, but from the numbers I saw during the test, I think it’s going to be confirmed. Since this is an autonomic issue, they’ve referred me to an autonomic neurologist. Unfortunately we couldn’t get into see her this week, so we will be returning to Mayo later next week. They reiterated to me how difficult it is to treat dysautonomia, and how since I’ve failed every medication used to treat POTS already, there isn’t much they can do. It’s incredibly discouraging, but not surprising. My electrophysiologist here in Texas wanted me to have a complete ablation of the sinus node, but given the statistics they quoted me, it definitely isn’t on the table right now, since it has a greater possibility of making me worse or doing nothing at all than helping.

On Thursday, I began my GI transit test, which is basically a gastric emptying scan only they look at the whole GI tract. I had to eat a breakfast of two eggs, a pice of toast, and a glass of milk in ten minutes, which made me really sick. Then for lunch I had to eat a sandwich made with butter, mayonnaise, 5 ounces of turkey lunch meat, with a whole bottle of water and a container of jello all in 30 minutes. I ate as much as I could, but I had to stop when I started violently retching, because throwing up could have altered the scan. Friday morning I had more x-rays to do for the scan, and then I had my autonomic testing done.

Friday afternoon, I had my follow up with the gastroenterologist, and frankly its been hard to digest (no pun intended) the news he gave me. Essentially I have gastroparesis and pelvic floor dysfunction, neither of which was I expecting, let alone two separate GI diagnoses. Gastroparesis is also something that is not easy to fix, and knowing how severe it can get for some people really scares me. At this point mine has progressed to moderate (out of mild, moderate, severe) and they’ve recommended I eat mainly pureed and soft foods. Following a gastroparesis diet is going to be a complete 180 for me, since the main things I eat are fruits, vegetables, and brown rice and I’m no longer supposed to eat any of those. As for the pelvic floor dysfunction, I’m not emotionally ready to try and treat that yet. It involves very invasive physical therapy, that I do not feel is necessary, and I definitely want a second opinion about before I do something so drastic.

The cardiologist thinks I also have fibromyalgia, and the GI suspects endometriosis. When I go back next week I’m seeing a gynecologist for the first time, and also the fibromyalgia clinic, as well as a dietitian to learn more about how I should change my diet. This has all been incredibly overwhelming, but I finally have some answers after six hard years of looking. I’m going to try and go back to school on Monday, but I honestly can’t even imagine going right now. I feel as if I’ve been living in an alternate universe, and being thrown back into daily life feels so odd. Even though I was only gone for one week, I feel like I’ve been gone for a solid month, but as I’m writing this I’m curled up in my own bed with my cat, and some level of normalcy feels restored. I apologize for being MIA, and a lot less active on here for the past two months, I hope you can see a lot has been going on in my life! I will continue to keep y’all updated through my Mayo Clinic experience when I travel back next week.

It’s Been a Minute: Life Update

It’s been a little while since I talked about what’s going on in my life, so I thought I would catch you all up!

First, I got the results back from my endoscopy and they were inconclusive. I had elevated mast cells in my biopsies, but they weren’t nearly high enough to diagnose mastocytosis. I had a serum tryptase test done to see if I had any elevated levels there, and it came back normal. It looks like I probably don’t have systemic mastocytosis, but my gastroenterologist is referring me to a new allergist/immunologist, who I have an appointment with on the 16th. Having negative results for tests is a good thing, because you don’t want anything to be wrong with your body, but it is also incredibly discouraging when it was the only new idea a doctor had in a long time. Since, I looks like I don’t have any mast cell issues, the gastroenterologist diagnosed me with post-infectious IBS.

I continued to have trouble with exhaustion due to my IST, so the electrophysiologist upped by digoxin dose. It had been working really well, but the past couple of days I’ve been exhausted and have felt my heart racing. It’s hard to know if the medication is no longer working or if I’m just having a rough few days.  I have an appointment on the 22nd with him, so we’ll see what he says. The gastroenterologist put me on Linzess for my IBS, and it hasn’t worked. It’s supposed to help with chronic constipation, but instead it’s making me have no bowel movement for two to three days, and then diarrhea. I stopped taking it, and became incredibly constipated immediately. Luckily, I see him on the 8th so hopefully he has some ideas on how we can get my digestion under control.

With school starting back on the 16th, and three doctors appointments in January, this is going to be a pretty busy month for me. I’m also starting to volunteer at a nursing home this Friday, which I am excited about. I feel ready to go back to school, mainly because I’ve been bored. I really hate feeling unproductive, but having the time to relax is nice, and something I try to take advantage of. I hope you all are doing well, and enjoying the new year so far!

November Health Update

Quite a bit has changed since my last health update!

I’ve now seen my electrophysiologist two more times, even though he originally wanted to refer me on. I went on flecainide acetate for a few weeks, but it made me incredibly hypotensive and I couldn’t properly function on it, so we decided to discontinue it. I’m currently on Digoxin, and my symptoms have improved. A major part of the improvement is due to coming off the flecainide acetate, but I do think the Digoxin may be helping some. I saw him on Monday, and we are going to continue to digoxin and possibly increase it, depending on the results of my endoscopy.

At my last appointment, he brought up the possibility of having another electrophysiology study, but this time actually ablating my sinus node. I didn’t have an ablation last time, because I don’t have SVT so technically nothing is structurally wrong with my heart. The complete ablation of the sinus node for people like me who have IST, a form of dysautonomia, results in a pacemaker over 50% of the time. To me, this would be a last case resort. I’m technically on the last medication that is prescribed for IST, so if it doesn’t continue to work I’m kinda screwed. However, I’ve read all of the research papers I can get my hands on and this procedure is often contra-indicated for people with dysautonomia. As of right now I don’t really view it as an option, but if things get worse it may have to be a possibility.

On Wednesday, I had an endoscopy mainly to test for systemic mastocytosis. I had no visible abnormalities, which we expected. This was my third endoscopy, so we were basically only doing it for the biopsies, which they did a ton of. The procedure went really smoothly and quickly. I had felt absolutely terrible on Tuesday, but even with the anesthesia I felt okay Wednesday. Thursday and Friday however were a whole other story. I felt like I was being stabbed in the stomach for most of Thanksgiving, and Friday I had a migraine most of the day. I tried by best to celebrate and push through, even though I felt quite terrible.  I’m moderately nervous for the results, since having systemic mastocytosis is kind of a big deal, but on the other hand having yet another false test is going to be frustrating. You really can’t win for losing with chronic illness.

I keep having really bad days/weeks and then really good days/weeks, so it’s been hard to judge the pattern of my health. I’m incredibly grateful for the good days, especially when they’re proceeded with a terrible day. I think I’m doing a pretty good job of handling it all, but I am pushing myself pretty hard. Having a few days off of school for Thanksgiving has been nice, and before we know it, it will be Christmas break. I still feel like I’m slowly declining, but I also feel hopeful due to the new doctors I’ve added to my arsenal.

How’s your health been?

I hope you’ve all been having a good November!