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Brief doctor visits
On Tuesday I saw a gp about the results of a blood test. I’m honestly not sure why I had to have an appointment. I had a cytomegalovirus test that came back equivocal in December and then had a repeat test a couple of weeks ago. That one also came back the same and that’s why I was called in. It could just be a false result or perhaps a reactivation of a virus I’ve had in the past. But it’s not really of any concern since I have no symptoms and it’s not causing any problems.
This morning I saw the specialist regarding my CT scan and blood tests and that was a short and easy visit. My iron levels are so good I am almost on the upper end of normal. She doesn’t think there’s any need for further investigations so I won’t be having the capsule endoscopy after all. I do have a follow-up blood test and doctor visit to do then, just to monitor things. I suspect if everything is still good I won’t need to see her again.
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Short term
As I posted yesterday, I was in to see the doctor about my test results today. My usual doctor is currently away so I saw a different one, who is a registrar (sort of gp in training although not really training). I saw this one before about my fracture in my foot and she was fine then. This time her inexperience was really obvious.
Since my iron stores keep dropping so fast, the plan right now is to have an iron infusion, which is scheduled for Friday. I’ve had one once before when I had iron deficiency from menorrhagia and it worked well. This one should keep me in good shape for a few months and hopefully, answers will be available on the dropping iron before I need another one. I must admit I’m not very confident the capsule stuff will uncover anything but you never know.
Most of the other irregular results weren’t anything to be concerned about in isolation. A couple of tests will need to be done again. And then there is the antibody testing that again showed super-high anti-nuclear antibodies. That’s nothing new though. There was, however, mention of cytoplasmic antibodies and my questions showed this doctor knows almost nothing about them even though it’s a fairly common finding. There is also a positive test on a liver antibody which can relate to autoimmune liver issues. This had a note but was not highlighted and she would have missed it had I not pointed it out. She’s not concerned since my liver is looking really good right now. But in the past, I’ve had an ANA pattern that has had some associations with autoimmune liver disease. If something is developing I would rather know earlier than wait for it cause issues. She’s going to consult with my regular gp when she is back. Also, my liver results are “deranged” which apparently means they are up and down. About every second test shows some abnormal results. While they look great right now, they might not be quite so good next time. I never heard of deranged results before but on searching, I found it’s a common term in the medical community. Weird. They weren’t that high last time so I can’t help thinking my doctor had concerns when she ordered the tests.
All that said, my main concern is the low iron and that will hopefully be sorted, at least temporarily, after Friday.
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Not so good results
Last Monday I went to get some bloodwork done and it was ten tubes or more that were taken. Not all were full and there were various colors involved. Plus a midstream urine test. Fortunately, I didn’t pass out after losing all that blood. :D
On Thursday I got a message saying my results were ready so I downloaded the pages and was a bit surprised by some of them. I think most relevant was the fact my iron levels are actually much worse than over a month ago. My ferritin went from 24 to 15 and my iron is down to 9, getting close to low. Fortunately, I am not anemic at this point, just deficient. The only thing that stayed the same was saturation which is at the top end of the normal range. At the rate I’m going, I will likely be anemic by next year as iron stores will be gone by then.
There were some other out-of-normal range results, some that I don’t understand and so I need to talk to the doctor next. I have an appointment tomorrow morning and hopefully, some of this will make better sense. The helicobacter pylori and celiac came back normal which narrows down possible causes for my iron deficiency. I do have a follow-up appointment in January with the doctor who did my colonoscopy and gastroscopy where I understand I may have a capsule endoscopy where I swallow a camera to get more images of my gut.
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Bits and pieces
As is obvious from my last post, I’ve finally made some progress on writing about our holiday. I wrote most of that a few weeks ago but it was only tonight that I finally edited it in preparation for posting. I fear I will forget much of what I wanted to write as time goes on but there is nothing to be done about it.Â
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I’ve been in a much better state of both physical and mental health over the past couple of weeks. While I don’t exactly feel energetic, I don’t feel like I need to sleep all the time. It seems the thyroxine must have been doing something after all. My tonsillitis episode did mostly resolve after about a week and a half.
This week I had my annual appointment at the immunology clinic in our local teaching hospital. Last year I had a disastrously incompetent doctor, and despite the other doctors being good to great, I was worried about a repeat. Fortunately, it was all fine, although it took longer than I expected. She was rather abrupt and gruff when we first got started but improved as we talked further. She later mentioned that she’d only been in immunology for a week so I assume she’s still settling in and that might have been the reason for the less than friendly start to our discussion. We covered my low thyroid issues caused by being off my medication and also discussed some abdominal pain episodes which had occurred while I was away and for a while after I returned. She examined my hands and found them quite cold, then asked if my feet were the same (which they were). Later she checked my blood pressure and found it was quite low (95/55) and was worried that I might be light-headed (which I wasn’t). She checked my abdomen thoroughly for anything unusual and presumably found nothing amiss. She asked about a couple of spots/rashes on my stomach but I wasn’t able to provide any useful information except that one has been there for a couple of years and the second, smaller one appeared recently. I’ve presumed they were due to some sort of skin condition but the only notable thing about them is the larger one sometimes seems to change color slightly. She had a thorough look at my mouth and throat and noted my tonsils are swollen.  After we covered pretty much everything, she went off in search of the consultant (head doctor) for the department to confer before we finished.
 The doctor was on a phone call for quite some time before she was able to reach him. Eventually he came to the consulting room and they discussed my case right there, which was kind of unusual. I’d seen this doctor at two previous appointments and he’d concluded that my autoimmune condition is Sjögren’s syndrome based on my symptoms and my ANA. I have antinuclear antibodies of at least two types. One type is called anti-coilin and seems to be fairly unusual but mostly is seen in people with primary biliary cirrhosis and Sjögren’s syndrome. The other type is common and also non-specific but also seen in Sjögren’s. This doctor had previously given me lectures on careful attention to dental care and keeping extremities warm (as I have early symptoms of Raynaud’s syndrome). He repeated the dental lecture again even though I’d confirmed I’d had it before. It may have been as much for the registrar’s benefit as mine. Discussion was had over which blood tests I needed to have done and it was decided I’d be reviewed again in a year. Appointment concluded.
In addition to the usual auto antibody tests, I also had tests specific for autoimmune liver disorders along with immunoglobins added in. I found the pathology department at the hosptital was too busy for me to wait so had them done today at a local pathology center. I think I’ve reached a record with seven tubes of blood this time. Apparently I will be contacted by the clinic if any results need any follow up.
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The semester started last week at my university so I’ve started my last class for my degree. It’s an external unit and it seems to be a small class as there has been almost no discussion online so far. Also, the unit outline hasn’t been updated for this semester. I pointed this out to the teacher but have had no response after several days. It would be good to have some interaction with others in this class. It’s already isolating to study by distance education but it’s worse when you feel like you’re the only one out there.
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My favorite band, Crowded House, are coming to Perth in Novemeber and I have purchased tickets for the event. We are fortunate to have them playing at a nearby winery so it will just be a fifteen minute drive instead of 30-60 minutes to reach Perth or Fremantle. The Scientist and I will, however, be trekking down to Freo for a concert with Megan Washington and support act Dan Kelly at the end of the month. Tickets were quite inexpensive as these are up and coming artists…so it should be good value for money. We’ve seen both as support acts for other performers and both were excellent.