I had my GI appointment which didn't have the result I hoped for.
I guess I have to be satisfied with the smallest steps.
It is just so frustrating.
The bad thing first: my GI doc won't perform any tests before my in-patient stay since he thinks that this should be done while I am in-patient and by the endocrinologist who can interpret the results.
Also, he does not know the reason for the vein alterations but he doubts the correctness of the finding. However, I know that the finding is right since I have reviewed my older reports from the heart ultrasound and the abdominal ultrasound three 4 months and 14 months ago and when comparing the findigs one can see a significant development, a progressing obstruction of the vein and liver enlargement.
As I insisted and pointed out my new symptoms he agreed in doing another ultrasound when I am in-patient. if the finding was confirmed further claryfing must be done since the most obvious cause, right sided heart failure, is not present.
I also have a pressure pain in the upper epigastrumwhich is not worse with eating and stomach distension and thus, not due to the motility disorder...I wonder if this pain could be related to the cause of the vein obstruction. I know that neuroendocrine tumors of the mediastinum, eg. tumors of the thymus, lung etc and of the pancreas can block and/or compress this vein. And pancreatic neuroendocrine tumors are often associated with MEN syndrome.
The good thing: while last time, he just sent me to the neuroendocrine oncologist saying that he can't deal with this endocrine issue as he did not have enough competence in this subject he is now willing to take care of me together with the endocrinologist when I am in-patient.
He was also quite interested in my phosphorus level since they are consistenly on the upper range of normal or increased and this may be related to an endocrine issue with the parathyroid glands. Parathyroid hormones is sometimes secreted with neuroendocrine tumors, too.
High phosphorus is also seen in kidney/renal problems.
I am afraid that they will do the standard tests and that this won't be enough to rule these issues out, especially as I might have intermittent hormonal hypersecretion and an in-patient stay will only reflect a short period of time.
In addition one cannot exclude that there is still interference with the immune assays caused by the immunoglobulins. The effects from immunoglobulins can sometimes last up to six months. However, I can't wait so long I would drive nuts in the meantime as i continue to get worse with my endocrine issues.
I hope that if my GI doc takes care during in-patient stay and can talk with the endocrinologists the endocrinologist will take me more seriously and will not consoder my symptoms as psychosomatic cagain.
Regarding tthe anwer of the urologist I waited for: Well, thsi was another big frustration. Although he assured me at first that he was allowed to do surgeries his chief doc would not do himself the chief doc suddenly seems to refuse the cystectomy which basically means any surgery at all.
I begin to hate these chief docs since they only see their own reputation. I first wrote to the chief doc and he himself referred me to his neurourologist who is the second "man" in the hierarchy. And now he wants to speak with my urologist...this does not make sense. Moreover I don't have an urologists who takes casre abou me as I could not find someone suitable; I just go into the clinic to have the catheter changed.
In the mail the neurourologist sent me and explained the situation he did not even express his own opinion I had waited for. I guess it is all due to the chief doc, again.
Post Edited (pelztier86) : 10/13/2010 7:06:12 AM (GMT-6)