drtinsac journal - GERD/LPR - part 2

Hi BG :)

I've been waiting for the biopsy results. I asked before the EGD, and he said they were taking them, apparently they took them from the mid and lower esophagus. Last time, I had the biopsy results 4 days after the procedure, seems to be taking a bit longer this time, but they are coming.

The results of the EGD itself are "normal". No notation of anything visibly wrong.. very similar to my pre-surgery EGD.

I've been taking Omeprazole 20mg for over a week now, I do believe it's helping my throat in the mornings a bit, and I figure anything to protect my sensitive throat/tongue is only going to help.

Tuesday is my neurology appointment. I have prepared a list of medications used to treat BMS that I've yet to try.. I suppose that is the "worst" case, that we just throw meds at it. I'm hoping to get some testing done, of some kind, if it exists.

Of course, if the biopsy results show eosinophils even without reflux, then I need to go down the allergy road. The 2 weeks without gluten, soy and dairy, had no effect on my symptoms. There is a lot of dog dander in here, I'm sure, though I certainly don't have typical allergy symptoms to them. Running out of ideas..

I have started to have tongue issues off and on. I think it is due to my teeth getting too sharp. I am cutting and bruising my tongue. I am going to the dentist to have them file my teeth down. I wouldn't have thought of this but my last visit to my dentist he mentioned it. I passed on him filing them as I thought It was nothing. But a year later I am thinking my tongue is actually hurting because of this. It even feels swollen sometimes but that is due to the teeth cutting them like injections.???????

Had my neurology appointment today. My doctor was young, but listened good. He took my history, did an exam, then went to confer with senior doctor. The senior doctor came in and said he's seen this sort of thing before and that it can be tricky to treat. He asked me if I had a high pain threshold, did sports, etc. I told him I worked out. He asked if my parents had high pain threshold, which I wasn't sure about. He then did some tests on me and said I had a very high pain threshold -- squeezing a tendon on the back of my foot, and pushing a metal rod down on my thumbnail. I don't know why but that was cool to find out :), though it could be part of the problem. He also checked cold sensitivity around my body, checked my tongue. He said given that I have a high pain threshold, there could be some problem with pain pathways (but I lost him and I have no idea how that would work).

He also mentioned how some people are sensitive to titanium, and I have a titanium nail in my femur (though it was there for several years before any symptoms started). As they were leaving to have more discussion, I thanked them and told them that this was the best, most in-depth exam I've had for this. It really made me feel hopeful about a possible resolution, like I was finally at the right place, and like these guys would dig in and try to find something. For a while I've been looking to have a visit where the doctor really THINKS about what's going on, and this senior doctor did exactly that.

I was hoping he'd try some medication, but that will have to wait. For now he gave me viscous lidocaine which they say will help with diagnosis, and they ordered a bunch of apparently very specialized blood tests that could take many weeks to process. My next appointment with him is early October.

No EGD biopsy results yet.

I stopped taking gabapentin a few days ago, I didn't think it was helping much if at all, and I feel like it was knocking my brain power down slightly. So right now I'm just on omeprazole 1x a day. It's definitely for hypersensitivity, it helps my throat feel better which I'm guessing is from very small amounts of reflux/vapor/whatever irritating a hypersensitive throat.

BG, the senior Dr was saying quite a bit to the younger doc, but I didn't understand or even retain much of it. I know he called it a hypersensitivity.I believe he mentioned "basal ganglia" too. I only remembered bits of it. He didn't specify how lidocaine would guide diagnosis.

Here are the labs they ordered FYI. But it sounds like you should see a neurologist who can try to figure your stuff out, have you seen one yet?

Medical chart said...


Recommendations made during today's visit include:
- Inflammatory marker labs.
- Viscous lidocaine added for diagnostic/therapeutic purposes

The following diagnostic tests have been ordered to help us better determine the underlying cause of your condition as well as guide best treatment. :
- Multiple inflammatory labs including ANA, HepB/HepC, ESR, CRP, C1Q, antiganglionic antibodies

ANTI-NUCLEAR AB (ANA) 7/16/2013 7/16/2014
C-REACTIVE PROTEIN 7/16/2013 7/16/2014
C1Q IMMUNE COMPLEX 7/16/2013 7/16/2014
HEPATITIS B CORE AB, TOTAL 7/16/2013 7/16/2014
HEPATITIS B SURFACE ANTIBODY 7/16/2013 7/16/2014
HEPATITIS B SURFACE ANTIGEN 7/16/2013 7/16/2014
HEPATITIS C AB SCREEN 7/16/2013 7/16/2014
IMMUNOFIXATION, SERUM 7/16/2013 7/16/2014
LAB MISCELLANEOUS PROCEDURE 7/16/2013 7/16/2014
RHEUMATOID FACTOR 7/16/2013 7/16/2014
SED RATE WESTERGREN 7/16/2013 7/16/2014
SYPHILIS TEST TPPA 7/16/2013 7/16/2014
VITAMIN B6 (PYRIDOXAL 5-PHOS) 7/16/2013 7/16/2014

drtinsac
I recently attended a luncheon with a bunch of friends and we discussed dentists and the material used in dental work such as 'plastics' type for crowns and bridges etc. If not SEALED properly, can cause burning in the mouth and leaching. I thought I'd mention this as I found it interesting. Have you had dental work. You may have researched this already. Also here are some dental/mouth solution examples with actual case studies and pictures. I don't know many dentists that would go this route to help solve BMS ! But it sure is interesting. Explains physiology. Kind wishes.

http://www.step.es/~jlarena/bms.htm

drtinsac,

Just a thought.

MILD CHRONIC ANTRAL GASTRITIS, NO ACTIVITY.

I have read that gastritis can mean bile reflux issues, as bile can cause gastritis.

Have you ask the gi about possible bile reflux or irritation.

I feel I have a lot of burn in the throat and mouth due to bile.

drtinsac
Hope you are doing okay. We haven't heard from you in a while. Please let us know how you are. Kind regards.

drtinsac thanks. Did you take a look yet at the dental/BMS site I posted to you earlier. Just wonder what your opinion was.

Here's the first abnormal test result in this latest series. Not sure what to make of it yet.

medical chart said...

ANTI-NUCLEAR AB (ANA)

Component Your Value Flag
ANA SCREEN POS A
ANA TITER 1:80 A
ANA PATTERN Speckled A

Yes I researched it a bit, and apparently a 1:80 is not high, and some percent of healthy people have ANAs.

I had my f/u appt today with GI. Basically a waste of time, no new treatment, however the docs I saw, after reviewing my records, seemed to say that neurology thinks my implanted hardware (titanium nail in hip) may be the culprit..

I know they mentioned that during my neuro visit, but I understood it to be a possibility among other things, whereas these GI docs made it seem like neuro's best guess is that it's the hardware.

So, I guess I'll do more research on the hardware and allergies to titanium implants.

The implant was ~2005, I don't recall any symptoms till about 2009. Hmm, around that time I did have a chipped tooth repaired I think. But I didn't notice any immediate change following anything.

As I read through the literature, I do find cases of weird reactions to titanium/nickel implants. So it is possible. There is also some allergy testing they can do to specific metals, to see if maybe taking the implant out would be an option.

The f/u with neurology isn't until October.

I googled chipped tooth repair bonding.. one of the first results I got was someone who had bitter taste/burning tongue after some work was done using a certain bonding material, that resolved after it was removed.

http://www.healthboards.com/boards/dental-health/831065-relyx-bonding-material-allergy.html

I'm going to stop by my dentist office to find out what was used in my tooth chip repair, and when it was done. Since neuro seems to be very busy, I might see if my PCP could do any allergy testing in the interim.

Post Edited (drtinsac) : 7/31/2013 4:16:50 PM (GMT-6)