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Archive for September, 2011

For a couple of months I had been experiencing pain on my right side, under my ribs, wrapping around to my back.  I had an ultrasound done at 34 weeks to investigate, as my symptoms sounded like gall bladder disease / gall stones.  Everything looked normal except for a “1.0 cm right subscapular echogenic area, likely representing a liver hemangioma.” Well, that is where my pain is, however, the report noted that “No cause for patient’s pain is identified.”

From what I’ve read on the internet, other people have experienced pain there, mimicking gall stones, only to be told it’s a liver hemangioma, and that it shouldn’t be causing pain. Several people also noted that they have IBS (irritable bowel syndrome), which I have been told I have due to years of constipation and bloating (basically since birth).

Recently, in January 2010, I started getting other weird symptoms like numbness and tingling. After 6 months of seeing 8 different doctors, including the emergency room at the hospital, an endocrinologist (I have Graves disease), a neurologist (for the numbness & tingling), and a rheumatologist (who told me it was fribromyalgia, which it isn’t), I was finally diagnosed with vitamin B12 deficiency (it was 115 at the time), low calcium (hypocalcemia), and low ferritin (anemia). The current hypothesis is malabsorption and I go to see a gastroenterologist in February, and I’m getting an MRI just to rule out anything else (Jan 2012 – completed – came back clean.)

So, after 3 months of supplements with vitamins I find I still have malabsorption issues (diarrhea), despite many pills a day:

  • 2 mg+ Calcium
  • 4 IU vitamin D
  • 1-2 Iron pills a day (Palifer/Euro Fer)
  • Vitamin C (I take with iron, and now with each meal as I read it can help with malabsorption)
  • B12 (sublinguals and injections)
  • prenatal vitamin
  • B complex vitamin
  • 1 magnesium pill

I suspect that my history with IBS could be caused by low stomach acid (hypochlorhydria ). It is interesting that the low vitamins happened less than 2 years after my Graves disease diagnosis, which makes me wonder if any of it is autoimmune. Pernicious anemia (low b12) can be caused by an autoimmune disorder, but doesn’t explain the low calcium.  Updated Jan 2012 – I feel fairly certain it’s adrenal fatigiue/insufficiency

So, until I have this baby (less than 4 weeks to go!), and until I see a gastroenterologist (3.5 months from now), I just have to keep taking vitamins, ignore the pain under my right ribs, and hope that it’s all treatable in January!

I know a scope of my stomach and colon is likely in my future, but if it produces the cause of my symptoms (hopefully, all benign), then I’ll be happy. However, I am disappointed that it is taking so long to diagnose. It’s already been 9 months since the onset of my symptoms and it will be over a year before I see the gastroenterologist (it took 3 months of supplements not making much of a difference, and even then, I had to ASK to see one).

Note: my Graves Disease has been perfect throughout pregnancy. I take a pill at breakfast (50 mg), and another pill at bedtime (50 mg). I will let you know if it flares up after birth, but so far, so good!

Post-Birth update

About a week after birth my calcium levels seem to be off. I feel very hypocalcemic, however, I’m taking more calcium than ever (up to 4,000 mg / day). My lips are tingling and my muscles get crampy. However, I’m prone to constipation right now – well, large, firm stools right now, which is odd because I’ve had fibrous, slimy bowel movements leading up to birth, despite the calcium and iron I’m taking.

Update: Jan 2013

Still have constant flank pain in this region. Kidneys look okay. Think this might be the source of all my problems – liver cyst.

Liver cysts are usually asymptomatic, and most people having them are unaware about their condition. It is found that less than 5 percent of people with hepatic cysts develop noticeable symptoms. Also, the benign sacs don’t affect the normal functioning of liver. When the cysts grows larger to about 7 cm, or if there is bleeding inside the cysts, then only they cause symptoms. Bleeding into the cysts is characterized by sudden pain in the upper right abdomen. Symptoms associated with hepatic cysts include the following.Upper abdominal swelling and discomfort
Abdominal pain
Nauseated feeling
Eruption of the cysts
Digestive problems
Shoulder pain
Liver enlargement
Blockage of bile ducts
Infection of the bile ducts

Diagnosis and Treatment

Diagnosis of liver cysts is done when a patient undergoes a CT (Computed Tomography) scan or an ultrasound procedure of the abdomen. Usually, they are detected incidentally, while doing imaging tests for other abdominal problems. If required, examination of a sample of fluid from the cysts, biopsy of the affected tissues and blood test (for parasitic infection cases) is conducted. It is common that an individual has more than one cyst in the liver tissues and rarely, there are multiple cysts.

Since liver cysts don’t disturb the normal functioning of the body, there are no significant treatment methods. In case, the cysts are big enough (for example more than 3 cm), it is advisable to go for a follow-up abdominal imaging to check the growth of cysts. People go for treatment of liver cysts only after they experience discomfort symptoms that disturb their normal routine. Treatment for the same is done by aspiration and/or surgical removal of the cysts.

Of the two available treatment methods, removal of the cysts via laparoscopic surgery is a more reliable intervention. Simple aspiration of the cysts is not recommended, as fluid tends to fill up the cysts after some time. In the surgery, 2-3 small excisions are made in the abdomen. With the help of laparoscope, a large part of the affected tissues including the cyst wall is removed, and the incisions sites are sutured. Laparoscopic surgery is also recommended, if the cysts prevent normal flow of bile juice to the small intestine.

This minimally invasive procedure requires 1-2 days hospital stay. Usually, candidates achieve full recovery within 2 weeks after the surgery. As the liver regenerates on its own, it recuperates successfully. In case, the cysts are infected, then treatment may include administration of antibiotics and other prescribed medications along with excision of the tissues and cysts. For people who have participated surgery for hepatic cyst treatment, recurrence rate is very low (almost negligible).

To conclude with, no specific treatment is needed for asymptomatic liver cysts. However, one should be aware about the complications of liver cysts, such as infection, jaundice (yellowing of the skin and sclera), bleeding into cyst (causing pain) and disturbance of the flow of bile juice. If anybody suspects that he/she has liver cysts, it is recommended to consult and seek advice from a physician so as to get proper medical attention. Except for the mild discomfort cases, hepatic cysts do not pose risks for liver cancer and liver failure.
Read more at Buzzle: http://www.buzzle.com/articles/liver-cysts.html

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So, about a month before I got pregnant I started having numbness & tingling, followed by a host of other symptoms. Six months later I finally got a blood test that said I was low in B12, calcium, albumin, creatine, ferritin, etc…

For two and a half months I have been on supplements. While technically most of my numbers are now in the very low-normal range (still severely anemic and low ferritin), my symptoms, while better, are not gone.

I have chronic muscle pain. Last night I had a very painful calf cramp that lasted way too long and was extremely painful. I couldn’t stand on my leg, my calf wouldn’t relax enough to put my foot flat on the floor. There is one spot, halfway up my back, close to my spine, and on the right side, that constantly hurts.

I have been to many doctors (family doctor, her intern, her vacation replacement, a walk-in clinic, the emergency room at he hospital, my endocrinologist, a rheumatologist and a neurologist). None of them ordered a blood test for 6 months. Finally my family doctor who was tired of me complaining, who constantly told me I was anxious and that my family was worried about me because I was “worrying too much,” gave me a blood test that revealed all of these deficiencies.

I am hoping that my problem is malabsorption caused by a bacterial overgrowth because it is treatable. I do not have celiac’s disease (been tested for that). Low B12 levels can also be caused by pernicious anemia, chronic pancreatitis, and terminal ileal disease. A combination of low B12 and high folate levels is suggestive of bacterial overgrowth, because intestinal bacteria use vitamin B12 and synthesize folate. Have I been tested yet? Nope!

I see my endocrinologist tomorrow and am going to beg to see a gastroenterologist, who specializes in diseases digestive tract. While taking 15+ pills a day is fun and all, I am truly hoping to find a cure soon. I am now 8 months pregnant and been symptomatic since January 2, 2011. Should it really take this long to get help? Being pregnant is uncomfortable enough; muscle spasms, tingling, and extra swelling & fatigue certainly don’t help.

7 weeks until my due date. She can’t come soon enough for my liking!
(check out my blog on adrenal insufficiency!)

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