Rheumatology Report
I liked the rheumatologist . . . I really wish I could find a primary care physician with such a kind, respectful, attentive and knowledgeable manner as this specialist. She was a lovely, soft-spoken Indian lady with just a hint of an accent, and not at all hard to understand (unlike the last doctor I saw).
She just saw me for the one consultation, but she made some recommendations of things for my primary care doctor to follow up on. Nothing earth-shattering or really new, but it was nice to get a second opinion and a confirmation from a specialist that my diagnoses are probably accurate and to (again) be told that I'm really doing quite well at managing it all.
"And you have three children and homeschool them! I don't know how you do it. That's amazing," she said. "That would be a challenge even for a normally healthy person." Her tone did not in the least imply that it was a bad thing. :)
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The rheumatologist agreed with the last doctor I saw that, although it's quite possible that I may have the chronic form of Epstein-Barr Virus, it seems a bit more likely that I just recently caught the acute form of Infectious Mononucleosis. Both doctors agreed that there wouldn't be much point in running titers to try to figure out which it is, so I'm content to let that be.
She did suggest a few medications for consideration. The medications she mentioned included two (Lyrica and another one) that I had actually heard of being useful to treat fibromyalgia pain, and a third that I hadn't heard of to treat fatigue. The third one piqued my interest . . . it's usually used for patients with narcolepsy, but she said it has been shown to be quite helpful with some chronic fatigue patients just to get them past the fatigue enough to be more functional and get necessary things done during the day.
She didn't think any of the medications were compatible with breastfeeding, though. I appreciated that she didn't bat an eye when I told her that my 2.5 year old is still nursing a few times a week. She didn't even ask me when I was going to finish nursing Ebee or push me to try to wean her faster, as most of my doctors have done.
Regarding the chronic fatigue syndrome and my sleep difficulties, she thought I should probably have a sleep study done. I'll have to talk to my other doctor about that and try to find out what that might show and whether it's likely to show anything that would be treatable.
I know that I have irregular sleep cycles, but I'm pretty sure I don't have apnea or anything like that. I do know that I often have trouble falling and staying asleep and reaching the deeper stages of sleep, and that has to contribute to the fatigue. But a sleep study would be very expensive, even with our insurance, and I'm not exactly sure what would be gained by knowing exactly how insufficient my brain is at reaching REM.
I'm wondering if it might be possible to try to address the sleep issues before going to the time and expense of a full-blown sleep study. I'll have to ask the doctor about that.
Oh, and the rheumatologis caught something that both my PCP and I had missed--I haven't had a thyroid test done recently. I was thinking my doctor had done that with the rest of the blood tests, but there was no record of one. I haven't had thyroid function checked since 1996. The rheumatologist said that I should be having it checked yearly, especially with my health issues and the family history of thyroid problems.
She also told me about a fibromyalgia clinic at the nearby teaching/research hospital and said I might want to consider getting a consultation there at some point, and gave me some information about finding a CFS/FMS support group.
In a way, it's always kind of a letdown to go to a new doctor and be told that, yes, I have fibromyalgia and chronic fatigue syndrome and, no, there's nothing they can do about it. But at least she assured me that my symptoms and complaints are very normal for that set of diagnoses, and she certainly didn't try to tell me it was all in my head.
I did forget to ask about a couple of things I wanted to know. I really should have written it all down. Oh, well.
She just saw me for the one consultation, but she made some recommendations of things for my primary care doctor to follow up on. Nothing earth-shattering or really new, but it was nice to get a second opinion and a confirmation from a specialist that my diagnoses are probably accurate and to (again) be told that I'm really doing quite well at managing it all.
"And you have three children and homeschool them! I don't know how you do it. That's amazing," she said. "That would be a challenge even for a normally healthy person." Her tone did not in the least imply that it was a bad thing. :)
###############################
The rheumatologist agreed with the last doctor I saw that, although it's quite possible that I may have the chronic form of Epstein-Barr Virus, it seems a bit more likely that I just recently caught the acute form of Infectious Mononucleosis. Both doctors agreed that there wouldn't be much point in running titers to try to figure out which it is, so I'm content to let that be.
She did suggest a few medications for consideration. The medications she mentioned included two (Lyrica and another one) that I had actually heard of being useful to treat fibromyalgia pain, and a third that I hadn't heard of to treat fatigue. The third one piqued my interest . . . it's usually used for patients with narcolepsy, but she said it has been shown to be quite helpful with some chronic fatigue patients just to get them past the fatigue enough to be more functional and get necessary things done during the day.
She didn't think any of the medications were compatible with breastfeeding, though. I appreciated that she didn't bat an eye when I told her that my 2.5 year old is still nursing a few times a week. She didn't even ask me when I was going to finish nursing Ebee or push me to try to wean her faster, as most of my doctors have done.
Regarding the chronic fatigue syndrome and my sleep difficulties, she thought I should probably have a sleep study done. I'll have to talk to my other doctor about that and try to find out what that might show and whether it's likely to show anything that would be treatable.
I know that I have irregular sleep cycles, but I'm pretty sure I don't have apnea or anything like that. I do know that I often have trouble falling and staying asleep and reaching the deeper stages of sleep, and that has to contribute to the fatigue. But a sleep study would be very expensive, even with our insurance, and I'm not exactly sure what would be gained by knowing exactly how insufficient my brain is at reaching REM.
I'm wondering if it might be possible to try to address the sleep issues before going to the time and expense of a full-blown sleep study. I'll have to ask the doctor about that.
Oh, and the rheumatologis caught something that both my PCP and I had missed--I haven't had a thyroid test done recently. I was thinking my doctor had done that with the rest of the blood tests, but there was no record of one. I haven't had thyroid function checked since 1996. The rheumatologist said that I should be having it checked yearly, especially with my health issues and the family history of thyroid problems.
She also told me about a fibromyalgia clinic at the nearby teaching/research hospital and said I might want to consider getting a consultation there at some point, and gave me some information about finding a CFS/FMS support group.
In a way, it's always kind of a letdown to go to a new doctor and be told that, yes, I have fibromyalgia and chronic fatigue syndrome and, no, there's nothing they can do about it. But at least she assured me that my symptoms and complaints are very normal for that set of diagnoses, and she certainly didn't try to tell me it was all in my head.
I did forget to ask about a couple of things I wanted to know. I really should have written it all down. Oh, well.
Labels: health issues, just life
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Posted by purple_kangaroo at 7:51 PM[Permanent link]
2 Comments:
The sleep issues you describe are very much in line with adrenal fatigue and hormone imbalance. Once I got on cortisol and progesterone my fatigue issues fell away and I returned to sleeping deeply once again. I wonder if this may be worth investigating? The genova diagnostics site does a great job of listing all the areas worth testing for fibro patients if you are interested in following up.
I'm glad this doctor was friendly and supportive.
Hooray for a kind, supportive, and encouraging doctor!!
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