Saturday, October 30, 2010

Tummy and Nose Perspective from Family Doctor

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Just went to see my family doctor.  I just switched to someone who is taking more interest in driving the train than my old GP

Dr Sander had felt a lump near my thyroid which she wasn't uncertain about and had me go in for an ultrasound.  The ultrasound was negative for a tumor so she suspects that it was just drainage  from fluid in my ears.   

Dr Sander is pleased that my sinus surgery went without incident.  She thinks having the sinuses cleared will probably decrease the amount of fluid in my ears.  As fluid behind the ears can lead to hearing loss, we want to make sure this is cleared up before I go in for auditory therapy and evaluation for a hearing aide next year.  

Also, in order to ensure that there won't be more fluid accumulating in the ear, she has ordered some allergy testing.  Given that insurance companies only reimburse for one of these kinds of tests per year, this time, she is testing for airborne allergies and not food allergies.  No sense in dumping more crap into the sinuses that will trickle into the ears.

Also, she is getting on top of my B12 deficiency.   In my blood test, my MCH and MCV values are low.  Dr Sander has ordered tests for B12 and intrinsic factor.  This is important because these deficiencies  might be leading to my fat malabsorption digestive issues.   Dr.  Chang, my Gastroenterologist,  and I had discussed doing a Schilling test which is a rather involved set of tests involving drinking cobalt radioisotopes-- 57Co and 58Co, -- not a pleasant prospect.  Also, no one really does the Schilling test anymore as it is easier and cheaper to see whether it is necessary to just take some B12 shots with or without intrinsic factor. 

Other problems that might be indicated include pernicious anemia, a decrease in red blood cells that occurs when the body cannot properly absorb vitamin B12 from the gastrointestinal track.  If I have a lack of intrinsic factor, I won't abosorb B12.

 In addition to being implicated in neurological conditions,  pernicious anemia  also has symptoms that include:  bleeding gums,  impaired sense of smell, and unsteady gait -- all of which I have.

So we shall see whether this is just simple fat malabsorption and/or pernicious anemia. 

I will see Dr. Sander in January and based upon the results of these tests, we will plot a course.
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