Friday, November 20, 2009

More updates

I went back for a third and final visit for the kidney infection on Wednesday. The results from the labs:

  • Urine culture:  Confirmed bacterial infection that is sensitive to Cipro. That means that the kidney infection is no longer suspected but confirmed. That also means that a 10 day course of Cipro should have resolved it. They are repeating the urinalysis one last time to make sure the entire infection has been treated. If not, I suppose I'll need another course of antibiotics. 
  • Blood work:  Kidney and liver function tests were normal! That rules out something huge and life threatening and is a major relief! The labs also measured my TSH (Thyroid Stimulating Hormone) and found that I have an overactive thyroid.  I've had this test done several times and it has never come back anything but normal. The doctor ordered more blood work to investigate the thyroid thing in more detail. So, stay tuned.
So, those are the test results. Now, onto how I'm feeling. I'm still incredibly worn out and still taking steroids and still feel kidney/flank pain and am still retaining lots of fluid. The blood work ruled out a lot of possibilities but has left me without an answer about why I'm retaining so much fluid and have occasional flank pain. I'm going to have to investigate it further on my own and maybe in 6 weeks or 2 months a doctor will be able to look back, long after I've figured out roughly what was going on, and finally provide me with a diagnosis. That's the way it usually works. I mean, the kidney infection was pretty straight forward and handled very well by the doctors at urgent care. But, I'm still the one that figured it out and diagnosed myself long before they got my file. But, most diagnoses take forever and are incredibly frustrating. My guess is this fluid retention/kidney situation will follow suit. 

On a positive note, I came down on my dose of steroids a bit without problems! I have needed 4 tabs a day for about a week or so now and that's a very high dose. A few days ago, I tried 3 tabs and woke up extremely inflammed the next day. So, disappointed, I went back up to 4 for another few days. But, for the last 2 days, I've gotten by on only 3 tabs without that crazy inflammation rushing back! Any reduction in the dose is a good thing. Now that it's been a couple of days of stability on 3 tabs a day, I'm going to see how it goes on 2 and report back. 

On a not-so-positive note, my heart rate and blood pressure are out of control now. As of November 10th, my average blood pressure reading is 130/80. The highest I've seen it go is 135/85. I've always gotten low readings. For years, the readings were low enough to cause lightheadedness but not low enough to be dangerous. But, about 6 weeks ago, I started getting the lowest readings ever, like 90/56. I've been on beta-blockers for years, which lower your blood pressure, but my dose has never changed and my readings have always been about 110/70 with beta-blockers. Then all of the sudden, they started getting lower and lower until I finally got that 90/56 reading. My cardiologist said if the systolic pressure (the top number) gets any lower that I would need to call him. So, fast forward to present day and my readings are now high by anyone's standards. What's going on? Worse than that, my heart rate has been out of control, even on beta-blockers. Lately, I've started every day with a heart rate of 125-135. That's way too high. Anything over 100 is tachycardia. Even 110 would be acceptable, but not 135. It's been like this everyday. So, I take my beta-blocker earlier in the day and it comes down either to normal or to near-tachycardia for a few hours. It's not good. I need to call my doctor, check in, and see what's going on.

At first, I thought the increased heart rate and blood pressure were a response to the overwhelming inflammation, my body's fight or flight response. But even after a week or so of the inflammation being controlled fairly well, they're still too high. My best guess now is that the steroids are causing it. The fluid retention alone can increase your blood pressure and the steroids could be responsible for at least some of the fluid retention now. I'm assuming that the lower the dose of steroids, 2 tabs a day vs. 4, the better my readings will be. We'll see. I'll see what my doctor has to say about it. In the meantime, the only things I can do to try to control my heart rate are drink more water, avoid caffeine (of course!) and do breathing and relaxation exercises. Since I don't yet know if my beta-blocker should be adjusted temporarily, there's not much more I can do to keep my heart rate low. Oh, it's all so confusing. One problem causes another. Medication treats one problem only to cause another. It's all so messy. 

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