Heartburn Support - Nissen Surgery- Recovery Slow....Very Weak-Blood Test Results

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Nissen Surgery- Recovery Slow....Very Weak-Blood Test Results

MrUsaMike

2006-08-06, 4:24 pm

Hello Fellow Members:

As you remember I had the Nissen surgery a little over (3) months ago.
The healing process was abit slow but the acid pain went away after 2-3
weeks and a 24ph test conformed this. Here in lies the problem.

Approximately 3 weeks after surgery, and for the last (3) weeks I have
been painfully weak. I began to get very fatigued and weak. I went to
my GI who scoped and biopsied me from top to bottom. Results: No cancer
and other diseases. My physician has directed me to see a neurologist,
rheumatologist, ear, nose and throat specialist. The general
speculation is that I need more time to heal and my energy level will
come back. However my GI surgeon disagrees and says its got to be
something else. My primary physician conducted numerous blood tests.
Some of the results were out of the range:

Ketone-UA- Trace *A
Lymphs 19 (low)
ReacLymp 1 (High)
Bun 23 (High)
Tbil 1.12 (High)
CO2 20 (low)
Copper 60 (low)
B-12 325 (Low normal)

I am not sure where to turn to at this point. My GI just wants me to
take vitamins and ride it out for 3-4 more months. Does this make any
sense?

Mike

Howard McCollister

2006-08-06, 4:24 pm

"MrUsaMike" <mrusamike@hotmail.com> wrote in message
news:1154878727.207270.47850@m73g2000cwd.googlegroups.com...
> Hello Fellow Members:
>
> As you remember I had the Nissen surgery a little over (3) months ago.
> The healing process was abit slow but the acid pain went away after 2-3
> weeks and a 24ph test conformed this. Here in lies the problem.
>
> Approximately 3 weeks after surgery, and for the last (3) weeks I have
> been painfully weak. I began to get very fatigued and weak. I went to
> my GI who scoped and biopsied me from top to bottom. Results: No cancer
> and other diseases. My physician has directed me to see a neurologist,
> rheumatologist, ear, nose and throat specialist. The general
> speculation is that I need more time to heal and my energy level will
> come back. However my GI surgeon disagrees and says its got to be
> something else. My primary physician conducted numerous blood tests.
> Some of the results were out of the range:
>
> Ketone-UA- Trace *A
> Lymphs 19 (low)
> ReacLymp 1 (High)
> Bun 23 (High)
> Tbil 1.12 (High)
> CO2 20 (low)
> Copper 60 (low)
> B-12 325 (Low normal)
>
> I am not sure where to turn to at this point. My GI just wants me to
> take vitamins and ride it out for 3-4 more months. Does this make any
> sense?
>

I wish I could help you Mike, but it's obviously unusual and it would be
impossible or irresponsible to start lobbing in opinions based on internet
information.

It sounds like you're getting thorough attention. I can't tell whether or
not it's accurately directed, though.

Best of luck with your recovery.

HMc

Pete

2006-08-06, 4:24 pm

MrUsaMike wrote:
> Hello Fellow Members:
>
> As you remember I had the Nissen surgery a little over (3) months ago.
> The healing process was abit slow but the acid pain went away after
> 2-3 weeks and a 24ph test conformed this. Here in lies the problem.
>
> Approximately 3 weeks after surgery, and for the last (3) weeks I have
> been painfully weak. I began to get very fatigued and weak. I went to
> my GI who scoped and biopsied me from top to bottom. Results: No
> cancer and other diseases. My physician has directed me to see a
> neurologist, rheumatologist, ear, nose and throat specialist. The
> general speculation is that I need more time to heal and my energy
> level will come back. However my GI surgeon disagrees and says its
> got to be something else. My primary physician conducted numerous
> blood tests. Some of the results were out of the range:
>
> Ketone-UA- Trace *A
> Lymphs 19 (low)
> ReacLymp 1 (High)
> Bun 23 (High)
> Tbil 1.12 (High)
> CO2 20 (low)
> Copper 60 (low)
> B-12 325 (Low normal)
>
> I am not sure where to turn to at this point. My GI just wants me to
> take vitamins and ride it out for 3-4 more months. Does this make any
> sense?
>
> Mike

Mike...I believe you are getting jerked around by the doctors and it is sad,
and seeing the three more specialists that your PC physician mentioned
sounds like a lot of bullshit to me. My heart is with you and I wish you
the best. Please keep the group informed on your progress...Pete

MrUsaMike

2006-08-06, 4:24 pm

Hello Howard:

Actually I have been weak for 3 months, not three weeks. If you could
point me in a direction perhaps without a diagnosis? The neurologist,
endocrinologist, rheumatologist both say I am in their speciality,
"disease free". I feel like at this point that my primary physician
is just throwing darts at the dart boards. His last suggestion is that
I see a hematologist. I respect your opinion, any suggestions would be
greatly appreciated.

Thank you,

Mike

Howard McCollister

2006-08-06, 4:24 pm

"MrUsaMike" <mrusamike@hotmail.com> wrote in message
news:1154891994.383135.323450@i3g2000cwc.googlegroups.com...
>
> Hello Howard:
>
> Actually I have been weak for 3 months, not three weeks. If you could
> point me in a direction perhaps without a diagnosis? The neurologist,
> endocrinologist, rheumatologist both say I am in their speciality,
> "disease free". I feel like at this point that my primary physician
> is just throwing darts at the dart boards. His last suggestion is that
> I see a hematologist. I respect your opinion, any suggestions would be
> greatly appreciated.
>
> Thank you,
>
> Mike
>

Return to work, basically unrestricted activity within a week is the norm in
our practice after most laparoscopic operations. A prolonged recovery such
as yours would definitely have my attention.

I am curious about your elevated bilirubin level. Was it elevated before
surgery or at any other time in your life? Bile metabolism is pretty closely
regulated and even mild elevations suggest that further workup might be
indicated. First place I'd start would be working up your metabolic panel.
I'd want to fractionate your bilirubin and distinguish direct from indirect
bilirubin.

HMc

MrUsaMike

2006-08-06, 4:24 pm

Howard McCollister wrote:
> "MrUsaMike" <mrusamike@hotmail.com> wrote in message
> news:1154891994.383135.323450@i3g2000cwc.googlegroups.com...
>
> Return to work, basically unrestricted activity within a week is the norm in
> our practice after most laparoscopic operations. A prolonged recovery such
> as yours would definitely have my attention.
>
> I am curious about your elevated bilirubin level. Was it elevated before
> surgery or at any other time in your life? Bile metabolism is pretty closely
> regulated and even mild elevations suggest that further workup might be
> indicated. First place I'd start would be working up your metabolic panel.
> I'd want to fractionate your bilirubin and distinguish direct from indirect
> bilirubin.
>

Hello Howard:

Yes it has, about a month after my gall bladder surgery (Oct 2005)
when they found, "Calcification" spots on my liver in addition to
hemangioma on my kidney/ liver. Interesting enough, a month before the
latest test was taken (June), all blood levels were stone cold normal.
The elevated tests occurred in July.

I wonder if it was a mistake to have my gallbladder removed and to have
the Nissen surgery done within (6) months of each other. One question I
do have for you is do you think that its worth my time going to the
hematologist? If you ever change your policy and do phone consultations
please let me know. I meet with the GI again on the 15 of August. I'm
sure he will tell me the same thing again. (More vitamins)

Take care,

Mike

MrUsaMike

2006-08-06, 9:22 pm

Howard:

I did forget to mention that I did have an ERCP procedure last December
because they believed that my ducts were blocked. (Elevated Rate).
However when the GI Dr got to the duct area it was clear, no
obstruction. I had asked if they should have biopsied the liver at that
point due to the calcification's and hemangiomas but he said no. Maybe
the subject matter should be revisited again.

Mike

Howard McCollister

2006-08-06, 9:22 pm

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"MrUsaMike" <mrusamike@hotmail.com> wrote in message
news:1154896576.512219.9880@n13g2000cwa.googlegroups.com...
>
> Howard McCollister wrote:
>
> Hello Howard:
>
> Yes it has, about a month after my gall bladder surgery (Oct 2005)
> when they found, "Calcification" spots on my liver in addition to
> hemangioma on my kidney/ liver. Interesting enough, a month before the
> latest test was taken (June), all blood levels were stone cold normal.
> The elevated tests occurred in July.
>
> I wonder if it was a mistake to have my gallbladder removed and to have
> the Nissen surgery done within (6) months of each other. One question I
> do have for you is do you think that its worth my time going to the
> hematologist? If you ever change your policy and do phone consultations
> please let me know. I meet with the GI again on the 15 of August. I'm
> sure he will tell me the same thing again. (More vitamins)
>
> Take care,
>
> Mike
>

Taking the gallbladder out is usually not a big deal, most of my patients go
home within hours, so I doubt having that within 6 months of the Nissen is
playing a role. It would not be unusual for me to take the gallbladder out
at the same time I do a Nissen if the patient has gallstones.

It does sound like you've been worked up, and I'm not sure I would have done
anything differently. The only difference is that I would have done the
entire workup myself - and while it would likely have been the same workup,
you wouldn't necessarily be faced with the multiple doctor/multiple message
problems that are so common in medicine in this age of subspecialization.

Based on what little I know, seeing the hematologist isn't necessarily a bad
idea. It does appear that they're kind of shotgunning it and he's just one
more shot, but in some puzzling cases that does inevitably happen.

HMc

MrUsaMike

2006-08-06, 9:22 pm

Howard McCollister wrote:
> "MrUsaMike" <mrusamike@hotmail.com> wrote in message
> news:1154896576.512219.9880@n13g2000cwa.googlegroups.com...
>
> Taking the gallbladder out is usually not a big deal, most of my patients go
> home within hours, so I doubt having that within 6 months of the Nissen is
> playing a role. It would not be unusual for me to take the gallbladder out
> at the same time I do a Nissen if the patient has gallstones.
>
> It does sound like you've been worked up, and I'm not sure I would have done
> anything differently. The only difference is that I would have done the
> entire workup myself - and while it would likely have been the same workup,
> you wouldn't necessarily be faced with the multiple doctor/multiple message
> problems that are so common in medicine in this age of subspecialization.
>
> Based on what little I know, seeing the hematologist isn't necessarily a bad
> idea. It does appear that they're kind of shotgunning it and he's just one
> more shot, but in some puzzling cases that does inevitably happen.
>
> HMc

Dr. Howard:

Any chance that I can get you to move you and your and your practice to
the San Francisco Bay Area?

Mike

Howard McCollister

2006-08-07, 2:23 am

"MrUsaMike" <mrusamike@hotmail.com> wrote in message
news:1154915199.198689.100670@b28g2000cwb.googlegroups.com...
>
>
> Dr. Howard:
>
> Any chance that I can get you to move you and your and your practice to
> the San Francisco Bay Area?

>
> Mike
>

Thanks Mike, but I feel pretty confident you're getting good care, certainly
as good as I could deliver. It sounds like the issue is communication as
much as anything. Multi-specialty ping-pong can be frustrating for the
patient and I'm sorry you're caught in that situation.

On the positive side, serious, dangerous medical conditions are often easier
to diagnose and you should take at least some comfort from the fact that no
one has uncovered some major problem as of this point. Best of luck - please
keep us posted here.

HMc