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Discussion Forums » General Discussion
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Medical question
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30 Oct 2010, 08:19
Poetic Justice
Post Count: 229
I have this friend from work who seems to be very sick. He's gone to COUNTLESS doctors, and they all tell him the same thing- "You're fine, go home." But he's very obviously not fine, and no one will help him. He can't eat. At all. And no, he doesn't have an eating disorder. He just gets very sick any time he tries to eat even the smallest of things. All the color runs from his face, and he says he gets dizzy right after swallowing a bite of food. He usually ends up throwing it back up, and he has no control over it. As you can imagine, this has left him very malnourished. His cheek bones protrude quite dramatically (I've known him a while now, and they didn't before...), his eyes are sunken in with heavy redish-black circles around them.. He literally looks like a concentration camp survivor. And he seems to have very little energy. We both have very physical jobs, and he is trying so hard to overcome whatever this is and be a good worker that he busts his butt, and he goes into these fits where he's hyperventilating and it almost looks like he's having a panic attack.

I guess the doctors told him that he has "Small gall stones" but they're "too small to worry about". And he said that there is some chemical/protein in your body that increases when your body has inflammation (I can't remember the name he said, but it started with a 'C' or an 'S'), and the doctors told him that his is FIVE TIMES the normal level. But they say he's fine and send him home every time, and the poor kid looks like he's about to fall over dead. He's only 22.

I guess I'm just wondering if any one here has heard of anything like this, or have an idea as to what it may be? Or even who might be the best person for him to talk to about it- Someone who will actually listen and won't just turn him away. Anything. Because he's frustrated to the point of giving up looking, and no one takes him seriously. I don't know him too well, but I'd really like to help him. At least give him something that might be incentive enough for him to keep looking himself. I just feel really bad for him, he's way too young for this :-/

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30 Oct 2010, 17:45
Sunlight Silence
Post Count: 28
You could suggest he see a geneticist who specializes in metabolic disorders - it may be a long shot but there's always a possibility and they tend to listen to patients. Many many physicians have a tendency to "forget" about genetic conditions and don't think about the possibility or even think to refer to a genetics specialist. As a result, there are a lot of people who go without a diagnosis of their condition for a long time until someone finally thinks about genetics. You'd think genetics would be near the top of the list of possible diagnoses, but sadly it nearly never is and people wonder for years about what is wrong. It's always worth trying.
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1 Nov 2010, 02:20
empire state
Post Count: 3
sounds like a blockage somewhere.
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1 Nov 2010, 09:09
~RedFraggle~
Post Count: 2651
@Empirestate: That would have a far more acute presentation. This has been going on for a long time. He does not have an obstruction.
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30 Oct 2010, 08:31
Estella
Post Count: 1779
I've read articles in magazines about people who had this symptom, and docs couldn't find anything wrong, and it turned out there was some sort of blockage in their intestinal track so no food could get through. I think this is quite rare, and obviously I can't say whether that is the case for your friend, but if he literally can't pass any food through his body, then it's a possibility. Has he had an endoscopy?

Another possibility when people have these symptoms is that it is some kind of psychosomatic thing, which they are unaware of, but is caused by some bad experience, and creates physical symptoms.

Or it could be something wrong with the swallow - a videofluorscopy could ascertain if anything is wrong in that area. He'd have to see a speech and language therapist for that.

Hopefully some medical people will come up with other ideas. Seems odd the docs are saying nothing is wrong, but if the weight loss has happened quite suddenly, maybe he hadn't lost enough weight when he first saw them. He should document the weight loss and return to the docs to show them. Obviously if he can't eat, he will soon have signs of malnourishment and they'll have to acknowledge something is up.
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30 Oct 2010, 09:02
Poetic Justice
Post Count: 229
I hope you're right. I don't really know him well enough to try and discuss his endoscopies (if he's had any lol), he's more of an 'acquaintance' then anything else. I can just imagine how frustrated he is, so I was hoping to at least have an idea or two to offer him. But the intestinal thing sounds plausible. It may also be his stomach. The way he described it, it seems like more of a reaction TO the food, rather than the act of swallowing it, so I doubt it's his throat. But it happens with everything, so I'm guessing it's not literally like an allergic reaction or anything
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30 Oct 2010, 08:45
Transit
Post Count: 1096
My housemate Emma has lost a lot of weight and often vomited after eating, she had constant diarrhea also, however it turned out she was severely constipated and had undiagnosed ceoliacs disease.

Has he thought of going to hospital, he may be taken more seriously there.
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30 Oct 2010, 09:05
Poetic Justice
Post Count: 229
He's gone to hospitals and The ER on several occasions. Everyone's in such a rush to move on to the next patient that they push him right out the door with something stupid like 'the flu'. And ER visits aren't cheap, as you can imagine. He works at the same poverty-level job I do, so he can't really afford to deal with their crap, either. No one helps, but you bet they still send that bill!
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30 Oct 2010, 17:56
HorrorVixen XO
Post Count: 869
he needs to request a specialist. this is obviously something very serious and his dr is treating like its nothing. they need to do a poopy test for sure. an MRI is prolly needed too.
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30 Oct 2010, 18:36
Poetic Justice
Post Count: 229
Yeah you guys are probably right. I'll tell him to find a specialist
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31 Oct 2010, 05:17
~RedFraggle~
Post Count: 2651
First of all the 'normal' CRP is less than 3. Five times that is 15, which is not really of any significance. People with inflammatory or infective problems have a CRP in the hundreds!

Secondly the reason genetic disorders are never at the top of the differential diagnosis is because they're rare. It's much more likely to be something common. 

It sounds as if he's likely had numerous investigations, but without knowing which ones, or the results, it's impossible to even speculate on his diagnosis. There's lots of possibilities, but I do not think intestinal obstruction is one of them (that usually would present far more acutely and would not produce normal tests). More likely would be something like IBS, gastritis (which can be confirmed easily with an endoscopy), a pharyngeal pouch, or even a psychological problem with food (which could have been triggered by something brief like food poisoning). 

As for all this "tell him to ask to see a specialist" nonsense... A specialist in WHAT exactly? Given that we don't have even a possible diagnosis (because you of course don't know what tests he's had etc), we can't know if his problem is a gastrintestinal one, a metabolic one, a psychological one... The only person who can know the right route for referral is his own doctor. Same goes for an MRI. There may or may not be an indication for such a test, but one thing's for sure, someone who is not medically qualified and does not know your friend's medical information is certainly not qualified to make such an assessment! For all she knows this guy may have a pacemaker!
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31 Oct 2010, 05:40
Poetic Justice
Post Count: 229
Lol Don't say it as if you sincerely believe I planned to knock him out and try to perform the test(s) myself in the breakroom or something. It's really nothing to get worked up over. I was just going to go up to him and say "Hey. Did you hear about this?" and then he would say "Hey. No, I didn't." and then maybe he'd ask someone who IS qualified if he felt that the symptoms matched whatever it is he's experiencing.

These 'doctors' he's been seeing obviously don't have the motivation to look into it themselves, and he's turned to discussing it with people he barely knows (like me) to try and get any information he can. He doesn't expect his friends to cure him. I think he's just hoping that someone might say something that will put him on the right path.

You may think that talking to various doctors IS the right path, but for people that have a very limited income, it's often both the most costly and ineffective path. Exactly how much money is he supposed to devote to people that shuffle him out the door and say 'there's nothing I can do'? They don't even try. But they still expect to be paid, of course. I only asked because I can understand why that would be frustrating.
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31 Oct 2010, 11:13
~RedFraggle~
Post Count: 2651

Umm... You don't get knocked out for an MRI. And he's already told numerous doctors about his symptoms. Do you not think if there was an indication for an MRI he'd have had one already? Maybe he has, or maybe he's had a CT, in which case an MRI is unlikely to show anything new. Do you really think that your idea of an MRI would be one that wouldn't have crossed the mind of a medical profession (yet has crossed yours!) if it was medically indicated? This idea of doing the biggest most expensive test to find a diagnosis is a very American attitude. I mean over there people are PAYING for pointless (radiation exposing, increasing cancer risk) full body CT scans, which thankfully doesn't happen here where we have a health service where tests are driven by clinical indication not what the patient can afford to pay for.

Anyway, that's slightly off topic, but brings me to your next point... If you're so concerned about the financial implications for this guy why would you suggest a very expensive test which likely wouldn't show anything new anyway? Now that would be a waste of money!

Furthermore you're making a lot of assumptions about his doctors. How on earth can you know that they have no motivation to look into it? How can you say they haven't tried? Were you sitting in on the consultations? Have you seen his medical notes? We have NO idea what tests this guy is had. Sometimes there simply isn't a diagnosis to be found based on the tests available. Particularly if the problem is something like IBS, or functional vomiting, or is psychological. I think it's rather judgemental to assume his doctors don't care because they haven't been able to find an organic cause for his symptoms. 
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31 Oct 2010, 12:51
Greta Garbage
Bloop Community Organizer
Post Count: 297
What are you talking about, Red? I don't see where Poetic mentioned an MRI or any other specific test.
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31 Oct 2010, 15:56
Poetic Justice
Post Count: 229
*Sigh* I didn't. Red Fraggle was the one who mentioned the MRI, but I think she's just trying to pick a fight so I'm not even getting into it. I don't have the patients to match wits with a 'medical mind' right now :-/
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31 Oct 2010, 17:08
~RedFraggle~
Post Count: 2651
Actually I just made a mistake. I'm tired from night shift and thought you were Fearlesslove. Who DID suggest an MRI. Still, my other points stand. Unless you were there in the consultations you cannot possibly know how hard doctors have tried to diagnose him. Sometimes all the tests will be normal. You're assuming their missing something obvious, but have binnacle for such an assumption. Have you asked this guy if anyone has done an endoscopy? Or a CT? Or been referred to a psychologist? You don't know the very important points of his case. And no-one here is going to know better than all the doctors he's seen.
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31 Oct 2010, 17:10
~RedFraggle~
Post Count: 2651
Clearly I am still half asleep... They're, not their!
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31 Oct 2010, 17:39
Greta Garbage
Bloop Community Organizer
Post Count: 297
Now I am unconfused. Actually, I missed the MRI part in Fearlesslove's comment so I didn't catch it either lol
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1 Nov 2010, 02:17
Poetic Justice
Post Count: 229
It's all good. I know what you mean, I'm just basing all this off of what he told me. HE said they haven't done anything. HE said they haven't even tried- Not me. And he was there for all the consultations. I'd like to have a little more faith than that, personally. But everything I've said in the original post is exactly what he told me, exactly how he explained it. (And no, I didn't ask him about the tests. I should, but I don't really know him that well and he gets pretty upset about the topic, so I'd rather not bring it up. If he mentions it again, I'll ask him.)

I'd love to believe that the doctors really do all they can to help, and maybe over where you are they do. But over here, everywhere you go people are in a huge rush. 'Quality over quantity' is no longer the standard, in fact, it is the exact opposite. If you come in to a doctors office with common-ish symptoms, they will give you the most common diagnosis and send you packing. If you're lucky enough to only have the flu, that's fine. But some people don't have the flu, and they actually have to fight for their opinions to be heard. Based off of what he told me, that's what I think might be happening to him. Believe me when I say that I would not have come here ranting and raving about the carelessness of his doctors based on my own assumptions and lack of information. This information came directly from him. But I guess you had to be there to see the pain on his face and this kid on the verge of tears to understand why I asked.
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1 Nov 2010, 02:54
Makayla
Post Count: 751
Well all I can really suggest is for him to seek help from a psychologist. Since he's seen medical doctors before then I'm guessing the next step would to be to seek help on that sort of spectrum. It might be a psychological issue. But I certainly hope he continues to seek treatment because if he's malnourished that's definitely not a good thing.
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1 Nov 2010, 04:38
Poetic Justice
Post Count: 229
I agree, it's not a good thing at all. I have a hard time believing it's psychological simply because he WANTS to eat- Pretty desperately, in fact. But he can't. He doesn't have an aversion to food or anything. But I suppose it could still be psychological. Anything is worth mentioning
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1 Nov 2010, 04:44
Makayla
Post Count: 751
Have they not tried to at least give him something to treat the symptoms? Like a nausea medicine to take before he eats?
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1 Nov 2010, 06:28
Poetic Justice
Post Count: 229
I'm not sure. I think they did, but they didn't help, I could be wrong
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1 Nov 2010, 09:07
~RedFraggle~
Post Count: 2651
Unfortunately because you know so little about his symptoms, his treatments, his investigations to date, it's really impossible for anyone here to speculate on what's wrong. When we have such a tiny fraction of the details we're not going to come up with something not considered by his doctors who have had all the details. If you really want suggestions from people here (which I generally don't think is a good idea) then we need to know more about his symptoms... Is the sickness always after eating? Is it associated with pain? What investigations has he had and what were the results? What treatments has he been given? Has he seen a psychologist or has anyone suggested it?
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1 Nov 2010, 18:43
Poetic Justice
Post Count: 229
I know. I was just hoping to throw his symptoms out to a lot of people, and maybe someone would have known someone who went through a similar thing with the same symptoms. I'm not looking for 'an answer' per se, just an idea, or a possibility even. Of what you asked, all I do know is that he said his symptoms (like vomiting and dizziness) always come after eating. He did mention cramping-type pain, also after eating, but he only touched upon that (like it wasn't common, or he didn't see it as being a big deal in comparison to everything else maybe). The only 'symptom' he's had unrelated to food (this being why he told me about it to begin with) is at work, sometimes he has to do something very physical, like pulling heavy pallets long distances in the store, and when he finishes, he starts hyperventilating, gets really pale, and looks like he's about to fall over dead. He actually had to leave early the other day for that reason, which he's never done before. It kind of made me think that maybe it's getting worse, so I started to worry. But I assumed that it was because he's malnourished. You wouldn't need a doctor to tell you that if you could see this person. He looks like a corpse.
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