Tuesday, March 07, 2017

Med Update

Now I feel a little weird about having shared my medical issue publicly, but I guess there's no turning back at this point.

Image result for parathyroidI had a round of tests last week regarding my hyperparthyroidism, up at Oregon Health and Science University (OHSU) -- a very impressive place. Everyone I dealth with -- doctors, clinicians, residents, assistants -- was first rate, and extremely organized.

They did find an adenoma -- a benign tumor -- on my right lower parathyroid gland (there are four). It's about 3 cm x 1 cm x 1 cm, hanging off a parathyroid gland that is itself only the size of a grain of rice. My diagnostician said I may have had this disease for 10 years or more. Due to a lack of insurance I didn't have a lot of blood tests over the years, but one I paid for in cash in 2005 showed slightly high calcium in my bloodstream, as did another in 2011. But when you don't have insurance, and are barely able to afford basic doctor visits and some basic medications, doctors tend not to get too deep into your issues -- no one ever mentioned my high calcium before. By now it's 30+% above the upper limit, and my production of parathyroid hormone (PTH) is at least 3 times too high. I never had my PTH level checked before either, again due to lack of health insurance. Blood tests are expensive. Everything about health care is expensive in America.

My bone density has significantly decreased, as the increased PTH has had my body taking calcium from my bones. It was especially alarming in my left forearm -- they only tested my left leg, left hip, and left forearm -- and I'll probably be on calcium supplements for years.

Based simply on this low bone density risk, and an increased risk for kidney stones, the diagnostician recommended I have surgery to have this adenoma taken out, and the surgeon agreed. I had a kidney stone circa 2002 -- the most pain -- urgent pain -- I've ever experienced (they say it's akin to childbirth) -- but none since, somewhat surprisingly.

My diagnostician said he can't guarantee I'll feel any better after the surgery -- in terms of getting rid of this generalized crummy feeling I have, the tiredness and headaches and fatigue and the feeling one has the day before you know you're coming down with the flu -- but he said about 50% of patients do feel better in a few months. I'm optimistic, but I do need the surgery at least for the reasons of bone loss and kidney stone risk. My surgery is scheduled for Wednesday, March 22nd, and I'll be in the hospital overnight.

This disease seems to strike at random, about 1-4 per thousand people, depending on culture. They said I didn't do anything "wrong" to acquire this hyperparathyroidism -- it just sometimes happens. I don't know of anyone in my extended family who ever had it, and it doesn't appear to be genetic anyway. But my health is only so-so -- I've been dealing with chronic pain since my early 20s, when I broke my coccyx playing squash, and I have since acquired two other problems that have never fully healed -- and I need to pay more attention to it. It's frustrating trying to get exercise, because no matter what I do, something hurts for it.

But I'm optimistic about this upcoming surgery. I couldn't possibly feel better about the doctors treating me -- both were extremely impressive in their understanding of this disease, rattling off data and percentages about treatment options. Of course, I appreciate that kind of thing.


Steve said...

Hi David. I am a regular reader of your site though I rarely comment.
I wish you all the best for your upcoming surgery, and hope that you recover from this problem.
Your post reminds me how lucky I am to be an Australian. Basic medical services such as visiting the doctor (general practitioner)and pathology are free - paid for by the a tax (the medicare level). Even about half of specialist fees are paid for.
This system is loathed by conservatives who try to undermine it but they can't get rid of it as it is wildly popular.
I shudder when ever I read descriptions of the US medical system.

David Appell said...

Thank you Steve. I also shudder when I read descriptions of the US medical system. Obamacare has been very helpful to me; the Ryancare plan just released would likely mean I'd have no insurance again.

OnymousGuy said...

Ciao, David.

I will be sending good thoughts your way.

Steve said...

Gee, that's the second Steve from Australia commenting about how we love our health insurance here. (I was the first on the first post about your illness!)

Anyway, all the best with the operation and post op.

Layzej said...

Thanks for the update David. We're eager to see you on the mend. Keep us posted!