True tales of botched self-diagnosis

Miscellaneous and Personal Stuff I Must Share
1

I grew up in a household with two nurses, my mother and sister, and being the inquisitive little monkey that I am, I spent many a day reading their textbooks as they went through nursing school and developed a lasting interest in medical science in the process. Over the past decade I’ve worked in various capacities for a prominent medical facility here in Minnesota that rhymes with “K.O. Cynic.” Somehow I’ve developed a condition which forces me into spasms of hypochondria whenever I experience a symptom beyond the usual cold/flu signs, and I tend to automatically assume the worst. In the following case, however, I thought I had just cause to assume the worst…

I’ve always had a high tolerance for alcohol. Matching me drink for drink is likely to get most people to pass out long before I’ve started to approach slurred speech and falling down modes. I’m a big guy, and part Irish, so maybe that’s part of it, but in any case I shouldn’t be able to down that much alcohol without some severe side effects, as I had a RNY gastric bypass surgery years ago. So each drink ought to affect me MORE than it would affect someone with normal plumbing. How much drinking are we talking about here? Well, I would generally keep either 3.0 ltr bottles or 5 ltr boxes of wine in the fridge at all times, and typically I could get a box of wine on Saturday and need a new one on Monday…but that’s not all. The wine at home was for drinking when it was too early to go out and drink - or too late. So I’d go out and order a bottle of wine, then maybe a second bottle, or maybe some double shots of tequila or schnapps, THEN I’d go to the bar that the restaurant workers go to after work, and maybe get another bottle of wine or shots, then finally at 2 in the morning I’d go home and pour myself a couple of glasses of wine as I watched TV, going to bed around 5 or 6 in the morning. And this was pretty much every day. (This wasn’t always the typical scenario; I used to just drink 6 or 8 beers and maybe a couple glasses of wine. You know, light drinking.)

Over the past few months I’ve gradually gotten more and more fatigued and withdrawn, preferring to stay in bed and sleep most of the day away, then go out at night and drink until 2 a.m., then come home and drink some more to fall asleep. I’d sometimes go days without eating; I either forgot or just couldn’t be bothered. Of course I was letting responsibilities slip; I even messed up a great chance I had for what would have been an ideal job for me. I’d wake up in the mid-morning (I couldn’t sleep longer than a few hours at a time) and dry heave for a few minutes, try to wash the bitter taste from my mouth, and fret over the dark orange urine I passed or the bloody stools that had become a regular sight for me. My hands would shake uncontrollably as I tried to work the TV remote or perform some precision movement like putting in my contact lenses. And I was periodically experiencing painful cramps in my legs, crippling pain that would leave me sore and hobbling for days afterward. My skin was bruising easily and my wounds were slow to heal. The swelling I had in my legs for years had gotten worse and I wore compression stockings constantly. I felt a dull ache in my side and back, a sure sign of liver distress. And finally a week ago today my hands and feet all cramped up in excruciating pain as I was attempting to get some drawings done while I was out at my favorite watering hole. It took hours for me to get my hands and feet to relax long enough for me to get home.

When I got home and researched the symptoms, one thing stood out to me; chronic kidney disease. I could swear I had every single one of the symptoms, and all of the web sites agreed that if you had some of the more severe symptoms, you were either experiencing kidney failure or you were on the brink of it. At that point, the only options left are dialysis and transplant, and mortality rates are high.

I shat myself, in the figurative sense, and immediately stopped drinking. I had contemplated stopping before but was afraid of serious withdrawal symptoms so I kept putting it off, but now I quit cold turkey, and honestly I felt no additional side effects or withdrawal symptoms. I had excessive thirst and dry mouth prior to quitting, so I don’t count those, though I maybe have had a few moments of disreality.

I started cleaning my apartment, getting rid of leftover wine bottles and boxes, trying to pretty much get my affairs in order before getting an appointment with my doctor, anticipating that members of my family would be coming up to see me once they found out I was dying from renal failure. I kept researching dialysis machines and transplant procedures, then I finally called to get an appointment to see my doctor on Wednesday of last week.

The doc was out so I got to see her nurse practitioner (NP) and I told her I came to see her because I thought I had the symptoms of end-stage kidney disease. I described my symptoms and my drinking habits and she ordered a battery of blood tests for Friday; she told me that she thought most if not all of the symptoms could indicate diabetes, not kidney disease…and I began to think, yeah, that makes sense because I do have those symptoms but I don’t have the flank pain characteristic of kidney disease.

Now, prior to meeting with the NP, I had gone to my friends and pretty much told them I thought I was going into renal failure. I was in shock and thought pretty much that death was close, possibly only a matter of days or even hours if I was truly in renal failure. After meeting with the NP, I began to think that I was in fact diabetic, so I began researching THAT. I was carefully avoiding certain foods and wondering if I should be doing something with my diet to avoid aggravating the disease. And I went around the next day telling people that I may in fact be diabetic instead of in renal failure after all, and that I thought that was a relief in comparison.

On Thursday night, I was sitting at my favorite restaurant/bar, drinking water and looking up more symptoms when I started getting severe abdominal cramps, and I looked that up and noticed alcoholic ketoacidosis, which is typically brought on by consecutive days of excessive drinking with little or no food. The web sites said it was a life-threatening condition and you should go to the ER NOW NOW NOW DAMMIT! So of COURSE I decided I had THAT, and went to the ER. I told them what I thought I had, and they took some blood and ordered a CT scan of my abdomen. (note that I had just eaten a couple hours before) They suspected pancreatitis but the blood work and CT scan showed nothing wrong, so they prescribed some Prilosec for me and sent me home.

I was already fasting for the blood work to be done Friday morning, so I drank some water and went to bed. I slept in two or three hour spurts and went in early for my blood to be drawn. Later in the day the NP called me and told me that my numbers were worse than they were in the ER, and we would talk on Monday, but first I was going to start on high-potency Potassium and Calcium supplements because I was very low on those. I was still having some pain in the liver area despite not drinking alcohol at all, so I began to think it was liver failure!

(continued…)

2

So over the weekend I was trying to gently prepare my family for the worst, mentioning some of my symptoms and what I thought it might mean, and my sister told me it was likely diabetes but that we needed to wait for the results first.

This morning (Monday) I went in to see the NP and found out the following:
[ul]
[li] I’m not diabetic[/li][li] I’m not hypoglycemic[/li][li] My kidney functions are optimal[/li][li] My total cholesterol is 144[/li][li] My blood pressure is 112 over 79[/li][li] Most every other number is well within the ideal range for those factors[/li]
The negatives:

[li] My THS is a bit high at 5.6, indicating possible thyroid disease[/li][li] I am severely deficient in Potassium, Calcium, and Vitamin D[/li][li] The combination of elevated liver enzymes and the CT scan indicate that I have alcoholic fatty liver disease, but get this; it’s relatively mild now and had not progressed to Hepatitis or Fibrosis or worse, and therefore is likely to be reversible. [/li][/ul]

I echoed the NP’s genuine shock at how well most of my numbers came out, and how, given how much and how often I was drinking, that I even had a liver left, let alone one that was “merely” in the first, most easily reversible stage of liver disease. The NP had even said to me on Wednesday, “You know your liver is shot, right? It’s shot.” I thought for sure I had fibrosis or even cirrhosis at this point, but not so!

So I went from constantly drinking to thinking I was going to die within hours due to renal failure, then to diabetes, then to alcoholic ketoacidosis to who knows what, and came out of it with, “Abstain from alcohol, eat better, and take your supplements.”

CRAZY!

Funny thing is, I wish this had happened to me sooner, because then maybe I might have quit drinking early enough that I might not have screwed my chances of getting that job I wanted, plus I’d be in better health. Well I suppose what’s done is done, and I now can only proceed to make the best of things.

And yes, I am staying off alcohol entirely; I honestly feel no desire for it and that’s another thing that surprises me; I hear stories of addiction where someone will lick spilt beer off the bar or pick up smokes off the sidewalk and light 'em up, and that definitely is not me. I still am going out to meet up with friends, but I’m having water or a mix of cranberry and orange juices. I have the bartender put the water in a short glass with a drink straw so people ask less questions sometimes!

3

Just FYI, the CT isn’t anywhere near 100% in determining complete lack of scarring in your liver. You could easily have Stage I or II fibrosis and it wouldn’t necessarily be seen on the CT. Only liver biopsy would tell for sure, but that would definitely be overkill, since even if it is Stage I or II, the treatment is alcohol avoidance and the expected outcome would be improvement in your liver status.

I wager your TSH improves if you stay off the sauce, too.

Congrats on not having CKD!

4

Well, you’re right, there is a definite connection between alcohol and thyroid function, and what worries me a bit is that my TSH was at 5.6, which is just a bit high according to the “old” range that K.O. Cynic uses, but the proposed “new” range is 0.5-3.0 and the 5.6 would put me WAY over the top in that case. I need to see an endocrinologist, methinks…

5

Frankly, I don’t generally consider investigating further or even supplementing with thyroid hormone until my patient’s TSH starts rising close to 10 (unless other clinical signs/symptoms are present) so I’d not consider the thyroid a top priority in the setting of alcoholic hepatitis. I’d check again on my patient’s TSH level in 6 to 8 weeks, and periodically after that.

6

Mistaken self-diagnosis is a hazard among medical students and even physicians who see so much illness that they can hypochondrize (sic) themselves into thinking they’ve got some dire condition.

Over the years my pseudo-illnesses have included appendicitis, viral hepatitis and various cancers.

Single lab test results (i.e. blood tests) often need to be taken with a grain of salt. Isolated abnormal readings may represent a false positive or simply not have any clinical relevance (this is common enough with, for example, liver function tests). It doesn’t mean they should be ignored, but you probably don’t need to run right out and update your will.

7

My father has OCD that used to be unmanageable. He’d spend all night on Wikipedia looking up these rare diseases and tricking himself into thinking he had them. Spent thousands on medical tests.

8

You mostly hear about the people that can’t keep away from liquor. They’re what make the news. You DON’T hear about the people that don’t have problems giving it up. I’d been worried that I was developing quite the problem (nothing near what you’re describing, but my tolerance was getting pretty well developed.

I decided to drop 20 lbs after Xmas and just stopped drinking. Didn’t miss it. Went from 2-3 drinks a night to maybe 1 a week.

The ability to stop drinking on a dime doesn’t generate the same interest as the degenerating alcoholic that just can’t keep away.

9

My appendix burst a few years ago, but I mis-attributed my symptoms to thinking maybe I had swallowed a piece of pizza crust without chewing it enough, and it got lodged in my digestive tract somehow.

Two and a half days later I drove myself to the ER. I was running a temperature of 105.7 and had Sepsis by then. I was a mess.

10

I was convinced that my teeth were crumbling because, as a post menopausal woman, I was osteopenic, (close to having osteoporosis, calcium levels dropping, losing bone density, etc.)

My dentist informed me such is not the case, my teeth are crumbling because I am aging and I’ve always been a jaw clencher. Years of wear and tear, not lack of calcium.

11

I was certain that the lump on the sole of my left foot was a plantar wart. Nope; the podiatrist said it was an abcess.

He lanced it twice (quite painfully), and it filled up a third time. It finally burst on its own, leaving a rather spectacular mess in my sock. It never came back after that.

12

Congratulations, Cuckoorex, for being (mostly) healthy!

13

For a while I thought I was diabetic. I was peeing a lot, tired, achy, etc. I thought I had diabetes. Turns out I was preggers (later miscarried, but nonetheless…)

14

Not me, but my dog.

My dog has a lot of benign lipomas (fatty tumors) on her back and chest. I’ve had each one tested, they’re fine.

We went to the vet one day and they told me she was slightly underweight, due to me being to aggressive with her “lite” food. She also is having trouble jumping up, due to a leg injury. The doctors didn’t seem too concerned with either of these things. They told me to give her more food, and come in for an x-ray if her leg didn’t heal.

The day after the vet visit, I found three lumps on the dog’s belly and freaked. thefuck. out. Low weight? Trouble with her backside? Lumps? (remember, a dog’s breasts are on her tummy). Cancer. I was sure my dog had cancer.

Oh yeah, and my roommate’s girlfriend had casually mentioned to me just a few days earlier how her dog was fine, she felt a lump, the dog died. Cancer for sure.

I spent a week crying about it, and not telling anyone about it, and avoiding the vet for some reason. All I had to do was go in and have the lumps aspirated and we’d go from there. But I didn’t want to know!

I finally did go to the vet, and she was fine. Just more lipomas. Nothing to see here. I slept for almost 2 days straight after that, being so stressed out. Ugh!

15

Never mind.

16

What other clinical signs would you be looking for, by chance?

17

Probably the signs of hyper/hypothyroidism is what QtM is going for there, I’d wager to guess, and I’m sure you’ll probably be googling those to check the symptoms out.

Anyways, congrats on dodging a really close bullet there, and hopefully you can use this experience and draw from it to keep yourself away from the sauce. Not many people get the lucky warning signs before the full blown stuff, and so best of luck to you on keeping yourself on the straight and narrow path!

18

Glad to hear it isn’t as bad as you thought. Good luck!

19

In my late 20’s, I suddenly noticed a lump on my throat (I could feel it on my neck) that hurt and it was hard to swallow.
This was before Internet, and I was absolutely certain I had throat cancer and this was the first deadly sign.
I suffered in silence and refused to go to a doctor, dreading the actual news.
My throat hurt and I was sure that lump seemed to be getting bigger, although all I could do was feel it.

Weeks went by and my throat continued to hurt and it was getting harder and harder to swallow. I got very depressed and was sure I would be dead soon - again contemplated going to a doctor, but was too afraid to hear those words; “terminal throat cancer”.

Woke up one morning and had a wild coughing fit. This was it. I was going to die now.
I coughed really hard and

out popped one half of a peanut that had been lodged in my throat for the past several weeks. It was instantaneous relief - no more lump, no more sore throat and I could breath regularly for the first time in ages.

20

This is why I can’t read* Reader’s Digest* anymore- every time I read it, it seems, there’s a story about some dread rare disease, and I have every symptom. By the time we get to the part where they’re dying, I am convinced that I have this! and I freak myself out. If I don’t read about it, then I don’t have the symptoms.

That was a lot of drinking. I’m glad you’ve got a handle on that now.