Big Weight loss, recent blood work...Thoughts?

[CAT1962]

Hi....I go to a new GP tomorrow. I went to my Rhuemy last Monday..all he could say was "You are depressed..let me give you some antidepressants." I said NO THANK YOU. I am not depressed! Here is what is going on...I have lost 22 lbs in the last 6 weeks, I am nauseasted, I can only eat a little at a time, I have little appetite for anything, especially in the last week or two. I feel weak. I have low-grade fevers that come and go and have been awakened at night  2-3 times by sweating...I never do that. I know I am not drinking enough. He could not feel any big lymph nodes. He ran blood work and did a urinalysis. I forgot to mention some bad on-going constipation. Now I can barely "go" at all. I am not so much constipated anymore but don't go much at all. I forgot...omg...total brain fog at the appt...to tell him that my grandmother passed away from colon cancer, too. I also have some pain in my right kidney area, and was at the urgent care center the day before for some pain in my bladder area but they said my urine looked fine except for some protein in it. can anyone tell me anything about my blood work? He simply gave a copy to my husband to give to my new GP, not even a word about it. 

Monocytes  high...0.87 (normal range .20-.80)
Albumin  High....5.1 (normal range 3.9 - 4.9)
Ketones said Test results Abnormal
Keukocytes UR...2+
WBC/uL...84.6 (Normal range 0 - 60)
WBC/HPF...15 High (Normal range 0 - 10)
SQ EPI/uL (I guess Squamous Epitheliel cells in urine?)...51.1 High...(Normal range 0-31)
Hyal cast...0.77 ...(normal range 0 - 0.75)

Anyway, sorry to be a bother.....XOXO

[bloodless]

I'm glad you're seeing a GP. I don't know what the results mean, but your symptoms do not sound good. Let us know what happens.

[gurs]

SOunds like you might have an infection of some type, your WBC is high..keytones are found in urine.

You could have a kidney/UTI infection. Not to scare you, but I would have  headed to the ER so they can do all the testing that will be needed.

YOu could also be flaring big time, maybe have gastroparesis which would account for the weight loss/etc..

Make sure you have everything checked out....insist on it....stomach/colon as well.

let us know..

gursie

[CAT1962]

I did think about going to the ER but thought they would think I wasn't "sick enough", charge me $$$ and then send me home. I wish now that I had gone sooner.

[gurs]

I feel for you!!! been there. My insurance has picked up all my ER charges, but if you have to pay, I would be cautious too!!

But, if your feeling that sick, best place to be. They can run all the tests needed to try and find out whats wrong with you.
I usually demand specific testing when Im there as well.  If all comes back ok, then I can chalk it up to the autoimmune usually.

I have alot of  your symptoms, the weight loss was more gradual, and I also have alot of hormone issues involved since my hyster/menopause started. I think my autoimmune and hormones are waging war with each other.

Anyways, if your GP doesnt seem to be helping, find another doctor please...

Gursie

[Navigator]

I do not know what the blood work means but I would suggest you also get checked out for lymphoma.   It is a very rare complication but better to cover all of the bases.   Take someone with you to the doctors and insist on being thoroughly checked out.

I will keep you in my thoughts.

[Carolina]

Oh dearest Cat,

I agree that something is surely going on.  Ketones generally mean that you are metabolizing your body, not just fat, which isn't good.   But I'm not an expert, for sure.

That sort of weight loss is very serious, so with everyone else I think you need to follow up with your new GP.

Let's hope he takes the time to evaluate everything.  But with Sjogren's I'm not sure a new GP is your best resource.  You won't know until you see him or her tomorrow.

Ask the GP for a referral, or try to coordinate ALL the information and tests you've had with your Rheumatologist.   You may BE depressed, Cat.  That is a condition that is PART of Sjogren's.  And with the recent passing of your grandmother, you have stress indeed.

Please keep us posted on what happens every day, if you can.

Hugs

Elaine

[CAT1962]

Thanks, Everyone....Elaine, my grandma (maternal) passed away in 1980 of colon cancer. I mentioned it because of the constipation issue. The doctors also think that my OTHER grandmother (paternal) passed away of it, too, because of her long history with diverticulitis and diverticulosis (can't spell that one, and too tired to Google..lol...she was 95 and they did not want to put her through an invasive colonoscopy since her body was shutting down anyway. This was in 1999.

I will update with what my new GP says tomorrow. I am very curious. The last two days have really been dragging by!! 

[Pisces24]

My old family dr recommended just fruit juices, prune juice especially. That does help with constipation.
There are anti-nausea meds out there available from the dr. I know that for a fact as I had to take some to do my colonscopy a couple months ago. No way could I hold down the prep.

I would also check on any meds you are taking regarding the side effects and allergies. Most people do not do this and sometimes the meds are causing problems. I had my iron shoot real low once due to a med that a side effect was loss of appetite. Two weeks off the med and iron was a lot better.

Oh unfortunately we all have learned here that we have to be an advocate for ourselves which involves metaphorically "kicking a dr's butt" when needed.  You just should not put up with that Rheumy. Depression diagnosis is "I don't know what else it is and I don't want to do the work to find out so get her out the door". We all had those kind of drs.  Dump this rheumy and find one that will do some work!

I go to a research and teaching hospital here in Iowa. All my -ologists are there and I am happy with them. I already went thru 6 yrs of "lazy and duh?" drs.

I would definitely see another dr - gird your loins to do battle with them or take an advocate with you. Good Luck

[Skylar]

I'm glad to read that you seeing a new GP tomorrow - I don't think you need to rush to the ER for this - but clearly need to be tomorrow. You may or may not have a urinary tract infection - possibly kidney but usually there is excruciating pain involved. Clearly your kidneys are not functioning properly normally. Your current diet with nausea, not eating, losing a large amount of weight quickly may also play a role in some of these results and your complaints.

I would write out all your current problems - list them. Keep it short and to the point - hopefully you won't leave the office feeling that you've omitted important information. There is something wrong and you need to find out what the problem is and treatment.

I hope this is a positive and productive experience with your GP. Good luck.

[CAT1962]

SKylar, Thank you..A list! I need to. I will do that tomorrow on my break. Right now I am so nauseated. I have noticed that when I eat, an hour later I become very, very sick to my stomach. Also, I have had some bladder pains, almost like an impending infection, without evidence of infection. So weird. She had better be a diligent doctor...I am going to ask for stuff...

[ohiolady]

CAT,

Please ask for a CT scan of the pelvis and abdomen.  Also, the night sweats and weight loss do not sound good.  I would think they would want to check you for the possibility of lymphoma.  Do not stop until you have been thoroughly checked out.  Depression does not cause night sweats, fever or pain in the kidney area.  The kind of weight loss you have experienced is a major red flag. 

Please let us know how your appointment turns out.

Anna

[CAT1962]

Excuse any cell phone typos........Well, what a nice GP! She was extremy thorough. She sat with me for a long time, asked me a million questions and evrn wanted to copy my scibble scrabble notes I had ready to read to her! LOL. I old her I would like a CT and she said, oh of course! That was the first thing I was going to schedule." She also did a lung and ab xray. Lungs good....my dad died of lung cancer in 2004. Because of constipation issues the colon/ ab xray was a "bust". I am waiting for the CT date..insurance approval you know. Anyway...have to do the lovely colon stool sample card for her and she told me due to family history should've had a colonoscopy 10 yrs ago. :-/ Also...she pulled my head down and I said, "Yes...I can thank Sjogren's for the hair thinning." She is familiar with Sjogren's and said "Yep!!" LOL...I will post about the CT. Thanks, my friends...:-)

[irish]

Cat, You certainly do have a lot going on and it is good that you have a doc who will do the right tests. The kidney function looks a little off but if you are not drinking that alone can raise havoc with the kidneys.

Also, if you are having some type of infection you could have night sweats plus all the other issues that we sjoggies need to watch for such as lymphoma, etc need to be ruled out. A diagnosis is dependent on ruling out what it isn't.

As far as depression goes, do not rule that out either. I am not saying that you are depressed, but depression can cause so many symptoms that most people are not even aware of them. I must tell you that back in 1989 after a very stressful out of state move (plus autoimmune issues that I didn't even know about) I developed a depression almost overnight.

I never lose my appetite and in 3 weeks I lost 15 pounds. The only thing I could eat was cheese and Mountain Dew. Really a nutrious little snack!!! I would cook meals and then I could not eat them-- at all. I have suffered from depression all of my adult life so I knew that I was in trouble and got myself to the doctor. I was given lithobid and in 3 days I was so much improved I could not believe it. Lithium is used for bipolar and for regular depression with good results.

I will add that depression can cause constipation, diarrhea, nausea and vomiting, loss of appetite, insomnia, loss of interest in activities around us, inability to cope with much of anything, hypochondria,insomnia,  sometimes compulsive activities, poor concentration, tearfulness, sadness that can be overwhelming, flat affect (this is when someone has very little expression on their face-doesn't react much to anything seen, heard, etc. ---flat reaction), poor or little if any motivation. excessive happiness, anger, etc., the list goes on and on.

When the chemicals in the brain aren't doing what they need to do it affects us emotionally and very much physically and this is what many people don't realize. When you get all your testing done and if nothing is found wrong, then it may be to your advantage to talk with your GP about antidepressants. However, you are so right that the physical illnesses need to be checked on---especially in someone who already has an autoimmune disease. There are so many tag-a-long autoimmune diseases that we need to be aware of.

Good luck and I hope all goes well with you and again, you are so lucky to have such a caring GP. That is half the battle. Irish

[gurs]

CAT,

Have they also checked your thyroid levels? you may have the hyper/hypo thing going on as well...which can cause all kinds of symptoms.
All your hormones need to be checked...sounds like you might have some estrogen issues...in addition to your other things going on in your body I mean. Would see your endocronologist.

Gursie