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RichGotsPots

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Posts posted by RichGotsPots

  1. It sounds like what you are describing is Gastroparesis. You need to see a Gastroparesis specialist and not just a regular GI. You could have an inert colon which could lead to a bowel onbstruction. That needs to be monitored very carefully and I suggest to get a smart motility pill to test your whole digestive tract and not just your stomach emptying.

     

    i won't advice you what can help because this is a delicate situation that needs careful monitoring 

  2. Dysautonomia is associated more with fatigue rather than weakness. But there are many causes of Dysautonomia which involve weakness. The first thing you need to do is get an EMG done by a Neurologist specializing in Neuropathy. If your EMG is normal then you need extensive bloodwork looking for different types of anemia, hormonal imbalances, an autoimmune Dysautonomia panel sent to the Mayo Clinic to look for paraneoplastic syndrome especially. And lastly if all that is normal I would see a Mitochondrial Disease specialist and get a Whole Exome and Genome blood test and possible muscle biopsy. Mitochondrial are bacteria that live in symbiosis with humans and manufacture all of our energy for us.

     

    good luck

  3. I have Sjogren's Syndrome, Hyperadrenergic POTS, IST, autonomic Neuropathy and Delayed Orthostatic Hypotension.

    the only thing that matches a symptom of Sjogren's that you mentioned was dry eyes. You need other things for a diagnosis. Also keep in mind half of almost all Autoimmune illness patients are seronegative, which means they have not positive antibodies at all, not the antibodies for their particular illness which is SSA or SSB for Sjogren's and usually not high ANA. Many doctor will stop looking when a patient is seronegative and that is a big mistake. In Sjogren's if your SSA or SSb is negative then the next step is to get a lip biopsy by someone who does a lot of lip biopsies for Sjogren's. If done wrong not enough nodes are taken and also it can cause permanent damage. So be careful if you do that. I had a positive lip biopsy. I also recommend you call the sjogren's foundation and ask for a referral don't just go to any rheumatologist. The other test if you lip biopsy is positive is salivary nuclear scan. Also if you have dry mouth is another symptom.

    its important to mention that your parasympathetic nervous system controls your tears and saliva. So you could just have a dysautonomia causing that. And an abnormal Valsalva means your parasympathetic system is messed up.

    as far as temperatures issues they could be hormonal like thyroid and other things or you could have autonomic Neuropathy or Mitochondrial.

    High white blood cell count means either Allergies (even mast cell), parasite, Autoimmune or infection. In healthy people it usually means infections. In sick people it's trickier.

  4. That's a good point. Not much research on this subject at all. It never fails to amaze me by the lack of research in Dysautonomia in general. Such a simple thing to compare active HR and autonomic labs don't do it. Students could do this research. 

    Another thing I'd like people to test is how long it take their HR to slow down. So they walk on a treadmill and get their HR to 150 and then slow down a minute. Get off the treadmill and lay down flat. How long will your HR return to that low resting HR?

    Laying HR: 90-108

    Sitting HR: 110-125

    Stand HR: 135-155

    Walking HR: 150-165

    if I walked for 5 minutes straight and my HR went up to 165-175 range and then I sat down one min and then laid down it would take hours before my HR was 108 or less

  5. It shouldn't be a second line option to add a biologic or immunosuppressive with IVIG it should be done as a first line. Many years back Mayo Clinic published a group of 8 AAG case studies half seropositive and half seronegative and they said the best results came from combining IVIG with a biologic or Plasmapharesis with a biologic. 

    As a side note many POTS patients in Australia, Canada and some in America are reporting significant improvement with low doses of just IVIG. This needs to be studied. Many who get the low dose IVIG also report no change or only minor improvement.  If subset of POTS was caused by Autoimmune factors like receptor antibodies then low dose IVIG should not be improving symptoms. If patients are low blood volume then lose doses likewise should not increase volume significantly more than an IV saline bag. So something else is at work here that needs more research..

  6. On 11/12/2016 at 6:31 PM, ares22 said:

    I have been diagnosed with AAG, and was previously receiving IVIG every 3-4 weeks (1g/kg). In August, I switched to SubQ Immunoglobulin, and have not had a good response to this treatment.. and have experienced a resurgence of symptoms (orthostatic intolerance, GI dysmotility... typical AAG stuff) despite increasing other medications (ie. midodrine, florenif, etc.). 

    My doctors are say keeping this disorder in balance will be a lifelong challenge.. which can be disheartening at times. They are suggesting the next step, to be decided soon, is plasmapheresis (PLEX). I was wondering if anyone could share their experiences with this treatment. How has it worked for you? How often do you receive treatments? Do you have a permanent line, etc.? 

    Anything is greatly appreciated!! Thanks in advance

    Did you ever start PlEX? Mayo published cases studies for AAG and said they think IVIG are basically equal, but that the key was a combo therapy of either of those with a powerful immunosuppressive drug.  Because I know roughly 400+ patients who get IVIG, PLEX and Rituximab, I can tell you CIDP patients are the most comparable to AAG and they actually do well on SCIG, but if they don't do well on IVIG or SCIG they do best where they alternated between IVIG and PLEX all in the same week

  7. Sometimes doctors do not check though enough (meaning they don't run all the proper testing) to make a diagnosis and they that causes us to rule out illnesses as our cause. For example you said," huge panel of tests (looked for autoimmune, paraneoplastic, organic acids, mitochondrial disease)." Which sounds to me like they did blood work/panel because there is a paraneopplastic and autoimmune dysautonomia panel at Mayo Clinic that they would send the "panel" to. The only thing that panel and any other blood work would confirm is Paraneoplastic syndrome. 50% of Autoimmune patients are seronegative for most types of autoimmune illness and the main one that panel looks for is Autoimmune Autonomic Gangliopathy (which is very rare and also 50% are negative with it). So blood work can never rule out autoimmune illness. 

     

    That same is true for Mitochondrial Disease. There are over 50 types of Mitochondrial diseases and only a few rare ones can be picked up with different special blood work that only a Mitochondrial doctor would know how to order. All the other 40+ types use blood tests but only as part of the whole picture. Mitochondrial disease can only be diagnosed with a muscle biopsy or whole exome/genome genetic testing (cost $20,000) and only a Mitochondrial doctor would be able to get it approved. A routine muscle biopsy would look for Mitochondrial disease. From what you described a few thing match up to Mitochondrial disease such as slow recovery after getting sick from something. About 80% of Mitochondrial patients have dysautonomia, but a very low % of dysautonomia patient have Mitochondrial disease. Also a few adult Mitochondrial patients have both autoimmune disease and secondary Mitochondrial disease. There is no treatment as of yet for Mitochondrial disease but a few are in the pipeline doing trials now. But it's crucial to get the diagnosis more for avoiding certain meds and things that could make it worse like anesthesia, certain antibiotics, Ringers Lactate, etc... if I were you I would contact the United Mitochondrial Foundation and ask for a referral to a specialist near you. And I would see a top Rheumatologist at a teaching hospital to test you further for Autoimmune. Good luck

  8. Lots of possibilities. One is mitochondrial disease, causes weakness, and is sometimes due to lactic acid build up. Another is mysthenia. It can cause pots and muscle weakness. There are other neuro muscular illness that can cause large fiber neuropathy as well. An emg will help dx that. 

     

    I have this and my emg is always normal. So now I am looking hard into mito disease which can be dx with muscle biopsy and sometimes genetic whole exome and genome testing. 

    Lastly a lot of illness that can cause dysautonomia can cause fatigue like Sjogren's syndrome or other autoimmune illness, lyme or other infectious disease, diabetes or other hormonal illnesses or you get my point..

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