Discussions By Condition: I cannot get a diagnosis.

I believe my husband may be dying and we wont know whats wrong until the autopsy

Posted In: I cannot get a diagnosis. 17 Replies
  • Posted By: TheMommyJ
  • December 29, 2008
  • 06:21 PM

If anyone has any ideas PLEASE help??

basics: 45 yr old male, no health problems, heart and lungs in excellent shape...former drinker..smokes 1 pack per day....no history of drugs no current drug use. no medications...140 lbs, 5'5".

family medical history:
aneurysms, high blood pressure, cardiovascular disease, cancer, lupus, arthritis.

personal medical history:
presented with headaches 5 yrs ago. when the headaches would come, the blood pressure would go up. diagnosed with migraines. had allergies or severe side effects to all migraine meds. Pain meds dont even touch the pain. 2 yrs into it, the doctor put him on blood pressure meds, which did n othing to control the blood pressure. two years after that, he was taken off of blood pressure meds.
In the last 6 months symptoms have become worse.


recent medical findings:
CT scan done one month ago showed nothing abnormal. CT scan done last week showed mild generalized brain atrophy higher than expected for man his age.
blood work showed low immunoglobulin G QN.

Chief Complaints and symptoms at this time:

weakness (he can not work for the past 5 weeks)
fatigue
constant headache (pain comes from deep in head..unlike a headache or migraine)
a feeling that brain is smaller than head and every turn causes it to bounce against skull causing severe pain
aversion to noise
elevated BP with headaches
most recent, he has developed nose bleeds
and
a fungal skin rash that continues to grow in spite of lotrimin cream.


Help please...I honestly feel like something is bad wrong, but I just dont seem to be able to have any info to share with doctors that would help them to look deeper into this...

thank you in advance

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17 Replies:

  • .................................................
    TheMommyJ 8 Replies
    • December 30, 2008
    • 00:35 PM
    • 0
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  • has he been checked for spinal fluid leakage?
    pamelasmc 82 Replies
    • December 30, 2008
    • 03:07 PM
    • 0
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  • has he been checked for spinal fluid leakage? no I hadnt even thought of that.
    TheMommyJ 8 Replies
    • December 30, 2008
    • 03:59 PM
    • 0
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  • we went to doctors today, she noticed clubbing of his fingernails and ordered an MRI plus a full autoimmune workup...she said something about vascular disease as well.....if the MRI shows nothing, she said they would be doing a spinal tap seems like we finally found a doc to take us serious.
    TheMommyJ 8 Replies
    • December 31, 2008
    • 03:45 AM
    • 0
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  • He needs to get Ketoconazole shampoo for the fungus. Instructions on how to use it need to be given by the dermatologist but he should say to rub it all into his entire body and then let it sit for ten minutes. He will need to do it probably 3 times a week to kill the fungus...for like a month...talk with the doctor. Since he's been screened and doesn't have a brain tumor, it could be some fluid builing up/leaking in the brain somewhere. I imagine it will take a round of specialists to figure it out but certainly, the smoking could be killing him since it says so on the package. Detox...sweats; vapor caves, mud wraps, hot springs, diet, juices..http://healingtools.tripod.com/thn10.html There's a homeopathic for skull smaller than brain feeling:http://abchomeopathy.com/go.php?no=30&symptoms=skullhead; pain, headache; pressing; as if brain bound up; as if skull too small
    Monsterlove 2921 Replies
    • December 31, 2008
    • 05:25 AM
    • 0
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  • What is his BP now?Something has to exist that will lower it.
    richard wayne2b 1232 Replies
    • December 31, 2008
    • 01:42 PM
    • 0
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  • A leaking aneurysm can cause a severe headache.Has he been tested for an autoimmune disease?
    richard wayne2b 1232 Replies
    • December 31, 2008
    • 01:45 PM
    • 0
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  • How low were his gamma globulins?Alittle or a lot?
    richard wayne2b 1232 Replies
    • December 31, 2008
    • 01:47 PM
    • 0
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  • im not sure if you are aware of this...but high BP can cause blood noses, so they could be cause of that.
    taniaaust1 2267 Replies
    • December 31, 2008
    • 05:27 PM
    • 0
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  • had th MRI done today...I watched some of it....there was a bright white spot perfectly round on the left side kind of in the middle of midway and skull...maybe at the halfway point down...it was perfectly round....I seen some other things too that looked odd... what would cause this white spot so perfectly round and extremely lit up like the 4th of July? should we be prepared to hear cancer? or is it something autoimmune? its going to be a long weekend.
    TheMommyJ 8 Replies
    • January 3, 2009
    • 05:32 AM
    • 0
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  • I dont have his blood work anymore the doctor took it...I dont remember what his gamma globulins were.
    TheMommyJ 8 Replies
    • January 3, 2009
    • 05:34 AM
    • 0
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  • IT could be a meningioma,a benign type of brain tumor if you really are reporting what you saw accurately.
    richard wayne2b 1232 Replies
    • January 3, 2009
    • 00:59 PM
    • 0
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  • The location described would place the intensity at about the level of the caudate and thalamus, depending upon how inferior to the cortex it is positioned. This would be inconsistent with meningiomas, which arise from the arachnoid layer of the meninges located at the inferior layer of the skull and do not actually invade brain tissue but rather displace it depending upon size. It may be difficult to assess specifically what you were observing on your husband's MRI and based upon his medical history as described, I would not think the hyperintensity on the film to be something like a glioblastoma, a certain type of cancer of the brain that tends to demonstrate what we call a ring-enhancing lesion on imaging. These types of cancer move swiftly and a 5-year history would place it well beyond the timeframe within which other symptoms would have become florid. With space-occupying masses, we tend to see symptoms arise that are directly related to the focal area of the brain in which the mass is forming and headache is typically a very late-stage symptom because the mass is creating compression within the closed space of the skull. Metastatic disease tends to appear as multiple lesions on enhancement rather than in single form. So I would think cancer at this point would be less likely. Perfectly round and solid hyperintensities, depending upon the type of enhancement used, T2 etc., tend to represent cysts but again, without observing the film I'm afraid it's nothing more than a guess at this point. I would also assume that they've performed an MRA as well. Cortical atrophy can arise for a number of reasons and this is most likely due to the former chronic consumption of alcohol, which commonly does demonstrate reduction in cortical mass. The description that he feels like his brain is moving inside his skull is more common among persons with migraine headaches and would not be associated with the brain actually being able to slosh around inside the skull. In other words, the pain he is sensing is not the brain bouncing against the skull. It's important to realize that the brain itself has no sensory nerve endings. The pain felt on rapid movement is most likely sinus-related, which although localized can cause general head pain in many cases. You also mention hyperacusis, or aversion to loud noises and this would also be consistent with migraine syndrome. It is also of note that hyperintensities can be infrequently observed on MRI sequencing in persons with migraine syndrome, although the description you provide would be inconsistent with patterns more associated with the syndrome. The epistaxis, or nose bleeds, can be due to several factors; burst microvessels which are very near to the surface of the skin can erupt in some cases where hypertension is severe, but more often occur as a consequence of the condition of the nasal mucosa, which when dry from cold air such as during the present winter season, would cause rupture and bleeding. Smoking can aggrevate such tendencies as well. Epistaxis is also seen in certain hematological disorders and the weakness & fatigue would be remotely suggestive, but since bloodwork was performed, markers would have been noticed. Where is the fungal rash located? If you're speaking of the more common forms such as jock itch or athlete's foot, then I would point out that they can be difficult to completely resolve in many healthy people because treatment is often delivered in an inconsistent manner and exposure to conditions which caused it to arise typically are not avoided. If the rash is located in an atypical area of the body, then it would more suggest a possible immune problem that needs to be evaluated further. Lastly, there are very few cases of hypertension which cannot be controlled by medication and I would suggest that you seek out a more competent evaluation where this is concerned. Uncontrolled hypertension in an individual who smokes is asking for trouble that will likely occur. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 3, 2009
    • 01:53 PM
    • 0
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  • My father used to get headaches like those you are describing along with high BP readings, and bloody noses. It turned out to be cardiovascular related in his case. It was very important that we didn't try to stop the bloody noses as they were happening due to the high blood pressure and the bloody noses acted as a release for the extra pressure. The headaches may be causing the doctors to focus on the brain and miss important cardiovascular signs/symptoms.Best wishes to both of you and I pray the doctors be guided to the proper diagnosis soon.~Judi
    NotSoTweetOne 2 Replies
    • January 3, 2009
    • 08:41 PM
    • 0
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  • The location described would place the intensity at about the level of the caudate and thalamus, depending upon how inferior to the cortex it is positioned. This would be inconsistent with meningiomas, which arise from the arachnoid layer of the meninges located at the inferior layer of the skull and do not actually invade brain tissue but rather displace it depending upon size. It may be difficult to assess specifically what you were observing on your husband's MRI and based upon his medical history as described, I would not think the hyperintensity on the film to be something like a glioblastoma, a certain type of cancer of the brain that tends to demonstrate what we call a ring-enhancing lesion on imaging. These types of cancer move swiftly and a 5-year history would place it well beyond the timeframe within which other symptoms would have become florid. With space-occupying masses, we tend to see symptoms arise that are directly related to the focal area of the brain in which the mass is forming and headache is typically a very late-stage symptom because the mass is creating compression within the closed space of the skull. Metastatic disease tends to appear as multiple lesions on enhancement rather than in single form. So I would think cancer at this point would be less likely. Perfectly round and solid hyperintensities, depending upon the type of enhancement used, T2 etc., tend to represent cysts but again, without observing the film I'm afraid it's nothing more than a guess at this point. I would also assume that they've performed an MRA as well. Cortical atrophy can arise for a number of reasons and this is most likely due to the former chronic consumption of alcohol, which commonly does demonstrate reduction in cortical mass. The description that he feels like his brain is moving inside his skull is more common among persons with migraine headaches and would not be associated with the brain actually being able to slosh around inside the skull. In other words, the pain he is sensing is not the brain bouncing against the skull. It's important to realize that the brain itself has no sensory nerve endings. The pain felt on rapid movement is most likely sinus-related, which although localized can cause general head pain in many cases. You also mention hyperacusis, or aversion to loud noises and this would also be consistent with migraine syndrome. It is also of note that hyperintensities can be infrequently observed on MRI sequencing in persons with migraine syndrome, although the description you provide would be inconsistent with patterns more associated with the syndrome. The epistaxis, or nose bleeds, can be due to several factors; burst microvessels which are very near to the surface of the skin can erupt in some cases where hypertension is severe, but more often occur as a consequence of the condition of the nasal mucosa, which when dry from cold air such as during the present winter season, would cause rupture and bleeding. Smoking can aggrevate such tendencies as well. Epistaxis is also seen in certain hematological disorders and the weakness & fatigue would be remotely suggestive, but since bloodwork was performed, markers would have been noticed. Where is the fungal rash located? If you're speaking of the more common forms such as jock itch or athlete's foot, then I would point out that they can be difficult to completely resolve in many healthy people because treatment is often delivered in an inconsistent manner and exposure to conditions which caused it to arise typically are not avoided. If the rash is located in an atypical area of the body, then it would more suggest a possible immune problem that needs to be evaluated further. Lastly, there are very few cases of hypertension which cannot be controlled by medication and I would suggest that you seek out a more competent evaluation where this is concerned. Uncontrolled hypertension in an individual who smokes is asking for trouble that will likely occur. Best regards, J Cottle, MD Dr. Cottle... thank you for replying.. I didnt see his entire MRI so I cant know if there were more spots like the one I seen. We have been to several cardiologists who have all said that the BP is a symptom of something else and thus can not be controlled. There really isnt a medication we havent tried. The doctor we are currently seeing, seems to be looking in two directions... vascular disease and autoimmune the fungal rash is on his side and chest. the doctor also noted he has clubbing of the fingers. Also, 6 months ago, he began to have some difficulty keeping an erection, but as of this last week has lost the ability altogether.
    TheMommyJ 8 Replies
    • January 4, 2009
    • 11:16 PM
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  • Clubbing equals oxygen depletion usually with a dx of emphysema. The mass could be an arachnoid cyst. Could have been dormant all along but vascular changes could have caused changes. A neurosurgeon should look at his pics/especially any vessels leading to the mass. Good luck and God Bless!
    iamamazed 2 Replies
    • January 5, 2009
    • 02:50 AM
    • 0
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  • Hi there. In addition to what has previously been said about the MRI, I wanted to mention that there is PLENTY of normal anatomy that will show up as bright white and Unilateral (if an oblique slice is taken/ant or post horns of the lat ventricles). There are several image gathering modes, some designed to give a better picture of brain tissue, some designed to emphasize potentially damaged tissue, some 'turn down the volume' on surrounding bones to focus on areas of interest. Depending on what mode you are in, the skull, brain, CSF and space occupying entities are depicted in shades from white to black. Try to keep this in mind as you wait for results.
    fewd4thought 126 Replies
    • January 5, 2009
    • 04:20 AM
    • 0
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