Discussions By Condition: I cannot get a diagnosis.

symptoms don't add up

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: hamlet
  • January 10, 2007
  • 11:33 PM

My husband is not at all healthy and has poor lifestyle. A number of chronic symptoms he has had for years do not seem to "register" with doctors here - they either don't notice them or if my husband asks, he lies.
So here is what is happening, any feedback would be appreciated.

He is age 47.
1. He is diabetic with uncontrolled blood sugar. In European numbers around 18+. That was a year ago, he hasn't controlled his sugar in a long time.
2. He takes a medication for the blood sugar, not insulin. He diagnosed 8 years ago.
3. He is about 50 lbs overweight. Been this overweight for most of adult life.
4. He was a very heavy smoker from age 13 to age 45. Still works with a smoker in small office.
5. In the past year he has begun to have bouts of diarrhea - needs to go to toilet very soon after meal. And very early morning. Takes up to 30 minutes to finish a bout. Explosive bowel movements. The toilet is a mess.
6. He has arrhythmia and takes a beta blocker for it plus a small dose asperin.
7. He has always been a "heavy breather", but for about 4 years the least bit of movement causes him to breath very deep and fast, like deep panting, about one breath per second. He is insistant that he has no troubles with breathing, but his loud heavy breathing is one of the first things people notice (except doctors!) and you can locate him in a store just by listening. Lately mild motion will cause him to pant with a bit of trembling, like when a kid has been really sobbing. Also his heart is pounding so hard you can see it.
8. Resting heart rate is 90 -100. You can practically hear it thump and it shakes his chest. I had to talk him out of boosting his heart rate at the gym to 170 - brisk walking will do that. (He goes to the gym about three weeks a year before his diabetes check to get his sugar down low enough to keep the next check a year away.)
9. After he more or less quit smoking I thought his chronic cough would go away. It did for about 2 years but came back. It is a nasty, deep clammy sounding cough, which he claims is a dry cough.
10. He is tired all the time, also due to mild sleep apnea and snoring which he also claims not to have. A sleep lab tested him and gave him a machine but he refuses to use it. He falls asleep almost anywhere any time, more than 10 % off vertical and he is snoring. He has very enlarged tonsils, which the specialist did not want to operate because he had so much surrounding fat it was apparently a high risk operation.
11. Mild edema in the legs.
12. Huge belly - when he lies down you can see the lump of his liver.
13. He doesn't look healthy - looks about 65 or more, kind of pale and pasty. However his gums are pink, no blue nails. But generally he looks deteriorated enough that people remark on it if they haven't seen him in a while.
14. About 2 years ago he had a bad episode of arrhythmia and they kept him in the hospital overnight to observe and stabilise. At that time his resting blood oxygen was 95%. My understanding is that this is pretty low, but they said it was quite fine and okay. I know that at 94% you can lose consciousness and 93-92 you can go into a coma and die, esp if there is also pressure from abdominal area, such as if a heavy guy is hogtied under arrest (big stink in Denmark about that a year ago when three people died this way.)
15. Has borderline blood pressure (135/100 - 140/110) and reasonable cholesterol (Danes eat loads of salmon and herring)

In November he had a couple of serious episodes of arrhythmia, which he atypically did not get checked out. (Just heard about it today). For the past couple days he has had painful pressure in the middle of his chest. It comes and goes. Three days ago a sharp stinging pain to the left of the heart for about 20 minutes then it stopped.
Over Christmas he was exceptionally nasty and depressed and aggressive.
he also has shown signs of confusion and ppor memeory and delayed thinking over the past year. Part of this is probably due to aspartame - I can pretty well predict when he's had a light cola within the past 12 hours. You don't want to be in a car with him then! But part seems to be a general lowering of function.

He finally went to the emergency room tonite after reading on the heart association website that chest pain was a typical symtom of heart trouble. Also a colleague recently had the same thing and ended up with emergency surgury.

At the hospital they told him his chest pain was not indicative of heart trouble (!) but they would keep him for observation and do three blood tests over the next hours. He did not seem to know what tests they were. (I did not go with him, he did not seem to think it needful.) I do not know if he is telling the truth, he doesn't always.

He has never had a chest x-ray or scan - they just won't do it here in Denmark, even on cancer-ravaged patients, to save money on treatment.

I would say adult onset fibrosis and probably enlarged heart, maybe some lung cancer or pulmonary edema. Wouldn't be surprised if there is arterial schlerosis. But he doesn't seem to have typical symptoms for that like leg pain, arm pain, restless legs etc.

But it seems that whatever it is it is going under the radar with the medicos. My feeling is that he is a great candidate for a stroke or similar very soon.

Any ideas?


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3 Replies:

  • Has anyone ever mentioned CHF, emphysema, COPD? He has signs of all of the above and being a diabetic and an exsmoker he is prone to all of the above. Here in Texas if you go in with chest pain you will get a chest xray, ekg and the lab work he is talking about is called a triponin level. Sounds like he is being up front about what is going on now.
    Anonymous 42,789 Replies
    • January 11, 2007
    • 02:28 AM
    • 0
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  • Thanks for that. I agree - think also general fibrosis, and necropathy in the GI tract. Possible fatty liver also. But I usually treat people after diagnosis, so I am at the mercy of the folks with the needles, and machines that go ping. In Denmark it is almost impossible to get a chest x-ray if you are not actually coughing up blood or have a clear case of pneumonia. For this reason c. 90% of lung cancers are not diagnosed here until stage 4/terminal. There is no regular screening of smokers with CT or MRI to catch problems early. They have the machines, they just don't have a policy of early diagnosis so they don't use them. It is estimated that most cases of CCF/CHF and emphysema are uncovered at autopsy. I could cite numerous examples but not here.The standard check at the hospital for chest pain is an ECG and blood oxygen percent. If that is okay (96% resting is considered Olymic athlete) you are sent home. His ECG was fine, but that can also be the case of somebody on the verge of a massive heart attack requiring a quintuple bypass. He is having a triponin level check (they just didn't tell him what it is till today) and they will do a stress test - which they do on a bicycle here and I understand it is a very poor version of the test, but that is what they do. Most of which are only indicative of a past catastrophic event, not predictive or diagnostic of ongoing chronic problem until it is at a near catastrophic stage.It is a state health care system that used to be one of the finest in Europe but with no investment and virtual total takeover by the pharmaceutical industry has deteriorated to the second worst in Europe. Care is aimed at doing as little as possible until the problem is end-stage catastrophic and in most cases the patient has less than six months to live. This is cheaper apparently than early diagnosis (at least if you have a drug dependent system where the drug companies set the cost!). GPs are prevented by law from mentioning or dealing with health issues the patient does not themself bring up. So many folks think they are perfectly healthy when they are not.I have encouraged him to push for a scan, as that will settle a lot of hash about his lungs and heart and if they peek low enough also his liver. But he is having trouble even getting to talk to anybody not a nurse technician. He can't even get them to give him fruit and vegetable to eat (the food is beyond belief). He feels inadequate to talk to medical professionals, and worry is easier than action, so I am making him a symptom list he can wave around while chanting MRI and see if that works! And if that fails they get to deal with me. ;-)
    hamlet 1 Replies
    • January 11, 2007
    • 10:46 AM
    • 0
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  • You say that the symptoms don't add up- I think that's probably because it's a combination of many things, however, I'm not going to even try to imagine what serious health problems your husband might have (because I'm not a health provider & I think other's are more qualified to answer your difficult questions). I'm sorry to hear that he isn't managing the problems better & isn't always honest about them (my uneducated guess is he is probably clinically depressed if he won't do anything about his health). I'm sorry to say that my father had many of the same symtoms & attitudes. Eventually he died at age 62. He had congestive heart failure & other problems. It was so difficult to see him go from an enthusiastic, happy man, to a sick man, who looked much older than he was Apparantly, among his other problems he had also suffered some mini strokes- a major stroke finally took him. I hope your husband will get his health under control & not let something like that happen. My dad died 10 years ago & I still miss him so much. I just wanted to mention one thing that came to my mind- You mentioned his cough. I was struggling with a cough for many months (I've never smoked). I thought I prob. had a sinus infection, or something. However, I was surprised to learn that I have acid reflux. You might want to have him tested for that. I did have to have some sort of test done at the hospital, in order to have it diagnosed (I think it was some sort of x-ray). I don't know if that is available to you. (USA's health plans really need help, but I guess it's better than your's- sorry to hear about that). I am your husband's age (but I'm a woman) & have many health problems, however I'm very honest with my doctors & I'm making great efforts to get well. As determined as I am, I must admit, it's very difficult & depressing. If your husband doesn't even want to try, if he's in denial, or depressed, or something it's going to be so difficult for him to get well. I know how frustrated you must be- I was very frustrated with my dad. However, now that I'm not well, I find that nagging & judgemental comments from loved ones makes it much harder for me; so I would suggest that whatever you say & do, that you do it in a very loving, caring, supportive way. It's not easy. Good luck, my thoughts & prayers are with you.
    Anonymous 42,789 Replies Flag this Response
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