During the process of diagnosis the Doctors decided to test several of my nutrient levels. My Vitamin D level (among others) came back low. Because of this they decided that I needed to have a Bone Density test. I must admit that I am truly grateful that we have the technology we do because all that was recquired of this test was to lay on a bed and be scanned. I went into this test thinking "No problem, what could go wrong with this?" (I didn't even have to have my mom come with me!!)
So, the day of my appointment came. I happened to be getting the test done in a Breast Health Clinic. That made sense to me; Old ladies need regular mammograms and bone scans, why not have it in the same place. When I walked in I was definitely the youngest person there, by about 40 years. I got some pretty odd looks. After a few minutes I got called back and was given some instructions to prep for my test. It went something like this:
Nurse: "Undress, completely from the waist up and put your clothes on one of the hangers."
Me: (If I needed to undress at all wouldn't I have to completely undress?)
Nurse: "Here is a gown for you. The opening goes in front."
Me: (Why would it really matter? It's not like I'm gonna have to take it off.)
Nurse: "Are you wearing deodorant?"
Me: "Yes." (Why wouldn't I be?)
Nurse: (Giving me a look of 'you should know better') "Well, use one of those wipes there and clean the underarm and breast area completely.
Me: (Getting slightly nervous as my worst fears are realized) "Why do I need to take off my deodorant?"
Nusre: (With exasperation now) "Because it gets all over the machine and messes up the results of the test."
Me: "I just want to make sure we are on the same page. I'm here for a bone scan, not a mammogram."
Nurse: "Oh... well then I guess you can keep your deodorant on then."
Me: (Right, because that is really what I was worried about. Not, the fact that you were about to send me through the squish-o-matic 20 years too early.)
So everything turned out fine and I ended up getting the right test done (although I did have an escape plan ready just in case). The bone density test was the easiest test I have done yet; No poking with cold hands, no needles, and best of all, no squishing!! All you do is lay on a table and this arm-thing passes up and down you (you seriously feel like you are in a computer scanner; makes the same noise too).
Alright, getting to the whole point of this post... The results came back and I have Osteopenia. The medical definition for Osteopenia is a bone density that is 1.0 to 2.5 standard deviations below the norm. Osteoporosis is anything below 2.5 standard deviations. The norm is the average bone density for a 30 year old woman. The reason the norm is set at 30 years old is because up until 30 you increase your bone density. After 30 you start to lose bone density. So what is the big deal with Osteopenia? Well, nothing really. If you are over 30 and you have Osteopenia your risk for later Osteoporosis is VERY high. In this case doctors may start you on some treatment or just wait and see if Osteoporosis set in. Luckily for someone like me, who has several years before I hit 30, it's not a big deal at all. I have plenty of time to build back bone density once I start absorbing nutrients again.
Here are some things that help increase bone density: Calcium supplements Vitamin D supplements Daily exposure to the sun, unprotected (15 minutes in unprotected sun exposure will give you 1,000 IU of Vitamin D) Weight bearing exercise (This could be something as simple as walking) So right now I will be taking a lot of sunny walks! What could be better than that? :)
An interesting side note... For anyone who has malabsorption problems DO NOT take any Osteoporosis medications like Boniva or Fosamax! When your body can't absorb the calcium it needs from what you intake, it turns and takes it from your bones instead. The way Osteoporosis medications work is it seals off your bones so that your body can't take the calcium from them. If you can't get the calcium from what you intake or from your bones this leads to a serious depletion of calcium which could cause things like strokes. No good!
Showing posts with label Medical Tests. Show all posts
Showing posts with label Medical Tests. Show all posts
Tuesday, September 15, 2009
Sunday, August 30, 2009
Endoscopy
An endoscopy with multiple biopsies is the only way to have a 100% accurate diagnosis of celiac disease. Maybe one day they will find blood work that is accurate enough not to do the endoscopy but right now that is not the case. The biopsies are sent to a pathologist to assess if there is any damage to the villi in the small intestine. It is important to continue eating gluten until the endoscopy is preformed. The body is a miraculous thing and begins to heal immediately. Patients, especially children, who are diagnosed soon after onset of celiac disease can heal rapidly causing the biopsies to come back negative for damage and thus negative for celiac disease. So continue to eat gluten until all diagnostic measures are taken.
It used to be that a second endoscopy was preformed 18 months after starting a gluten-free diet to ensure that the intestines were healing. However, that is not the common practice anymore, though some doctors still do it. If patients are improving on a gluten-free diet and their antibody levels are decreasing the doctors don't find it necessary to go back in again.
I will admit, the endoscopy was not a fun experience. Did you know that if you are an adult they think you are mature enough not to be completely put under? Well obviously they didn't take into account me. I can handle a lot of things, but there are three things that I really don't like; needles, people in my mouth (my poor dentist), and throwing up. This, in a way, combined all three things. (I didn't throw up, but did gag when they pulled the tube back up which is just as bad as throwing up) I'll just say, the nurses were not amused with me. Granted, the 'mild sedative' did take the edge off and made me loopy enough to comply to their instructions I otherwise would have put up a fight against, like "open your mouth". In the end I survived, and I guess if I really had to do it again I could. But only if I REALLY have to. When my doctor came in to start the procedure she said: "Usually I can't tell anything by just looking, unless there is severe damage, beyond the damage to your villi; we usually have to wait for the pathologist report to come back. So, after this you can go and eat all the Krispy Kreme donuts you want." I politely told her that I didn't care if she could or couldn't tell anything just by looking, I was starting to eat gluten-free that day because I was tired of being sick. Well, when she finally got down into my small intestine I heard her say, through my mildly sedated haze, "Wow, you definitely have it! No more Krispy Kremes for you." Ha! I told you so. So in the end, she told me no more gluten, gave me some souvenir pictures of my intestines, and sent me on my way. When the pathologist report came back it said the same thing only in greater detail. "Near complete obliteration of the villi; Chronic inflammation of the intestine" and a lot of other stuff that I didn't fully understand, but it's not good. But as I said earlier, the body is a miraculous thing. It can heal itself even from extensive damage. So as long as I stay away from gluten I will completely heal. It just may take a few years. But I don't mind because if 15+ years of damage can be healed in 2 years, I'm not complaining.
It used to be that a second endoscopy was preformed 18 months after starting a gluten-free diet to ensure that the intestines were healing. However, that is not the common practice anymore, though some doctors still do it. If patients are improving on a gluten-free diet and their antibody levels are decreasing the doctors don't find it necessary to go back in again.
I will admit, the endoscopy was not a fun experience. Did you know that if you are an adult they think you are mature enough not to be completely put under? Well obviously they didn't take into account me. I can handle a lot of things, but there are three things that I really don't like; needles, people in my mouth (my poor dentist), and throwing up. This, in a way, combined all three things. (I didn't throw up, but did gag when they pulled the tube back up which is just as bad as throwing up) I'll just say, the nurses were not amused with me. Granted, the 'mild sedative' did take the edge off and made me loopy enough to comply to their instructions I otherwise would have put up a fight against, like "open your mouth". In the end I survived, and I guess if I really had to do it again I could. But only if I REALLY have to. When my doctor came in to start the procedure she said: "Usually I can't tell anything by just looking, unless there is severe damage, beyond the damage to your villi; we usually have to wait for the pathologist report to come back. So, after this you can go and eat all the Krispy Kreme donuts you want." I politely told her that I didn't care if she could or couldn't tell anything just by looking, I was starting to eat gluten-free that day because I was tired of being sick. Well, when she finally got down into my small intestine I heard her say, through my mildly sedated haze, "Wow, you definitely have it! No more Krispy Kremes for you." Ha! I told you so. So in the end, she told me no more gluten, gave me some souvenir pictures of my intestines, and sent me on my way. When the pathologist report came back it said the same thing only in greater detail. "Near complete obliteration of the villi; Chronic inflammation of the intestine" and a lot of other stuff that I didn't fully understand, but it's not good. But as I said earlier, the body is a miraculous thing. It can heal itself even from extensive damage. So as long as I stay away from gluten I will completely heal. It just may take a few years. But I don't mind because if 15+ years of damage can be healed in 2 years, I'm not complaining.
Monday, August 24, 2009
Preliminaries
Unfortunately I am not talking about a Miss America swim suit competition. I decided I would go ahead and start writing about the tests I've had. It's a bit of a process to be diagnosed with Celiac disease, and I'm not even talking about the years I and other people have gone through of random medical tests before the doctors even get around to Celiac disease.
When I finally went back to the doctor a few months ago, determined to figure out what was wrong with me, I knew I needed to at least be tested for Celiacs thanks to my mom's research and knowing a few people who had it. Thankfully after talking to my new doctor he agreed that I should be tested for Celiacs as well. (It's a good thing he agreed because there was NO WAY I was leaving that office without being tested, and I would have put up a BIG stink)
However, being the good doctor he is he wanted to test several other things as well. So, along with the Celiac panel he did blood tests for thyroid problems, hepatitis, and some other basic nutrients testing. Those tests are all pretty basic and should be done with the symptoms I was presenting. We've all had blood tests. They are easy and relatively pain less. Although I will admit that I have this fear of needles and turn into a four year old girl who wants her mommy when anyone comes at me with a needle.
He also wanted to rule out parasites and intesinal infections which meant a stool sample test. I'll say one thing about that test; some things in this life are just wrong, and that was one of them. Painless, but wrong.
Well, all of the tests came back negative, except the Celiac panel. I got a call from the doctor's office saying everything was fine but that the doctor wanted to talk to me about my Celiac test. I happened to be in the area the next day so I called to see if there was time that morning I could come in. All the nurse said was, "We'll make time. The doctor really wants to see you." So I went in and got taken back right away. Normally when the doctor walks in he is cheery and talkative, that was not the case that day. He was very quiet and solemn. He came in, pulled up a chair close to mine and sat down (he never sits down). Then he said to me in his Russian accent, "Unfortunately you were right, you definitely have Celiac Disease." I think he was expecting me to be sad or shocked or something. But I was actually relieved and happy. I had actually figured out what was wrong with me! Plus, with Celiac disease I could live a symptom-free life as long as I didn't eat gluten. This was a great day! He gave me the name and number of a gastrointestinal doctor so that I could go and get the next step of diagnosis done, an endoscopy. While the Celiac panel (blood test) is a good indication of whether or not you have Celiac disease it is only a starting point. The true diagnosis comes from an endoscopy with multiple biopsies of the small intestine. I'll get to that story later.
Here's some technical information about the Celiac Panel for those who want to know. The Celiac Panel tests for 3 anitbodies that are produced as a result of the autoimmune response that the consumption of gluten causes. These three antibodies are Ttg (Tissue Transglutaninase Ab, IgA), IgG (Gliadin Peptide Ab, IgG), and IgA (Gliadin Peptide Ab, IgA). The main one is the Ttg antibody, but the other ones are indicators as well. Some tests only test for one antibody but it is important to get all three tested or at least the Ttg. Normal levels for all three antibodies are <7; >10 definitely has Celiac disease and will need to get an endoscopy to assess the damage. Just for reference here are my levels: Ttg >128 (The scale wouldn't go any higher they said.), IgG 84, IgA 60. Verdict is: 100% chance that I have Celiac Disease!!
The other good thing about the Celiac Panel is that you can get the test redone after several months of being on a gluten-free diet. If the levels of the antibodies are decreasing you know that you are healing. If the levels are the same or increasing you know you are getting some gluten somewhere in you diet. This test is especially important for assessing improvement in patients who are asymptomatic (they don't have physical symptoms but do have intestinal damage). I will probably have to have this test done every few years once I get everything under control just to make sure that I am staying in the normal range. Even though I don't like needles I'd much rather get a blood test done every few years than an endoscopy every few years!!
When I finally went back to the doctor a few months ago, determined to figure out what was wrong with me, I knew I needed to at least be tested for Celiacs thanks to my mom's research and knowing a few people who had it. Thankfully after talking to my new doctor he agreed that I should be tested for Celiacs as well. (It's a good thing he agreed because there was NO WAY I was leaving that office without being tested, and I would have put up a BIG stink)
However, being the good doctor he is he wanted to test several other things as well. So, along with the Celiac panel he did blood tests for thyroid problems, hepatitis, and some other basic nutrients testing. Those tests are all pretty basic and should be done with the symptoms I was presenting. We've all had blood tests. They are easy and relatively pain less. Although I will admit that I have this fear of needles and turn into a four year old girl who wants her mommy when anyone comes at me with a needle.
He also wanted to rule out parasites and intesinal infections which meant a stool sample test. I'll say one thing about that test; some things in this life are just wrong, and that was one of them. Painless, but wrong.
Well, all of the tests came back negative, except the Celiac panel. I got a call from the doctor's office saying everything was fine but that the doctor wanted to talk to me about my Celiac test. I happened to be in the area the next day so I called to see if there was time that morning I could come in. All the nurse said was, "We'll make time. The doctor really wants to see you." So I went in and got taken back right away. Normally when the doctor walks in he is cheery and talkative, that was not the case that day. He was very quiet and solemn. He came in, pulled up a chair close to mine and sat down (he never sits down). Then he said to me in his Russian accent, "Unfortunately you were right, you definitely have Celiac Disease." I think he was expecting me to be sad or shocked or something. But I was actually relieved and happy. I had actually figured out what was wrong with me! Plus, with Celiac disease I could live a symptom-free life as long as I didn't eat gluten. This was a great day! He gave me the name and number of a gastrointestinal doctor so that I could go and get the next step of diagnosis done, an endoscopy. While the Celiac panel (blood test) is a good indication of whether or not you have Celiac disease it is only a starting point. The true diagnosis comes from an endoscopy with multiple biopsies of the small intestine. I'll get to that story later.
Here's some technical information about the Celiac Panel for those who want to know. The Celiac Panel tests for 3 anitbodies that are produced as a result of the autoimmune response that the consumption of gluten causes. These three antibodies are Ttg (Tissue Transglutaninase Ab, IgA), IgG (Gliadin Peptide Ab, IgG), and IgA (Gliadin Peptide Ab, IgA). The main one is the Ttg antibody, but the other ones are indicators as well. Some tests only test for one antibody but it is important to get all three tested or at least the Ttg. Normal levels for all three antibodies are <7; >10 definitely has Celiac disease and will need to get an endoscopy to assess the damage. Just for reference here are my levels: Ttg >128 (The scale wouldn't go any higher they said.), IgG 84, IgA 60. Verdict is: 100% chance that I have Celiac Disease!!
The other good thing about the Celiac Panel is that you can get the test redone after several months of being on a gluten-free diet. If the levels of the antibodies are decreasing you know that you are healing. If the levels are the same or increasing you know you are getting some gluten somewhere in you diet. This test is especially important for assessing improvement in patients who are asymptomatic (they don't have physical symptoms but do have intestinal damage). I will probably have to have this test done every few years once I get everything under control just to make sure that I am staying in the normal range. Even though I don't like needles I'd much rather get a blood test done every few years than an endoscopy every few years!!
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