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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

AIBU to ask what’s wrong with my ill DM?

72 replies

FixTheBeak · 18/09/2022 07:09

I know this sounds really desperate … but I am!

My lovely mum is in hospital and she’s really unwell but the doctors don’t seem to be able to find out why. We are so worried - she’s fading before our eyes and has aged about 15 years in just a few months.

if any medic or savvy person is reading this, I’d love any idea of what I can suggest.

my mum is 78 with well managed hypothyroidism and she has Covid mildly this year. at first we assumed her symptoms were linked to that. She’s normally very energetic for their age and has always been in good nick.

Symptoms
Anaemia
low bp & racing heart

heartburn (now improving)
ateial fibrillation dx 2018
fatigue
dehydration
loss of appetite
craving salt
low mood
blood in urine - started a week ago
intermittent stabbing pain in lower left quadrant - started a week ago
lost all strength in her voice - now v weak.
one 8 day bout of constipation in August and some sluggish bowel in general - although this seems to have largely resolved

biochemical markers
potassium low
sodium low

CRP VERY HIGH - 134 a week ago now swinging between 101 and 123
HB (91) and Ferriritn low (5)
cortisol is normal so not Addison’s although we are waiting for a synectin test
TSH normal because she takes levothyroxine
creatine slightly raised
ALT & AST slightly out of range (by a point or two)

May: initially the GP dx Hiatal Hernia because constant nausea and heartburn
June-July fatigued
August: she then had a really bad UTI - fixed

then an ultrasound indicated a polyp on bladder but she wasn’t well
enough to go to do a urogram. I had to move her in with me to look after her and as we’re in England and she’s in Scotland - this meant starting the two week wait all
over again.

September: she’s been in hospital a week admitted because her blood pressure fell through the floor and she has tachycardia.

diagnostics
Private CAT scan neck to groin - completely clear so no obvious cancer of structures

bowel test clear - no blood

brain scan clear

EEG normal but it says previous heart attack
due: gastroscopy and colonoscopy next week as inpatient

her private consultant who we went to re hiatal hernia, is convinced she has cancer but he’s going mainly on CRP levels and anaemia and exhaustion. I think that’s tenuous?

I think if she does - I think most likely bladder - but there seems to be no urgency is getting her a cystoscopy even though she’s in hospital. Can I insist on this being done as an inpatient?

despite the cortisol number, I really think she might have Addison’s disease as those symptoms fit completely plus we’re a family riddled with autoimmune diseases and she’s had a horribly stressful few years. Also there’s a link with hypothyroidism which she has always had.

Her health really fell off a cliff earlier this year when there was so intensely upsetting stuff going on in the family. Part of me thinks that much if this is stress and depression. That’s the exact point at which she got much worse - sleeping all the time constant heartburn and basically living on milk & Omeprazole.

has anybody got any ideas? Im
being proactive as I can but ultimately they don’t seem to be in a mad hurry to diagnose her and I’ve told them I’m not taking her home until we know what’s wrong and she’s been stabilised and has a treatment plan in place.

Thanks for listening

id be really grateful for any advice 🙏
Especially on how best to advocate for her.
I’m terrified that something is being missed and that she might die. She’s just so weak

OP posts:
Summerofcontent · 18/09/2022 07:13

Why won't they test for Addison's?

Summerofcontent · 18/09/2022 07:14

What was her cortisol levels and what time was it taken

FixTheBeak · 18/09/2022 07:22

They were supposed to do it at 9am
on Friday but they didn’t and they did it at 1130 when I went to the hospital and made a fuss. Then they said it was normal.

i complained to her consultant about that and he’s told them to do a synectin (so) test which they’re doing today

OP posts:
FixTheBeak · 18/09/2022 07:23

Summerofcontent · 18/09/2022 07:13

Why won't they test for Addison's?

They’re supposed to be doing that but they’ve so far not done it at the correct time

OP posts:
ittakes2 · 18/09/2022 07:32

Is she B12 deficient?

CollywobbleisCreepy · 18/09/2022 07:34

Definitely Addison’s - they must rule this out properly, Hope she’s ok .

FixTheBeak · 18/09/2022 07:34

B12 is fine. She’s been wearing patches for six weeks and it’s normal. B6 will be fine too as she eats a lot of marmite

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FixTheBeak · 18/09/2022 07:35

CollywobbleisCreepy · 18/09/2022 07:34

Definitely Addison’s - they must rule this out properly, Hope she’s ok .

I think so too but they keep telling me that it would be low sodium and high potassium, not both low.

OP posts:
KangarooKenny · 18/09/2022 07:37

Has she had a scan of her heart ? I’m wondering if she has some heart failure.

FixTheBeak · 18/09/2022 07:39

I wondered about heart too but she has no oedema

also doesnt fit with pericarditis/myocarditis as far as I know

OP posts:
Fraaahnces · 18/09/2022 07:39

Testing at the wrong time of day does not rule out Addison’s at all. I’m also thinking that perhaps she has not been eating or drinking enough due to stress. That will mess up her electrolyte balance and affect her heart and renal function. Could your mum have anorexia?

FixTheBeak · 18/09/2022 07:40

Plus CT would have shown anything heart related I think.

Consultant said that CT scan is best for structures - anything like bladder and bowels will need scoped

OP posts:
beststepforward · 18/09/2022 07:42

A ferritin of 5 can cause so many more issues than we think. Migjt not be the true cause of all this but I urge you to join the iron protocol group on fb and read up on low ferritin.

FixTheBeak · 18/09/2022 07:42

Fraaahnces · 18/09/2022 07:39

Testing at the wrong time of day does not rule out Addison’s at all. I’m also thinking that perhaps she has not been eating or drinking enough due to stress. That will mess up her electrolyte balance and affect her heart and renal function. Could your mum have anorexia?

She’s eating small portions of healthy food, I wouldn’t let he live on rice pudding etc. she’s been eating fish chicken and vegetable based meals, salads, and I’ve been giving her carrot juices etc. am also taking food in because the slop they are serving her isn’t great. So she’s not been eating much but it’s been decent food for the past few weeks.

OP posts:
PoppyBird · 18/09/2022 07:43

I was also pondering malnourishment. Has she been eating since her admission?

FixTheBeak · 18/09/2022 07:43

beststepforward · 18/09/2022 07:42

A ferritin of 5 can cause so many more issues than we think. Migjt not be the true cause of all this but I urge you to join the iron protocol group on fb and read up on low ferritin.

Thanks. Will do. Her consultant has promised me he’ll get her an iron infusion next week and I think he will. He’s being quite forceful even though the ward staff are lackadaisical

OP posts:
PoppyBird · 18/09/2022 07:44

Cross post, sorry

FixTheBeak · 18/09/2022 07:44

PoppyBird · 18/09/2022 07:43

I was also pondering malnourishment. Has she been eating since her admission?

I’ve been taking in food and she’s eating pods of fruit n veg. We’re trying to avoid hospital food as there’s nothing in it

OP posts:
Namenic · 18/09/2022 07:53

autoimmune might be a good call. Sometimes there are systemic diseases that affect many organs - rheumatology opinion. Also fits with high crp.

I presume she has had blood cultures to rule out infection? What discipline is the consultant doing the investigating?

Maybe get a renal opinion?
Could there be some issue with the collecting tubules?
Plus blood in urine?

is she still on omeprazole and milk? Can these cause some of the sodium and potassium irregularities?

Namenic · 18/09/2022 07:54

Coeliac?

Namenic · 18/09/2022 07:55

Ps - probably discuss with dr before stopping any meds etc.

FixTheBeak · 18/09/2022 08:03

They’re doing blood cultures today

The consultant is a gastroenterologist who we saw privately regarding Hiatial
Hernia. He also works in an office right next to her NHS ward. I sent him an email asking for the CT scan report and explained why and he walked straight over and started to interrogate us and the staff. She’s on an elderly ward and the consultant there seems to be doing not much lateral thinking. I’m really grateful to him. He’s ordered them to

do blood cultures
iron drip
gastroscopy/colonoscopy
teat properly for Addison - they left it til 1130 on Friday and it should be done bang on 9

OP posts:
FixTheBeak · 18/09/2022 08:04

She’s doesn’t need Omeprazole any more seemingly - her heartburn seems to have disappeared. No more milk - she’s eating frui veg and chicken/fish

we are taking in her meals and the ward ones are revolting and no nutritional benefit

OP posts:
Summerofcontent · 18/09/2022 08:26

What was the actual result of the cortisol test.

Most labs use 100 - 550 as their in range but at 9am it should be between 450 and 550

FixTheBeak · 18/09/2022 08:37

It wasn’t done at 9am, they were seeing about and she called me at 10am to say they hadn’t done the test and I went straight over to the hospital and asked them to do it immediately

I didn’t ask for the numbers as I knew it was prob alt invalid

they’re really slapdash

OP posts: