Lab tests--what to cover for one last go?

AHI15 wrote:What is CPX?

Cardiopulmonary Exercise Test. Simultaneously stressing all 3 components of Work (heart, lung, muscle) to max to expose abnormal subtleties.

This relationship can be diagramed as:

Do you work around a lot of electronics? Have WiFi in the home, or at work?
A friend noticed he wasn't sleeping well, and hadn't for the past 3 years. Investigation uncovered the city had installed a Neptune 'smart' water meter in his home about 3 years ago. It broadcasts every 14 sec. a powerful radio frequency 24/7, strong enough to reach the street. He took a roll of aluminum foil and molded a 'hat' over the meter to shield the rest of the house. He slept a lot better that night and began feeling better the next day. This improvement went on for several weeks. Next he shut off his WiFi before bed. He continued to improve: feeling less restless, irritated, and moody. Next he switched off the cordless phone.
Don't know if this would apply to you, but it has worked for 3 people I know.
Good luck!
Cindy

Before hubby's hearing started to decline, he could tell where the ultrasonic security whistles were in Sears.
Yes, he could actually hear them--and they gave him a headache.

Mundy wrote:Thyroid can be tricky. Most doctors only test TSH which is a pituitary hormone. Many with thyroid problems ( me included) feel that a free T3 and free T4 which are thyroid hormone tests are more accurate. If I'm getting too little thyroid replacement hormone, I'm dead tired, want to sleep all the time, and feel somewhat depressed all the time.

A typical TSH panel will include tests for TSH, free T4, anf T4. The free T3 test usually has to be requested in addition to the TSH panal. I agree that testing for TSH (thyroid-stimulating hormone produced by the pituitary gland) alone is a waste of time.

Some people believe that treating hypothyroidism by targeting the free T3 hormone range with Cytomel is better for combating thyroid-related fatigue than targeting only the free T4 range with Synthroid or with dissicated thyroid (Armour). One of the problems though is that many patients do not feel better unless their free T3 levels are in the lower portion of the typical lab range. Consequently, a lot of patients are within the targeted range, yet they still feel considerable fatigue. Furthermore, a lot of endocrinologists do not like to Rx Cytomel because the science surrounding its use is very nebulous and because Cytomel can cause additional problems for patients if it is not taken the same time each day and if the dosage is too high. Cytomel also interacts with quite a few meds, so that's an additional issue that often comes into play. I have an endocrinologist who was willing to work with me even though he wasn't convinced that Cytomel was the way to go. Anyway, I tried it for almost a year along with Synthroid and then switched back to using only Synthroid. I actually felt better using only Synthroid, so I dropped Cytomel altogether.

One huge caveat with thyroid-related treatment is that there is a lot of quackery associated with non-mainstream treatment. For example, a lot of cash-only doctors and chiropractors (yes, chiropractors!) will require expensive tests ($3-4K) through their respective practices before they begin actual treatment. They will promise the world and prey off of desperate patients who are trying to overcome chronic fatigue. It's a very sad state of affairs.

I don't know about the stress test, I had one before a routine ventral hernia operation because when the surgeon did my pre-op and asked me about chest pain, I told him in the previous 6 months that I had experienced a lot of stress and had 2 brief bouts of mild chest (not even pain) feeling moments. That was on a Wed. with surgery scheduled for Monday, he made me get a stress test on Thursday, which they called and told me to go right to a cardio Dr. made the appointment for Friday, next thing I'm getting a heart cath, as the stress test told them I had a 95% blockage of the major artery, next they told me, I was fine, no blockage, still I could not get a satisfactory answer how you go from a large blockage to oops your fine?

deltadave wrote:While there are undoubtedly several (dozens?)(hundreds?) of possibilities, given the sudden onset, nebulous history of drug abuse and overwhelming fatigue (as opposed to sleepiness) I think I'll go with cardiomyopathy. Add echocardiogram and/or cardiopulmonary exercise test.

cardiomyopathy -- blech! That doesn't sound good. I don't think this is likely. Here's why:

When fatigue troubles started 19 yrs ago, I resorted to exercise to stir up energy. And I mean a lot of, and intense exercise. I was doing 2 hrs a day of hard core ice figure skating training, plus weight lifting.

That went on for 5 years or so, until I finished college and moved to a new job. Over the past 10 yrs my endurance has deteriorated as the OSA kicked in, and who knows what else might be underlying it. Even today I can usually force myself to exercise, and for light aerobic, I can perform for 30 minutes and feel like there is no cardio or pulmonary limitation. The only thing that sucks is that when I am done, I no longer get a period of boosted energy to put to use like it worked in the past.

Anyway, the Dr. has done some EKGs and wasn't alarmed. But I can ask about these tests. Seems like a long shot.

Aren't there some other obvious symptoms of something heart related like this besides fatigue, tiredness, and insomnia?

Thanks for input.

Thanks to all for the suggestions. It's probably been 3-4 yrs since I've had anything looked at, so I'll have a list of stuff tested next time I see the Dr.

One of the first things for which I was tested when I began this journey to tackle chronic fatigue was to have an EKG/ECG done by my PCP. She determined that my EKG waveform was slightly irregular, so she had me see a cardiologist. He agreed with her diagnosis, so he had me have a stress test. The results of my stress test had my cardiologist a little concerned, so I was scheduled for an echocardiogram next. The results of that test determined that I had either had a silent heart attack, or that there was some blockage. The next step was to schedule a cardiac catheterization procedure and prepare for possible angioplasty and stenting. During the cathing, I was awake, and the doctor showed me on the viewing screen where I had two blockages. One was at 99%. I ended up getting a couple of medicated stents that day, and I've had those now a few years, and everything is fine. Even if I hadn't had the fatigue issue, I was glad to take care of the heart issue. Atherosclerosis runs in my family on the maternal side (My grandfather died of atherosclerosis at age 51.), so I didn't want to take any chances with that.

I still had fatigue after the heart issue, and that's when I had a lot of blood work done, and it was discovered that I have hypothyroidism. I'll spare you the details.

Anyway, I say all this to let you know that since you have chronic fatigue, it's a good idea to have your heart checked. If the doctors find that nothing is wrong, then you can at least cross that issue off of your list and have the peace of mind that your heart is in good shape. If you've been chronically tired for almost 20 years, it's probably better to get this done sooner rather than later. Good luck!