Friday, January 09, 2004

Tick tock, talk with the Doc

The neurologist called. "I thought you were going to have MS."

But he said the multiple sclerosis results are normal. I don't have MS. He says he is also happy that my protein counts are normal, because abnormal protein counts can be caused by a lot of conditions.

He said that he asked the lab for several things which they have not performed and did not even put on the report as "pending." But he did ask them to freeze and save my spinal fluid sample, so hopefully I won't have to have another spinal tap. That would suck. Or poke. Or whatever. Anyway, he and the able assistant are going to jump on the lab people and make them produce:

bacterial and viral cultures of spinal fluid
cell counts of spinal fluid
fungal culture of spinal fluid
tuberculosis culture of spinal fluid

He also wants me to go to my GP and get a TB skin test, and chest X-Ray.

The doc cleared my mistake. See, the lab report lists a glucose level of 55 for the spinal fluid. But it lists a glucose level of 72 for the blood serum. The normal range is 70-115 for both. So my blood sugar level may be low, but it is within normal range. I made a, um, mistake. Cateye, does this sound similar to numerous incidents in the past? (By the way, thanks for the official blog logo, Cateye.)

The doc said that spinal and blood serum glucose counts are supposed to be equal. A ratio of 1:1 is expected, but his textbook says that at worst they are supposed to be within a ratio of 6:10 spinal:serum. And I am within that ratio. If they are not equal, you may have a bacterial infection in the spinal fluid (which bathes the brain as well).

However, he said that a bacterial infection would have shown up very brightly on the MRI. And it usually has sudden, severe consequences.

So he said he is going to have the radiologist take my MRI to some kind of association meeting those guys have on a regular basis, to show it to the whole gang and see if anyone has any bright ideas. He said he did not go down to look at the MRIs in person as he thought he would.

I liked it that while we were on the phone, the doc did some research on Google, and admitted it! This guy is no faker. Then he flipped to his textbook and found that viral infections do not typically consume glucose like bacterial ones do.

He said that in 25 years, this is the first time he has seen a low spinal glucose count. "I can't think of being this mystified in a long time," he said. "This case is still a mystery." He also said that if he can't figure it out, he will refer me to the wizards at the UCSF medical center.

The reason he suspects tuberculosis, other than it just being on a list of possible syndromes, is that I recalled going to Prague in 1996, getting a horrible flu, and coming back with a bad cough that took months to recover from. And now, whenever I get a cough, it seems to drag on for weeks if not months. Tuberculosis? It's highly infective. So why don't my wife and kids have it? Maybe they do.
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